In 1865 Lewis Carroll wrote a classic for children. However, the logic contained therein seems to be the basis for present political discourse.

A firestorm was kicked up this past weekend by comments from Obama and Kathleen Sibelius. Has his “requirement” of a public option itself become an option, a dispensable element of a plan he is willing to accept as a victory for reform?

Senator Conrad of North Dakota, a less than staunch supporter of the President, appointed himself head head counter. He told everyone that there are not enough votes for a public option. He claimed there never was.

Not counting a few who once declared for a public option but are now going the other way, there seems to be a fairly firm potential 54 to 55 votes for it in the Senate. There are certainly enough to filibuster its absence. The Senator, as senators are wont to do, forgot that there is another chamber of Congress.

New York Congressman Anthony Weiner came forward to remind everyone that there is a letter, signed by 57 members, that they will not vote for any bill that does not contain a strong public option. Seven others have said they fully concur. Only 40 of them need to stick to their guns. One should realize that almost all of these Congressmen are from overwhelmingly Democratic districts. Their position reflects the feelings of their constituents. They are unlikely to cave,

It just came over the ticker that the expected next president of the AFL-CIO is warning Democrats that, without a public option, the unions could sit out the next election cycle. The loss of their money and manpower could hurt lots of incumbent Democrats.

I am not alone in thinking that Obama will take anything he can get that can pass for reform. He seems to understand a failure to get any bill this year will mean large congressional gains for the Republicans in 2010 and jeopardize his chances in 2012.

It’s time for the Blue Dogs and other Democrats in Congress wake up and smell the Budweiser. They will give him a public option or he gets nothing and they return to the minority, or such a slim majority as to stalemate Congress.

Just what is this co-op plan that Conrad is touting? Basically, it is a sham. It would be organized on a state-by-state basis. At the claimed viability level of 500,000 members each, most states would not be able to sign up enough members. Credible actuaries, not politicians, expect fiscal viability to come at a much higher number.

These co-ops would require very large subsidies from the government for start-up costs. Most or all would be too small and have too limited financial resources to really compete with the private corporations, much less cause them to reduce prices.

Some of you may have heard of Blue Cross. They began in the deep, dark past as nonprofit co-ops. They have morphed into standard insurance companies. Some have actually been reorganized as for profit corporations. They could not survive purely as co-ops. The proposed co-ops are to be free from government control. In other words, there is nothing to stop them from following the Blue Cross path.

The Government Accounting Office (GAO) conducted a study of 5 co-ops in the year 2000. Their assessment was that the idea was essentially very much less than a success. As I stated earlier, co-ops are a sham. Those promoting them are at the top of recipients of health insurance lobbyists’ generosity. The insurance companies know that they don’t represent a danger to them, or even a low hurtle.

If you haven’t considered this one aspect of co-ops, you might give it a moment’s thought. Co-ops have more than a passing similarity to communes. The basic concept is the same. Make one of these Regressive’s head explode by connecting their support of co-ops to their support of communism. Then, just stand back and be entertained.

Regular readers know that my opinion of the proposed public options are almost negligibly more positive than of co-ops. They will not be open to everyone. They fail to address the problem of those who have an employer-paid plan if they change jobs. They will have to charge unnecessarily high premiums to allow the private plans to compete. This is a subsidy by public plan participants of the insurance companies’ profits and administrative costs.

Back to Alice and the logic she confronted in Wonderland. The Regressives were adamant that the taxpayer should not save the automobile industry. They were incompetent. They brought it on themselves. They deserved to be consigned to the junk heap of the “Free Market.” Though failing to take into account all of the relevant factors and oversimplifying an industry that generates about 10 percent of our economy, it was consistent with their flawed economic religion.

That position would seem to require them to render the same judgment on the health insurance industry. They are the ones primarily responsible for a far greater screw-up of their industry than the automobile moguls could hope to attain. This fiasco was achieved despite the myriad of government subsidies they have suckled on for decades.

The Regressive support of the health insurance industry is inconsistent with their proclaimed faith. Perhaps the failure of the automobile industry would destroy union jobs, unlike failure of the health insurance industry. I know that those driving the automobile industry are far less generous to politicians than is the health industry. They never came close to the level of six lobbyists for every congressman.

