John seems to be burned out from all craziness, so I’m going to continue with my rant against those who say that if Democrats were Republicans they would have rammed their health care bill through, the same way that legendary Senate leader Bill Frist rammed immigration reform, Social Security privatization, and drilling in ANWR through.
The reason I don’t like the myth of the omnipotent Republican majority is that it reminds me an awful lot of the myth of super-terrorist. Let’s face it: these unstoppable Republican political leaders of yore are cut from the same cloth as the America-hating geniuses who will bust out of that prison in Illinois and roam the country detonating suitcase nukes. And that cloth is paranoia about “the enemy”.
Did Bush ram his war resolution through the Senate? Sure, but our whole system is set up to make war seem appealing. We have “news” networks that get better ratings during wars, foreign policy think tanks that are funded by defense contractors, just war “philosophies” that (I recently learned) even liberal bloggers are not allowed to mock. And tax cuts have a similar array of wealthy interests, hacks for hire, and pseudointellectual whack-a-doodle behind them.
Health care reform has a similar array of forces opposing it. Even the great Bill Frist would have trouble getting something reasonable through, trust me.
None of this is to say that the health care bill we get won’t suck or that a better a health care bill wouldn’t be smart politics. In fairness to the Hamsheristas, they were right about Joe Lieberman, right about how things would go down in the Senate, right that a bill with a public option would be better, both politically and in terms of reforming the system.
But all this DEMS ARE TEH SHITTIEST PARTY EVAH stuff is crap. And to the extent that Democrats are a shitty party, it’s because they share Republicans’ fealty to corporate interests, not because they lack Republicans’ super-human ability to pass legislation.
aimai
Its not an “either/or” its an “and/also.” If I have to hear one more time about the Democrats “big tent” and how we “aren’t like the lockstep Republicans” I think I’ll vomit. Here’s a big difference between the two parties–the center/right “Rockefeller Republicans” were run right out of the party,a nd the ones that remain (Collins and Snowe) know that their concerns and ideas will never be given the slightest respect or aid within their own party. They are reduced to sniffing around the dems for some love.
On our side the fringe rightist elements within our caucus are given all the power and all the attention. This is stupid. Yes, support the Landrieus, Nelsons, Baucus’s et al when it comes time to get them elected. Yes, let them vote the way they want on important legislation if they can’t figure out how to sell good legislation to their stupid right wing populace. But never, ever, ever, allow them to achieve important posts inside the party and never allow them to deviate from the strict party line when it comes to tv discussions or cloture votes. Just don’t.
There was a lot of caterwauling on the left when Bush and his Majority leader held open a vote, illegally, for an extra 45 minutes of begging, pleading, and bribery. I thought it was great. Look, if you want to get something done using prima donnas, soreheads, and idiots and you need their votes *buy their fucking votes* or *scare their fucking votes*. If you don’t want to get something done, just hold a series of polite tea parties and radio addresses and leave it all up to chance. Its that simple.
aimai
The Republic of Stupidity
And this is HEAVEN for the righties… I’ve been hoppin’ around on the Intertubes, and people of all different races, creeds, and levels of IQ are LIVID about this bill, and they’re blaming the Dems… I am truly afraid this ‘debacle’ will turn into many, many Congressional seats changing colors in 2010, from blue to red… not that I’m all that loyal of a Dem anymore… I just cain’t stomach the idea of the same Superassclowns who dug such a wonderful hole for us all from 2001 to 2009 taking over again… and I’m amazed their imbecilic backers would be so enthusiastic about putting them there and somehow, magically, expecting them to ‘do better’…
What’s that old definition of insanity?
Robin G.
I’d like to say that I love love love the “Manic Progressive” tag. Love.
I think everyone will calm down pretty soon, more or less. It’s just so fucking infuriating to be knifed by Lieberman and not be able to do anything about it, at least at the moment. It harkens back to the old days of 2006, when all the establishment told the progressives that, oh, no, Lieberman’s gotta be supported! Stop all the Lamont foolishness! Good ol’ Joe’s one of us!
I’m angry about the mess HCR has become, but a lot of the bile I currently feel is old, festering bitterness and anger over the fact that we tried to get rid of Lieberman, failed (with no small help from the establishment), and look where we are now. That’s what makes me see red. I’m able to take a deep breath and see that a lot of my intrinsic emotional meltdown comes from that, but I think there’s a lot of progressives who’re at the same place, but don’t realize it yet, because they’re just too angry for self-reflection.
Give it time, and some alcohol, and I really do think people will start to sort themselves out. Not that the anger will stop, but it will be more sensibly directed, rather than blind emotional flailing.
Shygetz
I think that you can make a very valid argument that the Democratic Party does suffer in comparison to the Republican Party it it’s ability (or will) to move the Overton Window in the desired direction. For example, Bush went out and pushed a wholesale privatization of Social Security, which resulted in a debate on SS “reform” that is still going on today. On the Democratic side, we have yet to have a serious debate on single payer health care reform, or an NHS-style plan. Which means that, if/when we go to push health care reform further, we will have to start all over again prepping the soil for the debate. Democratic leadership is just not willing to go out on a limb to push the debate left, while Republicans are eager to push the debate right and settle somewhere in the middle.
JenJen
There was actually a very, very good discussion on “Morning Joe” today, with Howard Dean, Ed Schultz, Arianna Huffington and David Axelrod all making appearances.
It remains frustrating to me that Arianna, especially, seems more than willing to cast herself in the role of Manic-Progressive Spokesperson, and that Schultz seemed to agree with Peggy Noonan (!) that the Democrats just don’t have the moxie to push stuff through the way the mythical, omnipotent GOP does. Hell, Nooners even defended LBJ, that’s how bad it’s gotten, and that’s how much GOPers like her are licking their chops at this narrative.
ETA: Were the Hamsherites right about Lieberman, though? Remember a month or so ago, when Reid decided to put the public option in the base bill… didn’t the WH say something to the effect of “I hope you guys know what you’re doing”? Did Reid ever have the votes? Was the WH really unaware that the road to 60 would go through Lieberman? That’s hard for me to believe.
DougJ
There was a lot of caterwauling on the left when Bush and his Majority leader held open a vote, illegally, for an extra 45 minutes of begging, pleading, and bribery
Wasn’t that in the House?
Hunter Gathers
It’s comforting to know that the left has gone full metal teabagger. Wake me when it’s X-mas.
DougJ
I think that you can make a very valid argument that the Democratic Party does suffer in comparison to the Republican Party it it’s ability (or will) to move the Overton Window in the desired direction.
I agree. That’s what comes of owning think tanks and a good chunk of the media.
Incertus
This. It feels to me like somewhere along the way, Democrats bought into the idea that the best way to protect Senators in tough states would be to give them important posts so they could bring home the pork. But you don’t need a Chair to do that–you just need a Senate that knows how to take care of its own.
General Winfield Stuck
I am burned out on the crazy also and need to take a break. But please dougj, add me as a cosponser to your ongoing rant on this topic.
Hunter Gathers
@DougJ: That was in the House. They woke up Bush and passed the cell phone they were talking to him on like a spliff. He guaranteed goodies for the home districts the fence-sitters resided in.
nutellaontoast
Your main point is right but it is also at least somewhat true that Dem’s lack “resolve” (ugh, saying that makes me feel dirty) to get shit done. They are at least somewhat scared of a backlash from our “center-right” nation.
I mean, the Reps didn’t have 59 senators for those initiatives, did they?
Noonan
For the win
I continue to be impressed at the ability of Hamsher and Kos to pass themselves off as hardened realists and at the same time go nuts when when the totally expected happens.
dr. bloor
The Republicans didn’t pass all that legislation because they had some Jedi-like powers over their caucus members (although they did a better job with Chafee, Snowe, Collins and Specter than the Dems do with Nelson, Lincoln et al). The reason we got shit like Justice Sam Alito is because Harry Reid had a fetish about keeping his powder dry.
Kennedy
DougJ – I don’t think it’s about the myth of an “omnipotent Republican majority.” I think a lot of people whining about how Democrats are teh suck refer to the fact that the GOP makes damn sure that their members toe the party line when it comes to major legislative initiatives. That can be a double-edged sword (see how they aim to purge moderates), but ultimately, the notion is that Republicans don’t tolerate fuckups like Nelson whining for attention or concessions in order to secure their vote.
I have been one of those people that wishes that Reid could do a better job of keeping his caucus in line. The idea of a Republican well-oiled congressional machine probably bears validating, because in the age of the 24 hour news gibberish, this could very well be another one of those preconceived memes.
Noonan
@nutellaontoast: It’s not just a backlash from the “center-right.” It’s pissing off corporate interests and giving the media an opportunity to attack their Big Government terror spree.
swellsman
Look, forget about whether the Dems are the worst party evah or what. But, what, exactly, is the victory that is going to be proclaimed if the dregs now being debated in the Senate are going to become the law?
As I understand it, the problem isn’t with our health care, it’s with Americans’ lack of access to health care — which is provided almost exclusive through private insurance companies. Too many people can’t get health insurance because they have a “pre-existing condition.” Too many who otherwise qualify for health insurance can’t afford it. Too many people who can scrape together enough for health insurance find out that when they get sick, they get dropped (“Sorry you developed leukemia at 40 — after paying premiums for 20 years — but you failed to disclose that when you were 13 you took steroids for an acne problem. Rescission!”). Too many people who have health insurance, get sick, and don’t get dropped find out that what they have isn’t covered (maternity care is great for this) or that they can’t afford the deductibles and co-pays. Etc. Etc. Etc.
Liberals recognize that a single-payer system makes the most sense, but pragmatically realize you really can’t destroy overnight an industry that makes up so much our our economy. So that’s out, but what do we get instead?
Will Congress get rid of the antitrust exemption, so that health insurance companies will be forced to compete against themselves to provide better service and lower prices (the way the “free market” is supposed to work)?
No.
Will Congress create a non-profit, governmentally run insurance system against which these monopolies will be forced to compete . . . even if only a small percentage of the population will be allowed to take advantage of it?
No.
Can we get, say, an “opt-out” public option?
No.
Can we at least expand Medicate to those 55 an over, the older people most at risk of finding themselves unable to obtain affordable health insurance if, say, they lose their jobs during a recession?
No.
Can we at least lower drug prices by allowing the re-importation of prescription drugs from industrialized countries — like Obama said he wanted to do when he campaigned?
No.
Can we re-import drugs from countries if the FDA goes and certifies that the source of those drugs makes them safe for our use (which, realistically will never happen)?
No.
Can we legislate a fixed percentage of all premium monies must be spent on providing health care coverage, and not go to compensation or profit or marketing?
No.
So what do we get?
We can force millions of Americans to purchase insurance policies from private entities who operate as monopolies and therefore can charge monopolistic prices, and we can do so by the threat of force (do it, or pay a fine, or go to jail for refusing to pay the fine).
Well, can we regulate the industry, so they don’t raise the prices and gouge all these new consumers?
No.
Can we stop them from rescinding their insurance policies if the consumer gets sick later?
Yes, but not in cases of fraud or misrepresentation — exatly the system we have now.
How can we force people to buy insurance that they can’t afford now?
We can give them government subsidies.
Can we regulate insurance companies so that they don’t raise premiums in order to suck up all these subsidies for their own profits?
No.
I mean . . . seriously. Given all the ways to reform the insurance industry that are now “non-starters,” how the hell is what’s left anything but a big sloppy kiss to the same insurance industry that everybody hates.
