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« Easley's man | Main | Oops, again »

Jan 21, 2010

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A. Bulluck

Is this not "change you can believe in?"

Account Deleted

I think the best plan is to not be "tone deaf" as Rep. Weiner said and go back to the drawing board.

1. Tort reform

2. Portability

3. Interstate competition

4. Listen to the providers of health services, not the lobbyists or the politicians.

Account Deleted

Oh yeah, how about no bribes to specific senators.

Tim

It really wouldn't have matter who won the seat. The healthcare bill would not have passed anyway with the democrats fighting among themselves over it.

Account Deleted

Lanny Davis had a sharp commentary in WSJ:

Bottom line: We liberals need to reclaim the Democratic Party with the New Democrat positions of Bill Clinton and the New Politics/bipartisan aspirations of Barack Obama—a party that is willing to meet half-way with conservatives and Republicans even if that means only step-by-step reforms on health care and other issues that do not necessarily involve big-government solutions.

Account Deleted

This one is good too:

To paraphrase Woody Allen, the Democrats have reached a fork in the road. One path leads to despair and utter hopelessness. The other, to total extinction. And they have put Nancy Pelosi and Harry Reid in charge of the map and compass.

Spag

Aw Sykes, you know they can't consider those Republican ideas. What would be bipartisan about that? No, Obama's idea of bipartisanship is to tell the GOP what Democrats are going to do and say "take it or leave it". Most politicians from both sides are like that when they have power, but Obama was supposed to be different, a real uniter, partisanship was to be a thing of the past.

Perhaps if Democrats had actually considered some GOP ideas, they wouldn't be in the mess they are in now. It was just much easier to call them "obstructionists" for not going along.

Jim Caserta

From this statement: "what seems unmistakably clear is that the White House is taking an extremely hands off approach to the whole situation.", I don't see how one could blame Obama.

Jeff, one of the biggest things, also not in your list, is the elimination of deniability due to pre-existing conditions. But, if you legislate that, you really need to mandate everyone getting coverage or else you get people waiting until they're sick before buying insurance. Then you've got people who can't afford it, so the plan would need some subsidies. That takes you close to the Massachusetts plan - something the new senator voted for.

I would also like to see exchanges or some way for people who today are buying individual policies to join into groups. Polls show that most people like their health insurance. I would imagine that most of the people happiest with their coverage are either on Medicare or covered through their jobs. Why do people like employer based insurance? Because of the flat rates across employees, and coverage is available to everyone. What Obama needs to do is to say, we're going to take the things you like about employer sponsored coverage and copy them over to the non-employer based insurance market to fix the things that we (republicans included) don't like about those markets.

I find it interesting that you list tort reform, but not the more general issue I have shorthanded the McAllen problem. The fact that some areas of the country pay 2-3 times as much for maybe equal or often inferior care. That is a more complicated issue, but one that could be initially dealt with entirely through the Medicare payment system. People often say that a proposal will be to cut reimbursement rates, but that is not the problem. The docs from the article will just churn out more procedures. The proposal will be to not pay for something that is not indicated by best practices. Hospital A always takes the expensive approach, while the Mayo clinic always takes a much cheaper approach, guess for yourself which one gets better outcomes at lower costs. Check the physician's response about the impact of malpractice on costs in that article also.

Another point is that we already pay for care for the uninsured. They go to ER's and receive charitable care - something Baptist hospital reported a 68% increase in for 2009. We already have a system people use to deal with catastrophic medical bills - the bankruptcy court. Wouldn't a system where people go to walk in clinics instead of ER's (walk-ins get paid or no service) and catastrophic bills went through insurance instead of bankruptcy court?

Think of how conservatives have responded to health care reform. Scare tactics about death panels, talk of government takeovers of medicine. Are those really signs that someone wants an honest debate? The farthest right 30 or so senators will not vote for any health care reform proposed by democrats, so I feel negotiating with them is a waste. Dems did try to talk to the most centrist Republicans, but it probably ended up seeming like it wouldn't matter what they changed, they wouldn't vote for it either. Obama needed to clearly spell out what he wanted in simple terms, and the legislation should not have frankensteined into the monster that it is. I don't think a hands-off approach by the White House now is the best plan.

