One of the things that has bugged us for months and months is health care opponents’ preoccupation with the number of pages in the health care bills that have been introduced in the House and Senate. The most recent bill to emerge is the Senate bill unveiled by Harry Reid yesterday and SURPRISE … it’s 2,074 pages.

As Politico points out, the bill “runs more pages than War and Peace, and has nearly five times as many words as the Torah.” Transcript of whiny health care opponents, please:

“While Americans have been clear about their opposition to thousand-page bills for new government programs, it’s now abundantly clear that Democrats haven’t been listening,” Senate Minority Leader Mitch McConnell (R-Ky.) said.

McConnell is undoubtedly railing against ANY bill Democrats might introduce, but he mentions that it’s a “thousand-page” bill. And our question is, “So what?”

Are the kind folks who demand good government (and less government) saying that a bill with such far-reaching implications – a bill that stands to affect virtually every American – would be better if it was simply shorter?

I suppose their argument might be that a shorter bill would mean there are fewer proposed changes to the health care system, and if that’s their point, too bad. The fact of the matter is that the U.S. health care system has been broken for a long, long time – and when proponents of change sat down to craft legislation, they had a lot to fix.

If the health care industry had historically responded to a legislative tweak here and there by implementing significant consumer-friendly improvements all along, we wouldn’t be looking at a tome that rivals the Encyclopedia Britannica. But here we are, decades into the history of health insurance and we’re having to talk about issues like denial based on pre-existing conditions – issues that should have been tackled decades ago.

We think opponents of the legislation should stop carping and look on the bright side: the legislation is extensive and explicit. It’s good news that the bill’s authors are being thorough. And honestly, if the legislation was shorter, wouldn’t opponents be lobbing accusations that Democrats aren’t spelling out everything that’s in the bill? Uh huh.

So enough about the number of pages. We read through the first House bill – and we’ll take a run at this Senate version. It will surely cause eye strain and likely some nodding off.

But we think our pain and suffering will be worth it in the end. After all, health reform has been a long, long time coming.

We weren’t the tiniest bit surprised by a new study on emergency care that revealed that patients who lacked health insurance were almost two times more likely to die from car accidents and other traumatic injuries than patients who had health plans.

Our response: Duh.

And, apparently, Kevin Drum, who blogs over at Mother Jones, felt the news was worthy of a “Duh,” too.

Well, OK some of it. Drum was perplexed that the study findings actually “shocked” trauma physicians, who couldn’t understand how uninsured patients possibly could have received a lower level of care from hospitals than patients who were insured.

“We don’t ask people, ‘What’s your insurance?’ before we decide whether to intubate them or put in a chest tube,” one ER doc said.

Drum says that “In fairness, part of the result in the trauma study might be due to selection bias,” and then goes on to talk about researchers’ possible explanations for the findings:

• that the uninsured often wait longer at ERs before they’re seen
• that they sometimes visit ERs at several hospitals before finding one that will treat them
• that (according to studies) uninsured patients receive fewer CT and MRI scans and other services and are less likely to be transferred to a rehabilitation facility.

These reasons made sense to us, but not to some of Drum’s readers. If you scroll to the bottom of his blog post, some of his readers accuse Drum of bias in reporting the study. The readers’ apparent conclusion: that the lack of health insurance is but one of a number of factors that would make the uninsured more likely to die.

We would agree, but only to say this:

Fine. Let’s remove one of the factors. Let’s make reliable, affordable health care a building block to a better life for these folks … so they can take advantage of preventative medicine more often and visit the ER only when they need ER care. Let’s give them more access to the system so they can become responsible health care consumers.

We should note that it was refreshing to read that most of Drum’s readers not only shared his conclusion, but also added supporting anecdotes … of hospital physicians who talk the equity talk but walk the bottom-line walk; of uninsured who may be unable to ask the right questions because they’re not even familiar with the system.

And we like Drum’s conclusion:

“A lot of people die unnecessarily every year because we have lousy, expensive healthcare coverage in the United States.  It’s about time to start doing something about it.”

