Lynn Woolsey turns on the Senate health care bill

Rep. Lynn Woolsey is a liberal among liberals, a Leftist who calls affluent Marin County her home (and Marin voters have sent her back to D.C. over and over again, with about 70% of the vote).  She’s not a very bright woman, but I give her credit for focusing unerringly on what’s wrong with the Senate health care bill:

Rep. Lynn Woolsey said Friday she would not vote for the Senate version of the Democrat’s health care reform bill without substantial changes, even though that is the only clear path toward passage of the legislation.

“The House bill was compromise enough for the people I represent,” said Woolsey, D-Petaluma. “The Senate bill would go beyond that to the point where we would just hand the insurance companies the gift of 40 million new customers with little or no controls on premiums and no competition from a public option.”

She’s even figured out that Paul Krugman, one of the people I credit with inadvertently helping me see how dysfunctional liberalism is, gets it completely wrong when he says to the Dems “Damn the torpedoes.  Full speed ahead!”  Reconciliation just won’t work because, even though it will turn the health care system economically over to the government, it still won’t fix those vexing liberal problems of how to make every citizen pay for every other citizen’s abortion (something even principled pro-choicers admit is wrong) or how to ensure that every illegal alien gets full medical coverage:

She said, for example, the Senate bill fails to prohibit insurance companies from rejecting customers due to pre-existing health conditions or to ban annual and lifetime caps on coverage.

“Even in reconciliation, we can’t fix that because reconciliation covers only budget issues,” Woolsey said.

The reconciliation process Woolsey referred to is a tactic that would allow Democrats to modify parts of the health care reform bill with just a 51-vote majority in the Senate. Under such an approach, Democrats in the House would first pass the Senate version of the health care bill, then pass a reconciliation bill containing the changes. Republicans have used this so-called “nuclear option” in the past to enact tax cuts.

But changes contained in a reconciliation bill may only deal with taxes and spending to bring the legislation in line with the budget. It would be difficult if not impossible to use reconciliation to address issues such as abortion funding and health care for immigrants.

Woolsey wants to follow Obama’s new suggestion of passing bite-size pieces of reform. The question now, is whether the American people will understand that insurance companies can’t stay in business if people are allowed to hold off on paying for insurance until they actually get sick. It’s really not insurance anymore, with the companies taking actuarial risks. In that case, it’s simply companies getting no benefit whatsoever to pay for our health care. It may be a good deal for the public, but that’s only until the insurance companies go out of business. Of course, then the government steps in and, voila — single payer health care. So I guess this is the start towards a backdoor government takeover.

As many have said, when it comes to liberals and their goals, it never ends.

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  • Charles Martel

    To paraphrase H. L. Mencken, nobody ever went bankrupt underestimating the intelligence of Lynne Woolsey. But, to paraphrase somebody else, even a cuckoo clock is right twice a day.

    I remember years ago when Woolsey was riding in the 4th of July parade in Larkspur, a sweet home-grown affair with amateur floats and rag-tag bands that always drew thousands. She was sitting in the back of a convertible when some 8-year-old kid decided to blast her in the face with a Super Soaker squirt gun. I immediately ran across Magnolia Ave., found the kid and fixed him with a death stare: “How DARE you do that to a congresswoman, let alone ANY person in the parade! You do it again and I’ll have you arrested for assault.”

    The kid shrank away from me in terror–the effect I was hoping for, and I returned to my side of the street.

    A few minutes later, his mother came over to whine at me.  I wish I’d recorded the bilge she fed me, it was so stereotypically thoughtless and inane. “You really hurt my son’s feelings and self-esteem, and I think you should apologize to him.”

    In between laughs, I told her that her son was a perfect example of what happens when a clueless, guilty mother decides that she’s doing a great job rearing a boy who will someday be a man by laughing at his disrespectful antics. I pointed out that he had attacked a member of Congress, which is pretty low, and that in doing so he may have scared the s**t out of her. “How was Woolsey to know that the assault by your precious doofus bastard retard wasn’t the beginning of real attack?”

