Pelosi: No To Health Care Co-Ops

Pelosi: No To Health Care Co-Ops


House Dems are bound and determined to make a public option their first priority, and I can understand why. This has been a long time coming and they’re convinced that only the federal government can compete with private industry.

But what she’s missing is the idea that Kent Conrad brought up…which is the public option may not have the votes. So if she pushes through a bill that can’t pass the Senate, could this spell the end of her tenure as the Speaker?

From CNN:

House Speaker Nancy Pelosi Thursday dismissed the idea of health-insurance cooperatives as an alternative to a government-sponsored health-care plan.

Asked at her weekly news conference whether she could support non-profit co-ops, Pelosi said, “No, not instead of a public option.” […]

Despite the Senate talks, Pelosi said House Democrats were moving forward with a bill focused on creating a government insurance plan. “In our House, there is strong support for a public option,” she said.

The speaker described the model, saying, “It should be actuarially sound. It should be administratively self-sufficient. It should be a real competitor with the private sector and not have an unfair advantage. When you say the words public option — if that is the term we will be using — you have to say right next to it, level playing field.”

Still, House Republicans are signaling that they won’t accept any type of health care reform that involves the government…

“I’m opposed to a government option, period,” said Boehner. “Listen, if you like going to the DMV and you think they do a great job, or you like going to the post office and think it’s the most efficient thing you’ve run into, then you’ll love the government-run health-care system that they’re proposing, ’cause that’s basically what you’re gonna have.”

Ahh, the sweet sounds of demagoguery.

This is gonna get ugly.

  • gerryf

    In addition to insulting thousands of workers in the post office and the dmv, Boehner is simply an idiot. People like to beat on the post office and the DMV, but only a superficial moron would look at the amount of people and items processed at these offices and call them inefficient.

    You can send a letter for less than 50 cents from any post office and it will get to anywhere in the country in typically less than 3 days after passing though dozens of hands and stop points along the way. That is incredibly efficient.

    Each individual DMV handles hundreds of people a day and rarely does it take more than 30 minutes.

    I wonder when the last time Boehner was actually in a DMV or a post office. Jerk.

    Meanwhile, Boehner and his colleagues (dems and repubs) in the house can barely process an email from a constituent, cannot pass any meaningful legislation without fighting like kindergartners, and hasn’t come up with even a semblance of good governence.

    Hello, pot, this is the kettle.

    On a good day, Boehner is a twit….when he opens his mouth….

  • kranky kritter

    We’ll see. With 10% + unemployment, I think support is probably at an all time high for the notion that going forward, our healthcare system needs a decent safety net at the bottom to ensure that everyone has access to some form of care that is delivered in a fairly sane, rational, straightforward way.

    The fact is, healthcare IS an entitlement in most other modern industrialized nations, and the folks there like it that way. For years, the GOP has continued to maintain that the US can keep doing better with the private patchwork we have. The more people who are exposed to the holes in the patchwork, the less compelling this argument is.

    Call that socialism or socialistic and you get no argument from me. Take the next step and say that it is therefore undesirable simply on the basis of being socialism, and all I can do is laugh. Several decades of growth in healthcare costs at rates much higher than income growth have gradually brought more and more (and MORE!) Americans to the point where they cannot remain unaware of the true costs of their healthcare.

    And that makes many of them very afraid of what they would do if they had to bear the whole cost without receiving employer-subsidized coverage. Then, as more folks actually experience this….

    The growth numbers in costs, and the failure of these costs to come down to some growth rate comparable to income growth absolutely WILL bring the current system to a point of untenability.(There’s no way around that, either some sort of balance is reached, or untenability is reached) Especially when the trends are reinforced by the aging of our population, which bring higher and higher costs for healthcare of retired folks.

    So, if you ask me, this safety net is coming. If not this year, soon. The rapidly growing numbers of older Americans with low income and failing health know how to vote. And they simply won’t tolerate explanations for why they must be pauperized in the name of some political philosophy.

    Regardless of that philosophy’s rectitude.