There are plenty of stories out there about the nightmares already faced in the nation’s existing health care system. But folks really want to know how coverage will look after health reform legislation is passed. (We’re assuming it will be.)

That why we liked this story, which examines what the current legislative proposals would mean to both the uninsured and those already insured. Max Baucus should be pleased with the coverage of The Missoulian, which provided a look at five Montanans and how his legislation would affect them if passed.

There’s a sense of optimism about expanded coverage balanced with against deep concern about how long it would take for health reform provisions to actually kick in. And that’s OK, because we’re concerned, too.

When the House passed its version of health reform legislation last week, the development may have sent chills down the spines of those who oppose the Democrats’ proposed solutions. But a quick read-through of Suzy Khimm’s piece in The Treatment yesterday should be equally chilling to folks who think the battle over health reform is anywhere close to being over.

Khimm’s piece should serve as an eye opener to anyone who might suggest that Harry Reid is padding his schedule when he says a Senate bill won’t pass until Christmas – at the earliest. (Other Dems are saying even that is optimistic.)

For as much as talking heads keep pointing out that Reid needs 60 votes in the Senate to stop a filibuster, what hasn’t been talked about much is the fact that Reid needs 60 votes at least three times in this process: 1) for a “motion to proceed” (a vote that could happen as early as Tuesday) 2) for a vote to move past a Republican “point of order,” and 3) for a final vote on passage of the bill.

That final vote happens only after debate on the bill’s amendments – and there are likely to be many introduced by Republicans. But that’s just the beginning of opposition stall tactics that could well include the reading of the entire bill aloud on the floor, as threatened already.

Reid’s work, Khimm points out, will be “heavy lifting.” We think that’s putting it lightly.

We think Reid’s going to need some steroids.

You’d think opponents of health care would be content with getting Americans worked up about issues like abortion and immigration in order to bog down passage of a health reform bill, but today, bloggers and Tweeters are whispering in a really loud, gasping voice, “Jail time for folks who don’t buy health insurance?”

We’re not that surprised. It’s actually a pretty logical leap for folks who want to scream about the tyranny of an administration whose goal to make sure everyone has affordable, quality health insurance is denounced as a “power grab.” (What? Grabbing of power from a powerful industry?)

Yes. You heard it. President Obama said in an interview yesterday that folks who do not comply with federal law – in particular folks who would decide not to comply with an individual mandate – could ultimately end up in jail. More specifically, they could go to jail if they did not pay the fines (actually tax penalties) that would result from their decision to not purchase health insurance coverage as mandated by health care legislation).

“I think the general broad principle is simply that people who are paying for their health insurance aren’t subsidizing folks who simply choose not to until they get sick and then suddenly they expect free health insurance.  That’s – that’s basic concept of responsibility that I think most Americans abide by,” Mr. Obama said, “penalties are appropriate for people who try to free ride the system and force others to pay for their health insurance.”

So what the President is saying is that – just like any other law that some citizens might deem unfair – a health insurance mandate as part of federal law must be obeyed. The law, in other words, is the law. Go figure.

The argument is that our new administration would oppressively force Americans to buy a product or service in a way that Americans have supposedly not been asked to do ever before. And that argument might hold water if you didn’t include government-ordered products like seat belts (which everyone is required by law not just to wear but to pay for in the price of their new car) or school buses (the expensive ones that keep our kids safe because they’ve been blinged up with federally mandated safety features). OK. Basically don’t include anything mandated by the federal government that makes Americans more safe.

And that’s the point here. No one should get a free ride – because in a well-run, civilized society, everyone should be safe. In the same way that everyone should have auto insurance so that folks don’t lose everything as the result of a car accident, everyone should have health insurance so they don’t lose everything to a health crisis – and so they don’t bog down the health care system and drive health costs higher.

It is, as the President points out, “a basic concept of responsibility.” And in a nation seemingly obsessed with personal responsibility, the goal of universal participation in health coverage should be a no-brainer.