And why do the Dems think that it is more important to “pass something,” even if that “something” is only going to make the situation worse?
What am I missing here? I’d really like to know.
Sanka
FTW
norbizness
Marge: (Going outside) Kids, I made some lemonade for you.
Bart (inside, watching TV): Sounds great.
Lisa: Bring it in here.
Marge: What the… ? What are you doing in here?
Bart: Work was hard, so we quit.
Marge: What?!
Lisa: Hard work made us quit.
itsbenj
Excuses, excuses. It’s ‘all of the above’. The Dems are crippled by the contradictions between their stated beliefs and their real beliefs, sure, but it’s not as though the problem ends there. That’s where it begins. That their loyalty is not to the public but rather to their benefactors prevents them from agitating effectively on behalf of anything that reigns in corporate power or cuts into their profit margins. One thing follows from the other.
lol
Bush’s legislative accomplishments were scaring Congress into passing national security issues that had legitimate bi-partisan support (sad as it was) like the Iraq war and PATRIOT Act, shitty legislation that looked good to Dems on paper but pissed off his base like Medicare Part D and No Child Left Behind and jamming his tax cuts through reconciliation.
His more ambitious domestic agenda (SS, immigration) didn’t get anywhere.
Frankly, without 9/11, Bush would’ve been deprived of any substantial legislation.
nutellaontoast
@Noonan: Six of one. Half dozen of the other.
DougJ
That was in the House.
That’s what I thought.
It’s worth noting that Nancy Pelosi doesn’t have to keep votes open extra long to get what she wants passed. Tip O’Neil didn’t have to either.
Michael D.
Something interesting I heard awhile back on NPR that I just remembered today:
Hearing that made me angry. If GE and Siemens can make a profit selling MRI machines to Japan at half what they sell them for here, then why can’t they do that here? Hell, the shiping costs alone to Japan should add a ton to the price!
Why does Corporate America hate America?
Or is it that we are subsidizing the healthcare around the rest of the world by jacking up the prices here? If we didn’t pay through the nose for healthcare, then other countries’ prices would go up, for example. Is that it?
Ryan Cunningham
That poor strawman. You’ve really done a number on him.
MikeJ
This health care plan is having a tremendous impact on my health. I’m spending far more time in the gym and out hiking just so I don’t have to hear the whinging. I’ll soon be in great shape!
DougJ
Why does Corporate America hate America?
A very good question.
LGRooney
Every now and then, we all need a cheerleader who can provide the appropriate pick-me-up.
Often this down-on-everything feeling we are widely feeling is the goal of the opposition, i.e., tie up things using every possible tool in the box so that we collectively throw up our arms in despair and say, “Fuck it all!”
The unfortunate part of our political system is that it is truly designed for only two parties and we, generally in the camp of the Democrats, have to deal with what is an internal multi-party function while the other side marches much more in lockstep. It is that ability of the GOP to work like an insect colony with whoever their chosen queen bee (hero of the moment), their males (the fluffers in the press and well-funded think tanks (who puff up the queen bee with gifted hagiographies), and the drones (who vote and speak in line with whatever their leadership tells them) that drives us to pull out our hair.
Democracy is a messy business and the Democrats are the ones exercising the chaos of democracy while the other side often only exhibits democratic credentials by being part of this system. It is disheartening, exasperating, and numbing. We can know that we have the better principles and know that, as a result of our heterogeneity, that we often will not get what we want. Nonetheless, we need to be aware of that two-party design for our political system and work through our frustration as best we can, supporting even limited achievement, or we can call it quits, sit on our hands, and be sure we never get what we want… even if it is only a sliver of our initial goal.
With all those slivers, perhaps we eventually can press a full board with which to beat the other side about the head but if all we do is piss on the saw dust we can be sure the other side will always be allowed to run rampant.
Not in the mood for pretty metaphors… apologies.
jwb
I doubt Obama would have been elected if he had the type of personality that would favor ramming legislation through. In any case, he certainly would have campaigned differently.
My only real beef with Obama on this matter has been that he hasn’t really seen mobilizing his supporters as a priority. (And, no, flooding my email box with eight messages a day asking me to call my representative and senators does not count as mobilization.) They were caught very flat-footed this summer when the debate moved out into the country during the recess, and I don’t see that they are preparing an effective response for when (if?) congress goes on recess over the holidays.
Jim
I’m not convinced of this. Snowe lives all alone in a little ivory tower of her imagination where she is the noble keeper of the Rockefeller Republican Flame (Miss Haverfeller?). Collins is dumb as a box of rox and seems quite happpy to be Joe Lieberman’s sidekick. And when it’s time to vote, they do what Mitch tells them to.
There are a few things I blame teh Dems for. They do seem to have internalized of lot of Beltway myths that become self-perpetuating because of that internalization, i.e. Democrats must always compromise. Somebody a few years ago had a great, concise description of how Republicans keep moving to the right, while Dems keep chasing the center that the R’s drag along with them. I also think that the vast majority of Beltway D’s still believe the “liberal media” is their ally. John Kerry bought into this, I think, much to his detriment.
another lesson D’s could learn from R’s: replace teh strict seniority system for Chairs with (IIRC) a caucus election. Make Max Baucus and Joe Lieberman explain to Bernie Sanders and Tom Harkin why they deserve their chairs.
DougJ
That poor strawman.
Read the comments here from the past week.
Leelee for Obama
I’m a great one for wait-and-see. The bill can still be adjusted to cause more angst among the comfortable (insurance companies), and the exchanges can be tweaked such that there are a few really inexpensive, basic coverage policies that don’t cause huge problems, with equally inexpensive catastrophic riders for really big issues that do not happen to everyone, but might. Insurance is, at its core, gambling. The odds are always with the house, so there’s no way to get that truth out of the mix, unless we go with single-payer, Medicare for all. Even then, there are some restrictions in Medicare, just not many. In a perfect world, i. e. a really awful world where no one has insurance, the Medicare for all would be a snap to do. That ain’t where we are, and I can’t say I wish it were. What I fear is that we will wind up with nothing, rather than something that ain’t real good, and the post-Apocolyptic really awful world I mentioned will happen. If it was only about me, I’d say, bring it. But it’s not about me alone, it’s about young people and kids who are going to be sick and maybe dying way before their time. If we want to hav a future United States of America, I think it’s time we stopped bitching and start trying the time-honored way that all liberty and justice has ever happened in our country, or most others. Organize, petition, educate, work for better representation and know that nothing good comes easy. Frederick Douglas was, and still is, right:
“Power never concedes anything without a demand.”
DougJ
@LGRooney
Good stuff.
jibeaux
@swellsman:
I would say that you are missing the fact that adding 30 million or so people to the ranks of the insured, whose coverage cannot be denied for pre-existing coverage or rescission-ed, and that you are providing subsidies to make it more affordable, is decidedly not worse than the status quo. The goal is not, actually, to stick to the insurance man, the goal is to get more people health coverage. See Ezra or Nate Silver if you are actually looking for articulate explanations. See the Jame Hamshers of the Left if not. We’ve talked about it to death.
nutellaontoast
@Michael D.: I think JEOL is based in Japan and makes MRIs, so that might have something to do with it.
Hunter Gathers
@DougJ:
They don’t hate America, per se, they just love to
anally rapesteal from us. It’s called ‘Servicing The Client’.sparky
DougJ–might i suggest that the problem would be solved by simply stop being enamored of your analogy? once you do that, it simply becomes a gripe, one among many, and not a particularly compelling one. and, yes, i don’t think it’s a good analogy because it seems strained and because it has no explanatory power.
additionally, because the point is silly, all this discussion seems to do is produce another fruitless argument. if you want to have us argue about whether the Ds can manage anything, have us argue about whether substantive regulation of insurance carriers is possible, for example.
i understand you’re the blogger, not me, but not all offhand comments must needs be seized upon.
or troll us some more. that would be ok too. :)
/nickel drops…
ooooh
(too much glue huffing or not enuf? hmmmm)
lol
@swellsman:
If you can’t find a plan less than 8% of your income, then you’re essentially not penalized for not buying insurance. So there’s the market cap for insurance right there.
As I’ve pointed out before, one of the things that fucks the uninsured is that hospitals and doctors charge them *significantly* more money than they would an insured patient.
Sure, you might have a shitty policy that only covers 30% of your medical bills. But if you didn’t have the policy, the bill would be 100-200% higher. That alone is the difference between a steep bill and bankruptcy.
DougJ
i understand you’re the blogger, not me, but not all offhand comments must needs be seized upon.
What did I have, 100 comments, agreeing with Dean and saying I was wrong yesterday? This blog has a tradition of continuing discussion when the commenters savage the poster (not my tradition, but John’s).
lol
@Jim:
Totally agree about ditching the seniority system.
jwb
@sparky: “Must needs”—OT, I’ve always loved that construction!
MikeJ
But it’s not merely a question of if the Ds can accomplish anything. There is a myth that Rs get things done. They don’t. That shouldn’t be controversial.
earlofscruggs
Well-said!
Noonan
Also, about reconciliation. Why are we assuming we have 50 votes? Off the top of my head I think you can safely assume that Baucus, Bayh, Lieberman, Nelson & Nelson, Lincoln, Warner, Landrieu and Cardin would be a sure no vote. And that’s even before the special interests and media attack and senators start getting cold feet. Reconciliation is a red herring.
jcricket
@Jim:
I think this is entirely it in terms of what bugs me about Democrats. I get that as a wider ideological tent we’re going to have Casey and Nelson. but Lieberman is totally unnacceptable. And internalizing the idea that we’re a “center-right” nation and the most important thing is making David Broder happy is something the Senate Dems need to stop, 100%.
SS privatization is a spectacularly unpopular idea, and yet the media all discussed it seriously, partially because Bush and his allies decided to push it so hard. Were we to try something similar on any number of ideas that are actually popular perhaps we might get some traction. But instead we allow Republicans to frame the debate, the media plays along, and we sulk back into our corners.
This post is a good reminder that there are some structural disadvantages working against dems, and that it’ll take a long time before (if ever?) those are addressed. I actually think the fall of the traditional media and all the concern-trolling pundits might help, along with the rise of more partisan blogs as a “replacement” in a sense.
“Faux objectivity”, “some people believe” and all that equivocating bullshit actually kills Democrats, because it allows the right to pretend their ideology isn’t totally bankrupt (on gays, global warming, evolution, healthcare, etc) and full of it.
Violet
@Michael D.:
Yes, this is part of it. Or, the healthcare providers’ (big pharma, etc.) profits would go down. It’s a global industry and profits are made somewhere. Either we provide them, other countries provide them, or they go down.
arguingwithsignposts
shouldn’t that be a new tag?
still here, amazingly.
General Winfield Stuck
@jwb:
Agreed
nutellaontoast
Oh, oops, JEOL only makes NMRs. Though, there’s a lot of crossover between NMR and MRI and GE et al might have some kind of agreement with them for production, but I have no idea.
Leelee for Obama
@LGRooney: Yes, good stuff. The problem we face as Democrats is that we really are diverse in many ways: race, faith, ideology, corporate connections, local connections. I know people love to say that it’s like herding cats, but I always found and electric can opener very effective. What we need is the political equivalent. Any ideas out there?
ThatLeftTurnInABQ
@DougJ:
Ding, ding, ding! We have a winner.
