Health Care Reform: A Peek Behind the Curtain

This is one of the things I like best about Obama. The health care problem isn't going to get manageable by nibbling around the edges. There is no one, no one, who thinks things are going well. So why not now?

Maybe we should ask the guys who thought this up to take on the job of health care reform. They clearly have enough imagination and good humor. Makes me quietly proud to be a human being along with them:
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I think that Obama realizes that since any economic recovery that occurs is going to be a long slow climb and because the American people are notoriously impatient for quick easy answers, he's going to steadily lose political support over the next several years.
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Therefore if he intends to get healthcare reform done, he's got to get it done this year or he'll lose his window.

People often talk dismissively of "process stories"
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I don't know who these "people" are, but I call it "reporting," and I wish we had more of it. Great story, great post.

KT: Nevertheless.

its nice to know that Obama wants to "get it done" this year -- but it would be even nicer to know what "it" is that Obama will be doing.
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right now, the big debate should be between "single payer" an "public plan in competition with private insurance". Instead, because of Obama's lack of leadership its between "all private insurance" vs "public plan in competition with private insurance".
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The real problem is that the plan advanced by Obama was complete nonsense -- you can't have "community rating" based insurance rates when you allow healthy people to opt out of the system (until they get sick.) The numbers don't add up -- and Obama rightfully abandoned his nonsensical plan.
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the problem is that he hasn't come up with a new plan -- he's provided no framework from which congresscritters can negotiate. Obama needs to do more than say "this year" and "no single payer", he needs to step up and define the framework, and then design a plan within that framework.

FT: These "people" are also known as Swampland commenters.
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KT, we make a distinction between "process" and "politics". A "process" story tells us what has happened, a "politics" story consists of gossip about what has happened.
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Its the difference between telling us what was accomplished in a meeting -- what ideas were offered, which were accepted and rejected, and what the votes were -- and telling us who showed up for the meeting, and what they had to say afterwards.

The former is "process", the latter is bullsh*t.

we make a distinction between "process" and "politics"
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Stated another way, a process story discusses how a law affects people and will be impemented. A politics story discusses what the liars who oppose the law claim it will affect people and be implemented.
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One ignores the truth, the other explains it.

I don't think single payer can be done right now and too much political capital would be spent to do it. Single payer is a possibility later. Now there is already a full agenda for ideological fights.
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I'm just guessing at what everyone thinks, but I think what bothers us about the process stories is the people-magazine-ish political trivia, cynical implied motives ("they're just jockeying for power" --which may be true but irrelevant), and excessive horserace coverage... If a story avoids those pitfalls, then I think we don't have a problem.

Speaking for no one else, the stories that I object to are the "who's up, who's down" variety.
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Democrats want to do X, but this gives Republicans an opening to depict the Democrats as socialists / soft on terror / tax and spend liberals / girly.
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... often with zero substantive discussion of "X", whatever it might be.
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Anyway, thanks for the link - interesting article.

It's a fine line between pushing ahead an agenda regardless of opposing facts (see Bush), and doing so against dissenting opinion. If Obama ever starts treading to far towards the former, process stories like these become very important. He's consistently said he wants people who will disagree with him and raise objections, and health care this year is an important risk to take. "Extremely cautious politician" sounds like someone who never gets anything done. Obama's style seems more like cautious direction. It may not be full speed ahead, but we're moving and on course. Whatever the outcome you can be sure he's considered the stakes.

KT:
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People often talk dismissively of "process stories" and the media's obsession with "inside baseball" in Washington.
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Not quite the whole criticism, actually. If you're going to defensively describe the critique, at least link us to a representative argument, instead of throwing out the standard "people often talk" line.
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Most certainly, the press will pretend to be above it all ("this is not something that we, the sophisticated political journalists, care about, of course"). But they yammer about Drudge-promoted gossip endlessly, and then insist that their own chattering is proof that it is an important story that people care about. And because they conclude that "people" (i.e., them) are concerned with the story, they keep chirping about it, which in turn fuels their belief that the story is important. It is an endless loop of self-referential narcissism -- whatever they endlessly sputter is what "the people" care about, and therefore they must keep harping on it, because their chatter is proof of its importance.