Arkansas voters to Sen. Blanche Lincoln: “BOO!”

It’s a day before Halloween, but a new poll back home should already be running a chill down Lincoln’s spine.

As a so-called centrist Democrat she opposes a public option, but that puts her out of step with the 56 percent of Arkansans which support it. That number climbs to 83 percent support among members of her own party. And perhaps the scariest thing of all in the poll, 57 percent of her fellow Democrats would consider dumping her for a new candidate in next year’s primary.

More results, and what numbers are haunting her fellow conservative Sen. Evan Bayh (D-IN) at the Huffington Post.

We’re happy to hear folks asking this question: If Democrats succeed in passing health reform legislation with an opt-out public option as included in Harry Reid’s Senate bill, would any states actually opt out?

Conservatives seem to like the idea that states could take a pass on a public option provision they dread. But really, Andrew Sullivan asks in the Atlantic Monthly, will Republicans at the state level really feel like having a discussion that ends with the state removing a potentially less expensive health coverage alternative for its constituents?

Sullivan says he can actually see the public option “becoming the equivalent of Medicare” – the public program that voters have been screaming about all summer. (”Hands off my Medicare!” and also “Medicare sucks!”)

But apparently, the answer may be “yes” for at least SOME of the state officials and wannabe officials. TPMDC polled a few of them here.

Problem is, Sullivan notes that opting out likely won’t be a snap for states that ARE committed.

And will opting out even be a hot issue when the states finally HAVE the option? (As Ezra Klein points out, states wouldn’t be able to opt out until 2014 – and heck, who knows what we’ll be worrying about five years from now.)

For a political proposal that appeared ready to be staked in the heart by its opponents just weeks ago, the public option looked surprisingly perky this week. In fact, the only thing that now sounds optional about the proposed reform initiative is the abundance of public option options being floated.

The perkiness is due, of course, to the latest poll from ABC and the Washington Post, which showed that 57 percent of American surveyed supported a government-sponsored insurance option. The news could hardly have been better for proponents, unless you consider that even MORE Americans – 76 percent of those polled – said they’d support the idea if it would be limited to folks who can’t get affordable private health insurance.

Sensing that the tide of public opinion is turning, advocates of a public option have turned up the volume on demands that it be included in the bill that will be voted on by the full Senate. Sen. Harry Reid, who’s working behind closed doors to marry the Senate Finance and HELP Committee versions of reform legislation, indicated that he WOULD include a public option in the bill. House Speaker Nancy Pelosi pledged ardently that a “robust public option” is still on the table for the House of Representatives, at least.

Some media also reported that the White House, feeling the heat from the red-hot poll results, finally signaled that it would support a public option – with an opt-out clause. But other media say the White House hasn’t drawn any lines in the sand just yet.

Who in Congress has pledged their support or opposition to the public option or versions of  a public option so far? Here’s a snapshot.

• House Speaker Nancy Pelosi, vocally.
• Sen. Bill Nelson (D-Florida) says all states need a public option.
• Sen. Mary Landrieu (D-Louisiana) says, “I’m not for a government-run, national, taxpayer-subsidized plan, and never will be.”
• Sen. Olympia Snowe (R-Florida), the sole Republican to cross the aisle and vote for the Senate Finance bill, says she’ll vote again a public option and could support a filibuster. She’s also said she’d consider an option only if it had a trigger mechanism.
• Sen. Charles Schumer (D-New York) wants Sen. Harry Reid to include a public option in legislation and force opponents to strip it out.
• Sen. Joe Lieberman (D-Connecticut) says he opposes a public option “right now.”
• Yesterday, Rep. John Larson (D-Connecticut), said the House had the votes to pass a robust public option.
• Sen. Roland Burris (D-Illinois) says he’ll oppose any health reform bill that does NOT include a public option.
• Sen. Blanche Lincoln (D-Arkansas) says she’s “ruled out a government-funded and a government-operated plan.”
• Sen. Max Baucus (D-Montana), says the option is still ‘alive’ but said a “pure option” may not get the 60 votes it needs to survive the Senate floor.
• Sen. Ben Nelson (D-Nebraska), says “it depends on what the public option is.”
• These 55 Republicans strongly oppose a public option (though they have their own “public option.” )
• Sen. Tom Harken said last week that he had counted 52 Democratic Senators who supported the public option and five who did not.

