Health Care

Rushing Health Care Legislation

Published August 15, 2009 @ 10:53PM PT

It’s not hard to get a health care bill passed in Congress, provided you want it in the worst way.

The recipe:  take a presidential candidate’s plan to address a big problem that directly affects millions of Americans, but on which the two parties irreconcilably disagree on the solution.  Then adapt the overall principles from the campaign plan but largely ignore the details – start from scratch. Construct a bill hundreds of pages long largely in secret and with the heavy influence of lobbyists, particularly from Big Pharma. Also, make it as broad and expansive as possible – pile lots of other goodies that you wouldn’t suspect in there.  Then get Congressional leadership to put their foot on the accelerator.  Bypass the committees, and severely curtail any chance of amendment or debate.  Pass it in both houses of Congress as soon as possible, using every parliamentary trick at your disposal to get it signed off on before anyone – including the public – has had a chance to read the bill, let alone discuss it.

I am, of course, describing the Medicare Prescription Drug and Modernization Act of 2003, which gave us the Medicare Part D prescription drug plan.  Then-Governor George Bush had proposed a subsidy for Medicare seniors to go out and buy a private prescription drug plan, with some caps out-of-pocket expense.  The whole plan was supposed to cost $158 billion over 10 years.  But the bill that emerged in 2003 only partially set up the large and ultimately confusing bureaucracy to carry out President Bush’s model of subsidies for private plans.  It was chock full of giveaways to the pharmaceutical companies in the form of waiving the ability for the government to negotiate for the best rates, providing a big subsidy for employers who were paying drug costs for retirees already, and creates an unexpected “donut hole” where Medicare patients would see their coverage cut off entirely at a certain dollar value and not resume again until they had paid an even larger dollar amount in out-of-pocket expenses.  At least half of this bill has nothing to do with prescription drugs.  It restructures and expands the deal with HMOs for Medicare Advantage plans, allowing them to market to seniors and get paid 14% more per beneficiary, all of of the taxpayers' pockets.  Finally, the CBO said the final price was actually $372.5 billion over 10 years – more than double the Bush campaign proposal – and every dollar of that would add to the deficit.

But no matter what you think the merits or problems of the Medicare prescription drug plan have been, the process stunk.  The bill was 600 pages long.  It was submitted on the House of Representatives on a Wednesday.  It bypassed any and all committees of jurisdiction and went right to floor for a maximum of 3 hours of debate.  One Congressman put forward a motion to at least get it reviewed by a committee, but that motion was squashed.  The bill passed at 2:30 in the morning on Friday, meaning it couldn’t have been available to members of Congress for more than 50 hours before the $372.5 billion bill passed.  How many representatives do you think read all 600 pages?  How many read any?  Congress broke for the 4th of July.  When they came back, the Senate passed the bill on the same Monday they received it from the House, with a few amendments.

Including days off for vacation, the whole process for the largest expansion of government health care obligations since the creation of Medicare and Medicaid in the 1960s had taken 13 days to pass the House and Senate.

That, my friends, is what cramming a bill down our throats looks like.

Contrast that with the reform bills moving in Congress.  The Senate Health, Education, Labor and Pensions bill was worked on in committee for 38 days after the bill was released, and hundreds of amendments from Republican and Democratic Senators got an airing and a vote.  It’s now hanging out, waiting for the Senate Finance Committee to complete its work, meaning we’re likely talking about at least a hundred days before it reaches the Senate floor.  The House bill has gone through even more committees – three separate committees had public mark-ups and hearings, each with dozens of amendments from members of both parties getting a hearing and a vote.  The most optimistic projection would be the bill would have been public for 87 days before a full House vote could take place.  (And if the rules limit HR 3200 to a mere 3 hours of debate, I will not only be shocked but call Congress myself to complain.)  Suffice to say, nothing like the town halls – where provisions of health care reform are getting a both a loud and public airing – happened for Medicare Part D.

And no matter what you think of the policies of HR 3200, the health insurance reforms and regulations, the Health Exchange, the establishment of minimum level of benefits, the creation of subsidies for low- and middle-income Americans to make coverage affordable, and the public health insurance option are all to be found in Senator Obama’s campaign health care plan.