The most important comparsion progressives need to be making between now-n-then isn’t today vs. the Bush 43 admin. It is between now and the progressive movement of the late 19th/early 20th Cen. What worked in the era of TR and La Follette, that isn’t working now? From the reading I’ve done, it seems like progressive media – both newspapers and magazines like McClure’s, were a more powerful voice than anything outside the blogosphere is today. So either left blogistan is going to replace the dead tree media and TV as a major info source, or we aren’t going to get much traction.
From what I can tell there are two other major differences between then and now. Progressives 100 years ago were much more patient than we are today – they knew they were up against an entrenched establishment and it was going to be a long hard grind. And the last difference is more chilling: 100 years ago rich people were dying. Anarchists were lobbing bombs into open carriages, and on any given day a Rockefeller or a Carnegie or somebody of that ilk had no way of knowing if it was going to be their turn next. There was an urgency to the sense of needing to reform and tame the raw capitalism of that era, part of which came from the sense of physical threat of social violence from below, of either the red or the black variety. We don’t have that now. Hopefully we won’t need it to get some traction, but my more pessimistic side thinks that maybe we won’t get serious about solving problems in this country until we do.
sparky
@DougJ: oh, fine, make a good retort.
/stomps foot
FWIW, i think it’s a crap notion too. it IS easier to pass feel-good legislation that shuffles the cost off to others who don’t vote for you anyway (tax cuts, for instance).
that said, visually the Rs have the upper hand in at least looking like they don’t hesitate to send the power goons out to get something passed. the Ds don’t do that for some reason, and that’s not a political science/democracy kind of question. that’s a question about the willingness of the people in power to use that power for what they purportedly believe in. you just don’t see today’s Ds willing to cross their corporate masters in any ways other than trivial ones. so i guess my point is that the Ds don’t really believe in what they advocate, or, more accurately, they do, provided it doesn’t upset anyone’s apple cart.
yeah, i think Glenzilla is correct.
The Grand Panjandrum
Let’s see:
1. $100 Billion a year in subsidies for people who can’t afford insurance. (Lower income people will not be forced to spend more than 10% of their income)
2. Significant expansion of Medicaid.
3. Community ratings for insurance pools.
4. Insurance companies must insure anyone who wants to buy a policy.
5. Caps on out-of-pocket expenses.
(I’m sure more is included but this is all I can think of at the moment.)
Yeah, this bill really sucks. Lets kill the fucker because it really is the ONLY possible way we will ever get to single payer or anything resembling real change.
Violet
@jwb:
Yeah, agreed. It’s really strange that he made such great use of his supporters during the campaign and now everyone’s left hanging. The rightwing astroturfers can produce large crowds of teabaggers pretty easily. Obama’s campaign crowds were huge. Why isn’t he getting his supporters out there doing something? Doesn’t have to be demonstrations, but pushing a few memes like “Republicans support Insurance Company Death Panels” might not be a bad idea.
Fwiffo
I think it’s been mentioned elsewhere, but what’s interesting is that the split in the Democrats is the same one that happened in 2003 about the Iraq war, with the same people. Who was right in 2003? Howard Dean, Markos and the other hippies, or the “pragmatists” like Josh Marshall, Matt Yglesias and John Cole?
Jim
It also gets into class issues. I’ve always thought that our media (at least the Beltway TV types) are not so much “liberal” as they are upper middle class (overwhelmingly white) college educated suburbanites, and they think (and vote) like UMCOWCE’dS’ites. They’re pro-choice but think abortion is icky, think the DJIA is a more accurate reflection of the economy than unemployment numbers, 200K/yr is middle-class, maybe UMC, etc.
Another point that Jon Cohn (I think) made about Lieberman, it may be that he’s not so much hateful and vindictive as stupid. He has a simplistic and childish notion of fiscal responsibility that is far more important than facts, figures or CBO scores. While I think Holy Joe is in fact hateful and vindictive, I’m certainly willing to accept that he is also stupid. And I definitely think the stupid theory applies to Bayh and Nelson (see their War Bonds idea, because we don’t want to increase the debt) as well as Lincoln and Landrieu. David Broder (also stupid) might as well have half a dozen votes in the Dem Senate caucus.
MikeMc
Do you need 60 votes to pass reconciliation?
Mike in NC
I made the mistake of turning on “Hardball” late last night, where Tweety and Chuck Turd were basically opining that maybe Obama should just pack his bags in the middle of the night and enter the Witness Protection Program, since the Republicans are poised to make major gains in 2010 and inevitably take control of Congress in 2012. I need to blow up my TV.
General Winfield Stuck
@Noonan:
This might brighten your day at least hope wise. From Tom Harkin, says must pass PO and has at least 52 votes.
PTirebiter
Indeed. I’m sick of all the comparisons to LBJ. In today’s Congress, Barry Goldwater would be castigated as a RINO. I’m all for disappearing Lieberman as an enemy combatant, but it wouldn’t get us any closer to cloture.
bemused
Now the John Birch Society is going to be a co-sponsor of CPAC. I can’t even imagine how far to the nutty hard right fringe the R party is going to end up being.
AngusTheGodOfMeat
Not sure about your rant, Doug, but to me this is not about parties as much as it is about the fact that Congress in general is made up of a whole bunch of people in both parties who are totally in thrall to moneyed interests and their lobbying machines, and who confuse reelection with representation.
Because of that, they do not act in our interests, but in their own. Dems, and Reps.
rachel
@ThatLeftTurnInABQ:
I hope it won’t come to that.
mcd410x
Politics in a democracy is a messy sport. Seems we’ve spent so much time in the wilderness we’ve forgotten that.
Welcome back to the fight, Democrats!
Tom Hilton
And along the same lines, there is a fetishization of “strength” on the left that is exactly parallel to the right’s fetishization of “strength”. Wingnuts believe that if we show enough
blusterResolve we will achieve Victory against Terror; manic progressives believe essentially the same thing about, well, legislative battles. In both cases, the world just isn’t that simple.Ecks
No you can’t fricking do that! The reason the drugs are cheaper in Canada isn’t because there are miracle manufacturing plants there that make it cheaper, it’s because the Canadian government uses its bargaining power to demand lower prices, and its still profitable for the drug companies to oblige. If the US starts mass-importing “Canadian drugs” (which are often made in the US anyway), the drug companies will refuse to negotiate with the Canadian government anymore, and we’ll get the same lousy prices you get.
If you want low prices like Canada has, negotiate them your damn selves. There’s nothing stopping you except for the corporate ownership of your congress.
And Michael D has it right – the reason insurance is so costly here has relatively less to do with profit-sucking insurance companies (dbags that they are, their profit is still only a tiny sliver of overall healthcare spending), and almost everything to do with health care providers charging way more for their services than other countries let them. THAT is where America is being slowly bankrupted. But insurance companies are much more hated than doctors and hospitals, so they are much easier to attack politically, so that’s where all the rhetoric is at.
Da Bomb
@Mike in NC: I blew up my tv a long time ago.
Not good for the blood pressure.
Leelee for Obama
@Mike in NC: Keep it for the rare but worthwhile-The People Speak was well worth my time. It reminded me of how bad things were and how much better they got because some people put themselves out there and fought for it. Yeah, you’ll read some righties (I already have) bitching about how anti-American theywere, and we are, but facts remain stubborn. People like us stood up and said the “Green Balloons” of that day, and lo, things changed, slowly and painstakingly, but they changed. It’s as American as laizzez-faire is to the right wing, at the least. For me, it is more so.
kay
@Tom Hilton:
Agreed.
plus C
On the other hand, if Democrats were Republicans we would already have moved on to impeaching Obama over Dijongate.
ThatLeftTurnInABQ
@rachel:
I hope not too, and that we can muddle thru with the incrementalism of Obama and the corporate whoredom of the Blue Dogs in Congress and still get things done. If it is any consolation, Congress was no better and in many ways a lot worse during TR’s administration, than it is today. What worries me most is that much of what the progressive movement was trying to get back in that era didn’t really come to pass until later under FDR and in response to the Great Depression, which really cranked up the sense of urgency. Today we have our own Great Recession, but it doesn’t seem to be big enough or scary enough to move the establishment out of their comfort zone.
Xenos
@ThatLeftTurnInABQ: That is similar to my thinking. All the righties declaring “Green is the new Red” have it wrong. Black will be the new Red.
NobodySpecial
@The Grand Panjandrum:
Well, I’m just damned glad I’ve got 10% of my income just floating around that I’d otherwise be spending on blowjobs and bigscreens.
Yossarian
I think the thing that annoys me most about the sudden left-wing revolt against the health care bill is the focus on the mandate. Now that the (weak) public option is gone, suddenly the Kos’ and Hamshers of the world are identifying the mandate plus subsidies as insufficient at best and criminal at worst. They set up the public option (which didn’t even use Medicare negotiating rates, so I don’t know where the fuck they got this idea) as the magic bullet for affordability, and now that it’s gone, they proclaim themselves opposed to the whole bill because the subsidies aren’t enough for poorer people to purchase now-required insurance.
Well, if that’s the case, where the fuck were they on the subsidies question during this whole debate? Why weren’t they fighting for an extra $80-100 billion in subsidies for the lower middle class? I don’t know if such a fight would have worked, but it seems to me to really get at the question of affordability in a far more direct and IMMEDIATE way than the public option. I mean, the hope of the public option is that competition for the insurance industry would EVENTUALLY drive down prices for private insurance lest the consumer decide to take a walk over to the government-run plan. But if you make insurance more affordable, then you’re doing that NOW, and without hoping for a process that will hopefully either change insurance company behavior or make the consumer slough off the insurance company altogether.
But despite all of that, I could count on half of one hand how many diaries, blogospheric calls to action, liberal TV shows (Maddow, etc.) were devoted to this question, versus the infinite number of appeals for a public option which may not have even had the intended effect (in fact, probably wouldn’t if the CBO’s scoring is to be believed). This is why I can’t take the lefties seriously when they now seriously claim they are fighting the bill because it doesn’t do enough to help working people. A combination of policy ignorance and fetishization of sticking it to the insurance companies seems to be more of a driving force, and to say it leaves me cold would be an understatement.
Pangloss
There’s another aspect— the range of interests and backgrounds in the Republican party is extremely narrow. They are almost all White, protestant and male, of mediocre intellect, and they’re all comfortable with or longing for an authoritarian power. They’re hearding cows while we’re hearding cats.
jibeaux
@Tom Hilton:
This is all very true.
In some ways, I think it stems from frustration that we just don’t seem to be able to get our firebrands elected. You can be a Republican Senator and say some seriously crazy-ass shit and no one bats an eye. The House has fucking birfers. Whereas we’ve got pretty much that guy in Florida, who is pretty awesome. But why can’t or won’t our guys just let their firebrand crazy out sometimes? Why can’t anyone publicly deliver at least as much of a Liebersmackdown as Ezra Klein, policy wonk and tofu-cooker? It just might make things more satisfying.
Emma
May I ask a question from those that say that Obama did not do enough to mobilize their supporters? What should he have done and what should he have asked of us?
In American politics, the way a citizen can try to influence the larger outcomes is by (1)electing people who think like you and (2)harrassing your rep or congressman with complaints, phone calls, letters to the editors, marches, etc. Obama held several town meetings, gave interviews, met with congresscritters it seems every week. What else should he have done, given that, unlike most Republicans, he does believe in the Constitution and in those pesky little details about separation of powers and Congress making the laws?