Where were all of those fiscally conservative Republicans and Blue Dogs when Medicare Part D passed? That program is more expensive than any of the plans proposed by the Democrats this time. They also forgot to enact any spending cuts to compensate for the costs of Part D.

Of course, if the Regressive religion is really based on the size of received donations, they are being imminently consistent.

As an added little morsel to think about, I offer this. Some are touting al-PhARMA’s putative contribution of $80 billion. Just remember that is only $8 billion a year for 10 years. Single-payer would save considerably more than $400 billion. By the way, that is almost $500 billion each year. The savings to be realized from permitting Medicare to negotiate with the drug companies also dwarf that puny little $80 billion.

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Someone recently asked me what the objections to single-payer are from those opposed. I’m glad they didn’t specify that it had to be rational objections. That would leave me searching for another topic.

My job was made somewhat easier by a column in the New York Times by Randy Cohen, former writer for David Letterman. Mr. Cohen suggests that Congress needs a Debate Umpire. He likens that position to a judge in a courtroom. The judge can rule and overrule to require participants to maintain certain standards as to logic, honesty and ethics. He assures that anyone using disingenuous arguments is called to task.

When it comes to trying to maintain the present system, or leach even more from us, the opponents of real reform have been most industrious in creating confusion, distortions, distractions and lies. I will paraphrase and take slight liberties in adapting his efforts to this post.

He addresses their objections to a public option. They say it would be unfair or destroy private options. That is not so with education. Private and parochial schools exist despite a public school option. The University of Tennessee has not driven Vanderbilt out of business.

FedEx, as he puts it, tolerates the U.S. Postal Service. He observes that no one is calling for closing down Yosemite because Six Flags is in bankruptcy court. Public libraries have not chased Barnes & Noble out of the mall.

Here I will simply quote Mr. Cohen, “In his critique of the public option, Representative Paul Ryan, a Republican from Wisconsin, invoked the inability of his 7-year-old daughter’s lemonade stand to compete with McDonald’s. (You’d think she’d thrive, incidentally, what with lemonade not being on the McDonald’s menu.) “It’s impossible to have a level playing field with a public plan,” Ryan said, asserting that private insurers could be driven out of business by the unfair competitive advantages enjoyed by a government-sponsored insurer.”

Further down, he writes, “In an op-ed for The Wall Street Journal, Karl Rove concluded: “If Democrats enact a public-option health-insurance program, America is on the way to becoming a European-style welfare state.” This is a slippery-slope argument, the sort of thing that should set off warning bells. If we impose a 65 miles-per-hour speed limit, we’re on the way to a 55 m.p.h. limit, then down to 5 m.p.h., and ultimately to mandatory driving in reverse.”

You shouldn’t be too surprised if a Congressman couldn’t come up with an appropriate analogy. Nor should it be a shock that the former political genius finds it more convenient to avoid logical arguments. The purpose of both was not to enlighten. Actually, neither were they seeking to debate. They were falling back on their mainstay – fear-mongering.

Some object to single-payer because it would mean the end of bribes. The government isn’t supposed to grease the palms of Congressmen. Others object because it would cause a major spill from their gravy train.

Then there are the true believers. They believe that government forced all those working for the Wall Street Casino to destroy the global economy. They believe that Halliburton-built showers in Iraq that electrocuted several of our troops were absolutely necessary to accomplishing the mission. They believe that Lockheed’s F-22 could fly in the rain if they were only allowed to sell us more of them. They believe that PhARMA, the AHA and the AHIP are being patriotic by forcing people into bankruptcy court and canceling 14,000 policies every day.

They believe that there is such a thing as a “free market.” They believe that a plutocracy is a democracy. They believe that the collusion of a few corporations is capitalism. They believe their simpleminded economic theology is more important than the lives and welfare of you and me and millions of others. Are you ready to die for their ignorance?

They claim that the government will ration healthcare. Unless lots more people start donating organs there will continue to be rationing of transplants regardless of who pays. I hope rationing means I don’t get a prescription for Nexium. I hope someone saves me from taking an ineffective, expensive, dangerous drug when Pepto-Bismol works better. I hope I don’t have some clerk in an insurance company rationing my healthcare because he wants to impress his boss or meet a quota. We have rationing. We will have rationing. The government is not going to ration care to increase profits or impress Wall Street.