GOP political spin-master Alex Castellanos came up with the tactic of pretending Congress is rushing reform, with the implication that they’re getting it wrong.  But let’s not kid ourselves – that’s a political talking point, not a description of an actual precipitous rush to throw process out the window in order to pass a bill before dissent can be registered and the surprise details come to light.

We know what that looks like.  This ain't it.

(Photo credit:  amarine88 on Flickr.)

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Comments (24)

  1. Barbara Kantola

    Rushing Health Care?  We've been waiting for it for 60 years, how can that possibly be rushing it?  I don't care what label the nutjobs put on it, we NEED Health Care for everyone and we need it now.  If they want to label it Socialism, so what?  What's so bad about Socialism Health Care except in their own minds.  We need the Insurance Companies reined in, they are covering less and less, dropping patients like flies, and charging way too much.  They are in need of some serious regulation and that is a part of the Health Care Reform.  If a person is really seriously considering the concept (there is no Bill yet), so squawkers are squawking about a non-existent Bill when they had the chance to give their ideas for the Bill and listen to what has been in consideration so far.  They distort the truth until it is a blatant lie.  What is honorable about spreading such trashy lies and making threats against our President?  Our duly-elected President.  He won the election for a reason, because he was willing to take on the tough jobs and try to get real help to the American people.  The ones who want his Presidency to fail, are then wanting all of us and America itself to fail.  That is unAmerican.

    Posted by Barbara Kantola on 08/16/2009 @ 07:40AM PT

  2.  I agree. Where are the Democrats spin team? How could they not have seen the town hall thing comming?
      Why didn't they have their meetings in conjunction with medical teams on buses giving free health care to those in need? 
      All of the protesters where white so why didn't they have these meetings and medical set ups in Hispanic and Black neighborhoods?
      Obama cannot do everything. Somebody up there has to start thinking and planing ahead. I have been to the blogs and there are more for than against.Maybe they never wanted single payer all along. Maybe they just needed a distraction.
      I can tell youl that most of my rhetoric has just been anti-republican ( they constantly admit that they are too stupid to run health care). I am not nearly as loud about both a private and public plan, but I am behind the public because it is better than nothing. This voting for something because it is better than nothing is getting a little old.
    P.S. why did Obama put Anne Northrupt in a position after the people of Kentucky vote her out of congress.

    Posted by t t on 08/17/2009 @ 08:49AM PT

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  3. Barbara Kantola

    Sorry, I don't know the answer to the last question, he must have had his reasons.  As far as the Dems, I've been wondering where they are too.  Why haven't they been storming the R Town Hall Meetings?  They need to give back what they are forced to take from these Screamers.  I've been calling for the Dems to take some action for a couple of weeks.  We've all just been so dumbed down that we are having a hard time coming out of the shells again and do some real footwork.  I've even been waiting to see if some Dems would come on this site and spread around some truth for a change.  Thank you.

    Posted by Barbara Kantola on 08/17/2009 @ 09:14AM PT

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  4. Reply to thread
  5. Barbara Kantola

    The only other Bills out there right now are the faked ones by your people.  I watch the Senate daily and I watched the committee hearings on the one rough draft of the Bill.  The other Bill is just being finished (no one has seen it yet); they need to then go to committee to be joined and voted and amended, then to the House for debates and more amendments, then to the Senate for the same, and then back to the Committee for final amendments and votes and then back to the House and Senate for final votes and passage.  I hope that enlightens you about how it all works.  Sounds like you are against having Health coverage for all and to have the insurance companies reined in so they have to insure people with pre-existing conditions, can't cut off people who get sick, can't decide they will not cover the surgery you need, etc.  Why?  Is it that you already have insurance?  Well, so do I, but there are 47 Million and counting who do not have Health Insurance.  You don't want them to have insurance?  Why?  Sounds like you are a "youngin" who doesn't know what has been going on the past 60 years as far as trying to get health coverage.  Why would you deny that coverage for everyone?  Who gives you the right to deny that coverage to everyone?  You need to read the REAL draft, and stop reading the false lies put out by the insurance companies and their ilk.  Our President and Congressmen were duly elected.  Did anyone elect you to stop this legislation?  What were you elected to?  You need to see the whole picture, not the smears and fears you and yours are spreading around.  You should listen, you might then know that this is not the final Bill, it is only the first step, there is a long way to go before it gets to the President's desk for signature.  You should know that.  Why don't you know that?