    What I remember most about the encounter wasn’t how she began to sputter–ineffectually as all who are afflicted by  liberal pedagogy do. It was the responses of the people around me at the parade. They all applauded my dressing down of this disaster of a mother, and told her to go back across the street and quit her kvetching.

    Now this was in the belly of the beast, where people think Obama is an intellectual and fetuses are like Kleenex–disposable. I was pleased to find that there are limits even liberals will observe.  

  • Ymarsakar
  • Mike Devx

    Here’s one aspect of the health care problem I find vexing, and I wonder what everyone thinks.
    Auto insurance is (partly) intended to cover the high costs of having an accident.  And when you have an accident, your premiums go up (generally).  But you’re not going to have a car accident every month from there on out.  The insurance company factors in your increased probability of having another accident into the actuarial tables, causing your increase in premium, but it’s a manageable increase.  You’re willing to pay, and because you’re not a persistent cost to them, they’re willing to continue to carry you of their own free will.
    Health insurance works similarly for the non-persistent sickness or injury.  (Flu, the broken bone, etc).  There is a “one-time cost” figured in for the period of the problem, and then the problem is gone.
    But what about persistent conditions, what are called “pre-existing conditions” in the context where the consumer is trying to join a new health insurance program?  (Diabetes or other life-long condition, or severe injury requiring years or life-long treatment.)  Now, you’re a burden for every single day of the rest of your life, on the insurance company.  It never ends.    Auto insurance companies will still compete for your dollars when you’ve had the occasional accident, and health insurance companies will compete for you if you have the occasional sickness or injury, but for long-term conditions, no insurance company will take you.  Why in the world would they?
    That’s where the comparison between the usual insurance paradigm, and the health insurance paradigm breaks down for me.  And I don’t see  a solution.  As soon as you violate the rules of the contract, the company will drop you – and why wouldn’t they?  You’re nothing but an everyday burden.  And medical costs are so out of control that if you make a mistake – or temporarily, for a few months, run out of funds, you will be completely hosed if you are suddenly on your own dime.
    Health care contracts controlled by the company you work for are the current common solution.  But lose your job… then what?  You can go on COBRA for 18 months or so, which is great.  And you’d better find a job within that period, because then your pre-existing condition transfers.  But again… run out of funds… or exhaust that 18 month period… and the new company, at your new job, will refuse coverage for the pre-existing condition burden.
    You might be able to settle for some low-cost solution that partially alleviates your problem, but the huge regulatory miasma surrounding health care prevents those low-cost solutions from even existing.  No one will allow it, it seems.
    Is there *any* possible solution to this problem?

  • Bookworm

    That’s an excellent question, Mike.  The one thing I know isn’t an answer is to let everyone wait to buy insurance until they’re sick, because then it’s no longer insurance.  It’s just a massive, unsustainable cost shifting.

    Pre-existing conditions are a disaster all around.  They’re not only a health care cost, they’re a drag on the economy generally, because they trap people in jobs they would otherwise leave but for their need to hang onto insurance.

    So, all I’ve done is restate, not as well as you did, the problem you just stated.  I’d love to hear from other readers.

  • Mike Devx

    Book, I am in complete agreement with you.  An additional question: These long-term conditions (medical or injury) also include lifelong prescription drug conditions. E.g., nitro for a persistent heart condition.  All three of these categories can be viewed as welfare conditions, not insurance conditions.  Risk is now out of the picture, and risk-pooling is, too.  It simply doesn’t meet the definition for *insurance* anymore.  It’s welfare now, except instead of paying taxes to the government to distribute to the welfare recipients, the other participants in the program are paying higher premiums so that those with persistent conditions (and I’m one of ’em), receive the monthly “stipend”.
    So, am I wrong to view these persistent conditions as welfare, instead of classic insurance?  And what the heck can be done?  When it doesn’t fit the insurance paradigm, is their inclusion in insurance programs even rational?