I am not being nasty or snide. I really want to know. What actions should he/we have taken? Other than throwing Lieberman under a bus, which I would love to see, but he can’t do because that is Harry Reid’s job?
kay
@Yossarian:
I asked the same question yesterday. Don’t expect an answer. I believe I was called a “classist” , whatever that is.
Cruel Jest
@Leelee for Obama:
I’m getting tired of this analogy*, but I like what you’ve done with it. And I thought of Obama as that can opener. I didn’t have illusions about his place on the political spectrum, but I thought he had the skills and ideas to keep the wave moving and swamp some of the inevitable blowback. Maybe he didn’t factor in the Idiot Media.
*I’m trying out “Democrats are like a truck load of super balls dropped 10 stories onto a pile of bricks.” It’s cumbersome yet vivid.
S. cerevisiae
Reluctantly, I say pass the bill. The definite political fallout from not passing it would be worse than the potential anger over the mandates. I am still not sure if forcing citizens to give money to private corporations is constitutional, and I would be mad as hell to be forced to pay for some CEO’s condo in Barbados.
Maybe some corporation with a good reputation like Costco would get into the health insurance business, or some kind of credit union type of organization. That may take some of the sting out of the mandates.
Thoroughly Pizzled
@Fwiffo:
Look, that’s not a very useful analogy. At all. Completely different situations.
Leelee for Obama
@NobodySpecial: Listen, I never made more than 25,000 or so my best year. If I could have bought a decent policy for $210/month, I would have been delirious. I don’t believe you wouldn’t, either. It’s the $150/week that stops us, with the knowledge that they won’t cover us when we need it.
This bill is not enough, but it’s a beginning.
Shawn in ShowMe
Stuff is going to be added in conference to this bill because that’s what happens in conference. The bill will look (slightly) better than it does now. Kos, Hamsher and all the other Internet progressives that have health insurance will continue to rail against it.
The millions of folks who are facing bankruptcy because they don’t have insurance will appreciate it. The millions of folks who can’t get coverage because of pre-existing conditions will appreciate it. The millions of folks too poor to buy insurance currently but who could afford subsidized insurance will appreciate it. The millions of people who only stay in their jobs because they are afraid of losing their health insurance will appreciate it.
We’re going to get a bill, people. Count all the people in Left Blogistan who are against it, multiply that by 20 and that’s roughly the number of people will benefit from it. Internet progressives are threatening to stay home in 2010 and 2012 and that’s their right. But keep in mind that there will also people going to the polls next year that would be dead in 2012 without this bill. That. Is. Powerful.
kay
@Yossarian:
They take it further than that. People will not mind at all writing a check to the public option insurance co., even thought the public option check might be higher if it comes in as estimated, but will reject the mandate if writing a check to a private entity.
Leelee for Obama
See me at #32
CaseyL
@jwb:
@Violet:
David Axelrod, the architect of Obama’s campaign, is now his Senior White House Advisor. Why isn’t he strategizing to turn people out? Is he involved in the HCR effort at all?
I can understand Obama’s desire to return US government to a more legal form, where the three branches of government are co-equals and one doesn’t ride herd over the others. But he’s dealing with people on the GOP side who are just plain saboteurs, happy to render the US ungovernable. And he’s dealing with people on the Dem side who (I suspect) preferred the good old days when they were marginalized and ignored, and could still collect their paychecks and their bennies without having to do any hard work or be held accountable for anything.
This is not a good environment to try restoring normal governance. It’s like insisting on using the Socratic method to teach class when your students are mostly bikers or potheads.
sparky
@Violet: strange? HELLOOOO…ever think what the reason might be for that? or that Obama was secretly negotiating with pharma at the same time?
all of those of you saying you have to learn to compromise are, with all due respect, missing the boat here. i agree things often have to be incremental, but that’s not what’s going on here. what Obama is trying to do is institute something without complaints from any of the existing players. and nothing meaningful can come about that way because Obama is unwilling to make any enemies. Ever.
Obama may very well want a better health care system in the US. but he is NOT going to break any eggs to do so. and when you try to reform something but refuse to tell anyone who has any power that they are just going to have to accept limits, you get this mess.
i’m not sorry i voted for him, but i am starting to think that if this is going to be the pattern of “reform”, i’d just as soon he become a lame duck/caretaker. i have no interest in continuing to assist in putting the wheels back on the oligarchy’s little red wagon.
kay
@Thoroughly Pizzled:
It also ignores the liberal Senators who opposed Iraq but are still at the table on health care, but never mind.
What’s important is that we conflate Iraq with Obamacare.
jibeaux
Ralph Nader was right about seat belts and the Pinto, ergo was also correct regarding Gore being indistinguishable from Bush.
The Grand Panjandrum
@Tom Hilton:
Well said.
@Fwiffo:
Although I have great respect and admiration for Kos I would not consider an expert in this field so his opinion doesn’t really carry much weight with me, especially after reading his reasoning for why the bill should be voted down. Dean is another matter and after reading this I wonder what Dean is actually complaining about.
I would love to see a better bill, but those who say this bill should be voted down are wrong. This bill does make progress. It doesn’t make as much progress as we would like.
ThatLeftTurnInABQ
@AngusTheGodOfMeat:
I think we have to be careful not to exaggerate this. There are a lot of good folks serving in Congress. I’m quite happy with my rep in NM-1 for example, who amongst other things voted against the Stupak admendment despite representing a heavily Catholic district.
The problem is that in a democratic system there are always choke points – thresholds of 50%+1 in the House, or the 60th vote for cloture in the Senate, which are of supreme value because of how our system works, and the knaves have a way of migrating to those choke points and extracting rent from them. The whole Congress doesn’t have to be corrupt but if the people in key posititions occupying those choke points are then the result is the same. And this is something we need to communicate to the rest of the Congress – they are the ones who have to do something about the Nelson’s and Liebermann’s of their group, not us, because we don’t have any direct leverage unless we live in the state that particular Senator is from. The problem is that the only threat we have is witholding support from the more worthy of our reps if they don’t do something to discipline the scoundrels in their midst, and in the face of GOP insanity that just isn’t a very credible threat. I’d love to call up my rep and my Senators and threaten them with 1994-redux, but with Sarah and the teabaggers lurking in the neighborhood it wouldn’t be a very honest threat would it?
Robin G.
@Fwiffo:
I’m not sure this really counts as a correct analogy. The Iraq War wasn’t really a question of the ins-and-outs of domestic policy; it had entirely to do with whether or not you were really paying attention to what the Bush Administration was saying. If you listened closely, it was blindly, blatantly obvious that they were lying through their teeth and knew they were lying — otherwise, they wouldn’t have given hedging, plausible-deniability statements at every opportunity that were obviously crafted to give false impressions. I mean, a basic understanding of the English language made it clear what was going on.
In HCR, though there’s lots of lying going on, we’re also talking about very complex matters. It’s not “do we go to war or not,” it’s “what’s this policy plank, what would it indicate, is it worth more than this other potentially-sacrificeable policy plank, will it net us the votes?” In other words, HCR can’t/shouldn’t be a yes or no answer, so it doesn’t make loads of sense to try to make it into one.
That being said, the fact that Howard Dean doesn’t like this bill does worry me a lot.
sparky
@ThatLeftTurnInABQ: thanks for reminding people of this, though i must disagree in part, and in i hope, a non-trivial way.
politically, reform was a much more powerful movement starting (unsurprisingly) after the Panic of 1873. so there was already a tradition of agitation as well as legislation that was in place but not used effectively. and TR was to some extent an accident of right time right place.
another item that is missing today is class consciousness. joe the plumber is probably the best example but you can come up with your own.
finally, one can fairly argue that Progressivism was really a heading off at the pass of real reform (ala Obama?). some of the problems we have today are due to failures then–the FDA and the USDA are good examples.
geg6
Well, I’ve spent the last 12 hours or so trying to figure out why I’m so pissed and so depressed and so hating about my end of the political polity and, much as I hate to reference GOS for anything, this post says exactly what I’d been feeling without realizing it. It’s deja vu all over again:
http://www.dailykos.com/story/2009/12/16/815365/-An-Observation-on-the-Split-in-the-Progressive-Blogosphere
He’s exactly right, right down to it being all the same usual suspects. And this is why I won’t back down on the piece of crap so many of you seem so eager to eat. Been there, done that. The same old clown car is hurtling off the cliff with the same people at the wheel. I have no choice but to keep my seat in the back seat, but I’ll be damned if I’m stupid enough to fall for the tale that it is just a short cut to the bottom of the mountain. It’s not and we’re all gonna get hurt and hurt badly. So as I scream at the drivers who always smile and say course adjustments can be made if the short cut isn’t all it’s cracked up to be, feel free to convince yourselves that this is the bestest short cut that anyone could have ever come up with given the circumstances, remember what happened the last time and consider whether you’re prepared for what we’re about to slam into if you’re wrong about that.
Kryptik
While the invincible aura of Republican Congressmen is overplayed, yes, you have to honestly admit, there’s a stark difference between the ability of Republican Congressmen and Democratic Congressmen. I don’t think it’s so much a matter of political acumen as it is a consequence of ideology, as well as the noted infuriating internalization of the myth that America is forever and will forever be a center-right nation.
Democrats fuck themselves over because they’re always working out of a position of weak compromise, not because it’s actually necessary, but because they believe it’s necessary. There’s no way to fight to make things more liberal, because leadership has completely internalized that making things more ‘liberal’ is suicidal.
It’s akin to running a 100 meter dash while purposely handicapping yourself with 10 lb ankle weights on each leg. In other words: chicken or the egg? It seems more like Democratic fealty to the idea that they need to push toward the center enables the Republicans to strong arm and demand more purity and lockstep: because they know that they’ll always, always, always have a core handful of Dems ready to cross over for the sake of a ‘center right nation’.
EDIT: I guess what I’m saying is that it’s not that Republicans are actually better, politically. Dems just need to stop fucking working out of a compromised position from the get-go. Go with something way out there on the left, and then pare down from there if need be. That’s where I think the fuck ups on the health care debate truly began.
jwb
@CaseyL: I don’t see how working to turn people out to support your agenda runs against respecting the three branches of government.
kay
@Robin G.:
It’s dishonest. I was surprised Dean, who I respect, repeated it.
There are members of Congress who opposed Iraq (at real political risk ) and are supporting this bill.
Conflating the two is dishonest.
Chat Noir
@Cruel Jest:
Thank you for making me laugh. I needed that this week. And your analogy is spot-on.
I honestly don’t know which way to think any more.
Citizen Alan
@The Grand Panjandrum:
FYI, the section of the bill which is entitled “Caps on Out-of-Pocket Expenses” actually has a provision in it which expressly allows for caps on out-of-pocket expenses, and its at such a low number that anyone who gets cancer can expect to exceed the cap within 2 years at most.
Tsulagi
Yep, and if there was any doubt, or of the fealty degree, seems it’s been answered with a couple of exclamation points recently. So in fairness to the Ds, it can be reasonably argued they pushed through what they really wanted.
Okay, maybe not “pushed.” This HCR saga has looked more like a public display of a battered spouse taking a beating. And after each beating coming back for more saying “I know I can make them love me.”
But could be kabuki hiding those 11-D chess moves in plain sight…
__
The Grand Panjandrum
@kay: Yes, that bothered me as well. And in my comment at #90 I link to Ezra Klein who questions just what Dean is complaining about. It really is a fascinating last few days. Because Kos, Dean and Hamsher were against the Iraq War they must obviously be right about this bill. Not exactly ironclad logic.
