One thing that I’ve been disturbed by is how many comments I’ve seen saying things like “we should be as willing to let good people die as they are”, where they equals Joe Lieberman and Republicans. I’m not going to provide links because I think the people who said these things don’t really mean it and I don’t want to embarrass them, but please, don’t accuse me of using strawmen here.
If you think that it’s worth fucking up people’s lives in order to teach Joe Lieberman a lesson, or even for some loftier purpose like advancing the overall liberal cause, I don’t think you’re really a hippie. Conservatives believe things like that. They believe that if you’re not willing to let a million people die for your cause du jour, then you’re a worthless pussy who can’t be trusted. They believe that the road to hell is paved with good intentions. Hippies are supposed to believe that the road to hell is paved with greed and sociopahtic assholery. That’s what I believe, anyway.
I understand the idea that, to paraphrase Jimmy McNulty, “Joe Lieberman is an asshole, he doesn’t get to win, we get to win.” But this can’t be about Joe Lieberman or about how Howard Dean was disrespected. I’m sure there’s all kinds of reasons to hope that this Senate bill doesn’t pass in anything like its present form. But those reasons shouldn’t involve personal antipathy or ideas about “winning and losing”.
The Moar You Know
Hey, I’m willing to sign on for that.
A nice breath of sanity, DougJ. Thanks.
kommrade reproductive vigor
We’ll be greeted with flowers and green balloons.
mattH
If someone is putting stuff out on the internet, let them be embarrassed.
As for the stuff, just shut the blog down. Set up some automatic open threads and walk away. Certainly isn’t doing anyone any good to have the front-pagers constantly reacting in anger. Nothing is going to happen today that can’t wait till tomorrow.
DougJ
Certainly isn’t doing anyone any good to have the front-pagers constantly reacting in anger.
I’m not angry at all. And I think all the back-in-forth I see in the comments is healthy.
NobodySpecial
Unfortunately, wherever you come down on this debate, you will have someone on the other side to call you either a sociopath or terminally naive. So the personal attacks will continue.
For myself? I’m pretty well convinced that, regardless of the happy talk, what I’ve seen from the Senate will won’t do much of anything to keep those people from dying who were going to die without a bill anyways. Nothing really makes it so the companies have to offer reasonable insurance at a reasonable price, so a lot of people with subsidies are gonna have to throw it at the likes of a Starbridge plan that counts for exactly jack and shit when real trouble hits the fan.
But hey, pass it. Everyone can get real excited. Woo yay.
J.W. Hamner
Honestly? I don’t think we should be playing with the stark moralism to make the case for or against the bill. I love Ezra Klein’s writing and think his blog is invaluable, but I think we’re the fallout of “causing a hundred thousand deaths” arguments.
The comment DougJ highlighted aside, I’m willing to accept that all of us liberals want to help people.
Just Some Fuckhead
Christ Doug, how about you read ALL the comments and get a comprehensive view about what is good and bad with the current legislation and base yer decision to support it on that instead of picking out one or two extreme comments and pretending like they represent anything other than an opportunity for you to demagogue.
DougJ
Unfortunately, wherever you come down on this debate, you will have someone on the other side to call you either a sociopath or terminally naive.
I wasn’t trying to accuse those who oppose the bill as sociopathic assholes, I was just describing what I thought the road to hell was paved with.
Zifnab
This is about reducing health care costs. It’s the only “winning” and “losing” that matters.
When Reid caved to Lieberman, it opened the floodgates. Now we’ve got Nelson pouring down the river. Expect more of this bullshit. The capitulation wasn’t the end of the debate, it was the beginning of a whole new health care hostage crisis.
Getting Lieberman in line is about proving that 60 votes in the Senate means something. If any one (conservative) Democrat can logjam the entire process, than every one will, given half an opportunity.
The bill that comes out of the Senate is going to get paired up with the House, and the votes to pass it are going to have to stick. Otherwise, we get to do this whole Filibuster game one more time post-conference.
Either the House completely kow-tows to the Senate (and by extension Lieberman and Nelson) and the bill is exactly as bad as it looks when it leaves the Senate, or we get to play hostage games all over again.
Reid’s got to line them up.
DougJ
I love Ezra Klein’s writing and think his blog is invaluable, but I think we’re the fallout of “causing a hundred thousand deaths” arguments.
Zifnab
@DougJ:
Hey! Fuck you too!
Brea
I felt the need to share with you the story of Jason Bromby, a 28-year-old British diplomat who has gone missing in China. This is very scary. Read more about it:
http://www.maolovesyou.com
Spread the word, something needs to be done.
El Cid
Maybe I’m completely wrong here, but I expect blogs to be the kinds of places filled up with comments which are off the cuff and over-emotional and abbreviated reactions, and are exactly the opposite of sober position statements.
PeakVT
How about we all agree that none of us know what’s in the bill or not?
Plus, there are so many other fun topics to consider: a couple of wars, Dyncorp just got caught bribing Pakistani officials, Copenhagen won’t produce a treaty that keeps CO2 under 550ppm, the US ranks at the bottom of developed economies in the child development index, etc., also, too, and then some.
Robin G.
@mattH: Compared to how badly DKos and others are melting down, we’re practically having tea and crumpets in the BJ comment threads.
Frankly, I think Cole, DougJ, and the rest of the mods should be proud of this blog and the posters. Yeah, the discussions are getting heated, overwraught, and angsty. But they’re still actual discussions. That counts for a lot.
scudbucket
If this were only about helping the uninsured, then why couldn’t we (and help me out as to why this is impractical) introduce deficit-neutral legislation to expand medicaid up to 4x federal poverty line and attach this bill to something the GOP has to vote for?
mo
I think the activist left made a severe strategic blunder on this: they made it too much of a zero-sum, black-and-white personal power play that was destined to fail for a few reasons.
1. If you publicly make it a power struggle, you’ve only increased the incentives of Nelson, Lieberman and Snowe to treat it like that and dig in. And guess what? They actually do have more power – instead of blogs and television pundit seats, they have Senate votes!!