Look at all of the lost jobs if we eliminate the health insurance companies. Two things. There will still be health insurance companies. They will be much smaller but people on Medicare buy medigap policies to cover the 20% that Medicare doesn’t. Those with enough money will be able to buy concierge service. They have that in the UK. It doesn’t improve the outcomes vis-a-vis the National Health Service but some people with money are willing to pay extra to feel that they are special.

Healthcare reform that provides universal coverage, or nearly so, will create far more jobs. These jobs will mostly be involved in caring for people rather than just taking their money. Not a single insurance company treats a single malady.

Whether public option, co-op, Aetna or any other plan, if it isn’t single-payer, it is not economically or fiscally viable. Each is a sham. Each is a diversion.

As I implied earlier, there are no real, honest, logical arguments in favor of any other option. Therefore, the opponents have put forth their efforts to attack single-payer and create fantasies about the plan that makes them wealthy, keeps them in office or assures them their 72 virginal Ayn Rand look-alikes in paradise.

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I‘ve written extensively about healthcare reform. Those postings are full of numbers, arguments, observations and such. If your Alzheimer’s is temporarily predominant and you need some refreshing of those details, read or reread some of those articles.

This post, based largely on those articles, is just to put all of the various options together in context in very simple terms. My intent is just to provide a bit of perspective and tie it all up with a neat little bow. It is the result of my desire to clean up before going to another topic.

I dearly want to cover other subjects but I am certain this is such an important issue I will not be able to stay away. Those greedy little brats in Washington will draw me back time and again to refute even more examples of their endless supply of inanities.

Not always but on occasion I feel glimmers of hope emanating from the President. In response to a question at today’s news conference Obama said, “If private insurers say that the marketplace provides the best quality health care . . . then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical.”

John Sheils, who is described as a healthcare costs guru, says, “The single most expensive option is to build on the existing system.” Perhaps I should have left it to John, rather than carry on at such length in my posts. It really is that simple.

Anyone who wants any reform plan other than a single-payer system is a charlatan or a dupe of charlatans. Well, lookie there. I can be concise too, though I’m unlikely to make a habit of it. Anyway, that statement may seem a mite harsh but it is just a simple, obvious truth. No apologies.

Let’s go through the various options quickly. Co-op has received support from some Republican Senators and some Blue Dog Democrats. Actuarially this is a joke. The numbers of people to be covered by each co-op would be too small. The plan calls for a host of these spread around the rural parts of the country. The costs would be higher than present plans.

There is no way to induce a sufficient number of primary care physicians and those from the main specialties to rural areas other than for the government to heavily subsidize them. The same is true for other services as well. It is intentionally designed to be small and inefficient. The healthcare industry formulated this and handed it to some of their allies in the Senate.

Public option came from the legislature. That doesn’t mean it is less beneficial to the industry. It serves as diversion. Every incarnation of a public option is said to be a way of keeping the industry honest. They also appear to require a “level playing field.”

Does anyone believe that it is possible to keep them honest? If they remain in business they will still own Congress.

Level playing field? Such nonsense would require unbelievable amounts of subsidies to the private plans to make it possible to offer competitive premiums. This means that the government would give them far more each year than the supposedly one-time loans to the auto industry. This means your tax money being given to the most profitable industry in the country to maintain their profits and inefficiencies.

The real problem with the public option is that politicians and great numbers of the public believe it is a viable option. It isn’t. It is no more possible to create a level playing field than it is to expect the healthcare industry to play fair. 0 for 2 for this sham.

The single-payer plan suffers from a probably fatal flaw. Since it would be run by the government there are no bribes. Congress is the greenest activity in our country, although activity may be a poor choice of words. Congressmen are powered solely by greenbacks. Single-payer would have a chance if someone could figure how to own a congressman for free.

My own suggestion is to break the reform legislation into two parts. The first part should be passed before the second part is written. The first part would require all Congressmen to participate in and rely exclusively on whatever plan results from the second part of the legislation.