    Posted by Barbara Kantola on 08/16/2009 @ 09:07AM PT

  6. Ira Jinkins, Sr.

    Thank You Barbara!  Enough with what the opponents, are trying to do, we must be getting close, because they are throwing everything. Bringing out kids, seniors, to make their false arguments.  Common republican tactics: divide, distort, distract, delay and when all else fail, question our president's credibility, fear mongering and race/class distortions.  Did the republicans, not get enough of this mess, during Bush's Reign of Terror?? Real Health Care Reform, This Year!!

    Posted by Ira Jinkins, Sr. on 08/16/2009 @ 07:11PM PT

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  7. Ira,

    Care to answer the questions below?  Maybe you'll learn something.

    Your tired old bogus accusations aren't working. 

    Posted by James Dunham on 08/16/2009 @ 07:37PM PT

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  8. Ira Jinkins, Sr.

    James, My comments may be tired and bogus, to you and some, that are still in denial about what tactics, got us into this mess.  These are facts, and you are trying to use some of the same old tactics.  Yes, James, you got burnt too, by the last administration.  Now that Change has come to America, some just can not stand this fact, and, will do anything they can to derail, this positive change, Fact!

    Posted by Ira Jinkins, Sr. on 08/17/2009 @ 07:21AM PT

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  9. James Turner

    Barbra,

    I'm new to this conversation but look, we have to slow down.  We don't have the money!  Check this out, I just got it.   http://usdebtclock.org/

    Look at the US Unfunded Liabilities per citizen.  Each of us is a whopping 191,839 dollars in the hole!  This is FACT!  Unfunded liabilities are Medicare, Medicaid and Social Security.  Where is the money going to come from?.  Charge it?  Our president hasn't exactly shown us he is frugal. 

    I agree with some of the others, we need a better system.  I think this can be done through laws.  Not adding a WHOLE OTHER CATEGORY to the national debt with another massive Entitlement system.  We need Clinton again!

    Posted by James Turner on 08/25/2009 @ 04:45AM PT

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  10. M Arnest

    James T, wow, great link.  I'll share via the web.  This is very scarey.  Thank you for the insight.

    Posted by M Arnest on 08/25/2009 @ 06:10AM PT

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  11. Reply to thread
  12. Barbara, you said there was NO Bill.  There is.  And yes, more are coming.  And amendments will take place.  But we have to deal with FACTS and what has been passed rather than what we hope is in a final Bill and defend a non-existent Bill.

    And I, as an attorney, have read and posted portions of the House Bill---in other words, I have read the actual Bill passed by the House, not summaries or spun descriptions of it.  I have also read the CBO report. 

    My comments are all based upon what I have read in the Bills and, primarily but not exclusively, what the Congressional Budget Office has concluded.

    If you have read my posts, I have repeatedly stated that I am FOR Healthcare Reform.  And I have stated I am FOR requiring coverage of pre-existing conditions, etc.  My other posts also reveal that I am over 40 and have a pre-existing condition.  I also have a disability.

    So I have not denied, nor do I wish to deny, health insurance to anyone.  But I do have an allegiance to facts, as well as the obvious concerns or consequences of (for example) offering doctors monetary incentives NOT to offer certain treatments, especially for the elderly and significantly infirmed.  I am literally trying to protect people and, maybe, myself.

    I was not elected, but I do enjoy the right of free speech.

    And, by the way, the 47 million uninsured is a very inflated number.  If our first concern is insuring everyone ASAP, however, we could identify and pay for all of the alleged uninsured who are not illegals, do not have access to programs they are not pursuing, and do not have the money to pay and choose not to.

    Even using the 47 million figure:

    47,000,000 x $5,000 = $235,000,000,000 annually.  That is cheap compared to what we are talking about spending.  And if it is limited to the actually needy who don't have access for reasons beyond their control, it would be significantly less.

    Then we could separately work on cost controls and noone would have to wait until 2013 for it to kick in.