2. Beyond the asymmetry of actual power, you also have, in Negotiations 101 lingo, an asymmetry of “Best Alternatives to No Agreement”: On the one side, the threat is not particularly credible – If you don’t give me the money, I’ll shoot myself. For most progressives, “winning” is not more important than passing a bill that extends healthcare coverage to millions of people. For the other side, the threat isn’t that much of a deterrence: winning is likely more important than passing a bill – they seem only moderately interested (if that!) in this succeeding. (I’d rather you not shoot yourself, but I’m not going to give you my money.)
3. #2 is especially true if you make the battle about something that is not central to the bill. You can argue that the public option is central but pretty much anyone who knows a lot about the POLICY vs the POLITICS classifies the alternatives being debated as a nice-to-have but not crucial. That portions of the left made something not central to the policy central to the politics was not only a strategic mistake but, in my mind, a moral one. From a strategy perspective, too many of the potential allies – including the President, I would argue – are wonkish or simply believe in being grounded in the reality of the policy. From a moral perspective, you only threaten to take down an important bill like this – WHICH SAVES LIVES – if it truly violates a fundamental principle or does harm, NOT if it’s a power play. (That’s for the Republicans and Liebermans of the world.)
For the left’s gambit to have had a chance of winning or demonstrating real influence, the demands needed to be more nuanced and about something more important – focus on the actual regulations or the subsidies or the exchange. The battleground should have enabled some room for win-win – because, again, if it comes down simply to “winning”, then you’ve given too much incentive and control to the Lieberman’s of the world. (Andy Stern seems to do this quite well here).
Given all this, you can disagree with, or be disappointed with, Obama’s unwillingness to take up this public option sword, but it was clearly a reasonable position and not obviously an instance of him selling out the left. In fact, if you believe the left is making a wrong-headed gambit that’s primarily about power instead of governance, then I would argue he made the right, governing decision. (I am personally disappointed about several aspects of the Obama presidency, but the main reason I supported him in the primaries was that he seemed a very rational, reality-based thinker.)
For Obama, there was likely no compelling political, policy or practical case for elevating the public option. If we believe Obama needs to show the left the love, we need to come up with demands that have more sense.
DougJ
Maybe I’m completely wrong here, but I expect blogs to be the kinds of places filled up with comments which are off the cuff and over-emotional and abbreviated reactions,
Sure, but here it’s usually more the carefree innocence of “you’re an asshole” and not the darkness of “people need to die.”
NobodySpecial
@DougJ:
Not saying you were, but I’ve seen those comments around too. You’ve got centrists bashing at the progs, progs bashing the centrists, rightwing trolls stirring up the general pisspot, and John losing his temper every other thread isn’t helping.
As for me? I surrender. Pass the fucking thing. Whatever they do to it. Regardless of how it comes out, it’s not gonna help me in the slightest, and I’ll be ready for Medicare at 65, assuming it’s still here. I should be good for another 25 years, maybe. I’m only still active right now for redistricting.
cyntax
Look we can’t pass as shitty a bill as the Senate has created. The public doesn’t want mandates without a PO:
Mandates are necessary for adverse selection but mandates aren’t acceptable to the public without a PO. The WH needs to get into the fray and make sure that whatever comes out of conference between the Senate bill and House has a PO. Them’s the breaks. If they can’t get that then maybe they can pass legislation through reconcillation to kill recision and maybe cap payments to get some immediate relief for the uninsured.
Morbo
Indeed this is what bothers me most about the “if Democrats just acted more like Republicans” arguments. The number one difference IMO in D and R lawmakers is that Democrats whether liberal or conservative are actually concerned with the effects of policy. Republicans hew to the ideology; policy consequences be damned. Obviously this is a gross generalization and I hate to use “serious people” unironically, but i just don’t see any serious persons on the R side of Congress.
danimal
@scudbucket:
It’s a good question. I think the answer is that the hospitals and AMA would scream bloody murder because Medicaid pays less. But that’s just a guess.
ellaesther
@The Moar You Know: Me too. This is one of the hardest things for me to keep hold of — not letting personal animus (or affection, come to that) get in the way of my actual values and the potential for actual progress.
Being a grown-up is so.fucking.HARD!
Some days.
TaosJohn
Some time back I had a hernia operation. This was at my own expense, having cancelled our useless & hateful Blue Cross policy two years previously.
Afterwards, I added up what those two years of premiums would have cost if I’d continued to go into debt to pay them (yes, I was writing credit card checks to pay the goddamned insurance). Would you believe that even with the amount Blue Cross would have paid if my policy had still been in effect, the total cost WITH insurance amounted to nearly DOUBLE what I actually paid out of my own pocket???
This is the vaunted “health care” the Democrats would force me to buy, so please don’t do me and the 30 million others any favors. As you can see from this example, the mandate isn’t for the uninsured: it’s really a way to shovel money to the insurance companies. THAT is what needs to be understood, amidst all the finger-shaking and name-calling. The Senate bill isn’t a moral “plus.” It’s a freaking hoax.
danimal
@mo: THIS
goblue72
Jimmy McNulty’s obsession with punishing the assholes and “winning” wound up descending into creating a fake homeless serial killer with a ribbon fetish and losing it all. He even managed to drag good ole Lester Freamon into the pit with him.
There’s a lesson in there for the progressive community.
dadanarchist
DougJ:
I don’t want to see thousands of people die, but I have to ask a question: how do we break the dynamic of congressional legislation, in which “moderates” like Nelson and Lieberman hobble legislation or extract ridiculous concessions that make the policy more expensive or less functional, while progressives are told to suck it up and just accept it?
Is the answer simply, we can’t?
What happens with financial regulation, global warming legislation, etc.? In the case of the latter, “moderate” half-measures will kill us as assuredly as no measures at all.
Meyer
At this point, IMO, HCR is dead. If you don’t like on on the right, you’ve got plenty of cover. If you don’t like it from the left, same there. So someone will bolt and that will be that.
I don’t expect anything to get out of the senate. Not this year, not ever. Certainly not something that can survive conference.
The best we can hope for is insurance regs – no recission without fraud, maybe, or raise caps, or maybe guaranteed issue where the costs can go sky high. Something that everyone can point at, something that is not controversial and something that is ultimately meaningless.