The entire exercise of creating healthcare reform is perplexing. In my simpleminded way of thinking I thought most of the discussion should focus on developing a rational, affordable, efficient plan to make healthcare available to everyone. I obviously missed the point.

Reading the news has been enlightening. I now understand that all of the health insurance industry and drug industry employees who sit in the House and Senate have only one duty: to protect the profits of their employers. If only someone had told me. It would have saved me from so much embarrassment.

The thought crossed my mind that some readers, having watched the Congress operate, may think that I also have a financial stake in this issue. If so, it would be very indirect. I enjoy the benefits of what might be seen as a single-payer system. I have been on Medicare for a number of years.

Whatever the outcome of the attempt to reform the system, I expect it will have minimal effect on me, one way or another. I do see what an undue and unsustainable burden the present system is for the people, the economy, the business community, our international competitive position and our government.

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Where does the Congress stand on healthcare reform? Who knows?

Nancy Pelosi is the leader of the House of Representatives. She has a commanding edge of Democrats over Regressives. One would think that would give her more leeway than Senator Reid. She should be able to at least make a stab at formulating a rational reform plan. See, you thought you understood politics.

Salvador Dali may have understood what his art represented. Or, maybe not. Either way it isn’t always clear to every observer. I find we are in the same situation with regard to what Congress means. It is also fairly certain that Senor Dali had a firmer grasp of what he intended than does Congress.

Below are excerpts from Speaker Pelosi’s recent press conference. I removed those parts not related to healthcare. My comments have been interspersed at appropriate points to highlight errors, confusion and inanities in Nancy’s answers.

I should note that Chris Weigant sent me the transcript and suggested that I compose a post based on it. Chris is one of the few bloggers left on Huffington Post. He is also one of those special friends from the Internet that I someday hope to meet.

PELOSI: Health care reform will be part of how we address reducing the deficit. This and the point that real reform can make our industries more competitive are two points that need to be given far more emphasis.
Health care reform is entitlement reform, as the President so clearly states.

With that, I would be pleased to take any questions.

QUESTION: On health care, Madam Speaker?

PELOSI: Yes, ma’am.

QUESTION: There are bipartisan discussions in the Senate about an idea, looking at creating a privately run cooperative instead of a public option. I am just wondering what you think of the concept. And given the concerns among some of your moderate members about a public option, is this something you might be open to?
Co-op proposals are a sham put forward by the insurance corporations and their toadies. They are intended to be too small to be a problem for private plans. They cannot be made actuarially viable. It is an attempt to substitute uncompetitive plans for public options.

PELOSI: Not instead of a public option, no. In our Caucus, I think Members have been — I know that Members have been very clear about what their concerns might be about a public option. And I agree 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 of art we will be using, you have to say right next to it “level playing field.” But in our House, there is strong support for a public option, and great respect for the concerns that have been raised within our Caucus. And we will address them.
More shams. The complete inanities of a supposed “level playing field” and the overwhelming problems with all of the public options being floated in Congress are addressed in my last post, It Ain’t No Game.

QUESTION: Madam Speaker, on health care, given what you just described is going to be very complicated for people to understand, and given the experience that the Clinton health plan had, and then that we had with Medicare part D, with public worries and anxieties and confusion, what strategy are you going to follow to explain this massive bill to people? Because health care is people’s most — one of their most basic worries in life.
This is just one more reason to go to a single-payer system. Make it simple. Medicare should be expanded into Medicare-For-All. It has been around for more than 40 years. People generally find the concept understandable.

PELOSI: It sure is. It is a personal worry in terms of their health and well being. It is also an economic issue for them as well. And I always say everybody in the country is an expert on his or her health care and how to be able to afford it.
A comment such as this is patently untrue and is mere pandering.