    That’s right. I said it. Regardless of that philosophy’s rectitude. Democracy is what it is. Older voting Americans will want support for their evolving circumstances, and they’ll vote for it. Aint democracy a B?

  • ExiledIndependent

    Demagoguery, Justin? So you honestly believe that a government run healthcare system will be more efficient than Amtrak, the postal service, etc.? Really? On what evidence do you base that? I’m wracking my brain trying to think of a really efficient government program-even a semi-efficient program–and I’m coming up snake eyes. Is it just faith?

  • ExiledIndependent

    Gerry, you bring up an excellent point that continues to be the GOP’s Achilles heel–they have no thinking, no better alternative. But your defense of the government services you mention is a big stretch for me.

  • Terry Ott


    A close friend recently retired from the Post Office. Early on he owned and managed a small business (restaurant/bar/rooming house), but sold it in middle age and went with the USPS for financial security for his family — and to be able to retire someday. His tales of the culture of inefficiency (“make work”), poor management, waste, union politics, favoritism in letting contracts, and frankly laziness are at the same time hilarious (over beers) and disturbing (over coffee). In our location, some opportunistic “long-timers” are able to manipulate their hours to take advantage of overtime and get close to (in some extreme cases, over) six figure incomes for delivering mail, something is seriously wrong. It’s not “all” of course, but when it is some then we know the system is broken.

    I had the typical stereotype in mind until he educated me and said the same things about “after all, it IS cheap”. But in his estimation, if it WERE run like a business, postage rates would be about half. And my friend IS a realist, and a Democrat, and a caring individual — not a tyrant or “ranter”. He’s one of the biggest Obama backers I knew back in the campaign period. His analysis is not politically driven, it’s just basic business savvy and awareness.

  • Justin Gardner


    So what’s the alternative? Leaving people uninsured and covering their costs with a hidden tax that drives all of our premiums up?

    And let’s remember that this is not replacing private insurance. It’s covering those who don’t have it. I’m sure they’ll be fine with a system that isn’t as efficient if they had nothing before.

    Also, let me just dispel the myth of the private enterprise and how efficient it is. It’s not. At all. You wouldn’t believe how long it takes to get things funded that seem obvious to all. And the larger a corporation gets, the more cumbersome it becomes to get things accomplished. I’m not saying they’re less efficient than the federal government, but I’ve had the same experiences at both the post office and the DMV recently. 10 minutes in the PO and 15 minutes at the DMV. That’s why I talked about it being demagoguery. Because, as gerry mentioned, it’s unlikely that Boehner has had to do anything like that recently.

  • Tully

    And let’s remember that this is not replacing private insurance. It’s covering those who don’t have it.

    The uninsured are not nearly as big a drag on the system as they are made out to be, because a huge portion of that demographic consists of the young & healthy who avoid buying insurance due to the cost — their need for health care is simply not that great, and they are making a rational dcision to not pay for wwhat they don’t really need. The stats bear out that they are making a good financial bet, even if some few lose that dice roll.

    Wanna take a wild-ass guess at how much of our overall HC system goes to “uncompensated care,” the industry’s euphemism for care provided to the uninsured that is not otherwise paid for? The answer will surprise you.

  • Paul

    The thought of Nancy Pelosi having the power to influence the course of our country fills me with trepidation!!

  • http://sidewaysmencken.blogspot michael reynolds

    This “government bad, private market good,” thing is quasi-religious, not rational. There is no law of nature that forces government to be ineffective. The US Marines are a government entity: quite efficient.

  • ExiledIndependent

    Michael, while invoking the Marines will usually get you points with me, I don’t think you would say that the US military is a financially efficient machine. Or are you saying that?

    And I think the reason that private is better than government is quasi-religious is that it *is* a truism. There are very limited things that governments are good at, and the way our country was constructed reflected that understanding (an understanding of a set of truths, not opinions or government du jour). Governments are at best inefficient necessary evils and at worst repressive and dangerous. This is why there is so much in the Constitution about checks and balances and guaranteed state and personal rights.