BTW anyone know where Ezra stood on the Iraq invasion?
General Winfield Stuck
@geg6:
I didn’t support the Iraq war from day one. Dkos can kiss my ass for drawing that analogy, and frankly, since you seem to endorse that line of crap, you can kiss my ass too.
Objecting to this bill is one thing, smearing those who disagree and think it will save lives with the Iraq canard is some rank horseshit.
How many lives do you think killing this bill will save?
ThatLeftTurnInABQ
@sparky:
Good points.
Another significant difference between then and now is that despite the “panics” (what we today would call a Depression) of the late 19th Cen (and close calls like the panic of 1907), the economy as a whole was rapidly growing, albeit very unevenly and unpredictably from year to year (and with the benefits therefrom unevenly distributed), and the US was on an upward trajectory as a world power. Today we have a combination of the wealth concentration and attendant unstable economic system of the late 19th Cen USA, and the problems of a fin-de-siecle empire in decline from its apogee along the lines of Edwardian Britain. I don’t think that is a good combination, and the challenges Obama is facing are in many ways greater than any his predecessors since Lincoln have faced, with the possible exception of FDR. Best case scenario is that Obama turns out like TR – an pathological compromiser in office who becomes more radical over time and whose rhetoric mobilizes a movement out of all proportion to his actual deeds while in office. Worst case scenario – he is our Gorbachev – a well meaning but muddle headed reformer who presides over the collapse of the system he is trying to fix.
dr. bloor
@Cruel Jest:
I’ll bet if you asked Obama, he’d say he’s done exactly this. I can’t find the source, but Feingold apparently said something to the effect that the current bill is pretty much what the administration was looking for all along.
If that’s his strategy, I don’t agree with it, but pass the bill. It’s not going to work as written, but neither would any of the other proposed bills. The system is too broken: the insurance companies are going to hoover the subsidies not to make themselves as rich as the banksters, but just to keep their merry-go-round moving.
I suspect the good Dr. Dean is advocating “blowing it up” in part because he knows very well that doing so isn’t losing a “generational opportunity.” I already have families coming into my office who have insurance plans that their employers can’t afford, and a growing number of these families are on the hook to me for three- and four-figure annual deductibles before their coverage kicks in. Once the comfortably employed, my-boss-pays-my-premiums middle class starts getting hammered, everyone will be back at the table in earnest. Three to five years, max.
sparky
@kay: well, i can’t speak for other people, but it is hard to be a supporter of “yes, let’s give more money to the insurance folks” as a rallying point for reform so long as there is some other option. now that those other options have been tossed aside it seems rather disingenuous to complain that people didn’t advocate for something they didn’t think was a good idea.
IIRC using government rates was always off the table because the medical part of the medical industrial complex has refused to support it. gotta be pragmatic, right?
if you want to blame people for thinking that they could have had “real” health care reform, ok, i can live with that. i didn’t think that we would end up in this situation. at this point it feels like declaring war on France and hoping it will all turn out well.
Violet
The Dems are idiots for not hammering home the “health care reform will save employers money and thus allow them to create jobs” idea. Right now more people are worried about jobs than health care. Show how fixing health care will help struggling companies and it’s a win.
Not sure this version of reform is going to help, which is probably part of the problem.
ellie
I haven’t read the comments, so someone already may have mentioned this. The reason the repukes are unstoppable is because I think the American people are stupid enough to buy what the repukes are selling, time and again. Over the past 40 years, the American people have voted for Nixon, Reagan twice, Poppy Bush and Bush the lesser twice. Now tell me how smart the American people are? A bunch of fucking idiots they are. There unstoppable propaganda machine and their unerring ability to get the voting public to eat their shit sandwiches is what I am afraid of.
sparky
@dr. bloor: on your last point, yes, exactly. and that’s why people like me say get rid of this abomination–because it will prolong the problem rather than fix it. at some point someone is going to have to stand up and say we have to have a significant do-over. it’s the only way there have ever been real changes in the US on the economic front. who knows, maybe it will happen when China decides it doesn’t want any more USTs after this farce of a recovery/asset bubble blows up in Bernanke’s face.
Jim
@geg6:
When you said “usual suspects”, I assumed you meant Senators and pols, people who actually have a vote. And I have been surprised–well, not surprised, because it’s all so predictable–let’s say I’ve been mildly irritated that no one points out that the same people telling us that HRC is the greatest threat to the country since flouridation are the same people who told us Iraq would be a cakewalk that paid for itself. As to who was right and who was wrong about Iraq, and who wants to “eat the shit sandwich”, what about that Krugman guy. And me.
The flaw in this argument was that wrt Iraq it was a case of, as Digby said, you can’t unshit the bed. That’s not the case here. If anything, I think the reverse is true. I have qualms about the question of subsidies and mandates, but none of the burn it down crowd seems to have an actual suggestion of how to start over again, in an election year, with all the real world political externals that would make HRC harder to pass next year.
Yossarian
Feingold’s being a dope. The fact that Obama knew we’d probably end up getting a bill similar to this from the beginning is NOT the same thing as wanting it from the beginning. If the story about his team telling Harry Reid “I hope you know what you’re doing” is at all accurate, then it sounds like Obama and his people had a strong sense a long time ago that they were going to lose the public option, and simply decided not to delude themselves about that fact. I don’t like the outcome, but I appreciate having a president who’s not willing to simply talk himself into improbable shit. The downside is that it looks cold-blooded to the activists, but as strategy it seems pretty sound to me.
General Winfield Stuck
@Yossarian:
THIS!!
edit- though I still hold out hope that senate liberals will take charge and use reconciliation. But it is not on Obama, despite activist ranting that it is.
Shawn in ShowMe
With a Republican President and and a lot more Republicans in Congress. Who will of course address the issue by advocating more tax cuts.
sparky
@Jim: well, at the risk of sounding strident–the point people like me are trying to make is that it IS similar. you cannot undo this. once you give the insurers this power, you will have a terrible time getting it back. hell, the US can’t cut its farm subsidies–you think the government will have any control over the insurers after this?
as for the election year argument, doesn’t matter. structural reform will occur when the system creaks too much. better to wait than force crud through now.
MikeMc
I’m getting really tired of the Obama isn’t tough enough idea. When he came into the White House the economy was dying. If he was seriously interested in only getting re-elected and keeping his polling high he could have shelved health care reform. He could have fully concentrated on stabilizing the economy and creating jobs. The majority of this country would have understood that. Hell, a majority probably would’ve applauded that. Although, probably not liberal blogs. Lately, their specialty seems to be losing their shit on a daily basis. Each double-cross more outrageous than the last!! Kidding. What i’m saying is the man went for it when the safer political option was to wait.
Robin G.
@Shawn in ShowMe: I’m not saying we’re not in political trouble, but there’s still no one coming off the assembly line that’s a real threat to Obama in 2012. I think it’s a bit panicky to say that in 3-5 years we’ll be back at three-branch Republican control.
Yossarian
I like this new strategy of waiting for the “system” to collapse until we get “real” reform.
“Come the apocalypse, we’ll get what we want!”
This strikes me as not a particularly strong selling point.
Robin G.
@MikeMc: This.
Fwiffo
My point is that the DFH crowd keeps being right about things and the “serious people” keep being wrong. I actually tend to find the “serious people” arguments somewhat more convincing on this particular issue, but it would be break what has been a very consistent pattern if it turns out they’re right this time.
Jack
We don’t have to accept the categorically awful, must because the Dems might be better than the message controlled Republicans on social issues.
We don’t have to accept the categorically awful just because it comes packaged with a few acceptable outcomes.
We don’t have to thrall out to corporate Democrats because petulant bloggers flamewarring with equally petulant bloggers with whom they agree 80-90% of the time are sick of disagreement and contention.
kay
@sparky:
That wasn’t the reason for the mandate. The reason for the mandate was to disallow pre-existing conditions refusal.
It’s been a year. There’s been a lot of back and forth. I think you better go back and check the record, on what liberals supported and what they did not support.
Without the mandate, you’re going to have to tell me how a public option insurance exchange could offer coverage to those with pre-existing conditions, at affordable rates.
Because that’s the rationale for the mandate.
Medicare is a universal program with a mandate. That’s the mechanism that allows universal enrollment.
Now you have a new problem to solve. How do you get to pre-existing conditions without a mandate?
We can just keep going over ground that was covered, if you’d like, but you’re going to keep ending up with the same problems we started with.
ThatLeftTurnInABQ
@Yossarian:
This is very much how TR operated. The activists in his day howled about how readily he would sell them out, if he could get a compromise which would result in legislation actually passing through a Senate which was deeply corrupt and controlled by old time hacks (see the negotiations which eventually resulted in passage of the Hepburn Act, for example).
Jack
@sparky:
And the “STFU and eat it” crowd would have us believe that the very same people who crafted this giant slap in the face (with a few butterfly kisses, of course) will, at some future date, change tack entirely and fix the mess they themselves created.
If only we blog our faith in the craftiness or pragmatism of Obama (or some other rank bullshit) and stopping being DFH…
…and that’s the rub. We are admonished to accept a faith position regardless of the fact that faith positions fail as politics and do nothing for policy.
Leelee for Obama
@sparky: The farm subsidies are a pretty fair analogy, I’d say, but only because of agri-business.
My feeling is that if this bill leads to all the awful that you predict, then nothing will save the health insurance industry. They are already reviled by many and likely to do little to improve their image, though they might. Ezra’s numbers yesterday about and industry going from 86th most profitable to 53rd most profitable is apt. They will do better, but people will expect and probably demand more. If it all blows up, then they will be out of business and go the way of the dodo.
Then-Medicare-for-all, and it won’t matter who’s running the show-the country will be witnessing their neighbors dying in the street. That will concentrate the minds. I’m not hoping for this, mind you, I just think it’s a possible outcome, if your predicition comes true.
Yossarian
Obama used to be blasted on the left because compared to Edwards and Hillary, his health care platform was “weak.” Why? Because it had no mandate!
Now he’s a corporate sellout because he does have one.
The Republic of Stupidity
What ellie said…
It is amazing to me that sooooooo many will continue to fall for the crap they pull, over and over and over again. The inherent level of contempt so many elected officials hold for the very people who put them in office is PAINFUL to behold.
Jim
@Yossarian:
One of the big problems I have with the blogosphere is the hero-worship. A legislator makes one good speech or, as in this case, calls for Bush to be censured, and becomes infallible. A columnist gets one thing right and his/her word is beyond reproach.
You always hear from Feingold after the fact. Harkin, Sanders, Whitehouse, Brown have been all over my TeeVee lobbying for this bill. Where has St Russ been?
The Grand Panjandrum
@Yossarian: Heh. Worry about the end of the world will get EVERYONE focused on HCR.
Shawn in ShowMe
@Robin G.
If the GOP succeeds in killing this bill, they will have find the magic formula for killing all Obama’s other major initiatives. The GOP campaign ads in 2012 would write themselves.
And who said anything about Republican control of all three branches? I wrote “a lot more Republicans in Congress” not “Republican control of Congress”. And that’s all they need to delay HCR for another generation.