  • suek

    The health care issue is a tough nut to crack – no question.
    I’d like to see a couple of things done – first, the legal stuff.  I think there are a lot of lawsuits that are scams.  Lawyers and defendants make boodles of money off cases that really aren’t justified.  The tobacco cases, for example.  Edwards case of the child born with a condition that was due to natural causes, but which the sympathetic jury gave a settlement of millions  because it was obvious that the child was going to need lifelong care.  The blame was on the doctor for having done a caesarean.  I’d like to see a panel of medical experts as the first line of consideration.  Experts in the field being questioned.  If a doctor is really guilty of malpractice, the insurance company should pay – and so should the doctor.  Don’t let the doctor off the hook for his own mistakes – even if it’s necessary to make him pay a penalty of some sort.  If the mistake is serious enough, take his license away – don’t let him practice.  Keep a tally of the number of malpractices against doctors – if there are multiples by one doctor that are judged to be legitimate, take away his license, even if the errors are not terribly serious.
    Second, portability.  Insurance may be negotiated by companies or groups, but the insurance belongs to the person.  If they lose their job, or if they change jobs, the insurance stays with them – whether the new job negotiates for insurance or not.  Part of the problem is that usually, a company is not allowed to deny coverage to someone they already cover, if they get a disastrous condition, but if that person drops their coverage, then all bets are off.  If your condition means you lose your job and the insurance is job related, then you’re up a creek.
    Allow insurance companies to sell across state lines, and establish a set of criteria for insurance “levels” which would allow a person to choose how well covered they want to be, and permit them to choose a deductible level they’re comfortable with.  Like car insurance – insure up to a hundred thousand, or up to a million.  Choose a $100 deductible or a $5000 deductible.  Then, you pay for your care till it reaches those limits.  Of course, we still have the problem of the over the limit cases – but that’s a different issue, and to be honest, one I don’t see an answer to unless it falls into the “declared disaster” category in some way. 
    Maybe create an insurance “pool” that assigns expensive care patients expenses to be spread among all the companies….sort of like coverage for uninsured motorists insurance.  Or assign high risk people on a even steven basis that all the companies have to share – like high risk drivers.
    Mike, you mention the welfare aspect of receiving care long term…there probably needs to be some kind of requirement about paying for that care yourself, up to a percentage of income or capital.  That’s one of the tough questions.  There’s also the end of life care problem.  Some people die quietly in bed, but these days, many more spend very expensive time in the hospital.  My Dad was in the hospital 6 days at $10,000 per day.  He was in the ICU, and had monitors plus an intravenous and some tumor shrinking medications, but that still seemed very steep.  The doctors were telling me that they were hopeful that the tumor would shrink enough that they’d be able to operate.  There was no question in my mind that he wouldn’t make it.  I don’t know what they were basing their hope on, or whether they were just telling me what they thought I wanted to hear.  Maybe there needs to be a means of special savings toward that end.
    Obviously the question is not about health care – it’s about how to pay for it.  The problem is that nobody wants to die or live miserably when there’s an option not to – but nobody wants to pay the premium it takes to _get_ that care.  There’s no such thing as a free lunch, and if you’re (not you personally) unlucky enough to have a serious condition, you really need to recognize that it’s _your_ bad luck and everybody shouldn’t have to pay for your misfortune – at least until you’ve paid all that you reasonably can.  Of course, I said “reasonably”…now there’s another very arguable word…!

  • BHG

       In the Swiss system all citizens buy insurance through private companies. Premiums are based on health history. No one is excluded but those with the expensive pre-existing conditions are divvied up among the companies.
      The wealthiest pay their way entirely but the poorest have their entire monthly premiums paid by the government. As I understand it, the government has minimum requirements for services that must be paid for by the insurance companies. Wealthier people pay more for more services.
       To cut costs we need to reign in the tort lawyers and allow the purchase of insurance across state lines. Obama and the Dems lacked the will to to the first – heck, Obama is a tort lawyer. Worse, they refuse to see that the single-payer system they think of as hot stuff has always produced rationing and substandard care. Just ask the Canadians – who had to sue their own government to get a hip replacement in a timely manner in 2005!
           Elderly Dutch are terrified of being euthanized. 10,000 elderly French died in 2006 due to heat prostration. How many thousands of hemophiliacs died in France because government bureaucrats decided to wait until a French test for HIV had been patented. 