    JUst an idea for comparison.

    Posted by James Dunham on 08/16/2009 @ 03:08PM PT

  13. Barbara Kantola

    If you are truly an attorney, but obviously not, you'd know that there is a difference between a draft done and approved by the Committee and a Bill passed by the House.  The draft bill has been passed by the COMMITTEE.  The house has not debated, amended, or voted on any Health Care Bill yet.  The House one was just passed out of Committee just a week or 2 ago, they've been in recess all of August, and will not be taking up any Bill in the HOUSE until after the recess.  Same with the Senate.  There are now 2 rough draft bills passed out of COMMITTEES, neither has been presented as a Bill yet, as they have more work as I mentioned above to be done on them before they can be debated in the House and in the Senate for passage.  All Bills have to be passed by the HOUSE AND THE SENATE yet.  Besides that, the Senate is working on a version too.  All the versions have to be reconciled into ONE Bill before the House and the Senate can vote on them.  By the way, I managed a law firm for several years.  Lawyers know how Congress and the Bills before it are done.   By the way, the news said today that the 47 Million is closer to 50 Million.  Because more people become uninsured as they lose their jobs.  You do not have a monopoly on the free speech either, we all have that right. 

    Posted by Barbara Kantola on 08/16/2009 @ 03:31PM PT

  14. Barbara,

    Give it up.  The nomenclature commonly used and referenced everywhere is to refer to the "House Bill".  Draft or not.  But you, of course, know that. 

    And the number loosely thrown around is inflated.  So you tell me Barbara:  Of the alleged 47 million uninsured, how many:

    1. Are illegal aliens?

    2. Are uninsured by choice?

    3. Are included because they were uninsured for a brief period during the sample period?  Say in between job?

    4. Are children?

    5. Have access to insurance programs but have failed to apply for it?

    And I never claimed that you did not have the right of free speech.  Nor that I had a monopoly.  You attacked my opinions because I wasn't "elected."  What does that have to do with anything?

    If you truly managed a law firm and interacted with attorneys for years, "obviously not", you would be able to make an argument based upon hard facts and objective analysis rather than partisanship and emotion.  And you wouldn't use  ridiculous statements and poor sentence structure like "What's so bad about Socialism Health Care except in their own minds?" and "false lies." And you would not compound the foolishness by not realizing you used the same nomenclature I used in referring to alleged "fake Bills". 

     So let's stick to the facts.  You've been wrong about everything: who I am, to which Party I belong, my age, my support of healthcare reform and more.  That is the problem with opinions founded on pure partisanship.

    Posted by James Dunham on 08/16/2009 @ 04:15PM PT

  15. Well James Dunham, if it looks like a duck (or duct tape)  and talks like a duck, my guess it is a DUCT TAPE. 
      Not one single American can say that our health care is working properly. Not for anyone.
      Which illegals are you talking about? The demonized Mexicans or the ones from Singapore and India? There are so many things we could agree on but the message get lost in the rhetoric.
    The right wingers want their cake and eat it too. They want low wages for their corporate buddies and at the same time they want a REBEL YELL for election time.
      Please let's stick to the facts and not be led around by the nose by Corporate Media. We know we have bad apples in the party (Billy Tauzin and John Breaux for starters). We are not blind and ignorant. However, every right wing corporate driven media I have listen to sticks to the party line. That line is driven by Multi national corportations. They certainly do not have the American workers rights at the center of their message.
      Here is one thing for sure , we live the facts and so we know the facts.

    Posted by t t on 08/17/2009 @ 11:30AM PT

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  16. Get the robber barrons out of health care and then we will talk.
    MUST THE JUGGERNAUT ALWAYS WIN?

    Posted by t t on 08/17/2009 @ 11:32AM PT

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  17. Not for anyone? -  I think the polls showing that 80% are happy with what they have would indicate the opposite.  Still needs to be reformed though.

    Which illegal aliens? - irrelevant

    We live the facts - I AGREE

    Know the facts? - not all of us obviously

    We ALL need to examine the "Party line" and reject it for the facts.  Which is why by answering the above, which does not involve anything but research and economic reports of the CBO, we can agree.

