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.

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.

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.)

Will Democrats unite to allow an up-or-down vote on health reform legislation? Robert Creamer explained on the Huffington Post this morning why he thinks it’s in Democratic legislators’ best interests to pull together. Creamer’s reasons include, briefly:

• That Americans have already swung overwhelmingly in support of the public option.
• A vote to defeat the filibuster isn’t a vote for the public option: it’s simply a vote to NOT give the opposition the power to thwart the will of the majority.
• Legislators who allow the filibuster risk the resentment of the majority party.
• The defeat of this legislation could threaten the election-year prospects of Democratic legislators in the next election cycle.
• More importantly, Creamer suggests, a defeat on this legislation could threaten the majority status of the Democrats and damage the political standing of President Obama.

The bottom line, Creamer says: the party has spoken in support of the public option. Now, members of the party need to stand back and make way for progress. As CBS News notes, the clock is ticking.

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.

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

Okay, we know that it’s the conservative members of the House that are called “Blue Dogs” (not members of the Senate), but what a perfect visual for the actions of the North Dakota Democratic-NPL party’s put-down of its own senator, Kent Conrad (D-ND).

The party’s members recently reaffirmed a commitment to an even much more progressive health reform idea – single payer – but support a public option as a fallback. And in a letter to its three-member congressional delegation, it put its disagreement with Conrad out for all to see.

Conrad has been a nattering nabob of negativity when it comes to the public option – and as a member of the Senate Finance Committee, he’s used his position to try to euthanize. As far as the public option is concerned, several conservative Dems on the finance committee have essentially been their own  death panel for the proposal.

The Democratic party in Nebraska is also wielding a rolled-up newspaper. Senator Ben Nelson (D-NE) is another example of an elected official stubbornly pulling back on the leash while his masters are trying to walk forward.

Looks like the winter temperatures in these Midwestern states are going to be more frigid than ever for these two senators, bringing to mind the old Warner Bros. cartoons where the shivering dog looks longingly through the window while Sylvester lies curled up by a roaring fire.

That ain’t dog food

Political contributions from the health industry:
Conrad: $1.6 million
Nelson: $2 million

Hmmmm. A CBS/New York Times poll says 81 percent of Democrats favor a public option; yet five Democratic senators on the Senate Finance Committee vote against it. Strange.

Go to the raw story, for the full scoop!

There’s something about this huge debate on health care that’s been sorely lacking and … and that something is a  discussion of what health reform could mean to entrepreneurs.

Remember the American Dream? Where you come up with a great product or service and then open your own business? You work harder, not smarter? The business prospers, you make lots of money, satisfy your customers and then you retire financially secure?

Health insurance very simply messes up that dream. Politicians can cite all the data they want showing that more Americans are chasing the dream of entrepreneurship, but the sad fact is that many of those industrious Americans chase health coverage right back to the corporate world.

Why? Because when they’re hired in the corporate world, they get to dodge the arduous task of hunting for a low-cost health plan with decent benefits. They skip right by the stress of waiting to see whether they’ll get flagged for a pre-existing condition and denied coverage. And finally, they’re spared the huge premiums and out-of-pocket costs that await in the individual health insurance market.

The trade-off, of course, is “job lock” – the fear of switching jobs over the prospect of becoming uninsurable as a result of temporarily losing insurance coverage. Naturally, “job lock” makes corporate employees even more reluctant to attempt an escape to self-employment.

Health reform – and the proposals being debated in Congress right now – is absolutely critical to removing the existing nightmarish realities of the American Dream.

As Ezra Klein points out in a piece yesterday, “the various health-care plans under consideration all make life better for a would-be entrepreneur who wants to buy health insurance. The subsidies will help him afford coverage. The regulations will make sure insurers can’t deny his family outright our jack up their rates. The exchanges will give him purchasing power and choice.”

But it’s not just the Dreamers who benefit from reform that helps cure “job lock.” As economist Jonathan Gruber points out, “job lock” is bad for U.S. employers, who are often stuck with employees unwilling to leave a job that may not be the right fit for the employer or the employee. “Job lock” is also a roadblock on the potential of employees. “Some of tomorrow’s potential entrepreneurs are today’s employees at firms that provide health insurance,” Gruber says.

What’s more, he says, “job lock” makes America’s fluid labor markets less competitive internationally.

So what happens to the American Dream without health reform? Maybe it becomes a European Dream, as envisioned by this disillusioned guy.

The European Dream? Ouch.

According to a new poll published in yesterday’s New England Journal of Medicine and reported on National Public Radio, 63 percent of the nation’s doctors want health care reform to include a public option, while another 10 percent would go even further, endorsing a single-payer plan.

Dropping Medicare age requirements

Furthermore, nearly 60 percent of physicians asked favor dropping the age for Medicare to 55.

Current system unpopular with doctors

Only 27 percent would elect to keep America’s current for-profit private health insurance  system as is. The United States is the only industrialized nation that makes it legal for private for-profit companies to provide primary health care insurance. Many countries have a mix of public and private non-profit options.

The full report can be found here.