Jim Caserta

For the first line above append, "blame Obama for the negotiating tactics of Congressional Democrats." He could get blame for not providing enough leadership towards health care reform.

cheripickr


Jeff:
"1. Tort reform

2. Portability

3. Interstate competition

4. Listen to the providers of health services, not the lobbyists or the politicians.

5. Eliminate pre-existing conditions and a plan being able to drop you when you become too expensive(Jim)
"

Routinely met with blank stares and ignored by the left, so they can continue to brand "the party of no" and claim they have no plan, and are pure obstructionists simply because the left doesn't want any debate about these alternate solutions, which might have risked being more appealing than single-payor turned public option turned dead bill.

So instead we have a dead bill.

Account Deleted

Jim: I am not philosophically opposed to universal coverage, but in practicality I am opposed to deficit spending and more bureaucracy. I am also opposed to omnibus bills that are 2700 pages long and include bribes to specific senators.

If they can break reform down to one piece at a time that normal people can understand, I think they would garner more support.

I spent 2006-08 agreeing with Democrats that deficit spending was a bad policy and I actually at times believed the current president's campaign lines about balancing the budget.

In my opinion, nothing is more important than a sound economy and a balanced budget. I stand opposed to any more social welfare programs until such time as we can pay for it.

As for the current president's leadership, I wanted to bring those articles to the table because I enjoy reading both sides of the argument. I know my beliefs, but I make sure to listen to the other side to have a balanced view.

I think it is clear that the current president did not want to make the mistakes that WJC made. As Ed's post title indicates, political success requires tactics and strategy.

The "let Congress lead" strategy has failed. I think that if the American people wanted the type of HCR being proposed then they would speak out about it and demand their elected officials support it.

Most of all, we must remember that this country belongs to each of us as individuals, not to right-wing or left-wing activists.

greensboro transplant

"1. Tort reform

2. Portability

3. Interstate competition

4. Listen to the providers of health services, not the lobbyists or the politicians.

5. Eliminate pre-existing conditions and a plan being able to drop you when you become too expensive(Jim)
"

i think the republicans would jump on that. but it would help the system and therefore weaken the case for single payer. so, i think the opposition would come from the left.

Bubba

".....but it would help the system and therefore weaken the case for single payer. so, i think the opposition would come from the left."

Don't you know that this whole sorry mess has been one long episode of "'Progressives' Know Best"?

Jim Caserta

Jeff/CP, I tried to highlight why you can't do #5 without mandating everyone get insurance. At that point you need some subsidy. Krugman refers to this as the one legged stool.

CP - I wish I could magically eliminate pre-existing conditions...I know what you mean, just liked the way it sounds written like that.

Tort reform needs to be matched with better malpractice reporting. Not all malpractice results in suits, and not all suits are in cases of malpractice. There are states that have enacted tort-reform, and it has not caused the reduction in overall health care costs that some claim it would. It (TR) is good for MDs though, which in itself positive.

Obama should have recruited Romney to help work on this. Obama's goal was something akin to the MA plan, and afaik Romney is available. Now, would Romney have helped craft a plan? If not, why not?

Jim Caserta

I think a lot of people don't understand the HCR proposed. Calculus is what it is, but having a good teacher explain it versus having someone who doesn't really understand it, makes a huge difference in what you think of it.

Lots of people are also happy with how the system works for them...today. What should be highlighted is that You Do Not (really) Have Health Insurance.

If, like most people, your health coverage is through your employer or your spouse’s employer, that is not what you have. At some point in the future, you will get sick and need expensive health care. What are some of the things that could happen between now and then?

* Your company could drop its health plan. According to the U.S. Census Bureau (see Table HIA-1), the percentage of the population covered by employer-based health insurance has fallen every year since 2000, from 64.2% to 59.3%.*
* You could lose your job. I don’t think I need to tell anyone what the unemployment rate is these days.**
* You could voluntarily leave your job, for example because you have to move to take care of an elderly relative.
* You could get divorced from the spouse you depend on for health coverage.

For all of these reasons, you can’t count on your health insurer being there when you need it. That’s not insurance; that’s employer-subsidized health care for the duration of your employment.