And we are well and truly fucked, BTW. Fucked beyond belief. Sure our medical system will soon fail, and that bites, but the real lesson here is that we are unable to act in the face of a true emergency. We squabble and we bitch and we make shit up to push the issue down the road, when there really is no more road left.
This should be most disturbing to our creditors. Not reforming healthcare means we *will* go bankrupt, at which point someone will be making these death panel decisions for us, probably someone chinese.
jibeaux
@TaosJohn:
I’m really sorry that you didn’t have more serious health problems so that you could’ve gotten your money’s worth, but you have really missed the point. I’ve paid homeowner’s insurance premiums for ten years, I don’t consider myself unlucky because my house hasn’t burned down. Insurance is about covering for risk. You didn’t need it. Congratulations and may you remain healthy. It has jack-all to do with the debate.
mo
@Jane Hammer
I don’t know – maybe it was just the emotions of the pending “defeat”, but most of the criticisms I read initially really did seem more interested in spiting insurance companies than covering poor, sick people. (I feel like the evolving rationales have become a bit more coherent – although I still vehemently disagree.)
And the continued comments from many about this being about power right now sound pretty neocon-ish to me. “We just can’t show them that we’re weak.”
Ruemara
@TaosJohn:
You had the money to pay for an operation? Wow. Congrats man, because I pay for insurance, because Ive never had enough money to pay for a tooth being pulled, much less the 3 operations I’ve had this decade. 1 on of which went horribly wrong and took double the projected time of 3 hours. Thank goddess for my terrible, horrible, overpriced, barely affordable insurance.
jibeaux
@danimal:
Other than troop funding, what do they *have* to vote for? And they’ve already threatened to block that on purely delay tactic grounds.
cyntax
Well, not sitting down and STFU may be starting to get some results:
jibeaux
@goblue72:
Whoa. I have got to finish watching that series.
NobodySpecial
@jibeaux:
Insurance that doesn’t help make us healthier means nothing, is the point I think he’s trying to make. Forcing us to spend money we don’t have for benefits that don’t exist isn’t going to help. I mean, I guess if we get real desperate, we can barf up a lung or something serious and pray it don’t get recissed, but that’s why I’m firmly in the ‘bill does nothing as written’ camp.
Dave C
While I generally agree with Doug on this, I do think that at least one of the “messages” of The Wire is that the road to hell really is paved, in part, with good intentions. See, for example, Tommy Carcetti or Hamsterdam.
mattH
Really? No anger? Guess I read you wrong.
pbriggsiam
DougJ, you’re right about having the wrong reasons to oppose this Senate bill.
On the other hand, the progressives advocating for the bill ought to stop right now this ridiculous demagoguing of their own when it comes to:
“more people will die if we don’t act…”
or
“if this fails to pass, the Republicans will run the country”
In the former’s case, government action on big bills like this will usually have life and death consequences – opportunity costs for deciding how to allocate the public pie. Thousands die monthly because we spend too much on Defense, for example.
In the latter’s case, gaming out hypothetical political outcomes at the expense of standing up for/advocating in community for what is right, is as bad as being so purist about your cause that you overlook political realities.
I for one find this bill and how we got here to be abhorrent to what I invested so much of my time of the last year and a half on healthcare. I do think Howard Dean, Keith Olberman, and Ed Schultz are right on this. I do plan on symbolically protesting this failure by Democratic Party leadership by changing my party affiliation to Independent. I don’t plan on ever being involved in OFA again (my time is better spent with organizations like DFA).
I have perfectly valid reasons for wanting this bill killed and nobody can question my rationale for it.
I
patrick
I’m against passing the bill as is…strip out the mandates, and scale it back to only focus on the insurance reform (AS HOWARD DEAN SUGGESTED WEDNESDAY NIGHT ON COUNTDOWN) and then pass it. then come back with a second bill focusing on cost containment. I’d also like the language that doesn’t allow states to go single payer stripped out, too.
the “but it will cover an additional 30 million people” is kinda BS. most analysis I’ve seen is it won’t necessarily change the status quo. these people will get subsidized “insurance”, but there will be enough out of pocket expense (copays, prescriptions, deductibles) on the lowest common denominator plans that will be all that the majority of the current uninsured can afford, that even though they have “insurance” they still won’t be able to afford care.
Pulling out the mandates gives incentive to fix the bad bill later…
On the Politics of it, I think progressives need to hold firm. if a Bernie Sanders or heck, even Roland Burris state they won’t vote for cloture unless it is changed back more progressively to actually help people, this sends the corprocrats the message that hey, maybe we can’t be guaranteed the base’s vote even if the bill doesn’t meet the party platform. It also brings the debate back to policy, and for the majority on the left saying “kill the bill” the intent is not to piss off conservatives, it’s to get meaninful policy reform.
it also could potentially open up the door to a better bill (maybe for the cost containment, a simple, under 100 page bill that would be offering as an option in the exchange, a buy in to Medicare for anyone of any age) that is passed through reconcilliation with 50+1.
What good is a bill so crappy to pass the senate, that it WON’T pass the house? about as valuable as a bill that can pass the house but won’t pass the senate.
In my ideal world, I’d pare down the huge “health care reform” bill to a small “health insurance reform” eliminating annual caps, recission, discrimination of pre-existing conditions, etc, maybe setting up the framework for the exchange(s), and come back on a health care spending bill with my “medicare for all” public option…..
The lack of transparency in the whole ordeal for the past month as Reid has been merging the two commitee bills and all the negotiations is frustrating. who actually knows what is and isn’t in the bill? nobody really knows, it hasn’t been relased. what is the most recent version publically available? one that doesn’t look much like what’s being debated on now. so much for transparency in washington–months of circle jerking in committees, only to have the whole thing rewritten multiple times again before getting any sort of debate on it.
aimai
I don’t get the recriminations for “the left”-even left commenters on blogs. We have no vote. We have had zero input into the bill. And at the moment it is Nelson and Lieberman who are refusing to let even the Senate bill come to a vote. Can someone tell me what effect “the left” has that can either get the bill through, or kill it? Really? Aside from some psychobabble about how “the left” is so “black and white” upthread?