    JG, I respectfully disagree. My low-government interference mindset says that if you are an able-bodied, able-minded adult, go earn your own insurance if you want it. If you don’t want it, don’t buy it. I’d much rather sink this money into services that give the opportunity to become highly productive individuals that can make their own choices than attempt to ensure some mythical equality of outcome. I just don’t buy into the “medical services as a right” argument.

    And yes, this will in a couple brief chess moves eliminate private insurance. If the government provides a choice to a business between paying $200 extra in taxes per worker (for not offering a private medical policy) or paying $400 per worker in private medical benefits, guess what the business is going to do? Unintended consequences, you know? So millions of people go off private insurance because a) the government option is *initially* lower cost (lower cost on the surface) or their employers, faced with a taxation Catch-22, decide to no longer provide it (which is no big deal after all, since all of the workers can just subscribe to the government plan).

  • Mike A.


    “I’m wracking my brain trying to think of a really efficient government program-even a semi-efficient program–and I’m coming up snake eyes. Is it just faith?”

    Do you own a well or do you get water from your local, government-run, water treatment facility. Extremely efficient. Most nations would kill to have a system as good as ours.

    There are some good government-run programs, just as there are many poorly-run private ones.

  • http://sidewaysmencken.blogspot michael reynolds


    I didn’t say financially efficient. The Marines do what they were designed to do, they do it better than any other competing entity in their category, and they are run by the government.

    I don’t think we have proof that the government is necessarily inefficient. The IRS, for example, does a rather amazing job. Three days after I formed a corporation, the IRS was contacting me. It doesn’t make me happy, but it was hellishly efficient.

    Meanwhile, on the private industry side of the ledger: CitiBank which on one card thinks it should extend me $40,000 a month in credit, and on another card thinks I’m worth no more than $250. Explanation? Duuuuuhhhh. . .

    Or AT&T which keeps trying to charge me the same $800 over and over. Why? Because one set of accounting computers cannot link to another set of accounting computers.

    Or health insurance which is pretty much run by a collection of houseplants and farm animals as well as I can make out.

    That’s before we get to the GM”s, Chryslers, AIG’s et al.

    We are deep in the territory of faith. Evidence is lacking. Truism is not truth.

    The French manage to run a government single payer health system with remarkable effectiveness, at a far lower cost than ours, and results that in many categories are better than ours. So why, if government inefficiency is a law of nature, can the French do it?

  • Justin Gardner


    This is a perfect example of how people are so incredibly snowed by the talking points. Seriously. They have no clue how everything would crumble in a matter of days if the government didn’t run most things like a swiss watch.

    They have no idea about the Corporate Failure Tax. That’s the amount of money that’s worked into the price of a product because that corporation screwed up time and time and time again. Think it was health care that cratered GM? Perhaps it was their product line that virtually nobody wanted.

    They don’t understand that had corporations not been allowed to ship all of their manufacturing overseas, that the price of goods would probably be at pretty much the same levels because more people would be employed and more dollars would be spent on those goods. But that’s protectionism. And that’s bad. Best to have Indians who call themselves Steve answering your customer service questions. We don’t need those jobs here. Nobody would want them! And yet…

    They don’t get that drugs would be 10 times cheaper if the marketing budgets weren’t 10x the research budgets. Because that’s justified. After all, it’s being done in private for profit. And if it’s for the profit motive, well, that’s good. But if it’s public it’s bad. Very bad. Communist even. Next stop Stalingrad!

    They don’t remember the deregulation of the energy grids that led to Enron’s insane energy markets that then led to the blackouts in California.

    And what really burns me is Dems get accused of being socialist, when socialist ideas essentially made it possible for the engines of this economy to run as efficiently as they do. Because if our infrastructure was F’d, does anybody think business would be able to flourish the way it has? But now we’re literally sitting on a crumbling infrastructure because we’ve been convinced that everything has to be done for profit, instead of for long term strategic goals. My hope is that this mindset with shift dramatically under Obama, but I have my doubts that the Friedmanites will realize just how much they’ve overreached.