You also need to explain how reform would make the overall system stronger, which while possibly not improving your situation, can be viewed positively.

justcorbly

Jeffrey, I have no objection to the four planks you list upthread. I think their impact would rather innocuous and marginal, even the right's tort reform totem.

I want universal health care. Not because I'm a Crazed Socialist, but because I want everyone to get the care they need. As I've explained at length here before, a system based on for-profit companies cannot deliver that, even if owned and operated by angels.

People on my side of the fence need to stop focusing on the machinations inside the beltway and start taking our case to the people in a coherent long-term way. If we really do believe, as millions of us do, that an ascendant right means disaster for this country at home and abroad, if we really believe that the conservative agenda will ruin the lives of tens of millions of Americans, we need at all costs to avoid Clintonesque compromises. If Obama chooses that path, then he chooses to abandon his base. We will not support a Democratic party that takes that path.

Lex

Tort reform, though certainly welcome, would indeed provide negligible benefit -- the equivalent of about a nickel on a $24 dinner tab -- and there are more effective and efficient ways to achieve the desired results than just capping damages. More here. (Also, capping damages would have no effect on the biggest single driver of malpractice-insurance premiums, which is the performance of the insurers' own investments, not anything that policyholders do or control.)

Much bigger impacts on the cost of health care could be achieved by comprehensive research into actual and comparative effectiveness. We spend roughly $800B a year on health care approaches, out of $2.4T on health care total, that lack any scientific basis for believing they're effective at all, or more effective than other, cheaper approaches.

Jim Caserta

Corbly - I, to some degree, understand your frustration, but I don't think your tactics could build a coalition large enough to get legislation passed. One major obstacle to getting reform done is that most people think the system is acceptable as it stands now, and (1) for them, (2) today, it is. However, shouldn't we know better that a system that appears to be working for me, today, might be extremely unstable?

How different is the guy who's 55, has good group coverage today through his job, but is uninsurable due to pre-existing conditions, then loses his job, from the person who took out a subprime option-arm assuming they'd be able to refi into a better loan after their home appreciated 20% like it did last year? I know the analogy has faults, but because a system is 'working' today does not mean it will work tomorrow.

There are ways to get people to look at things that will be more effective than claiming that their ideology will cause disaster. I didn't see anyone comment on my raising vs. lowering medicare eligibility age, making the insurance market more like employer-sponsored group coverage or the individual market. I think the medicare buy-in for those over 60 would have had popular support..."8. Do you think the government should or should not expand Medicare to cover people between the ages of 55 and 64 who do not have health insurance? Do you feel that way strongly or somewhat?"And 63% say it should. Suprisingly, in 2006, support was 75%

cheripickr

"The fact that doctors push patients toward diagnostics and treatments in which they have a financial interest is a far bigger driver than all malpractice-associated costs."

Source for this "fact" please, other than the link to your own blog comment. There are all kinds of bewildering Stark laws which limit that effect. Believe me, I know.

And you totally ignore the effect of fear of outrageous lawsuits and awards incenting defensive medicine and excess spending on diagnostics out of fear of missing something, however small the odds. I guarantee this drives costs higher than that which you perceive doctors deliberately misspend just to fatten their own pockets.

"Much bigger impacts on the cost of health care could be achieved by comprehensive research into actual and comparative effectiveness.We spend roughly $800B a year on health care approaches, out of $2.4T on health care total, that lack any scientific basis for believing they're effective at all, or more effective than other, cheaper approaches."

You make it sound like some novel concept, as if no such research has ever been done. And what would be the cost of the "comprehensive" research required to make all the difference compared to the cumulative body of research to date? I would like to see your source or breakdown of your $800 billion claim on unproven treatments. I'm suspect a significant portion of them are not FDA-approved or otherwise not covered by insurance.

Although the drivers you mention are real and significant, your preconceived conclusions and self-serving selectivity of your arguments is obvious.

Roch101

"Source for this "fact" please, other than the link to your own blog comment." -- CP

A+

Spag

Lex is conflating his argument, using figures that only reflect what the government might expect to save in terms of federal spending while ignoring the effect that tort reform would have on costs to the consumer.