Nelson at this point is asking to cut the number of uninsured people allowed/forced to buy insurance *in half*–specifically, he’s asking to remove the medicaid expansion. That’s on top of all his other craziness. Even if you imagine that this can be capitulated on by all the other Democratic Senators just for the sake of pushing through the bill–well? what’s left of the bill? talk about binary thinking–its far from clear that the post Nelson and Lieberman bill will even get through conference and to signing. There’s no guarantee that the Senate will ever get to sixty after conference and a high probability that it won’t. This has nothign to do with the left, and never did.
If blog commenters are upset, well, they are upset at being spectators at their own execution. First we’re told this is our only chance for reform, and then we are told that Reid and Obama can’t figure out how to get there? Fine, admit that they don’t have control over their own caucus and they need to come back and do it in two years after the next election, then fight like hell to force the centrists to toe the party line and to replace lieberman and a few key republicans (like Snowe and Collins). Its not the bloggosphere who botched the negotiations or the head count.
aimai
NobodySpecial
@Ruemara:
One thing that people may not realize is that uninsured get discounts. I had a small operation on a thing on my tonsils that might have been cancerous. Since I was uninsured, grand total of expenses was only about 4k, and more was cut because I went in and paid cash on time. Now, that being said, if my uncle hadn’t died when he did and left me some money, that spot would still be there, because 15% of what I made that year was not something I was ever going to have.
mo
@danimal
That’s probably the right explanation. Medicaid really does pay a lot less (a lot less than Medicare) – enough less that many, many more hospitals and doctors refuse to take Medicaid than Medicare.
Joel
In other words, you play the hand you’re dealt.
I agree completely.
cleek
@dadanarchist:
elect more democrats.
Lieberman and Nelson only have power because they are the rightmost edge of the Dem caucus, and the numbers such as they are put the rightmost edge of the Democratic caucus right at the edge of the 60-vote requirement. a couple more mainstream Dems would push Lieberman and Nelson into the “don’t care” territory.
fewer Dems would do it, too – if there are only 52 Dems, Lieberman and Nelson won’t matter because nothing big will get passed, no matter what it looks like. and that’s what we’ll get if the self-proclaimed Dem “base” encourages low-info voters to sit out the 2010 elections.
Mike from DC
I think the problem is even more basic, and the HCR bill is merely the most recent symptom of it.
The problem is that the democratic party is a relatively new coalition that is having difficulty finding its footing. The left feels (rightly or wrongly, my opinion is rightly) has been giving in to the demands of the “moderates” without getting much in return, which, unsurprisingly, leads to the other side expecting that they’ll give every time.
The only solution is a negotiated settlement between the various factions of the Democratic party where all concerned parties gives up some but gets other planks of their agenda. The trick is to keep everybody on the same page, more or less, and the only way to do that is to make sure that at least some of every group’s agenda are being met in one way or another.
The consequence of not doing this may not be clear to the “moderates” at first. They’ve gotten nearly everything they want so far, so they don’t see a problem. But, come election time, the liberal part of their base won’t be there for them. Right now, the rallying cry of moderate Democrats (as well as Obama) is, “well, we’re not nearly as bad as the Republicans.” That’s not going to inspire a whole lot of passionate campaigning from the liberal base.
Sadly, I think the only thing that will bring the factions together to negotiate is a serious drubbing in 2010, but here’s to hoping that it will happen sooner.
Xanthippas
Me too. Pass it.
There will be less, not more, Democrats in office after the 2010 midterms. This is all we’ve got, for years to come.
dadanarchist
We did. In 2008.
We are fast approaching the point at which there are no more places in which to elect more Democrats.
SteveinSC
Bernie Sanders was on TV last night and he said that we ought to go with the Senate bill(s). Bernie and Tom Harkin are both giving us the hint. Go with the bill (whichever one is THE bill). When two progressives like them say do it, I don’t have to read the bill, they know what’s up. If Bernie, a Democratic Socialist, says o.k. I follow his lead.
Robin G.
@TaosJohn: Well, thank God you had the means to pay out of pocket.
Let’s take your argument — I’m going to simplify it slightly. Let’s say Jane needs her appendix out. Let’s say it costs $3000 dollars (yes, it would cost more, but again, major simplification). She’s paying $250/mo for insurance; the insurance also has her pay $500 out of pocket. By the end of the year, Jane has paid more for her surgery WITH insurance than she would have without. This is true.
The problem is, Jane doesn’t have $3000 to pay up front.
At the end of the day, yeah, insurance is a racket. But illnesses don’t time themselves to flush years. There are people who can find ways to pay insurance each month, but can’t manage lump
sums. And that’s just relatively inexpensive stuff; God help you if you have something chronic.
So it’s great for you that you’re capable of paying out of pocket for what you need. Most people can’t.
dadanarchist
I agree with the thrust of your argument, but this isn’t a new phenomenon. We had the same problem in the 1992-1994 period, where liberals sacrificed. Granted, realignment had not been completed.
dan
@mo: I think it is always fair to criticize the tactics of the “activist left,” but when exactly was the left presented with any opportunity to do what you propose? When was it that this was a wide-open policy debate, as search and analysis of a variety of options in hopes of finding the best one?
When did “the left” have the chance to make their case in a non-hysterical fashion, before the 11th hour?
Was it before and after we let the Senate spend the summer negotiating with people unwilling to vote for any sort of reform?
dan
@aimai: Smart words.
dadanarchist
The fundamental tactical mistake was pulling single-payer off the table at the very beginning.
My gut told me this was a fatal mistake, but I allowed myself to hope. My fault, I see I should maintained my skepticism; I’d be a lot less angry, frustrated and disappointed.
DougJ
While I generally agree with Doug on this, I do think that at least one of the “messages” of The Wire is that the road to hell really is paved, in part, with good intentions. See, for example, Tommy Carcetti or Hamsterdam.