Jack
@Leelee for Obama:
JP Morgan’s monstrosity still exists, and with more hydra heads than when first described more than a hundred years ago…
Yossarian
Jim, agreed. And the hero worship is extremely selective, at that. Feingold wasn’t such a progressive hero when he voted for John Roberts to be confirmed out of some bizarre fealty to a (completely nonsensical) theory of presidential prerogative on Supreme Court selections.
mattH
First a general statement. If you haven’t read T.R. Reid’s Healing of America, get off your behind, down to the library or wherever, and READ THIS NOW. It’s both the most hopeful and most depressing book about U.S. healthcare. Insurance per se isn’t the issue, it’s our attitude to how we are going to provide access to healthcare. This book is essentially a baseline on how we should be talking about this. There are so many niggling things in a thread like this that seem misinformed, that the book clears away.
So many other countries do things slightly differently, or massively so, that we have “experiments” to help show us the way to change our healthcare, if we want it. But we need to decide where we want to go before we decide how we get there.
Second, I have a question for doctors that HCR is going to impact, and it will.
Are you willing to see your pay go down? Disregard student loans or other barriers to entry, can you see doctors giving up their revenue for the sake of HCR?
kay
@sparky:
Incidentally, sparky, Kos can’t answer the mandate question, so he punts, and does the equivalent of “I know you are, but what am I”.
He skips the next logical question raised by the mandate, which is pre-existing conditions.
Maybe he doesn’t know why he was advocating a mandate?
Yossarian
“You always hear from Feingold after the fact. Harkin, Sanders, Whitehouse, Brown have been all over my TeeVee lobbying for this bill.”
All of these people are clear corporate whores. And so are you for bringing them up.
Just Some Fuckhead
@Fwiffo:
I’ve been noticing this too. It seems like all the people yelling that we should pass a shitty health care bill at any cost were the same folks making the case (or supporting) war with Iraq.
But I loathe generalities like this so someone needs to break it down, pundit by pundit, blogger by blogger, so we can know for certain if we should be trusting the judgment of the pass-a-shitty-bill-at-any-cost folks.
aimai
OKay, granted–the dems need more think tanks etc… But violent’s point at 54 up above is pivotal: Obama didn’t mobilize the groups he had on his side, at all. Why is that?
In a democracy you need popular policies to get votes to elect people who will enact further popular policies. If you want to enact really stupid, unpopular policies (like massive tax cuts for rich people, or wars) you need to mobilize either voters, or legislators. You lie to the voters, using think tanks, mass advertising, important cultural leaders like churches and you simply buy or threaten the legislators to create the legislation you want. From the monied side its a virtuous circle.
Bush didn’t dream up the idea of social security privatization all on his own–the right wing has been against SS from the get go because it was good government, and was anti poverty, and made senior citizens free of worry and fear. They’ve been pushing against SS for a long time. SS privatization was, however, bigger than just Bush and the anti FDR crowd. It was also the beloved object of the money boys because it would have meant acres of fees for handling private money. And it was a toy of the anti-deficit crowd, who use the deficit scare to try to overturn the New Deal, SS, and medicare and force average citizens back onto the free market.
Big money buys big political actors, like Bush by marshalling the votes to put them in power. The reason people are angry with Obama right now is that they can’t see that all their little donations, all their work, put into power someone who was actually going to go to bat for them. Obama didn’t need to please the right wing, or the deficit hawks, to get into power. We put him there. We thought we’d bought him, fair and square. Admittedly those lower down on the political food chain still worry about getting votes to get into power, and the money needed to run campaigns. But Obama and the Dems didn’t need any think tanks to tell them what to do about health care–they already knew. Its very clear what you’d have to do to get real health care reform. And there’s nothing that the insurance companies and the think tanks and the forces of propaganda could have done in the few months it would have taken to ram a bill through that would have changed any electoral calculations. We had a Senate and a House and the Presidency. That should have been enough to get good legislation through. And because really good legislation, that immiediately pays off, is really popular the Dems could have campaigned on good legislation, instead of having to campaign weakly on ‘well, we got something done.’
The talking heads and the paid shills in this country are right of center. And plenty of hysterics in the lower ranks. But the truth is people are desperate for help with health care but the Democrats didn’t bother to make the argument publicly. They left the field to the right wing. And that wasn’t some kind of mysterious error. That was a plan. Because they didn’t want to be forced by the people to do something really good, like take down the for profit insurance system.
Jim
@Shawn in ShowMe:
Yup. Bill Kristol said it in ’93, Jim Demint said it last spring. They want to kill the bill so they can say Democrats are losers.
Jack
@mattH:
The doctors for whom my wife works (excepting only the one who is married to an evangelical preacher) are far more “leftist” than any BJer “centrist” any day, especially when it comes to universal health care, and health care delivery.
Anecdotal, but FWIW…
Leelee for Obama
@Jack: And for over 50 of that 100 years, we had a larger amount of control over that monstrosity. It was relinquished by people who forgot that the hydra must be fed, not gorged. We are recalling that knowledge.
williamc
wtf is up with crapping all over progressive activists now? I’m totally not understanding the mindset here. do you people think that if left-blogistan coalesces around this plan that it will pass and all will be great? remember what happened just last week? if we are happy with it, it will die, we HAVE to kick up a stink about it. we should have put up a fight about the opt-out public option and the medicare buy-in “compromises”, and maybe they’d still be on the table.
i don’t think the progressive activists making a ruckus are the one’s making a fool of themselves here by sticking with our principles, its the people who fight and fight for something and then just roll over and accept Liberman’s crap after getting punched in the mouth by him.
ThatLeftTurnInABQ
@The Republic of Stupidity:
Progressives need to get over this idea that folks who vote for the Right are complete idiots. They aren’t idiots just because they keep voting for reps who don’t look out for the economic class interests of their electorate. If you look at voting patterns in the US since its inception it is clear that our elections are mostly about looking after the interests and preferences of cultural blocs (which are strikingly regional in character), not economic class blocks. Only rarely and at times of great economic stress (like during the 1930s) do class interests rise to the very top in terms of the priorities of the US electorate. The cultural blocks that dominate our voting patterns are old, perhaps as much as 400 years old, pre-dating the settlement of most of the US, and are more stable and persistent than our economic system and the class interests which derive from its structure. Politics in the US is cultural civil war fought by means of ballots rather than bullets, unless and until such time as more urgent matters impose themselves on the family squabbles which are our daily fare.
Jack
@Leelee for Obama:
Feed the hydra?
That wasn’t remotely my point. You suggested that the truly awful would fail because it was truly awful.
JP Morgan’s many bastard children refute, in its entirety, that point.
Yossarian
I don’t blame “progressive activists” for sticking with their principles. I do blame them if their “principles” do not make logical sense, and they then inflate the not-sense-making arguments by making hyperbolic claims about what happens if they are not honored.
woody
The dynamic between Dims and Pukes is a combination of two dysfunctional systems: a high school clique system and a ritzy country club…
The Dims have no clout (or no “Klaudt,” either) because they are that wing of the Party of Property which is designated for the “losers”: the poor, the marginalized, the despised, the down-trodden, the needy, people-of-color, immigrants, etc.
Whereas the Pukes are the designated party of the Winners: bidness, power, money, heredity, privilege. The Dims, of course, function to only ‘nominally’ represent their designated constituency. They’d much rather be part of the cool crowd, so they dick over their designated supporters every chance they get, to demonstrate their bona fides for the Owners and those members of the Senior class whom they wish to emulate…
The Grand Panjandrum
@Jim:
Alan Grayson comes to mind. The guy is entertaining but he really is an asshole. Matt Taibbi had a run in with him that was pretty interesting.
Cat
The Dems are the “shittiest party evah” because they are like an selfish friend. Sure when your interests align they help you out, but if you are on a diet all they want to eat is ice cream and cookies and they’ll make up some excuse as to why they have to eat it in front of you.
kay
@williamc:
I don’t have any problem with your fighting anything, nor do I want you to “STFU”, nor am I silencing you.
I think equating the people that think they should pass a bill with the people that sold the Iraq war is dishonest as hell, and burning bridges with liberal allies in Congress, but, hey, use what you got.
Blow it up.
MikeMc
@ ainai:
How would you “take down the for profit insurance system”? What would you replace it with? Who would build it? How long would that take? How much would it cost? What would become of the people who currently work in that system?
I understand what you’re saying, but dismantling the current system and building a new one would be fucking huge.
dr. bloor
@mattH:
Ultimately, what doctors are “willing” to have happen won’t make much difference. Systemically, the only thing you have to worry about is not cutting back so far that various specialities are completely repulsive from a financial point of view (family practice), or making compensation insufficiently attractive to get smart young people to give up their earning power through their 20’s and take on a buttload of debt doing so.
But I’m not sure how much salaries will take a hit in a properly structured system that mandates “medical loss” (always a favorite term of art) and minimizes the $ hospitals flush down the terlet treating uninsured people.
The big discussion isn’t going to be about what the doctors are willing to give up, but what the patients are. The country needs to grow up enough to have a discussion about rationing before anything lasting can be done.
Leelee for Obama
@Jack: JP Morgan is no longer the major issue it once was, and was let out to raven by foolish and venal people who wanted money and power. It can be curtailed once again is my point. The health insurance companies are ravening at the moment, but they too can be curtailed. They can provide a service instead of running a cash register-if this bill provides a mechanism for that-then it’s not as imperfect as all that. If they use this bill to raven wider and become worse than they are now, they will be finished off. Fucking people out of their money is 3-card monte and the marks usually blame themselves for being taken in. OTOH, people dying left and right in far larger numbers than now, when there is something in place to insure them will not be forgiven, not will the marks be blaming themselves for it.
Just my 2 cents-FWIW
woody
Ummmm, I’m guessing its for pretty much the same reason the Pukes didn’t mobilize all the resources they had in place in 2008 to steal the ‘election,’ should they have wanted to–the were content with the way it was shaking out.
This way it looks just innocuous and innocent, and the result is what was needed…
Obama will get his “bill.” It won’t be worth a shit, but it will be “plausible,” and there will be such a conflagration of self-congratulation and hype as to make the arrival of the Titanic in NYC harbor seem to be a trifle…
Jack
@MikeMc:
Getting rid of segregation was a “huge” and generational endeavor.
What we ought remember is that the final outcome may have been legitimized by the CRA1964 (and additions), but the real work of change happened very much outside the corridors of authority.
It happened, in fact, against that authority.
To return to a theme expressed earlier, all gains made in favor of human rights, liberty, the expansion of democracy and justice, tolerance (et al) were won by women and men who were willing to threaten those who rule with the very end of their power. Jim Crow didn’t end just because LBJ signed a bill. It ended because black folk stopped taking it. We have the eight hour day because miners and millworkers and fighting unions scared the shit out of their bosses and the boss-pocketed politicians who defined property in law…
Tom Hilton
@Yossarian: I remember people who were sanguine about Reagan’s election for that reason–they thought it would hasten the day when Real Change would have to happen. What those people never get is that things can always keep getting worse without ever getting to a point where getting better becomes magically inevitable.
gVOR08
What exactly did Frist and Co. push through against the opposition of mega-million dollar lobbying efforts?
williamc
Yossarian,
I happen to agree with you on this, but really, back to my point: if the left coalesces around this plan and sings its praises, what do you think the effect of that will be? You don’t Liberman will pull another stunt where he will fall over himself moving the goalposts?