  • jj

    Mike (#3) –  When people point out that it’s very probably unconstitutional for the government to force anyone to buy anything, the standard response seems to be the one about the government forcing us to have auto insurance.  It misses a couple of points.
    First: You get a license to drive because you want one, nobody forces you to, and people who don’t own cars don’t have to have insurance for people who do.
    Second: If you do have a car, it’s your state government – not the federal one – that compels insurance.
    Third: The Constitution was designed and written to limit the powers of the biggest potential problem: the federal government.  It doesn’t apply in the same way to state or local governments.  We have a federal government in this country, not a national one – as do most places – and its scope is the one the Constitution limits.
    On Woolsey – did she have all these second thoughts and attacks of reasonableness before or after Tuesday?  Just askin’…

  • Richard Johnston

    Health care contracts controlled by the company you work for are the current common solution.

    Edwards case of the child born with a condition that was due to natural causes, but which the sympathetic jury gave a settlement of millions  because it was obvious that the child was going to need lifelong care.  The blame was on the doctor for having done a caesarean.  I’d like to see a panel of medical experts as the first line of consideration.

    To cut costs we need to reign in the tort lawyers and allow the purchase of insurance across state lines.
    Couple of responses.  Health care contracts controlled by the company you work for are virtually unenforceable in court and provide fake, illusory coverage due to ERISA.  See my ERISA-reform polemic blog.
    Juries are not so easy to convince; the stats are that the defense prevails in the majority of cases that go to trial, and in many places, such as California, you do have to have a physician affirm that the defendant physician did breach the standard of care as a prerequisite to filing a malpractice suit.  The great big verdicts make the headlines; the cases where deserving claimants are unjustly denied any compensation do not.  But they are out there.
    There is no prohibition whatever against insurance companies selling across state lines – they are just subject to regulation by the state(s) where they decide to peddle their policies.  What they are seeking is the ability to sweep into a state and start selling policies with that state having no oversight whatever – they seek to be regulated only by the state of their domicile no matter where they do business.  Thus we could expect to see a repeat of what we have with credit cards, which are pretty much all based in either Delaware or South Dakota, as those are the states where the regulation is most lax, and they are essentially unregulated at the state level.  So if Connecticut, say, decided to lure even more insurers by having extremely lax regulation, then Connecticut would soon end up being the de facto insurance regulator for the entire country.  That’s the thing I worry about with the “across state lines” thing – it really means “extremely lax regulation, everywhere, whether the citizens of a state want it or not.”

  • Mike Devx

    IS Richard Johnston right about the current laws about selling insurance “across state lines”?  If what he’s said is right, I completely agree with him.  As an analogy, if a company is based in a city near mine, and they open a store in my city, whose sales tax applies?  Mine, of course.  Similarly, a company based in Delaware wishing to sell insurance in my state (Texas) must be subject to Texas’ regulation.  I’m 100% behind that statement.
    My questions about the “welfare” nature of some benefits of the current insurance setup for health care are just that: questions.  I’ve got no solution, and I’m not advocating any particular solution.   It’s so true, you can’t have it all, and there ain’t no such thing as a free lunch.  I do know, that if you talk to any CFO of any company, you’ll get an earful about how health care costs are spiraling out of control.

  • Richard Johnston

    IS Richard Johnston right about the current laws about selling insurance “across state lines”?

    Well of course I think he is.
    Actually I am pretty sure on this one.  I do know my current health insurance (for as long as I can afford to keep it in force) is with Aetna, which is based in Hartford Connecticut.  I live in California, and they ran into no trouble selling me a policy here.  But they have to comply with California regulations in order to be able to do so.  Which they have chosen to do.