I would argue that it just shows that the road *out of hell* may not be paved this their particular good intentions.
mantis
It’s the same mentality, and the same people, behind the calls for Hadassah Lieberman to be fired from Susan G. Komen for the Cure Foundation. What would such a thing accomplish? Well, it would hurt a good cause for petty revenge, and would do nothing to help health care reform. And I don’t give a shit if Jane Hamsher is a cancer survivor. That doesn’t give her license to actively work against the work being done to help other cancer patients, IMO. Shame on Jane Hamsher for doing so, and shame on those who would rather have no health care reform, at the expense of millions of uninsured. You are all honorary Republicans.
And btw, without mandates the whole thing implodes. If you want an end to recision and exclusion for pre-existing conditions, the mandate is absolutely necessary, full stop. Without it, the whole thing is destroyed, as healthy people will have no reason to buy insurance.
jibeaux mentions homeowner’s insurance. Can you imagine if the only people who bothered to buy insurance did so when their house was on fire? If that were the case, there would be no insurance, as it would be pointless and without benefit. That’s what people who want HCR with no individual mandate are asking for. Stop advocating things that make the problems worse, just because you’re angry the proposed solutions aren’t perfect.
Anyone remember the Civil Rights Act of 1960? It was very limited, and very difficult to pass, but it paved the way for further reforms in 1964, 1968, and 1991 (as John noted this week, from Sen. Klobuchar). It was progressive in every sense of the word. Let HCR be progressive too.
Cat
Speaking of McNulty. The actor who played him was on “Have I got News For You” this week and its amusing to see him speaking with his very proper British accent.
mo
@amai
I assume the “black and white psychobabble” refers to my post, but I really don’t think you read it at all. Because first it wasn’t a pschoanalysis but a discussion of mistaken tactics. (The use of black-and-white alluded to the all-or-nothing call for the public option. Maybe the insertion of “personal” was over-the-top and not in that spirit.)
Second, I was basically saying what you say here, “Can someone tell me what effect “the left” has that can either get the bill through, or kill it? ” The left doesn’t ultimately have this direct power, but Nelson and Lieberman do. But many also are decrying how they can’t let this defeat happen, setting themselves up for a no-win situation.
What you say that I do disagree with is:
“Fine, admit that they don’t have control over their own caucus and they need to come back and do it in two years after the next election, then fight like hell to force the centrists to toe the party line and to replace lieberman and a few key republicans (like Snowe and Collins). Its not the bloggosphere who botched the negotiations or the head count.”
I agree (admit??) that they don’t have control over the 60-person caucus but not because they haven’t negotiated right – they just have limited leverage over some members. And I think waiting two years is VERY, VERY high risk and unlikely to lead to a significantly better bill. (I’m all for working to get rid of Lieberman and a few others, fighting for “up-or-down” votes, reforming the Democrat caucus’ rules about chairmanships and party discipline. But, again, those are longer term roads and not particularly to the current discussion about whether to kill the bill.)
DougJ
Can someone tell me what effect “the left” has that can either get the bill through, or kill it? Really?
Probably none.
I just don’t like see to “the left” argue the same way that Republicans argue. My biggest fear is that deep down my side of the aisle is not that different from Republicans. I don’t think this is in fact true, but anything that makes it seem true disturbs me.
Robin G.
I WAS IN THE MIDDLE OF WATCHING THE WIRE AND NOW I HAVE BEEN SPOILED!
:sobs: :rends clothing:
frankdawg81
again I am not saying vote no on the abomination to teach Holy Joe a lesson, vote no because passing this bill will make real reform impossible in the future.
The government will subsidize whatever the insurance companies want to charge & you can bet that will go up & hopefully you will not be surprised when it goes up faster when it is subsidized than it did before.
The Republicans will claim this escalating rate is because the government got involved and the press will not want to embarrass them by pointing out it is what they DIDN’T do that caused the problem. The result will be a conventional wisdom that says government intervention caused the situation to get worse so therefore we cannot do more & need to do less.
Passing this turd will make actually reforming the situation much, much, much harder if not impossible.
Midnight Marauder
@Brea:
The rabbit hole goes deep on that one. But it’s an incredibly interesting read. Looks like there’s another website to distract myself from all the madness going on in these intertubes these days.
Relax those shoulders, Balloon Juice. Someone else is gonna carry a little of the burden today.
Mike from DC
dadanarchist: I agree that the left has been taking big, giant mouthfulls of a shit sandwich for decades. However, I also think that Nader would not have been able to siphon off as many votes as he did in 2000 if the Dems made peace with the left in the 90s.
Of course, I’m speculating here, and Clinton had a psychotic Republican congress limiting what he could do to placate the left after 94. But, if he was able to throw a few more bones to the left, I don’t think Gore would have had to fight a rear guard action against Nader during the general election, allowing him to win both Florida and New Hampshire, and becoming president.
I believe that Nader only became an issue because the Dems have had a strained relationship with the left ever since the 60s, in part because the Republicans have been very successful by running against the 60’s left since Nixon.
mo
@ dan
I think this is a fair point, but I guess I would say two things:
1) They inserted themselves by putting a stake in the ground over the public option. They could have similarly inserted themselves on something that was more worth fighting for AND provided more room for win-win.
2) I’m also just taking a view that is a little more resigned to the current realities of a Senate that is hopelessly stacked against progressives. “The left” just wasn’t going to win big on this issue – except for the fact that something approximating universal healthcare is a HUGE win in this country.
Go for a small victory on the politics here while striving to actually improve the bill in a lot of little, progressive ways. And start the long, hard slog of reforming our Senate.
freelancer
@DougJ:
There you go. Giving a fuck when it ain’t your turn to give a fuck.
Meyer
Exactly. Subsidies and mandates without some counter to the insurance companies is madness. You not only won’t solve the problem, you’ll sink real reform until the insurance companies have squeezed every last dime they can out of this country. Which, since they are beholden to their shareholders, they are legally obligated to do.
jenniebee
@mo:
This is where we part ways. Progressives are only required to act if we can act in an unambiguously positive manner. That is, we should only be supporting this if we’re reasonably certain that it’s going to work and work reasonably well. There’s a lot more at stake here than “winning” and even more at stake than all those lives that could be saved, and that is that we have to demonstrate that we can use government as a tool to improve people’s lives. And in order to do that, we have to restrain ourselves from using it when we’re not sure that we can achieve the effect we want. Otherwise, we’re only justifying the conservative stereotype of liberals as well-intentioned meddlers who do more harm than good.
mo
@DougJ
I’ve felt this fear, too, in recent days. I don’t think it’s true, either – I hope, god help us.