We all want insurance reform, some of you just want 1/8th of a loaf, while others of us want 1/4 of a loaf, and the “Burn it Down” folks are being smart here, we HAVE to sh!t on this reform measure or it might get watered down more, and its a hedging also: policy-wise, this thing sounds like a clusterfcuk, the true-believers have to maintain some distance in case the politics of this blows up in the D’s faces, someone needs to be able to say, “look, we TOLD you this was fcuked, and you should have listened to us…”
what do they call it, plausible deniability?
Jack
@Leelee for Obama:
Citi isn’t still the epitome of The Suck?
Elie
I guess I’m relatively surprised that so many Democrats thought these very difficult initiatives, from healthcare reform to financial regulation change were somehow going to be easy as a walk in the park. There is no comparison, NONE in these difficult projects to ANYTHING that the Republicans have done — EVAH.
The Republicans are either stopping something (always easy) or passing something like war appropriations, that have a lot of corporate support from representatives who are supported by the corporations. No difficulty there at all.
We should be freakin PROUD to have gotten this far after several failed attempts to get healthcare done. Several administrations have tried and I am sure, scoped out the difficulty and just backed down. We know this to be true.
Instead, we spend all of our time, at this critical juncture, halfway into a very dangerous “climb” to spend time kneecapping those who are trying to get this done.
This is very hard stuff. Dunno how many of you have ever had to implement a big project with a big, varied team or multiple organizations (and I think that this an easier scenario than passing this legislation through), but it is pretty challenging to bring everyone along and there is always Joe who at some critical phase who should have said something important way back that is impacting everything, finally says it. Ooops! How to keep everyone on board and communicating and avoiding the blame game when something goes wrong — usually something big and costly.
Can any of you relate or extrapolate to that experience at all?
Instead we get a totally useless and incorrect allusion to “ramming it down”, like that works in a situation with multiple, complex interactions all happening at once in many directions with players of equal power. You couldnt run a war by cram down (although the Bushies tried something like that and we saw how well that worked). Very few complex initiatives are crammed down into anything for success.
I have had a sneaking suspicion that many of us always lusted for the authoritarian approach to our problems where you just dictate your solution and terms on events and fuck anyone else. That is immature, stupid and mostly doesnt work. When it “works” its usually brief because it sets up blowback of monstrous proportions that usually undo and usually actually damage the prospect of later moving forward to try again.
We may not like our Congress but its what we have right now..not what we wished we had but what we have. We deal best and are most successful when we stop indulging in emotions about woulda coulda and deal with it now as it is.
Right now, our team is pinned down by an ice fall. We have to try to avoid further injury and keep moving along to get to safety and accomplish what we can. Not the time to start screaming at each other about why we are on this route, why we went today and a bunch of other bull that isnt going to get us out the jam we’re in right this moment. Brains need to be unemotional and oriented to work best and we need brains to work here. That is called situational awareness and I wish we exhibited more of that and less of the pearl clutching self doubt that is just a freaking waste. There is time after for the debrief — not right now when we are in the actual hazard!
We have a lot of resources to bear on this. Lets use them from a positive place and see what we can get done and stop the needless back stabbing that just further hurts US, and impairs the ability to finish this challenge in some sort of style and gives a lot of people something very necessary that they dont have now.
Elie
@MikeMc:
Yep.
sigh
Somehow, we are just not understanding systemic change and what is involved…how huge what is being undertaken is and therefore the expectation of what success looks like and how fast you get there. People have expectations like we are docking a row boat instead of a ship (not a great analogy). Very frustrating but I am hoping that we can learn from this – eventually.
Leelee for Obama
@Jack: Yes, and so is Goldman-Sachs and all the other too-big-to-fail banks. They are also major parts of an economy in need of restructuring. They should be made less large, more controlled and made to understand they need to support the economy, not own it. Like I said, we allowed them out of the carefully constructed cages they were kept in after TGD, and have remembered now what their place should be. Again, we have to get out and BITCH, make ourselves heard and demand that things change. It’s not a new war, it’s a new battle in the oldest war in this country. I am not now, not have I ever been a huge fan of Alexander Hamilton’s Wall Street mid-wifery, but it is the system we have. Me, I’m a frustrated Social Democrat, but I know where I live and try my best to overcome the worst of the rapine.
This, BTW, was me you were referring to.
BC
There is no way to stop someone who doesn’t believe in governing in the first place. For GOP, the beginning and end of governance are tax cuts (see California). If it doesn’t involve tax cuts, then they don’t give a shit whether they legislate or not – in fact, they think the less they legislate, the better they are at this congressing thing. I know we are calling them the party of no now, but they have always been the party of no. The conservative ideology is simply that the government should consist of the military and maybe someone to pay the military. All the rest has no interest to them.
Jack
@Leelee for Obama:
The system we have is not an eternal artifact. It’s changeable. The First Republic (Saxon, mercantile, landed, slaveholding) barely resembles what we have now.
For a number of reasons
But also because pissed hoi polloi didn’t take it.
Elie
@kay:
Very difficult job kay. Two and two are always going to be four, not five. Many people seem to not want to accept facts. Facts are not debatable, only opinion. If you want to cover everyone, and you want some sort of coverage for preexisting conditions at anything near affordable rates, no matter what entity is covering, you need a mandate. Either you want this or you don’t. If you dont want the mandate, explain how you get what you are screaming about without it.
I just cant stand this! Trying to be patient but I just don’t get what is happening in some of the brains around here and why all this emotion about pretty straightforward issues in terms of understanding a policy reality.
Emma
<a href=”https://balloon-juice.com/?p=31389#comment-1487666Elie : This.
Emma
Hello. Something odd happened and the message posted without the message?????
Anyway. Just wanted to say to Elie: Yes. This.
Yossarian
Elie hits the nail on the head.
For people screaming about cost control, you have to A) explain how a weak public option that can’t even negotiate at Medicare rates will control costs, and B) explain to me how covering pre-existing conditions and banning recissions WITHOUT a mandate ensuring that healthy people are in the risk pool will do anything other than explode all of our premiums sky high.
The mandate is not just about universality– it is a KEY form of cost control. You can’t complain about a lack of cost control on the one hand and then turn around and advocate for removing the strongest method we have for guaranteeing that not only high-cost people are covered.
Leelee for Obama
@Jack: And, from the beginning, citizens rebelled and were put down, even by President Washington. It took almost 100 years to end slavery, and God knows how many African-Americans died fighting for their freedom before the Civil War, and then the over 600,000 Americans who died in the Civil War, and the many people of both colors who died fighting Jim Crow and other segregation. There was no Federal Reserve until 1911, well after the Gilded Age the led to it. It is, admittedly, an imperfect institution, as all institutions of man are likely to be. The FDIC wasn’t begun until after the Depression, and it, too, is not perfect. So many other alphabets to mention. They helped in the near term to prevent another Depression. What we have is teh Suck, but it could be so very much worse.
Perhaps therein is the real reason that change now is so much harder than we’d like it to be . Things were not allowed to completely collapse. Some people with poor men’s fortunes didn’t lose everything, so they are not part of the “Fix this, or you’re out” crowd.
mattH
Thanks, anecdotal or not, that’s good to hear.
aimai
I’m not some kind of utopian lunatic. I didn’t even think the Democrats would bother to attempt health care reform–I thought that was one of those convenient lies people tell during campaigns. So when I say “take down the for profit insurance industry” I don’t think, and never thought, that it would be something that would ever be on the table. But you know what? Creating a workable public option to go along with the mandates was the single way we could get to a good health care system in this country. Even though the public option as conceived in the house and senate wasn’t very good it was, in fact, something we could build on later. Without that there’s nothing much to build on in this bill.
As others have said the forced mandates and the limited subsidies, the creation of a class of unimportant people who can be gouged by the insurance companies *and still seen as a bunch of leeches draining the good taxpayers of their hard earned dollars* is just a recipe for electoral disaster for the Democrats. I’m sorry to say it, but it just is. There were only a few ways of creating a good bill that would have the potential to have the “buy in” socially and structurally that is necessary for the program not to be attacked by the right and by the populace: medicare for all or a very well thought out and well sold public option. In the end, we get neither. This is just bad politics and bad policy. I’m sorry for it but its not because the people are utopian nutcases, its because the House and Senate just debated a lot of these issues publicly and its really clear that without the public option or something that functions, nationally, just like it this bill is just going to piss off millions of people, frighten the rest, and be a continuous sore point for the Dems as they go forward.
aimai
Ecks
in 3-5 years we might not be back to full republican control, but we’ll be even further from 60 votes in the senate than we are now, and now that the filibuster is used for everything and its mother, and the republicans are in full scorched-earth, let-the-country-burn-if-it-brings-us-back-to-power-any-faster mode, that means nothing will happen, no matter how much it HAS to. I’m willing to bet they would let the country go flat out bankrupt and just try to blame it on the dems.
mattH
I asked you to leave education costs out of it because I think it’s an overall red herring that can be addressed much easier than current levels of pay without regard to debt. Med School can be made a public good obviating the need to overcharge for it. We can discuss that, but I think it’s much less important to the here and now of HCR reform.
I’m more interested in the power that doctors have, and the fact that even though they support extending medical care, will that support evaporate if HCR costs them outside debt repayment. In other words, are they going to use their power, authoritative and financial, to kill HCR if it’s going to take that money away. If you’ve read T. R. Reid’s book, you know for a fact that most of teh doctors interviewed make considerably less than U.S. doctors, often 3 times lower for a GP iirc, who knows what the differences is for a specialist. Disregarding that school debt, can we get the doctors here to do the same, give up those country club memberships, big houses, and fancy cars? Or are we going to make them our adversaries if we ask them to give up that pay?
I’m not trying to vilify doctors at all, just trying to see how resistant they are to the changes that are probably needed to make healthcare affordable for everyone.
Read the book. Japan consumes much more in the way of health care services, more visits, more MRIs, more drugs, for less than us. The doctors make less. The doctor interviewed for the book locks people in his parking lot to make extra money, has a vending machine in his waiting room, and it looks run down. Are our doctors going to put up with this?
aimai
also, on the question of mandates: mandates don’t just force young healthy people into the system. They force *everyone* into the system. The vast majority of people who aren’t paying for insurance today *can’t buy it* because they can’t afford it. They aren’t healthier than the average population, they are just poorer, have pre-existing conditions, and are priced out of the relevant medical care that they need. Mandates aren’t meant to, and will not, create a bigger healthier younger pool which, by spreading the risk, lowers the cost of everyone’s premiums. They simply force lots of people to buy into junk insurance. To the extent that this new group doesnt use all its insurance premiums on itself we are just asking a new group of people to subsidize older and sicker insured people.
aimai
ellie
Their
not There
Elie
@aimai:
“Even though the public option as conceived in the house and senate wasn’t very good it was, in fact, something we could build on later. Without that there’s nothing much to build on in this bill.”
Disagree.
Though I support public option and Medicare for all – or single payer of any kind, we can build on whatever we have. We just build on whatever we have. More work? Sure. But we deal with what we have at the end of this and stop with the woulda coulda
That said, I strongly hope that we end up with something much further along than it appears we might have now. Just saying, we deal with reality and work to improve it. We are progressives…we dont give up.
Ecks
@aimai: Excerpts from Ezra’s latest Q and A:
geg6
@General Winfield Stuck:
And you can kiss my ass right back.
I never said you supported anything. I don’t see your name referenced in the article. And I don’t see your name in my post. But feel free to feel insulted all you like. If a warning to remember your history is an insult, I’m okay with that.
Yossarian
“also, on the question of mandates: mandates don’t just force young healthy people into the system. They force everyone into the system.”
