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David Shuster talked to Howard Dean about where the health care bill stands in the Senate right now and whether we should not be allowing four Senators to hold up that bill.

Shuster: First Sen. Brown’s position on the public option—your thoughts.

Dean: He’s exactly right. Sherrod’s been one of the real champions of getting real health insurance. Look, what Tom Carper’s doing is silly. A trigger and all this business and opt-out and opt-in and all that—this is silly. Harry Reid’s got a decent bill on the floor, decent, it’s not great but it’s decent—it needs to pass. If they can’t pass it without real insurance reform and there isn’t any in the bill right now to speak of, then they just should go home and use reconciliation which is what they should have done in the first place. To let four Senators hold up the works in addition to the Republicans that we know aren’t interested in health insurance is a silly way to run the business.

Shuster: You mentioned Sen. Carper and his proposal being silly. Are you referring to the actual content of the policy or the politics or both?

Dean: No look, Tom is a serious guy. He’s a good guy. I served with him when we were governors together. But his proposal isn’t health insurance reform. Triggers are not health insurance reform. They’re devices put in for the health insurance industry. You know what today came out? Aetna is going to drop 600,000 people from their insurance so they can make more money. Now why is it that these Senators can’t get it in their heads that putting money in the health insurance system that we have now doesn’t work? That’s not health care reform. Knock it off! Listen to Sherrod Brown. Listen to the 56 Senators who want to do the right thing in the Democratic Party. Stop grandstanding and get this done.

Dean added that he doesn't think Sen. Nelson will actually filibuster the bill and what this means for the midterm elections.

Dean: I think an awful lot of people like me are getting awfully impatient. I think this is going to hurt a lot of people’s reelections too. People…you know the Democratic base has been incredibly demoralized by all this and it’s not going to hurt President Obama. People like him. He’s going to get reelected. It’s going to kill us in 2010 if we don’t get this thing done. The 2009 gubernatorial elections were about taxes, jobs and about getting health insurance off the plate, passing it and then start to work on some of these things like jobs. And if we don’t do that we’re going to get ourselves in big trouble as a party. We have got to get our act together here. You can’t allow four Democratic Senators to hold up the works, particularly when they get their chairmanships because they caucus with the Democratic Party. It’s not fair and I don’t think it’s right.

From The Colbert Report:

Senator Max Baucus will pay for your medical bills from the $3.2 million he's received from the health care industry.

When in doubt, I turn to Chris Bowers. He didn't disappoint me - he had ready a step-by-step explanation of what needs to happen to get the public option in the bill sent to the Senate floor:

The bad news is that we learned today that the Senate Finance Committee will not report a public option in its version of health care reform. The good news is that we also learned today that there are 51 votes in favor of Schumer's public option. Here is how we get to 51:

1. Take the 47 "yes" votes from the Washington Independent public option scorecard.
2. Add Bill Nelson and Tom Carper, who both voted for Schumer's public option today;
3. Add Claire McCaskill (who voted for Kennedy's HELP public option back in May);
4. Add Joe Biden

Arguably, proving that there are 51 votes in favor of Schumer's public option is the bigger news. This is because everyone knew the public option would be defeated in committee, but claims that there were 51 votes in favor of a trigger-less public option were pretty much all based on a post I wrote two weeks ago.

Because Democrats are not going to pursue reconciliation for the public option (see why here), the next step in the process does not actually involve Kent Conrad's Budget Committee, as I had previously reported. Instead, a source on the Hill confirms to me that the Senate HELP and Senate Finance committees will be merged by an informal, behind the scenes process involving the four major players in the Senate: Tom Harkin (Chair of HELP), Max Baucus (Chair of Finance), Harry Reid (Majority Leader), and the White House. Together, these four will meet and decide what sort of bill to send to the Senate floor.

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So Senate Democrats on the Finance Committee offered an amendment that would enable the federal government to bargain for lower drug prices for their bulk purchasing, a direct assault on the White House/Big Pharma deal from a few months back. Basically it would shift poor seniors back onto Medicaid for their drug purchasing, where the government can negotiate discounts. This would save the government over $80 billion dollars.

And Tom Carper of Delaware defended the secret deal in the most amazing of ways:

I was not involved in negotiations with PhRMA but I believe that the administration was, obviously PhRMA was, and I presume this committee was involved in some way in those negotiations.

And what PhRMA agreed to do through those negotiations is to pay about
80 billion dollars over 10 years to help fill up half the donut hole. That's my understanding. And they are prepared to go forward and to honor that commitment. As I understand it, the commitment from our colleague Senator Nelson would basically double what was negotiated with PhRMA.

And whether you like PhRMA or not -- remember I talked earlier today in our opening statements, I talked about four core values, and one of those is the golden rule, treat other people the way I want to be treated?

I'll tell you -- if someone negotiated a deal with me and I agreed to put up say, 80 dollars or 80 million dollars or 80 billion dollars and then you came back and said to me a couple of weeks later -- no no, I know you agreed to do 80 billion and I know you were willing to help support through an advertising campaign this particular -- not even this particular bill, just the idea of generic health care reform? No, we're going to double -- we're going to double what you agreed in those negotiations to do. That's not the way -- that's not what I consider treating people the way I'd want to be treated.

That just doesn't seem right to me.

This is incredible. The deal is transparently one to protect drug industry profits. There's just no doubt about this. Carper is saying that it's more important to get a few generic ads in support of health care reform than to save the US taxpayers $80 billion dollars. Backroom deals must be honored even if they hurt people. That's the "golden rule" in Washington.

Did Carper not know that cameras were rolling when he said this?