I also have a lot higher standards and expectations for “my side” – things like compassion, logic and rationality, and treating people with basic decency. That’s why I get discouraged – and probably why I should stop reading blogs :)
dan
@mo: Your Number 2 is a fair point, but wouldn’t it have been equally reasonable for a black guy with Hussein as middle name to think he could place second in Iowa?
I get the realpolitik. But if that framed the bounds of the possible there would be no President Obama.
He’s president even though he never asked white people who never thought they’d vote for a black guy to change their minds or admit they were wrong. He’s president because he said, “we’re not going to argue about that anymore. Let’s talk about something else.” And it worked.
Health care could have been just that sort of soft sell. Let use new words and not make the same stale assumptions about the political spectrum. But the strategy was, instead, pretty familiar.
dadanarchist
Exactly. I voted for Nader in 1996 and 2000 for precisely this reason.
People forget that there were large and raucous protests at the DNC convention as well as the RNC in 2000.
I learned my lesson, however, and won’t be making that mistake again.
Voters younger than I am, however, mobilized by Obama and disillusioned by reneged campaign promises, just might.
Fallsroad
STAGE ANNOUNCEMENT (Wavy Gravy): There’s a guy up there, some hamburger guy, that had his stand burned down last night. But he’s still got a little stuff left. For you people who still believe that capitalism isn’t that weird, you might want to help him out by buying a couple of hamburgers.
-Woodstock, 1969.
Hippies would buy the burgers cause some guy needs a hand.
Then McDonald’s comes along and makes us all so fat we can’t fit into the voting booth.
This health care reform business, for someone who is an epileptic and was at the mercy of the insurance and drug companies for many long years, is the most depressing political spectacle of my life.
My brother is a union organizer and negotiator who edited a book on single payer back in the 1990’s, and between the two of us we cannot quite figure out whether or not the current forms of the bills are worth supporting, and what the alternatives, if any, are. This is, for him, personal and professional and agonizing, as there are folks who have a say in this who use him as a resource when considering votes.
For me it is a deeply personal issue, as I’ve been on the wrong end of rescission and forced to buy drugs from Canada because the retail cost here in the US (for a French manufactured drug) was 300% higher. I am disabled and now on Medicare, so my basic health needs are met for a low monthly premium of $96.40 per month, plus my out of pocket stuff. Medicare is essentially a base model for a single payer system, if we as a country had the collective wisdom and will to go that route, which is the best available, IMO.
But if I were not on Medicare, I’d be out in the cold, struggling to get insurance, then struggling to keep it (I have other health issues beyond a severe seizure disorder), as so many of my countrymen and women are right this minute. It is a measure of our barbarity and susceptibility to fear mongering that in 2009 the allegedly most powerful nation on earth has yet to deal with a basic human rights issue for its own citizens while it goes gallivanting around the globe fighting irrational wars for illegitimate purposes.
But here we are. And I am beginning to suspect that the Kleins and Krugmans are going to be proven right, that getting what we can right now, establishing some form of a right to health care, recognized by and regulated by government, is the crucial beginning to a long and bloody process that ultimately offers us more progress on this issue than killing the effort altogether and hoping for some ill-defined second bite at the apple in some vague future time frame.
I am not exaggerating when I say this has been agonizing for me. I am covered. The bills are profoundly flawed. The medical industry is demonically indifferent to human suffering. People are sick, and dying, for lack of any coverage at all. My gut tells me the right thing to do is be a fucking hippie, and sidle up to the hamburger stand and buy whatever is left so my fellows can go to the fucking doctor.
mo
@jenniebee
I agree that there’s a lot more at stake than “winning”. That’s why I think it has been a mistake to frame it that way (which has been done explicitly by Kos and Digby and FDL and others). I care about a good – or at least decent – bill NOT about winning. (Activists should care about winning to some degree because that’s how we continue to make inroads. They just need to make sure it’s worth fighting and/or winnable.)
I also agree 100% that we need to make it a good bill that will make a positive difference in the lives of the poor and sick. I just don’t see how the public option truly, materially affects that. If this bill is insufficienct without the public option, it’s insufficient with it. If it truly is insufficient, let’s turn our attention to making it better. And there are lots of ways to make it better that don’t have to be a showdown with Lieberman or Nelson.
mantis
@frankdawg81:
The government will subsidize whatever the insurance companies want to charge & you can bet that will go up & hopefully you will not be surprised when it goes up faster when it is subsidized than it did before.
Even if this does happen, and I don’t know why you’re so certain it will, it will then be a big problem for the Congress, which can then implement more reforms. But considering how low insurance company profits actually are, the real problem of cost is in health care, not insurance, and the bill does have a number of good cost-control measures. Why are you so certain costs will go up?
The Republicans will claim this escalating rate is because the government got involved and the press will not want to embarrass them by pointing out it is what they DIDN’T do that caused the problem. The result will be a conventional wisdom that says government intervention caused the situation to get worse so therefore we cannot do more & need to do less.
Passing this turd will make actually reforming the situation much, much, much harder if not impossible.
Why, because Republicans will lie about it? They lie about everything. I’ll take passing good (but not perfect) reforms now and fighting their lies down the road over the status quo. You know why? Because there will be hundreds of thousands of currently uninsured people who will get sick, and will only have to deal with a fraction of the cost they would under the status quo. Far, far fewer of them will go bankrupt as a result of health care costs. That’s enough reason for me, and I don’t think we should determine our course of action based on what Republicans might say in the future, and how much traction they might get with their bullshit.
scudbucket
@dadanarchist:
The fundamental tactical mistake was pulling single-payer off the table at the very beginning.
Personally, I think the mistake was over-reaching: system-wide reform – progressive or moderate – would have (and still does) required a full 60 votes, and even a cursory glance at the likely suspects meant that this was highly unlikely. A better approach would have been to hammer through some significant expansions of Medicaid or Medicare while simultaneously addressing the long-term viability of both programs. It would have been an easier sell centrists, and would establish some bonafides with the voters. Plus, these programs already exist, and incrementally expanding them would be easier than the wholesale changes required by new programs.
mo
@dan
Again, fair enough. That’s a world we’ll never know.