But you’re making my point. The mandates will pick up sick people who would love insurance but can’t afford it, and they’ll pick up healthy people who simply wouldn’t spend their disposable income on health insurance. The mandate in this way expands the risk pool to its greatest possible point (or nearly). I hate using anecdotal arguments, but as a healthy 30 year old who gets employer-based insurance, I seriously doubt I’d go out and buy insurance if I didn’t get it through my job. That would be dumb on my part, and it would also jack up costs on those who are insured once I have to go to the hospital for name-your-ailment. But it’s probably the decision I’d make.
And I’m still not seeing how you can do a ban on recissions or pre-existing conditions without the mandate. You can’t credibly argue that you’re worried about cost control if you’re advocating policies that in combination NARROW the risk pool substantially for insurance companies. Nor do I see a credible argument for how a public option that can’t even use Medicare negotiating rates and will have HIGHER premiums than private insurance keeps costs down in any meaningful way. I mean, I started off baffled by this and I grow increasingly so, particularly when confronted by people who say they’re concerned about costs– how in hell did this weak public option become the gold standard of health care reform? Is it that the public option will start off weak but we can make it stronger down the road? If that’s the case, then fine, but that’s exactly what advocates for the larger bill are being continuously mocked for claiming.
Yossarian
Liberal who supports this bill: “This bill does not go nearly as far as I would like it to, but it’s a major first step and we can improve it down the line. The history of social insurance backs me up on this point.”
Liberal who opposes this bill: “You are a naive corporate sellout. Health care reform without a public option will require people to pay too much for insurance they likely cannot afford.”
Liberal who supports this bill: “But the public option under discussion will do little to control costs, and indeed premiums for people within it will likely be higher.”
Liberal who opposes this bill: “The public option does not go nearly as far as I would like it to, but it’s a major first step and we can improve it down the line.”
Liberal who supports this bill: “?”
dr. bloor
@mattH:
I think you might be overemphasizing the costs of physician reimbursement in the Big Healthcare Machine. It’s certainly not chump change, but the real money is in infrastructure (ever seen a hospital’s electric bill?), medicine and technology.
In any case, I can’t imagine the implementation of a system that abruptly cuts salaries by the percentages you’re talking about, and not just because doctors would (understandably) scream bloody murder if you hacked off a third of their earnings in one fell swoop. That kind of cost control would only take place over a long period of time.
Also, increased efficiencies and decreased costs won’t save us from the national rationing discussion. Perversely, medicine has become a little too good at keeping very sick and/or very old people alive, and it costs a great deal of money to do so.
Ed Drone
@Leelee for Obama:
Like, if we’re giving them this huge windfall, by requiring purchase of insurance, how’s about a whopping, huge, WINDFALL PROFITS TAX?
And, being purely a tax, it wouldn’t take any shenanigans to pass it under reconciliation rules (51 votes). Let it run out in 10 years — we’ll know by then whether it’s working or not.
Ed
ThatLeftTurnInABQ
@Yossarian:
I for one am deeply disappointed that the death panels were cut out of the bill. I figured if nothing else I would have the emotional satisfaction of seeing an entire generation of know-nothing old people turned into Soylent Green, and was eargerly looking forward to purchasing my first box of Cracker crackers down at the local 7-11 and munching them down while watching Top Chef re-runs. And now I find out that due to the perfidy and cowardice of the Dems I am to be denied that existential pleausure. Oh the humanity!
aimai
To me the entire focus of the bloggospheric discussion–is the left killing the bill? Are we being disloyal to Obama and the dems? is utterly, utterly, misplaced. At no time have the serious requests and interests of “the left” or even the rank and file Democrats like the unions been consulted. The entire thrust of the Senate and of Obama have been to attract the votes of just a few right wing Democratic Senators. OK, well and good. But it is these Senators who have so deformed the process, plus the previous secret agreements with pharma and the insurance industry, that the end bill is not very good. Its just not very good. It doesn’t even *try* to control costs (no drug reimportation) and it doesn’t offer voters any choice but a very limited monopolistic private insurance choice. Again–fine. But that happened because of Obama’s negotiations with the right wing of his own party and the insurance companies.
The left has nothing to do with this bill. At this point in time the bill is being held up not by the left, or the progressives, but by Nelson and Lieberman. And there is zero evidence that they will ever vote for cloture on anything. Their demands are not non negotiable, they are simply fantastical. SteveM has described it as a mass game of keep away.
And the refusal to vote on a good bill, a bill that actually does something good for the people as well as for the democratic party, continues right on through the conference report btw. Lieberman can continue to demand to have things stripped out for the rest of this process. And there is very little hope that he won’t.
So all this hysteria about Howard Dean and the left is totally misplaced. The bill is not being held up by the left at all. The most people on the left are doing is begging Obama and Reid to get a little creative on behalf of their actual constituents–the voters, the future democratic party voters, to try to fix the gaping flaws in the bill before ramming it through. If people use bullhorns, or if they whisper, its all the same–its just a negotiating tactic to make the bill better. A good response from Obama and Reid would be to be less defensive about how great this bill is going to be and admit that its going to suck, big time, way more than it needed to *because of the utterly irresponsible and evil acts of Lieberman, Nelson, et al*. Only if they do that can they allay the very accurate fears of the progressives that we are being forced to eat a shit sandwich on the grounds that it was “the best we could do” and “we’ll fix some of this stuff later” and that Obama and Reid and the rest of the Dems, as usual, will forget all about us once the bill is passed.
People are rightly afraid that this is going to doom the democrats as a political party in the next round of elections. That’s not because we are hysterical or anti democrat. Its because we have a very good idea of just how bad this bill is, how few of the obvious benefits are going to be obvious to voters and how many of the penalties and confusions are going to be laid at the door of the democrats.
aimai
Fallsroad
Everyone would do well to remember this as the health care fight and the other upcoming legislative fights get even more ugly and depressing. It is the one controlling constant in an otherwise dynamic, unpredictable sea.
Leelee for Obama
@Ed Drone: I was actually thinking of the anti-trust deferment being over-turned, and premiums being tied to rise in wages. I like your idea better, it has the benefit of using the budget reconciliation and lasting long enough to leave a mark.
General Winfield Stuck
@geg6:
Come on geg6, the clear implication, though in a smarmy round about was with dkos diary trying to paint those who don’t agree with killing an imperfect bill as going along with the Iraq war or even calling for it. It is absurd on it’s face to list Ezra for this, as he was like 20 or so at the time.
Even bringing such a dishonest analogy into the debate, and especially repeating it here without any caveats by you, and others is a low fucking blow. Especially, as you well know, this isn’t about the substance of what we all want, which is a PO, or the ideal of single payer. It is about tactics to get there, versus getting nothing to improve upon later and save some lives now, or not. Because the stars will not be aligned like they are now for some time to come.
I like you, and it pained me to write my last comment to you. But I took about as much as I could, and couldn’t take the Iraq BS.
Sleeper
@Yossarian: The difference, it seems to me, is that in your scenario, the for-profit players are all supposed to be “competing” with one another, when in fact, they all agree on the goals of the game (maximizing profit) and realize that it’s not a zero-sum game for them and if they all cooperate a bit (some might even use the term “collusion”) they can outwit, buy off, and frighten any outside actors, like congressmen or activists, and keep them from changing the rules of the game. They may suffer some short-term losses of profit (though with millions and millions of new customers compelled to buy their crap and with huge loopholes in all the “reforms” I tend to doubt that) but their long-term goal, maintaining the sanctity of their game, will be preserved. This point was ceded to them from the very beginning by most Dems – America is not ready for single-payer, we need to keep health care uniquely American and for-profit, yada yada. Obama either believes this wholeheartedly or else can’t bring himself to publically challenge this logic, and it doesn’t matter which one is the case, the end result is the same. The fact that ceding the argument to the for-profit health industry will also probably line the pockets of his 2012 re-election campaign just makes the logic that much more compelling to him and his people.
I am one of those stupid, lefty-puritan, naive, etc. “bill-killers” that a majority of commenters here are complaining about. I don’t think this bill represents any kind of fundamental first step forward for reform. I think the only way, the ONLY way, to ever do long-term damage to the profiteers (and that’s really the path to reform, wounding and killing this industry), is to introduce a new player into competition whose goal is different. A public, non-profit competitor, call it the public option (weak or strong), Medicare for All, or even state-based single-payer initiatives (highly unlikely, but the idea is out there…), who doesn’t have the institutional goal of maximizing profit but rather maximizing service and access, who doesn’t answer to a board of directors and to stockholders but to the federal government, and who is far, far less likely to engage in collusion and collaboration with for-profit players. Such a player DOES raise the spectre of changing the health industry into a zero-sum game for insurance companies, because in almost every case, those who leave private insurance behind won’t be coming back.
The vital difference for us is the public player. The competitor that won’t get along with the others in the game. Whatever form it takes, however nascent and weak it might be now, it can be strengthened later. But creating it at all is the hardest part. We think that if you abandon that part then you abandon real reform, and passing a bill now will only “settle the matter” for another 40 years. Killing this thing now gives us the chance to revisit reform much more sooner because both voters and the media elite will concur that “the Problem Remains Unsolved.” If your side wins and you pass this bill without public competition, then no politician will want to take up the fight again for decades and decades. We want a tactical retreat so we can regroup and attack it again much sooner than 2040 or so.
In the end I think we are all on the same side but disagree over strategy. I don’t think anyone here thinks the status quo is just swell. We just see different outcomes from passing this bill, that’s all.
Fallsroad
I’m on the fence, fwiw.
I hear this a lot from the “start over” folks, who, like those urging passage of “whatever we can get now”, are also mostly acting in good faith (though the Iraq accusations need to stop, because they are patently untrue and make Rove smile).
Define “much sooner”.
Also, 2040 is a bit of a stretch, IMO, in terms of making predictions (which are necessarily a stretch in any case, but you understand what I mean). I cannot foresee any circumstances where another, better bite at the apple exists in the current and nearer term climate. I’m betting that if it dies now, it will remain dead for as long as if it passes in craptastic form, and can be overhauled later. Arguably much, much longer. Letting this come to an even larger emergency makes no certainty that our response will be better or more rational than this time around. Recent emergencies actually indicate our national response to a worsening health care crisis will be a larger disaster than what is on offer now.
Ezra Klein may have this right, that putting something in place and fixing it is easier than trying to wholesale restart the process. Obama and the Dems want to move on to other things, and they will if this goes down.
As I said, I am stuck on the fence, not sure which way to jump. I despise the insurance and drug companies and their robber baron practices, but I also don’t see any practical way forward from where we find ourselves right now.
As John says, I need a drink. Or ten.
LongHairedWeirdo
The thing that *does* piss me off about the Dems is that they seem completely unable to get their ducks in a row for *any* vote. And they keep getting blindsided. It’s one thing to be unable to muster the 60 votes to break a filibuster, it’s another to find out from a flipping news show.
What’s even worse is, they don’t even do the theater. They won’t make Holy Joe vote against cloture; they just let him piss on the bill until he likes the smell better. They won’t announce that “we’ve *tried* to bring it to the floor for a vote, up or down – but thanks to Joe Lieberman, we can’t.”
The Republicans might use their lockstep voting for bad purposes, but god damn it, when they need lockstep voting, they *get* it.
Cain
@Ecks:
Yes, but getting an education to become a doctor is also huge. My wife has a lot of student loans after goign through dental school.
cain