     

    Posted by James Dunham on 08/17/2009 @ 12:14PM PT

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  18. Harold Lewis

    The polls don't leave room for satisfied as opposed to having something else. Most of the population is more or less satisfied with the status quo until other viable options are presented. It would be more accurate to conclude that the majority of Americans are more satisfied with what they have than they think they would be with anything else they've heard about.

    Keep in mind that the 80% includes Americans insured under the single-payer Medicare system as well as those who have employer provided coverage. They outnumber uninsured Americans. How certain are we of the questions asked and the polling samples? So much of our polling is like the Congressional debate, filtered by parties and corporate interests and influenced by corporate-controlled media exposure, which has been less than truthful, open, or bold over the last decade. We've posed more pointed questions on this blog, for both parties, than the press or the town halls.

    One question you raise calls up a fundamental flaw in our approach, the lack of continuity. Unemployment periods are lengthening, right now, as are periods of being uninsured. I can also say confidently that most jobs have a waiting period of about 90 days to start receiving benefits. COBRA costs can be debilitating, if not out of reach, for a family subsisting on unemployment checks and make mortgage payments.

    The workforce supporting a single-payer system for a growing segment of society is not being cared for and kept healthy. Worse, deciding that single-payer might be viable option for themselves isn't on the table for discussion. If the notion of single-payer is flawed, it will come out in debate. Leaving something off the table, that has congressional sponsors, is not supposed to be our process.

    Even drawing lines to limit single-payer to the Medicare recipients, indigents, the unemployed (as a bridge), disabled, terminally ill, all minors and full-time students living at home, and pregnant women would be a civilized start to covering those least able to provide for themselves. Medicare was intended to be expanded over time. Maybe now is the time.

     

    Posted by Harold Lewis on 08/17/2009 @ 12:45PM PT

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  19. Barbara Kantola

    Thanks for your great explanation, Harold.  They did announce on the news that it is closer to 50 Million uninsured now.  I'm sure they would like insurance.  Also, I received an email from Jim Dean on a Dem site today saying that the House says it will not pass a Bill without the Public Option.  If you have subs. to Dem sites, you may want to check your emails.  That was good news.  Have a great day, my friend.

    Posted by Barbara Kantola on 08/17/2009 @ 12:54PM PT

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  20. M Arnest

    James, I like your position.  Forget parties and do what is right.  Your statement blew the political fog away and now the sky is sunny and clear.

    Posted by M Arnest on 08/25/2009 @ 06:07AM PT

  21. Reply to thread
  22. Harold Lewis

    When we talk about rushing reform, think about how quickly they out Medicare together and passed it:

    H.R. 6675, The Social Security Admendments of 1965, began life in the House Ways & Means Committee where it passed the Committee on March 23, 1965 and a Final Report was sent to the House on March 29, 1965. The House took up consideration of the bill on April 7th, and passed the bill the next day by a vote of 313-115 (with 5 not voting).

    The Senate Finance Committee reported the bill out on June 30th and debate began on the Senate floor that same day, concluding with passage on July 9, 1965 by a vote of 68-21 (with 11 not voting).

    The Conference Committee to reconcile the differing bills of the two houses completed its work on July 26th. The reconciled version of H.R. 6675 then went to final passage in the House on July 27th and final passage in the Senate the following day.

     

    source: http://www.ssa.gov/history/tally65.html

    Posted by Harold Lewis on 08/17/2009 @ 12:15PM PT

  23. Barbara Kantola

    Don't you get it?  That's 80% of the people (probably 100) that they asked.  It does not count the entire country.  Haven't you wondered why so many want Health Care?  Did you think of that?

    Posted by Barbara Kantola on 08/17/2009 @ 12:22PM PT

  24. M Arnest

    Yes, which means only 20% needs fixed!  Not an infringement on the majority (%80) of the population.  This is why the single payer system is not plausible.  I'm on the fence and trying to be sensible.  I would not condone radical reform for the minority. 

    I can see where Republicans (I hate to use this label because they are of all walks of life: Rich, Military, Christian Conservative etc.) stand about the worry that government will grow.  Not a great rack record there (Most would agree).

