Thanks for all your hard work on this, Paul. It looks like the bill will pass now that the Stupak deal was announced, but the fight definitely continues. It will be interesting to see if Idaho and Virginia are successful at getting the Supreme Court to review this case.

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It appears Pelosi won't include the Stupak language since she would have faced a revolt from the progressive wing and has concluded she needs them more than Stupak, particularly since his bloc of "moderates" has been slowly caving to every demand from the left wing of their party.

Anyway, the problem is that if the bill passes tomorrow then, at minimum, the Senate bill becomes law. The GOP can only strike provisions from the reconciliation bill. That might result in some egg-on-face for supporters of the bill, but little else. The court challenges have more promise, but ultimately it will come down to electing politicians who vow to repeal the bill.

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I say that, but then at the same time I'm reading about a possible deal between Pelosi and Stupak. While that would surely put the bill over the top, it does signal where we should head next.

If Pelosi strikes a deal with Stupak, it would mean that once again, the Democrats are proving to be the worst enemy of abortion. The Hyde Amendment really does prohibit federal funding of abortion. Until now, that hasn't really affected very many people (except those on Medicaid) so the politicians never really cared about it. Now Stupak is telling it like it is, and what it means in a government-controlled health system as subsidies expand to a much larger percentage of the childbearing population. Pelosi may need to decide between supporting health reform and supporting easy access to inexpensive abortion, and it appears she already knows where she'll lie. This is an argument that may resonate with the left. Do they realize what they are getting themselves (and us) into? The GOP will eventually return to power. They will likely be unable to repeal the health legislation in its entirety (if they even want to), and so it is possible, likely even, that they will use health insurance as a political football, and restrict abortion rights and promote other social initiatives through the back door of health insurance.

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I think the immediate battle may be over, Paul. Another Congressman (Boccieri) is announcing at 10:40 that he's caving. Sadly, this bill looks like it will pass. The "blue dogs" wilted under pressure and the false cover that the CBO report gave them. Chalk them up as another set of false allies. As much as I hate to, I may need to vote GOP this fall. Divided government appears to be the only solution.

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I am thrilled to see that my fellow primary care doctors are going Galt with me. I am saddened, though, to see our patients fall inti the hands of the unqualified (but cheap) rabble the gov't will replace us with.

In the end, though, it is the last act of defiance against a system and a philosophy that teaches that a "human right" is simply something you want and hire a Congressional thug to go steal for you.

I won't help them perpetrate this crime.

Keep up the fight!

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The thing no one ever seems to understand is there MUST be "death panels" {eye roll} because there MUST be cut-offs for when care is too expensive or useless (antibiotics for viral disease, anyone? And yet they're prescribed and paid for a million time a month! Anyone suggesting that insurers refuse to pay for antibiotics for viral infection? Not so far, eh?). In emergency medicine, triage means directing care and attention (and money and supplies) towards the injured who have a chance of surviving; it also means NOT directing those limited resources toward people -- equally valuable, equally loved -- who do NOT have a chance of surviving. Spending a half-million dollars on some drug or procedure for someone in their 70s or 80s, or with a terminal or un-reversible illness -- while of vital importance to them and their families -- makes no sense in a country (or a world) that is in economic crisis (or population crisis, or food creation crisis -- pick your crisis).

As much as our hearts yearn to save everyone, it is not possible. It IS. NOT. POSSIBLE! And trying to work out some way to pretend it is, to throw the huge costs and burden forward in time or to people we don't know is politics, it's underhanded, it's foolish. I'd love to see a true free market medical world -- where, if you can't afford it, you don't get it! So sorry. End of story.

As soon as people begin saying: "Well, we HAVE to help...." (the poor, the old, the children, the unemployed, the lazy, the drug-addicted, the illegal.... ), then you've destroyed any hope for a working system. Most medical people -- even before the laws forcing them -- would not be comfortable turning away someone who needs help-- and thus the end of our great medical system, as hospital after hospital closes down because of unpaid and unfunded but demanded or required expensive care.

As long as ya'll keep avoiding the truth (there WILL be limits to any care, there HAS to be), then you're not actually doing the work that needs doing. Yes, it would be lovely to have catastrophic (affordable HA!) insurance. (I can't even afford that!) But as long as "we" keep allowing or demanding that "someone" has to pay for this or that group, then it can't work.

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I don't trust insurance companies. It's a big business, and some people confuse it with a charity. They need to think of themselves first.

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Here's a message you might consider sending if, like me, you have a "definite yes" representative:

"I urge you to vote against the Senate health care bill and reconciliation bill that is expected to be put before you later this week.