We have our overarching message of affordability, accessibility, and quality that the President has put forth. In that framework, we will have the initiatives to help us meet those goals and are deeply rooted in those values.
This sounds good but you would be well-advised to take it with as much faith as politicians commonly deserve.
Right now, the bill is being considered, and I can only speak to the House. The three committees are working in unison, practically, with a unified staff. They will have something on the table in a week or two. Hopefully, most of it will already be scored, because at some point we have to know how much each element of it costs to see what we can afford and then how we pay for it. Because it will be paid for. And that challenge for us is to relate what we are doing here to the lives of the American people and how this makes a difference to them.
A single-payer system has such great cost advantages that it essentially pays for itself, even as it provides coverage for all of those presently uninsured and under-insured. It means that funding sources must be juggled. Some of what is now termed premiums would be called taxes. The total amount of premiums and taxes could remain the same or, given several possible refinements, actually be less than what our system presently costs.

But we are very excited about it, whether it is about prevention and wellness, which is the important part of it, investments in scientific research, that we can have personalized, customized care for all Americans, with investments in technology so that we have a common record for all people to be on it, whether it is investments in community health centers to reach out to achieve this, as many people being involved as possible, because that is hard, and community health centers will enable us to do that. Whether it is having the resources to have sufficient health care providers at every step of the way.

We will be able to explain the bill to the American people once it is — a mark comes forward, and then Congress will work its will, people will make suggestions (Except that suggestions of a single-payer system will continue to be ignored), and we will have a product that will meet the President’s values, meet the needs of the American people, be paid for, and make America healthier.

QUESTION: Madam Speaker, on health care and the public plan or government plan, whatever you want to call it, is it your belief that this is central, you know, an essential element of health care reform? Can you have effective health care reform without a public or government plan?

PELOSI: Well, let me say at the health summit the President was asked this question by Senator Grassley. You may have heard him. He said, “Don’t you think that having a public health plan is unfair in terms of competition with the private plans?” The President said, “I think a public option is a way to keep the private sector honest.” But, and we want to achieve what I just said, accessibility, quality, and affordability so that all Americans have access to quality health care. He then said if you have another way to do that, put it on the table. And that is where we are.
The majority of the President’s supporters, and many who continue to call themselves Republicans, are not being allowed to put single-payer on the table. So, that is where we really are, or aren’t.

Everything should be on the table. (Should be, but isn’t.) From our perspective here, though, there is strong support for a public option right from the start.
There is a problem in that public option is often thought to mean single-payer. They are not the same. The confusion is intentional.
And there is also full support for having it be a real competitor, not something that has an overwhelming advantage. Of course it is not for profit and it doesn’t advertise. So it doesn’t have some of the overhead that the private sector has.
Remember, to be a real competitor would require a public option to be priced artificially high in order not to significantly undercut private plans. This is to require those with a public plan to subsidize the private plans and the profits of the leeches that have put us in the position of desperately needing reform.

Already just the thought of having a public option has sort of eliminated words from the health insurance glossary of precondition, portability. Everybody seems to be subscribing to the idea that we shouldn’t have a precondition in order to get eliminating you for health insurance.
Eliminating denials due to preconditions is essential but will cause present private plans to become even more expensive.

So this is what we have come to do. Our three chairmen have asked that Chairman Dingell be the author of this bill. Every year since he has been here he has been the author of universal health care. Before that his father was. When he was a young Member of Congress in the ‘60s, he gaveled Medicare. He gaveled down (?) the Medicare bill. Very few Republican votes, by the way, on Medicare. Very few Republican votes.

So we have heard the same concerns before. But it is a pretty — as I say, this is the life work for many Members of Congress, and it certainly is the responsibility for all of us. This will happen. We told the President we would have a bill by the end of July, that it would be paid for, and that is the course of action we are on. And I commend our three chairmen, Chairman Rangel, Chairman Waxman, and Chairman George Miller , for working together, eliminating any turf challenges that occurred in the mid- or early ‘90s, 1993 or 1994, and to facilitate this improvement in the lives of the American people.

Thank you all very much.

One may think that much of what she says sounds good. Those are known as platitudes. They are also the reason for the confusion. Those platitudes must come face-to-face with the realities of the proposals to which the Congress and the President are limiting themselves, and us. They want reform without harming the health insurance and drug corporations. One or the other. Choose. We can’t have both.

For those naive enough to think that the corporations that caused this mess need to be guaranteed continued existence and unconscionable profits, email me with a list of all of those countries with a national health system who are conducting a national debate about swapping their system for one like ours.

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