There were squeals of joy and howls of rage when Olympia Snowe crossed the aisle (or as Republicans would say “went over to the Dark Side”) yesterday to vote for the Senate Finance Committee’s version of a health reform bill. But now that it’s done, both sides might be rethinking their outbursts.

The Right could well rejoice in the fact that Snowe was asked to ostensibly stand up as a witness for the marriage of the Finance and HELP bills. The Left’s reason to whine? That Snowe won’t be just the witness; she’ll be giving away the bride – the Finance bill – to an undeserving groom – the HELP bill.

It looks like Snowe will fill that protective parent role, and naturally, she’ll have plenty to say about the groom’s intentions regarding what she sees as her baby. Most of the folks on the groom’s (liberal) side of the aisle are already concerned about whether Snowe forced some sort of pre-nup … and why she’s been invited to even watch the proceedings (since the Democrats had expected that this whole marriage would end up in Las Vegas, where they wouldn’t have to hear the whining of the bride’s parents).

Of course, the Left side of the church is just praying that IF the Reverend Harry Reid can convince the groom and the bride that they can get along, that some unruly wedding guest (we’re thinking Joe Lieberman) won’t stand up and object when the two finally meet for the nuptial blessing at the altar of the Senate.

If their prayers are answered, a successful marriage would inevitably lead to a steamy romance involving House and Senate bills. And then? Naturally, the delivery of adorable, living, breathing health reform legislation by none other than our trusted family physician.

Dr. Obama? Paging Dr. Obama?

A column by Thomas Frank in the Wall Street Journal made us pause and scratch our heads this week because it prompted one of those questions that we think lots of Americans must be asking themselves. The question is simply this:

Are President Obama and his Democratic Party up to no good in this health reform battle?

[Conservatives: Insert "Obviously!" here.]

The question, more specifically, might be “Is President Obama trying to turn the government into a predator?” or “Would the passage of a public option be a predatory move by government?”

[Conservatives: You can again insert "Obviously!" here.]

Phrase it however you like. As the WSJ column points out, Sen. Charles Grassley (R-IA) – who has been up to his hip waders in the health reform battle – said last week that a public option turns the government into a predator. And Sen. John Thune, (R-SD), has apparently agreed.

‘I know you are but what am I?’

The WSJ’s Frank thinks those two legislators have it backwards. Could be he right?

After all, what seems more predatory? A government insurance option, the stated purpose of which is to increase competition with private industry to drive insurance costs down for all consumers? or “actuarial-minded hardliners of the insurance biz, the ones who deny your claim or cancel your policy?”

We understand the concept of a “predatory government.” It’s a government that stands back and watches as the foxes of private industry feed on the hen house of American citizenry. We’ve seen it happen when corporations sucked the economic lifeblood of the nation through no-bid defense contracts. And we’ve seen it happen when, as Frank points out, the government used a prescription drug benefit to herd millions of Americans into the waiting arms of the pharmaceutical industry.

The “predator state,” Frank writes, materializes “when consumer protection, worker protection, environmental protection, and policing against fraud are handed over to lobbyists. And when health care is run for the benefit of private insurance companies, whose business model . . . is to target coverage on the healthy and delay payments to the sick.”

Keys to the hen house?

So is a public option “predatory?” We don’t think so. But we agree with Frank that without a public option, Congress may be putting its efforts into getting all of our hens in one hen house – and then committing the most predatory act imaginable: handing the foxes the keys.

Fundraising scorecard

Political contributions from the health industry:
Grassley: $2.9 million (despite the fact Iowans support a public option)
Thune: $1.2 million