    And so it goes…

  • gerryf

    Terry Ott,

    I think your friend has some insight to add, but I think he is overstating the case.

    Every single example you gave can also apply to private businesses.
    I can point to make work inefficiencies, poor management, waste, politics (both union and office), favoritism in letting contracts, and, yes, laziness.

    You say that in his estimation if it WERE run like a business, postage rates would be about half. It doesn’t matter if he is a realist, Democrat or Cliff the Mail Carrier from Cheers–it’s easy to make those statements, but the proof is in the pudding.

    Even then, it is amazing that you can drop a letter in your mailbox on your porch and it ends up in your friends mail box half a country away four days later.

    Hey, I am not saying the private sector doesn’t have a leg up in many ways. The Postal Service didn’t partner with FedEx for air transportation for nothing (and shouldn’t they get credit for this?–doesn’t this private public partnership show efficience and good decision making?)

    But it is also worth noting that like many instances where a government entity has to compete with the prvate sector, the Postal Service is at a serious disadvantage because it has to deliver everything while the private sector cherry picks the easier or more lucrative parts of the business.

  • phin

    “The fact is, healthcare IS an entitlement in most other modern industrialized nations,”

    An entitlement that we cannot afford, an entitlement in which bureaucrats (not you know actual health care professionals, but hey) are front line in making the decisions about what is or isn’t good for you, an entitlement based on not choice but “rationing” in which the bureaucrats decide on who and on what kind of medicine citizens deserve. Anyways, keep not paying attention to what has and is going on in say most European countries and even here in Canada (Quebec in my case). Don’t worry, the nanny state will take care of you, tell you what to eat, what to drink, what doctor to see, and so on and so forth.

    It’s funny. I only started working for the federal government in January, and the amount of incompetence that I’ve seen thus far, in a freaking very important ministry, surprised even me!

    Watching you geniuses from up here, it’s like a car wreck in slow motion. But hey, in a couple of years, when the actual costs are about 5 times more than what “they” initially thought it would be and your health care services turn out to be even worse than before and with a tremendous pile of debt as bonus, to paraphrase Nelson: “Ha! Ha!” Misery loves company so…Hope and Change baby, hope and change!!

  • http://sidewaysmencken.blogspot michael reynolds

    an entitlement based on not choice but “rationing” in which the bureaucrats decide on who and on what kind of medicine citizens deserve

    We already have bureaucrats making those decisions. They’re health insurance bureaucrats, and they make our health decisions in such a way as to maximize the profits of their company. If the CEO of Aetna needs a new private jet, you don’t get life-saving surgery.

    I’d rather have those decisions made by government bureaucrats. I at least have some slight control over them.

  • phin

    “I’d rather have those decisions made by government bureaucrats. I at least have some slight control over them.”

    Bhahahahahahahahahahahaha!! Like they give a flying f&ck!!! Thanks, I needed that!

    Except when government bureaucrats screw up massively, as they very often do, it is practically IMPOSSIBLE to hold them to account. I don’t think you realize how virtually impossible it is to fire or even discipline government bureaucrats (especially once they get their permanancy). But hey, what’s a couple of billions here and a couple of billions there, after all, it’s only taxpayer money!

    And if you don’t like it, you can go somewhere else…oh wait, you can’t…everything is run by the government…D’oooohhhhhh!!

  • the Word

    Interesting “logic” there. You’d rather be against government because of your already set bias and side with a group that 100% of the time will be against you. That seems a bit questionable to say the least.

    I’m with Michael. I’d rather have a chance that something positive can be done than a guarantee of no one on my side. Rich people will always have the best healthcare possible. They always have and always will. Nice that they don’t care about anyone but themselves though.

  • http://sidewaysmencken.blogspot michael reynolds


    You’re kind of missing the point: it has nothing to do with “screw-ups.”

    The insurance companies aren’t screwing up, they’re just screwing. Their policy is to screw us. They wake up in the morning and ask themselves, “How can I screw people out of needed medical care and use the savings to buy a new summer home?”