He also offers no cite for his figures beyond the deficit projections, but this is Lex so that isn't surprising.

Next, he'll probably email Ed and ask him to delete this comment.

Spag

Sorry CP, missed your comment that made the same point.

Ed Cone

This much-discussed article is not definitive on the comparison of test-pushing and malpractice costs across the system, but it does make a strong suggestive argument based on data from McAllen and elsewhere.

Spag

No it doesn't Ed. It proves only that some doctors in Texas overcharge. It has nothing to do with malpractice reform.

justcorbly

>>One major obstacle to getting reform done is that most people think the system is acceptable

Jim, if you mean our political system in its entirety, I’ll disagree. Fewer and fewer people have confidence in it.

If you mean our health care system, I’ll agree, sort of. The costs of care and insurance continue to rise. It isn’t unknown for run-of-the-mill middle class suburban types to pay more in health insurance premiums than in mortgage payments.

I’d also question any assumption that the 40 million or so that lack health insurance think the system is acceptable. Even if they do, and are content with running to the ER or ignoring their problems, that kind of behavior imposes a cost on society.

>>How different is the guy who's 55, has good group coverage today through his job, but is uninsurable due to pre-existing conditions, then loses his job, from the person who took out a subprime option-arm assuming they'd be able to refi into a better loan after their home appreciated 20% like it did last year?

There are some differences. If a person loses a job and health insurance through no fault of his own, and can’t get insurance because of a pre-existing condition, then the health care system is responsible for his lack of coverage.

On the other hand, information was at hand about the risks of a subprime loan that someone might have pondered. I know most people have no real understanding of or interest in economics or finance, but the possibility of learning something did exist.

>>There are ways to get people to look at things that will be more effective than claiming that their ideology will cause disaster.

I will admit that is true. But, to be honest, I really don’t think there’s been much evidence of a conservative willingness to consider alternative ideas in the last year. It would be hard work to convince me that the current GOP in Congress will not vote as a bloc against any reform legislation offered by Democrats. I know they say they are open to compromise, but, frankly, I don't believe them. I think they want GOP planks adopted wholesale in the name of compromise.

That said, I’m fine with lowering the Medicare eligibility age. I’m pretty much on board with anything that brings health care to more people. If the private sector does that, fine. If the government does that, fine.

My concerns about health care corporations, and corporations in general, are really not very ideological. I think our modern technological society needs and demands goods and services provided on a scale that only large multinational corporations can provide. I also think we need government to control and regulate those corporations to ensure the immense power and wealth inherent in their operation is not used to abuse people. i believe powerful corporations can distort and influence the behavior of the market, and of consumers, to a degree that renders faith in conventional free market ideas rather naive.

In addition, I believe it is a fact that for-profit institutions cannot solve society’s problems if there is no profit in it.

bubba

"People on my side of the fence need to stop focusing on the machinations inside the beltway and start taking our case to the people in a coherent long-term way."


Like the approach that resulted in the Manufactured Empty Suit Situation we are currently enduring, and the undeniable reaction to same in recent Viginia, New Jersey, and Massachusetts elections?

Spag

You have him there, Bubba. If he can't see by now that the case taken to the people by his ilk has been rejected over and over, he never will. Let him and his Left wing extremists drive themselves over the cliff.

I think there is some free space in Antarctica where they don't have to worry about global warming and can start their own country to build the liberal utopia that Americans reject.

bubba

"I think there is some free space in Antarctica where they don't have to worry about global warming and can start their own country to build the liberal utopia that Americans reject."

Let's cede the Moon and Mars to them. Many of them have always been members of the Space Cadet Corps.

justcorbly

Bubba and Spag, you two are eating your own lies and name-calling propaganda.

The approach I seek hasn't been tried. We endured Clinton's trianguation and that failed. Obama is not a progessive and does not represent my views. Your views o what I should do are unwelcome and insulting.

It's natural that you think my views are extremist or "utopian" (I assume you learned that word from recent talk radio) because you and your ilk are basically fascists. You don't believe indemocaracy and freedom. You believe in power, wealth, and, as Brandon put it, "white culture". At heart, you are liars and self-decievers.