I think in general Obama has operated pretty cautiously and been reticent in taking big risks. I think he’d rather have a 75% chance of getting a decent bill that sets the foundation for universal healthcare and for eventual cost-control measures than taking a 30% chance of getting something meaningfully better (and it’s not like truly transformative reform – what is there a 0.1% chance of single payer?).
I happen to believe the last decade has been such a mess that I prefer the route of getting us back on the right track with more certainty, even if it’s imperfectly. But I also think it’s a legitimate counterargument that, because things are such a mess, we need to think bigger.
mantis
@Fallsroad:
But here we are. And I am beginning to suspect that the Kleins and Krugmans are going to be proven right, that getting what we can right now, establishing some form of a right to health care, recognized by and regulated by government, is the crucial beginning to a long and bloody process that ultimately offers us more progress on this issue than killing the effort altogether and hoping for some ill-defined second bite at the apple in some vague future time frame.
Exactly. Progress.
Mike from DC
dadanarchist: Which is exactly why I’d like to see the dems finally come together and pound out an agreement so we’re not endlessly forming circular firing squads. We shouldn’t blame any one group, as we’re as guilty of not bringing this up earlier as anyone else is in the party. So, doing it soon, so they can rally the troops before the 2010 election is the right move.
The ironic thing here is that the left probably would be happy if they gave us something relatively small, as we’re rather accustomed to being so neglected.
Btw, I voted for Nader in 1996 and 2000 too.
Martin
Doug, I’ve had this donkey foam finger in my closet for 8 years and I don’t care how many people have to die, I’m gonna wave that fucking thing!
angler
Hey not bad, no Hitler comparisons in this thread.
cfaller96
Come on, you can’t possibly know what the core motivations of somebody writing on the internet are, unless they explicitly state them. There are a lot of people suggesting that the Senate bill isn’t good enough and should be killed, but nowhere have I seen anyone say that the primary reason they believe is because of Joe Lieberman or how Howard Dean was disrespected.
Yes, you’re arguing against a strawman here. You guys need to fucking cool it.
Fulcanelli
@aimai: Aimai, if you’re still around, I love your posts.
Now, all niceties aside… I’ve learned an awful lot about health care policy and congressional parliamentary maneuvering reading the posts here since this HCR mess started, so thanks, BJ’ers.
My $.02 worth is this: I don’t give a fuck how you slice it, a for profit, American style free market health care system will never work optimally for people of all income levels in this or any other country.
And IMO this is because health care is not a fucking product or commodity the “invisible hand” vampires squids on Wall Street and in the investor class can play around with and manipulate like it does with everything else to make ever increasing levels of profit.
You can’t subject someone’s ability to just stay alive and healthy to the profit making whims and manipulations of the oh-so fucking holy “Market”. As long as insurance companies and their investment backers on Wall Street are positioned as middlemen whose only function is to siphon off what should be rightfully be going to the actual health care providers, we’re screwed.
Look at all the other countries that have a health care system that works, whether public or privately funded. There are caps, regulations, etc. that restrain somebody, somewhere in that chain’s profit margin to keep it affordable for people, or they keep the middlemen out of it altogether. Imagine.
Health care and the services medical professionals and institutions provide are not the same as selling widgets, houses, oil, cars or anything else. It’s gotta be non-profit or we’re doomed long term. Now I don’t know where to start, but I’m not giving up. This bill is far from perfect, but it’s a start, I guess.
FlipYrWhig
@jenniebee:
But that’s “winning” all over again, isn’t it? Otherwise you’re saying that in order to demonstrate that we can use government as a tool to improve people’s lives, we have to stop this effort to use the government as a tool to improve people’s lives. Because the statement of principle is worth more than doing an amount of good that you have deemed insufficient. I don’t get that. I’ve been hearing it a lot, but I don’t get it. if you want to show that we can use government to improve people’s lives, improve them with a bill that changes the whole structure of health insurance in the country, and then keep fighting to make it better.
I get the complaint about individual mandates as forcing people to buy from private corporations, and that that’s odious. But I don’t find it odious that there’s a support program for low-income families to buy home heating oil (from private companies), and I don’t think I would mind it if there were a program to help low-income individuals have cheaper cell-phone service (from private companies). And those are just utilities, which I bring up because I think the analogy to health care is worth considering.
Offering rebates on higher-efficiency appliances puts government money into corporate pockets. Food stamps put government money into corporate pockets. _Lots_ of actual or imagined policies have that effect, because corporations are not exclusively agents of corruption and nefariousness–they are that, but they _also_ provide goods and services. So even if it’s bad to give corporations government support, I don’t think it’s all that bad _if the corporation is also providing important services with that support_. That’s where technocrats and regulators come in, and I’d want those to be as strong and effective as possible.
I feel like resentment at “corporations” is crowding out other features of the discussion. We inhabit a world where corporations and private interests have a lot of control over _everything_. I’d rather try to use levers and pulleys to tug those corporations in the direction of doing _less harm_ than deciding that the Rubicon that shall never be crossed is helping poorer people have some health insurance instead of none because the involvement of “corporations” makes it an evil, evil thing.
FlipYrWhig
Also, my apologies for all for going off on emo-adolescent-level curse-filled tirades the other day. I’m still pissed off for all the same reasons, but I need to control myself.
Meyer
Accounting games. Give anyone a profit margin to work *down* to, they’ll have no issues hitting it. And that is the basic problem of not introducing competition into the market; without it, these guys do not have to compete, and they will hit low “profit margins”, all the while have a merry old time.
We can either force them to compete – the public option, or the medicare buy in – or we can legislate overall price caps against them (“a basic policy shall cost no more than 30% more than the price of an equivalent policy in France, or else we will trigger a public option.”) or we could try to get more competition in the private market (how? There are not really enough of these guys that you can think that they will not form some sort of oligarchy.)
You are not going to get price improvements to the consumer by dropping health care delivery prices absent competition, either public or private, so that part of the senate bill is kind of worthless.