    I can also see where Democrats (I hate to use this label because we are from all walks of life: Rich A C L U lawyers, common workers AFL CIO etc.) stand because something should be done.

    I just wonder if this is more about winning or losing instead of fixing health care.  Shame on both sides.

    Dems, is this about control or helping?  Reps, is this all about "No for Obama"?

    Fix health care with sensible non-intrusive ideas, not with radical control nor killing the idea all together.

    I know both have good ideas.  We don't have to have the government run or kill the bill.

    I hope this is where the president will step in.  I would be disappointed if he didn't!  I would also be disappointed if he listened to the far left or far right but went with common sense and the majority of Americans.

    Posted by M Arnest on 08/25/2009 @ 05:39AM PT

  25. Barbara Kantola

    Well, James Turner, I thought I was done with this subject.  First of all, our President inherited nearly all of this debt, most of it war spending on an unnecessary war, not to mention the lives lost (some of my own family).  We definitely need a Health Care system.  Right now, there are several different plans out there that all need to be debated and voted through the House and then the Senate and several Committees to get them all consolidated thru to ONE BILL.  It will take some time to do this.  As far as rushing it, that is just an R excuse to slow it down to kill it, they use that stunt all the time.  I watch the Senate daily, the House during quorum calls and I watched the one Committee hearing with debates and votes on the first draft of a bill.  We have been trying to get a Health Plan in America for 60 years, I wouldn't call it rushing one thru, 60 years is a long time to try to get a bill thru.  The Insurance Companies pull out all the stops and even have their own employees attending the Town Hall Screams, and bus people from town hall to town hall.  We need Health Care, not Wealth Care.  The Insurance Companies have gotten rich enough off the backs of Americans and that needs to stop.  If we don't start now, when do you think we should start?  Another 60 years?  I think everyone should be insured.  Right now we are paying thru increased premiums and less insurance for the costs to pay for the uninureds to use the ERs for a cold, or many simple illnesses, that could be treated at a doctor's office if they had insurance.  That alone would save us all a lot of money.  The Health Insurance Plan will be self-supporting and will not raise the taxes for people who make less than $350,000 a year.  Those are the truths so far.  If you prefer to believe all the lies out there, well that is up to you.

    Posted by Barbara Kantola on 08/25/2009 @ 06:04AM PT

  26. Barbara Kantola

    I am thru with this topic, folks, I've said all I have to say, and a user gets some deleted, so please don't address any more comments to me.  It is just a waste of my time.  Thank you.

    Posted by Barbara Kantola on 08/25/2009 @ 06:16AM PT

  27. I was advised that my earlier post was deleted by accident, so I will just re-iterate.  Two wrongs don't make a right.  Under Bush they rammed through a bad piece of legislation at lightning speed, and this Administration tried and got caught (after putting a fast one across the plate on the stimulus package supported by both parties.)

    We need to get beyond Party affiliation to facts.  This should not be happening, PERIOD.

    So comparing one fiasco with another fiasco, and arguing that the second fiasco isn't a fiasco because the other was worse in terms of speed, doesn't make sense.  It's like comparing these movie stars that get married after a 3-week courtship to ones who waited 2 months and saying the 2 month courtship wasn't a rush to the altar.  (Or use your own comparative analogy.)

    Lastly, just to be factual and no offense intended to anyone, we are not talking about rushing healthcare per se.  Unless these politicians have been writing and debating these specific Bills and proposals for 60 years, it is a huge rush.  We are talking specifically about the President wanting something completed in mere months which involves a complete overhaul of the system, and a tremendous impact to our economy at a time of historic deficits (which were already historic and have since tripled or more since January). 

    If it takes several more months or a year to get it right, it is well worth the time spent.  We could even do it in stages and expand coverage to the uninsured first; after all, is that not the most pressing issue per the President?  Why do it all at once?  But I guess that is a question for another string.

    Posted by James Dunham on 08/25/2009 @ 01:50PM PT

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Timothy Foley

Tim has been an online organizer and blogger on health care policy for the Obama for America campaign (during the primaries) and currently for the Committee of Interns and Residents/SEIU Healthcare, a labor union for intern and resident doctors. Views expressed here are Tim's, and don't represent the positions of CIR or SEIU.

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