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To the substance of your post, I think there is a huge problem with your framing which can be summed up thus: "Doing Health Care Reform" is not at all the same thing as "Reforming Health Care".
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One reason why a focus on process can be detrimental to the story, is that "Getting Health Care Reform Through", or "not abandoning health care reform", or "doing health care this year" all assume that the actual content of something named "Health Care Reform" is completely beside the point.
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What version of Health Care Reform "gets done" is actually more important than whether it "gets done", because the meaning of the term Health Care Reform is the most important part of the story. "Health Care Reform", meaning "the extension of Medicare benefits to all citizens", could be completely different than "Health Care Reform", meaning "the compulsion of employers to provide health insurance combined with a subsidy for low-income uninsured". The degree to which access to health care will be "reformed" is where we'll find the real meaning of the term "reform", and where we'll find out whether the reform we're being sold will be net good or bad for all or some of us. Obviously the key time for such analysis would be before the thing gets done, i.e. now.
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A loose analogy can be made to the (now largely discredited) term "War On Terror". If one opposed the "War On Terror", all kinds of inane political arguments could be made against opposition, e.g. "Does the Senator wish the United States to surrender to Terror? How can he oppose the War On Terror, then?" If one opposes "Health Care Reform" in its eventual form, and the political press corps obsesses about whether the reform "gets done", won't the same sort of dynamic exist, e.g. "Does the Senator wish for our broken health care system to stay out of the reach of millions of Americans? How can she oppose the reform of health care, then?" The field can then be stupidly --but easily-- split into "those in favor" vs "those against" by the political press corps, and endless stories can be written about who's getting their way, and who's losing the race, and who the personalities are, and what anonymous sources said about whom.
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None of this helps engaged news consumers discover what's going to happen to their lives. None of it amounts to the heavy lifting involved in explaining in clear terms to the American people what they're going to get out of what's happening --and what they're not going to get. Most importantly, none of it helps engaged news consumers coalesce around shared information about what Health Care Reform reforms, and actively petition their representatives in Congress. A focus on process lets the few paid insiders possessing access to the lobbies of Congressional offices remain the only people with enough detailed knowledge of what's under consideration to petition the legislature for a desired outcome.
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Once we all agree on what "reform" means i.e. what the Congress has decided to accept on our behalf, then reporting on the status of its process becomes crucial. I very much look forward to intrepid reporters sweeping aside curtains, and letting engaged news consumers know who their allies and enemies really are in the battle to get the health care reform Americans are actually demanding enacted.
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That said, I wish to emphasize how grateful so many of us are for your work, and for keeping this story squarely in the focus of establishment media, since it is manifestly apparent that so many of our "representatives" in Congress (and some in the Administration) pay far more attention to you than they do us, their constituents. You can truly be said to be acting in the finest traditions of journalism on the public's behalf.
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Thank you so much again for your work, KT.

KT
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Great post but I am wondering if you could give us an example of a commenter other than hula or textee opposing to a "process" story. I and others called several times for a post on why the stimulus bill really did need 60 votes to pass but none was ever forthcoming. What I don't like is storys chock full of anonymous sources and hyperbolic assumptions. Your post today is the kind most commenters I think want to see more of whether postive or negative so we can see behind the curtain.

On another note, I would LOVE a process post on the story that the White House is considering a proposal to make veterans who sustained battlefield injuries use their own private insurance. I want to know who proposed such a thing and how much traction it has because I can tell you that most Americans myself included are NOT going to support that effort at all.

Given that doing nothing on health care might be the riskiest choice of all, you could argue that Obama has taken the conservative (small c) position in contrast to his dissenting advisors.

@sg,
I have to agree that the American Legion story, if half accurate represents a big tone-deaf blunder within the Obama administration.
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Having said that though, the fact that Conservatives are latching on to it and screaming loudly in defense of a government-run socialized medicine program and AGAINST the possibility of privatization strikes me as too rich for words!

And KT, If you want to see what kind of story aggravates the eff out of commenters, see Scherer's latest (just posted)
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I know....it's only a blog.....it's only a blog.......

KT-Per your post of Obama's court picks. I predicted the ACLU would be bought into the mix. Forgot about ACORN.
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Maybe the Obama administration should have nominated George Hamilton instead of David F. Hamilton. The hollywood actor may have an easier time at confirmation.Watch Hamilton in action here.
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The conservative judicial groups believe President Obama's first judicial pick is a hard left liberal. Let me give you a sampling of what they're saying about Judge David F. Hamilton:
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Read below from Wendy Long with the Judicial Confirmation Network:
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Hamilton has a history as a hard-left political activist, and his choice signals that Obama does intend to push extreme liberals onto the bench and politicize the courts as we've never seen before.
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Hamilton was a fundraiser for ACORN (nice ACORN payback, Mr. President) and served as vice president for litigation and a board member of the Indiana ACLU. In 1994, when President Clinton nominated him to the district court, the ABA rated him as ‘not qualified,' apparently because of his almost purely political (as opposed to legal and judicial) experience.
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Have a look at the comments of Ed Whelan, President of the Ethics and Public Policy Center. He's scratching his head as to how Judge Hamilton can be even remotely considered a moderate:
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It's far from clear what justifies the article's characterization of Hamilton as a “moderate”…Was it perhaps Hamilton's service as vice president for litigation, and as a board member, of the Indiana branch of the ACLU? Or maybe Hamilton's extraordinary seven-year-long series of rulings obstructing Indiana's implementation of its law providing for informed consent on abortion? That obstruction elicited this strong statement (emphasis added) from the Seventh Circuit panel majority that overturned Hamilton:
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http://www.cbn.com/CBNnews/561612.aspx

ACORN, the right's new boogie man.

Moderator(s):
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My comments are being held. Please release the last of the attempts, and/or email me with an explanation of why they are being held for moderation.
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stuart_zechman@yahoo.com

High Sheriffs, mess with SZ at your extreme peril.
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SZ, let us know when your comments have been released.

High Sheriffs-Make sure you the new TPS coversheet when you respond to SZ. And if you could go ahead and try to remember to do when responding to Swampland commentors from now on, that'd be great. All right!
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P.S. If you didn't get the TPS coversheet memo please let me know and I resend it.

Still waiting, High Sheriffs

Thanks for your support, folks.
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If I don't hear anything, I'll re-post in 3 brief sections.
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The system seems to have a bizarre problem with one of the hyperlinks to a February 2009 CBS News/New York Times poll in which respondents preferred "national health insurance" by almost 60 percent.
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The length of the post isn't the problem (this time, har-dee-har), it's my supporting evidence. Super.