That leaves you with some really stark choices, given the current bill-as-proposed. Most likely, you have yourself a shit sandwich. Mandates without price controls will jack up profits for the insurers (which they will hide) without dropping the cost to consumers. You maybe get guaranteed issue, but GI without price controls may as well not exist. If anyone can get a policy for $100K a year, how many will?*
Lose, lose, lose.
FlipYrWhig
@Meyer:
Ideologically, I’m simpatico, and I’m at heart a Huge Government statist. But it’s worth stating, I think, that we don’t do this with every service. Other public utilities are provided by a patchwork of public and private providers. Everyone hates the cable companies, but no one is out there demanding a public option for TV. Everyone gets disgruntled about their cell phone service, but no one demands a public option for that either. I’d love to see them, but there’s been no agitation for creating them. (And other nations on the social-democratic continuum do have services like that, IIRC.) Why is this public option a deal-maker or deal-breaker, but virtually no other public option has ever been? I’m genuinely curious if the public option for health care is legitimately much more crucial than a hypothetical public option for any other sector of the economy.
Meyer
Cable is strictly regulated both in terms of who they cover and what they can charge. In places, there are public options (towns who build their own – and people love it) or private competition (called overbuilders, rare, but it exists – and people love that too.)
The cable companies put up the same brutal fight whenever either of these things are proposed, FWIW.
lol
@goblue72:
lol. If I hadn’t already watched the Wire, I’d be pissed at the spoiler.
In any case, I don’t think your analogy could be more spot-on, especially given the series’ overall theme of the resistance to change that all institutions have.
DougJ
@goblue
Spot on.
Deschanel
I really appreciate reading all the comments the last few nights on BJ- a seriously smart crowd here, and I think the discussion of a very complex issue is well argued and persuasive by both sides as to whether the current bill is better than nothing, or worse, or everything we’re projecting. I thank BJ for hosting the discussion.
Just my impression: I think a lot of the POV saying, push this through, stop complaining, it’s this or nothing: I get the feeling that people saying this have health insurance themselves, and feel pretty secure in it. Which is fine, grand.
But with that comed the issues of mandates- that I will be forced to buy a shoddy inferior product, from a rapacious for-profit industry. I cannot afford insurance in the first place, so I go without. Compelling me to give a giant chunk of my small artist’s earnings (less than 20k) to a corporation makes me understand the teabaggers for the very first time. I think they’re insane- and here we have the exact same coercion they’re screaming about- except I shall be compelled to tithe to a corporation.
I cannot see how this is so blithely regarded here by many as acceptable, much less constitutional, much less a powder keg of absolutely validating the teabaggers points. You want to mandate them to buy private insurance? They . will. be. BONKERS by 2012.
Marcy Wheeler has some damned good points : it is absolutely unprecedented for the government to force people into corporate tithing, mandatory purchase of goods and services. That only a tantrum by Lieberman forced us to fundamentally change our system, fro common good towards the corporate oligarchy our elected leaders serve.
I’m damned glad to have an Irish passport, because this country is well and truly fucked if the government is compelling people into corporatist slavery over issues of their lives and health . This is unacceptable, and ferociously unconstitutional. Land of the free, what a bitter joke.
http://emptywheel.firedoglake.com/2009/12/15/health-care-on-the-road-to-neo-feudalism/
FlipYrWhig
@Meyer:
I’m glad to hear that — so then my question becomes, isn’t that kind of like the ill-fated and unappreciated Kent Conrad regional co-op idea? If not-national not-public delivery systems can improve service for other public goods, it seems to me that not-national not-public delivery systems for health care (or health insurance) can still be _helpful_ even if suboptimal.
I don’t like the fixation on the public option as The One True Method because it doesn’t seem to me like a binary thing: even if it’s the next best way to run a health care system (with single-payer presumably the best), if you can’t get it, why not keep moving down the list? I don’t see why the Rubicon is set at “public option.” I see why it’s a good plan, but I don’t see why it’s the only one that will do. Both for policy and for politics, it feels like that line got drawn in the wrong spot. Maybe it just proves that American politicians are cowardly and/or stupid, but that’s what we’re dealing with.
And even if we need to use the Shit Sandwich language, ya know, if you’re stranded in the Andes and you’ve eaten your way through food, and companions, you might as well eat the shit sandwich. The problem with martyrdom is that you still die.
Citizen Alan
@FlipYrWhig:
There’s also no legal requirement to buy any of these things either, as there will be for the insurance mandate. If Congress ever passed a law requiring everyone to have cable television, Congress had better regulate the hell out of the cable industry. And that’s without even getting into the fact that neither cable nor cell phone companies have an antitrust exemption that allows them to engage in price-fixing.
FlipYrWhig
@Deschanel:
I agree that that’s an issue, but like it was put in another thread, I’m not sure why it would feel so much worse than being compelled to “tithe” to the public option, which wasn’t going to be free anyway. Either way you’re being required to spend money. _We_ don’t feel as jobbed by taxes as we do by businesses, because we’re liberals. But I can think of ways that the government already compels people to give money to corporations. Now health care is different because everyone has health and there are ways of doing without, say, electricity. But I don’t feel like it’s really _that_ different. We pay a lot of corporations for providing crucial basic services as it is, ones that the vast majority of people cannot do without.
FlipYrWhig
@Citizen Alan:
That’s exactly where I’d like to fight in terms of policy on this bill. I would want to regulate the hell out of the health insurance business and take a hammer to their monopolistic tendencies. That’s why I didn’t have as much of a problem with the strong triggers and whatnot. Bring basic progressive-era safety-style regulation to bear on the health insurance business, and jam it far and deep up their most sensitive orifices. That would be my approach, after having concluded that there weren’t the votes for more dramatic changes to the system.
Peter
Another thing to remember is that the CBO said that the public option would cost more than private insurance, once the public option was no longer tied to medicare rates.
The public option is still good policy because it would give better care, but it was not going to be a major cost saving mechanism, at least not right away.
Dan Gicker
Doug sanest thing I’ve heard all week. I don’t care if Lieberman is pissing in my cornflakes, just pass the damn thing.