  • Ymarsakar

    <B>That’s the thing I worry about with the “across state lines” thing – it really means “extremely lax regulation, everywhere, whether the citizens of a state want it or not.”</b>
    Are you talking about companies you deal with or companies that do not provide employers with health packages.
    And since when did extremely lax regulation in the credit card business have anything to do with a negative impact on people’s health or the healthcare industry. If anything, that is a demonstration that the regulation is retarded and normal competition does a better job than government or lawyer mandated regulations.
    In case you hadn’t noticed, these entities are not interested in making businesses run. You’re interest is in something other than that and the same is true of government as well.

  • Richard Johnston

    In response to Ymarsakar, no. 12:
    I am referring not to ERISA insurers as such but to the proposal that insurance companies be allowed to sell “across state lines,” i.e. to sell policies in a state with no oversight by that state’s regulatory authorities.  As I noted it is the “race to the bottom” concern about states competing to be the most lax in regulation so as to attract insurers to set up shop there. No the credit card situation does not directly impact the health care issue.  I cite it as an analogy and as an example of what could well happen in the insurance industry if you gut the ability of states to regulate products sold within their borders, in favor of the lax regulation of another state.  Background about the credit card situation is, among other places, here: A quote from the cited article illustrates what I would expect insurance companies to do if the “across state lines” idea is effectuated: *** Had circumstances been less dire, the news of four urgent phone calls from a New York bank in a single day likely would have been easier to ignore. “Nobody’s historically more suspicious of outsiders than South Dakotans,” Bill Janklow, the former governor of South Dakota, told FRONTLINE in a recent interview. But it was 1980, South Dakota’s economy was a mess, and suspicion was an instinct that Janklow could not afford. “We were in the poor house,” he recalled. “It cost 42 cents a bushel in 1980 to haul wheat. When something’s only selling for $2.20 a bushel, you certainly can’t afford to be paying almost 50 cents a bushel to ship it.” The calls were from Citibank, which was having a serious problem of its own. “It was very simple,” said Walter Wriston, then the chairman of Citibank. “We were going broke.” The bank had lost more than $1 billion on its audacious foray into the credit card business, and the future looked even worse. The trouble, simply put, was that the rate of inflation exceeded the amount of interest Citibank was allowed to charge its credit card customers under New York usury laws. But the bankers saw opportunity and salvation in the plains of South Dakota. Within days of those first phone calls, a team of top executives arrived from New York with a proposal for Mr. Janklow: If South Dakota would quickly pass legislation that would enable Citibank to move its credit card operations to the state, they would bring hundreds of high-paying white collar jobs to the state. The unlikely alliance would clear the way for Citibank to turn a money-losing credit card operation into a vastly profitable business. “All of their senior people used to say it,” Mr. Janklow said. “That South Dakota saved Citibank. I believe it did. That South Dakota saved Citibank.” ***

  • Richard Johnston

    You know there were supposed to be some paragraph breaks in the previous response.  Sorry ’bout that.

  • Richard Johnston

    And finally, re Delaware, credit cards, and lax regulation across state lines:

  • Ymarsakar

    It’s a visual editor problem, not something that you should know off hand. Now things require two spaces for double space. The look as you write and how many spaces appear, are not the same.

  • Ymarsakar

    <B>“All of their senior people used to say it,” Mr. Janklow said. “That South Dakota saved Citibank. I believe it did. That South Dakota saved Citibank.” ***</b>
    My view is that if this is de-regulation, then even if it was half way applied to healthcare, things would improve.

  • Ymarsakar

    Which means that what you seem to see as a detriment to insurance being sold across state lines, is viewed by many of us as The benefit.