    The policies are the point. And I have more control over government policies than over corporate policies.

    So “bwahahah” away, genius. Then explain to me why a businessman deliberately bending you over without so much as a reach-around is a good thing.

  • Tom

    Phin–at least the government bureaucrat in essence works for me and has as part of his or her job description to serve my interests. Just because they may or may not do that efficiently is not an argument against government service; it is only an argument for public diligence to get rid of systematic abuse.

    I love how free market conservatives hate the government but love our military, as if that isn’t a government run entity. If you love market oriented solutions so much, then why not let the market run the military. As far as health care is concerned, a health insurance corporation first obligation is a fiduciary responsibility to maximize profits for their shareholders. As any idiot knows, this mean that the fewer claims you pay, the more profits you make, so it’s in their interest to deny treatment. If you are a true free marketer who believes that health care is a privilege merited only by the ability to pay, then you should ball up and to your principles and let the chronically ill or auto accident victim in the emergency room who cannot pay simply die, and, in the words of Scrooge, “decrease the surplus population.” The market won’t care, so why should you?

  • phin

    “Their policy is to screw us. They wake up in the morning and ask themselves, “How can I screw people out of needed medical care and use the savings to buy a new summer home?””

    I love how you assume “bad” intentions on behalf of insurance companies and automatically assume “good” intentions on behalf of civil servants and government bureaucracies. You automatically seem to believe that just because X happens to be a public servant, he gets up in the morning and automatically asks: “Well golly gee, how am I gonna be the most excellent public servant today!” as if the same greed, self-centeredness, selfishness, laziness and/ or incompetence found in the human beings working for private companies isn’t found amongst the virtuous beings working for the government on behalf of the public. What delusional utopia is your mind inhabiting. It took me just a couple of days (assuming I wasn’t already aware of this) to disabuse me of these ridiculous notions. Good lord!

    You know what the difference really is between the two entities: one is far more accountable, far more flexible, adaptive and able to evolve on average, than the other. I’ll leave it to you to guess which is which, but I won’t be holding my breath!

    Anyway, you guys deserve to experience this and other (as many as possible frankly) romantic and idiotic leftish fetishes for yourselves to truly see what most of us outside the US have slowly begun to realize about big, cradle-to-grave nanny state government. I personally hope that Obama gets everything he wants because he will eventually do to most progressive and left-wing causes what George W Bush did to “Compassionate Conservatism”, completely and utterly discredit and destroy them. And you’ll be far better off for it.

    “it is only an argument for public diligence to get rid of systematic abuse.”

    Heh! That’s cute too. If that were truly the case, our Medicare system would have been fixed, or at the very least improved a long long long time ago. But thanks for that little chuckle. A funny thing happens the more government expands, the less they give a shit about what the public wants or doesn’t want and the public, the less power it has left, the less life and energy it has to actually effect change, which, coincidentally, works out just fine for politicians and bureaucrats…funny that. Either way, the government just assumes they know better and tends to ignore the little pesky insects that annoy it…but keep dreaming the dream!

  • http://sidewaysmencken.blogspot michael reynolds

    I love how you assume “bad” intentions on behalf of insurance companies and automatically assume “good” intentions on behalf of civil servants and government bureaucracie

    I assume no such thing. I assume that businesses aim to maximize profits. That is, after all, what businesses are supposed to do. It is profitable for them to deny coverage and deny treatment, so that’s what they do.

    I don’t assume anything on the side of government. But they have no profit motive. And since they are public employees I have more recourse than I do when dealing with a corporation.

    You’ve offered no evidence or logic to support your view. Just assumptions and dire warnings based on those same assumptions.

  • ExiledIndependent

    Michael, while businesses aim to maximize profits, governments aim to maximize control. Or, put another way, politicians seek to maximize their own power. The wholesale deletion (in practice) of the 10th Amendment is one piece of evidence for this. The billions of dollars in pork spending in the “stimulus” package is another.

    Again, this is why our country was founded on the knowledge that governments are necessary evils and should be strictly limited and highly accountable to the people.