I know I told CP I'd refrain from wallowing in the dirt with people like you, but you really do give his part of the country a bad odor.

if you can't participate in a discussion with comments that have at least an inkling of substance, if you can't avoid engaging in cheap personal slurs and attacks, then please, just STFU! There are real adults in the room, and we are tired of wiping the crap off of our feet.

Beelzebubba

i knew this was going to happen.

Jim Caserta

For those that think malpractice reform will dramatically reduce costs, the case of McAllen is instructive. TX has instituted most of the malpractice reforms people want, yet McAllen still has costs that are well above average. CP, have you read the New Yorker article by Gawande? He is a surgeon, and the article is well researched. Excerpt:

“Maybe the service is better here,” the cardiologist suggested. People can be seen faster and get their tests more readily, he said.
Others were skeptical. “I don’t think that explains the costs he’s talking about,” the general surgeon said.
“It’s malpractice,” a family physician who had practiced here for thirty-three years said.
“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.
That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?
“Practically to zero,” the cardiologist admitted.
“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

As another example, the ACR's (American College of Radiology) stance on self-referral.

In its advocacy of HR 2962, the ACR noted that:
-The over utilization of imaging services through the practice of self-referral places a burden on an already cash strapped Medicare system.
-Independent studies estimate that reducing unnecessary exams by self-referrers can generate between $500 million and $1.5 billion in savings to Medicare, annually

I've commented the McAllen article at least 3 or 4 times, and Ed had a post on it, so I don't imagine that anyone will actually read it because of this comment. For more, the cost conundrum redux.

Bubba

"....and we are tired of wiping the crap off of our feet."

In that's a problem, perhaps those "real adults" should try wearing diapers, particularly when they're standing.

justcorbly

>>i knew this was going to happen.

Beezle, anyone who spends time here knows I'm more than happy to take part in a rational and civil discussion with anyone who doesn't insult or slander me.

But, I no longer have the patience to deal with, frankly, Freeper vermin.

If anyone wonders why I fear conservatives, they should look at the behavior of some of the conservatives who post here. We don't even need to consider their political positions. There personal behavior says it all.

Bubba

Meanwhile, the news for corb and his "real adult" crowd isn't getting any better.

What lesson do these two passages from the link teach you,corbs?

"Sixty-one percent (61%) of U.S. voters say Congress should drop health care reform and focus on more immediate ways to improve the economy and create jobs."

...and:

"Sixty-one percent (61%) of Democrats say the Obama administration should keep pushing health care reform. Eighty-four percent (84%) of GOP voters and 63% of unaffiliateds think the White House should wait until the economy gets better."

justcorbly

Bubba, is there any reason I should care what you, or anyone in any poll you choose to cite, have to say? i'm only interested in what I believe.

Of course, you won't answer that question. You never do. You're a coward.

bubba

"....i'm only interested in what I believe," he says, stating what everyone else has long known.

justcorbly

Everyone hear the coward barking?

Maybe he's just a software program geared to parse language and throw out random insults. After all, he always avoids any questions.

Too bad Ed's rather nice site has been infested with these diseased minds.

bubba

"Everyone hear the coward barking?

Maybe he's just a software program geared to parse language and throw out random insults. After all, he always avoids any questions.

Too bad Ed's rather nice site has been infested with these diseased minds."

You do a great Roch imitation, corbs.

Next, do Ed, or even better, Connie Mack.


Spag

Bubba, you have to ignore that guy. He probably has some psychological issues or social disorder like so many other angry Leftists that isn't being properly treated.

Ed Cone

Gawande's article on McAllen is only about a few doctors in Texas in much the same way Moby-Dick is only about a fishing trip.

While it is not offered as a final answer on the relative impact of malpractice costs and excessive services across the system, it does offer a serious look at the problems, and also goes far beyond McAllen in its investigation of pricing and pay.

This exchange from the article was interesting:

“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

Jim Caserta

Did you see my comment from 9pm last night? Same exchange. Probably much better to hear in person.

justcorbly

Dumb and Dumber, back with slurs and slanders. People who have nothing of substance to contribute. Somone states an opinion and they start calling him names.

Typical trolling and bullying from Freeper vermin.