  • suek

    Looking at Richard Johnston’s site, it appears that he is engaged in fighting against injustices being “legally” forced upon his clients.  So it seems reasonable to me that he wants tighter regulations on insurance companies, not looser ones.  He is also unquestionably more familiar with how insurance companies and claims work than anyone else here – but that familiarity is with a different kind of claim, and one that appears to me to have been influenced by federal regulation to the claimants loss.  It’s for that very reason that I’d prefer to see individual states controlling the insurance instead of the federal government, but at the same time there _does_ need to be an overarching regulation.
    It also appears to me that his cases go to court because courts are permitting insurance companies to avoid what seems to be very reasonable terms of contract – he describes a case where the company was attempting to avoid settlement because the beneficiary couldn’t absolutely without question have had an accidental fall without any possible contributing factor.  That’s absurd, which the court decided.  If it’s absurd, however, why did the insurance company go to court to fight the settlement?  IMO, it’s because they had been successful in avoiding claims in prior similar cases – though I don’t know this.  I suspect the problem lies within the court system, with those of a mind to argue how many angels can dance on the head of a pin rather than to simply enforce contracts.  I understand there can be contributory factors – but the courts need to minimize the blame game when the goal is to negate the intent of the original contract.
    And I don’t think the insurance he describes is the same as the health insurance situation – one of the reasons it’s difficult to buy insurance across state lines is, as he has said, because states put different requirements in place.  The feds also require “equality” so that men have to pay for reproductive insurance just as women do, because it’s “unfair” to charge women more.  Ditto for various optional operations.  And dental care.  Obviously, the more you include, the more it’s going to cost everybody.  If people could choose a basic package – or check off a list of what they want covered, maybe it would be different – but they can’t.  They have to buy the whole package, as specified by legislators.  It doesn’t make sense.

  • Ymarsakar

    Here’s been here before, Suek. So I can qualify him as a good guy who isn’t very good at deceiving himself concerning the realities of government corruption. That doesn’t make him flawless, but it does make him better than the average conception of a lawyer.
    <B>and one that appears to me to have been influenced by federal regulation to the claimants loss. </b>
    The dichotomy is that ERISA is a union backed federal regulation which was intentionally designed to loot businesses to favor unions, and which coincidentally motivated businesses to setup the job-healthcare connection. Yet even knowing this, Johnston views the solution in the prism of the law, of changing or creating regulations, rather than of a political science or philosophy of life that originates from elsewhere.
    <B>but at the same time there _does_ need to be an overarching regulation.</b>

    Regulatin or de-regulation isn’t the point. Who controls that regulation, whether it is evil corrupt Dems or somebody else, is what matters. Because there’s no guarantee that we can control who does the regulations, the best solution is to knock the petty aristos from the monument of power. Since we can’t count on government to regulate things like Fannie Mae, which they should have, we can only excise the cancer entirely and reduce the potential for corruption, rather than trying to fix it after it starts to kill the patient.
    <B>I suspect the problem lies within the court system, with those of a mind to argue how many angels can dance on the head of a pin rather than to simply enforce contracts.</b>
    I suspect this mostly has something to do with ERISA. The contract is with the business, not the individual. So there will always be less protection for the individual because you aren’t negotiating as equals (anyone who has done labor vs management knows about this kind of power dichotomy). If the individual had sued the businesses, perhaps there may be better odds. But if laws prevent that, then ERISA has probably insulated insurance companies from this liability.
    <B>It doesn’t make sense.</b>
    The entire system was built to make money for those controlling the strings. That’s not cynicism so much as it is a strategic perspective of how human beings function in the midst of too much wealth and luxury.

  • Richard Johnston

    Thanks for the thoughtful responses to my points.  Started to reply but it became a bit ungainly so I turned it into a blog post.  So go here:

    to see my response to some of the points above.  Thanks.

  • Mike Devx

    Thx to everyone as well for the enlightenment!  Especially SueK and Ymar.  This looks like a glass-half-full and half-empty situation to me.  My principles tell me, being a 10th Amendment guy, to leave it to each state.  But trust them, along with the federal ERISA enforcement, to completely muck it up for the citizens within each state.
    Maybe we could have Barney Frank throw the entire framework out and rewrite it from scratch!  As he is “proposing to do” for Fannie Mae and Freddie Mac.  Heh.  After twenty years spent guiding those, ahem, revered institutions, and never offering any complaint of any sort until now, he’s clearly a principled fellow who will do what is best for all Americans.