As Rep. Luis Gutierrez (IL-4) points out, under the current Senate bill and reconciliation bill, LEGAL immigrants (who often come here with little but their hopes and dreams) would be required to purchase health insurance, but would not be eligible for the subsidies. This places yet another obstacle in the path of legal immigration and citizenship, and encourages illegal immigration. As you know, [your district] depends on the hard work and dedication of tens of thousands of legal immigrants. The health care reform bills, which purport to help people, unwittingly harms them.

We cannot rely on future "fix" in the reconciliation bill or the forthcoming immigration bill. Despite their promises, the Senate will have little incentive in the reconciliation bill to make changes if the House passes the Senate bill and President Obama signs it, which appears to be a prerequisite. The only way to ensure a bill that treats all people equitably is to reject the Senate bill and start with a new House bill that can achieve broad support in Congress. The danger in one party "going it alone" is that other unintended consequences such as this one, will go unnoticed or be ignored in the rush to "do something." Please remember the first part of the Hippocratic Oath (first, do no harm) when you cast your votes this week on the upcoming health care reform bills."

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The fundamental problem is that most people accept the Left's premise that health care is a right. I hear over and over again "where's the GOP plan to end discrimination of pre-existing conditions, or expand coverage to everyone." It's an argument the GOP can't win, because they don't disagree with it. Sadly, I see the health care vote as a turning point. Obama will probably be strengthened by it. Many of the Blue Dogs are toast, but the Left doesn't care about them, anyway. They'll all be back, and even if they lose one or both Houses will view it as temporary, while the health care entitlement will be permanent. Since it won't do anything to reduce costs, they'll be back for more later (public "option", etc.). You described it as a Hail Mary. Unfortunately, Hail Marys are sometimes successful. This was more like the Statue of Liberty play (fake to one direction and hand off in the other), but I hate that analogy because this is for a cause that is completely antithetical to liberty.

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My worry is that they are pulling all the stops to get a vote. They have convinced themselves that it's better to pass something now and worry about it later. On top of that, they are using reconciliation as an opportunity to ram through a socialization of student loans. Naturally, the claimed savings will also "help" the CBO score.

http://news.yahoo.com/s/ap/us_health_care_overhaul

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I think that scenario is unrealistic, Jim. Sadly, I think the cause is lost. The Democrats found their solution to the problem of an uncooperative public and will spend the next few days cutting deals to ram this through. The last hope, ironically, is if Bart Stupak's bloc holds firm on abortion, but that seems unlikely based on what I'm reading on Politico:

http://www.politico.com/livepulse/0310/Pelosi_More_optimistic_on_abortion_deal.html?showall

Massa's resignation is a sign of how intense the pressure is on rank-and-file Democrats. The GOP has no coherent strategy or philosophy so the only hope is if the Democrats come to their senses.

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This article is fabulous! I just e-mailed Rep. Ryan at budget.republicans@mail.house.gov to point him to this -- slim chance, maybe, but perhaps it will make a difference!
THANK YOU!

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As an alternative to Stern's analysis, Democratic passage of health care could destroy the party politically by creating an equivalent of the 1800 election.

This would require the Republicans to have the austerity of Jefferson's Sec. of Treasury Albert Gallatin to overthrow the current budgetary spoils system and patronage schemes by eliminating specific programs, positions, and taxes in an effort to reduce the federal debt.

Come the next Congress, the choice could be the Republicans. Realistically, they lack the integrity of Jefferson and Gallatin needed to take the necessary action.

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We will be on a look on this one. Thank you for sharing this post.

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And if you need further evidence that both sides of the aisle are philosophically corrupt compare Republican use of the reconciliation process to their current expressions of horror over Obama's proposed use.

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Congratulations. Thank you for all your hard work on this very important issue.

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Unfortunately, what the people think no longer matters. It appears virtually certain this bill will be rammed through using reconciliation now. The Democrats have deluded themselves into the belief that "any bill is better than no bill."

http://www.politico.com/news/stories/0210/33398.html

I think the best strategy may be putting the pressure on the House, where the votes may be less certain. Barring that, the best strategy is long-term, starting with voting out anyone and everyone who voted for the bill and seeing if it can be repealed before the worst provisions take effect.

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This is a fantastic idea. Doctors financially rape the American public, and it's time to turn the tables.

All states need to employ this tax. Doctors have been limiting their own supply with government lobbying. They are crooked individuals who see the sick and injured as walking dollar signs.

It's time to fix the corrupt medical system once for all, and we need to start with the source -- the doctors.

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Politico has had some analysis on the reconciliation process. It could get ugly, but if the Democrats are determined enough they can pull it off, unfortunately.

http://www.politico.com/livepulse/

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It's a trap. Politico is reporting that the strategy is to go, full throttle, with reconciliation, and possibly even the public option, after the summit.

http://www.politico.com/livepulse/

The rationale is that since Bush passed bad legislation through reconciliation, so can they.

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