Spag

Ed, the passage has nothing to do with the effects of actual malpractice reform. I think the clear reading is that a few doctors in Texas offered insurance costs as an excuse for their high charges when the real reason was profit. That's not an argument against tort reform, its an argument against padding fees.

Ed Cone

It's a long, serious article, presented as part of a larger, ongoing discussion.

People here have pulled out quotes to draw others into Gawande's well-researched work, which goes far beyond a few doctors in Texas.

One need not agree with Gawande's conclusions, but to dismiss the article as simply an argument against padding fees is to opt out of that larger, ongoing discussion.

He discusses costs, high and low, at numerous institutions across the country, and under various payment scenarios. And he does consider malpractice costs -- they are not his major focus, because he does not find them to be the most important element in the equation.

Andrew Brod

Ed, the health-economics literature generally agrees that malpractice costs are a small part of why U.S. healthcare costs are so high. There is indeed evidence that doctors practice "defensive medicine" but not much evidence that it drives costs overall.

As a result, tort reform is really a red herring in this debate. Mind you, this isn't to say that tort reform isn't a good idea. There are numerous reforms that make sense, such as no longer paying punitive damages to plaintiffs, whose actual damages are already compensated. (Punitive damages could instead go to a victim's fund or something like that.) More comprehensively, moving toward a no-fault tort system should also be considered.

In contrast, capping damages for pain and suffering seems unfair to me, but regardless of my opinion, the economics literature shows that you get more cost-reducing bang out of reforms that make lawsuits less likely than from reforms that cap damages.

In any case, yes indeed, let's do tort reform. But let's not pretend that it's going to do much about the 800-pound gorilla in the room, namely the sad fact that the U.S. spends much more on health care than all other industrialized countries but gets significantly worse outcomes on the whole.

Jim Caserta

You can go back up to my comment from a couple days ago - "It (TortRreform) is good for MDs though, which in itself positive." BUT, it won't have the impact on overall health expenses. Ignoring the "effect that tort reform would have on costs to the consumer." How about ignoring the evidence that tort reform will not bring the cost savings some claim? TX has enacted tort reform, what impact has that had on their health costs?

Also to those that want tort reform, there are a large percentage of instances of malpractice that don't result in a lawsuit. Those drive health care costs up also, because the mess can often be much more expensive to fix than the original procedure. Very rarely do those who are most adamant about tort reform also talk about reforming the malpractice reporting mechanism.

Politically, how many votes would adding tort reform into HCR really bring?

Ed Cone

Andrew, exactly.

We all want a fair, reasonable tort system that protects patients without over-burdening doctors and serving as an ATM for lawyers.

But when Gawande went searching for the reasons for high medical costs, he moved past torts quickly. And that jibes with other research.

Returning to tort reform as the central focus when the subject is medical costs is essentially changing the subject. It's not an unworthy topic, and it has a place in the cost debate, but it just doesn't seem to deserve headline status.

Spag

What "other research"? He went to one city in Texas. Why not talk to actual doctors here about how insurance affects their costs?

Ed Cone

Dorothy Parker was right about horticulture.

cheripickr

The lawyer promotes tort reform while the doctor's son downplays it. Maybe we're all semi-objective after all.

Here's one purely political take on it. From what I'm hearing here, no liberal is making a big argument against it, rather claiming it's just not going to make much of a dent in health care costs. However, it is a cornerstone of most GOP reform platforms. Dems rightfully accuse repubs of being obstructionists. Repubs rightly accuse dems of leaving them out of the process and ignoring their ideas.

The whole thing is threatening to collapse by ONE VOTE. If tort reform is not outright antithetical to the dems, and they see no great HARM coming from it, why not throw the dogs that bone, neutralizing the "no bipartisanship", argument, clearly shifting the burden of proof against obtructionism back onto the Republicans in the public's eye, if that olive branch doesn't sway some votes. Seems like a brilliant maneuver for bagging the big prize with little risk that wouldn't directly clash with the dems' other main objectives.

I suspect it is because (A). it would be popular and/or really would cut costs and thus potentially legitize or create momentum for other GOP elements, but more likely (B). The dems are too bought and paid for by the trial lawyers for it to ever happen. Too bad for them.

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