Should Obama Be Fighting the Last War on Health Care? Or the Next One?
The old rule of thumb in journalism is that it takes three to make a trend. So I think we have a trend here in the question being raised by Jonathan Cohn, E.J. Dionne, and, today, David Brooks. Brooks concludes:
The great paradox of the age is that Barack Obama, the most riveting of recent presidents, is leading us into an era of Congressional dominance. And Congressional governance is a haven for special interest pleading and venal logrolling.
When the executive branch is dominant you often get coherent proposals that may not pass. When Congress is dominant, as now, you get politically viable mishmashes that don't necessarily make sense.
It's also important to remember that a bill--if it passes--is only the beginning of the process. Implementing any kind of far-reaching health reform is going to take years, maybe decades. And that is an argument for making sure that it starts with both a broad base of support, as well as with its gain and pain in balance. Congress, with its two-year election cycles, is not exactly known for taking the long view. As Cohn notes, in looking at where the Senate Finance Committee appears to be headed:
Consider the proposed reduction in subsidies. In the original schemes, families of four making up to $88,000 a year would get at least some assistance; under the alternatives under discussion, only families making up to $66,000 could get subsidies. Yet families making between $66,000 and $88,000 are precisely the sort of families who could use help--not a lot of help, but a little--paying for insurance. And that's assuming subsidies really end up at $66,000. Lawmakers could easily bid the number down more before reaching a final compromise.
Put aside, for a moment, the policy merits of these moves. The politics are lousy. Obama would be in danger of producing legislation that seems to offer little up-front benefit, particularly for the electorally vital middle class. And if some of these people end up paying even modestly higher taxes to help finance reform they're not likely to be happy about it. It's hard to imagine such legislation provoking a backlash that could produce total repeal. It's not so hard to imagine such legislation creating bad political feelings, the kind that linger around until the next Election Day and pave the way for legislative retrenchment later on.
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1
A family of four at $88,000 is far too much of a cut off. EVERYONE should get some assistance including individuals making that amount. The point is that everyone should have a choice between their current health insurance and a public altnernative. In some parts of the country you can make near six figures and still have crappy health insurance.
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2
Actual, I be thinkin' this be th' point tha' cuts t' th' chase (fr'm Brooks):
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"Second, Democrats learned never to go to war against the combined forces of corporate America."
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An' thar be th' sell-out o' any sort o' real health care reform.
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Sorry, Stuart - I be thinkin' we be on th' losin' side o' th' battle.
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YARR! -
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It's also important to remember that a bill--if it passes--is only the beginning of the process. Implementing any kind of far-reaching health reform is going to take years, maybe decades.
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I don't think that's being said anywhere near often enough. If there are problems with the bill that emerges, they can be addressed with additional legislation. Everybody's acting like this is their only shot and if it isn't perfect, its a failure.
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4
If only we were havin' a free press (b'sides KT an' a very few others) tha' weren't b'holdin' t' th' same interests th' congress be, we mi' be standin' a chance!
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Fer instance, we mi' be hearin' 'bout who be havin' a conflict o' interest drivin' health care "reform" fr'm th' pockets o' th' health services industry, indeatd o' an unendin' cycle o' celebrity sex an' death fer "news"!
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Arrgh! -
5
"instead".
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argh. -
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PD -
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I be believin' ye be ri' 'bout other aspects o' th' legislation bein' addressed later, bu' if we don't be gettin' th' public option a' th launchin', we won't be gettin' it a'tall.
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arrgh! -
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Cohn and Dionne seem to have the same advice. "Compromise but not too much."
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What the Democrats seem to not understand, and we saw this as recently as during the stimulus debate, compromise with people who won't/can't budge an inch has little upside other than showing voters you tried to be reasonable.
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Grassley says he can't support anything without someone other than Snowe signing on from the republican side so he has political cover.
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It's not about policy for Grassley, it's about political survival. -
8
PNNTO -
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I don't even be thinkin' it be showin' bein' reasonable - I be guessin' most people be thinkin' it be showin' th' democrats be weak an' ineffectual as they be tarred up t' be.
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Hell, I be a democrat, an' even I be startin' t' b'lieve it!
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It be like havin' th' keystone cops in charge.
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arrgh. -
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...a' least th' repubs were able t' be makin' their trains run on time...
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arrgh. -
10
I don't see any signs of the Republicans being any more willing to compromise than they have been at any point since January. Unless it is the - do exactly as we want and we will call it compromise.
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The latest poll indicates that 74% of Republicans favor Obama's plan to withdraw from Iraq, but I'll bet we will still hear some weak kneed Democrat wringing hands about it.
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4.7 million people watched the first hour of the Health Care special on ABC and when it went on after that, the show beat all the late night shows. However, what did I hear on NPR? An interview with a Republican claiming that the librul media was biased and didn't present their side. Democrats just have to stand up. -
11
I will be right in the $80,000-$100,000 group that will never get any subsidy (heck, we pay the most taxes from what I figure...people that are poorer don't pay income taxes, and people with more money get a bunch of different tax breaks). I don't feel particularly resentful that I will miss out on welfare (unlike the true working poor AND the subsidy-sucking insurance companies) because my hopes are:
-That my health care costs will drop partly from not having to pay $1300 a year for the uninsured, from competition put on the death-for-profit firms via a public not-for-profit entity, and from systematic efficiencies like e-records.
-My wife and I won't feel trapped by "portability" issues (i.e. one of us always having to work for the "man".
I fully expect to be disappointed. -
12
It may be a valid strategy to get something fairly significant but imperfect up & running, if only to disprove the "sky is falling" Republican claims. Amendments in response to demonstrated, r
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13
Olympia Snowe complained to the AP:
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"If you establish a public option at the forefront that goes head-to-head and competes with the private health insurance market ... the public option will have significant price advantages."
http://www.baltimoresun.com/news/sns-ap-us-obama-health-care-snowe,0,7253018.story
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Just like a crooked good Republican, it completely goes over Snowe's head that entire point of this process is that we spend too much on health care and need to save money. "Significant price advantages" are totally contrary to anything the Republicans and the Lieberdems are working for. -
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It may be a valid strategy to get something fairly significant but imperfect up & running, if only to disprove the "sky is falling" Republican claims. Narrowly targeted amendments in response to demonstrated, rather than predicted and disputed, shortcomings of an existing program are always an available path to improvement.
Meanwhile, it might give a number of senators sufficient time to grow a pair.
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Sorry for the double post. Sometimes these things leave the keyboard half-finished, of their own volition. There's some magic keystroke combination that does almost precisely what I don't want done.
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[...] Karen Tumulty in Swampland rounds up three op-eds. Jonathan Cohn: Bill and Hillary Clinton are off saving the world, he through his global foundation and she via the State Department. But their presence looms over the health care debate as surely as if they were running the White House. Their epic failure to pass reform in 1994 has become the defining object lesson in how to botch health care legislation–a lesson President Obama has obviously taken to heart. Push for reform right away; let Congress hash out the details; and, above all, don't threaten people's current insurance arrangements. You can sum up Obama's strategy for health reform as “WWCD”: What Wouldn’t the Clintons Do. [...]
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From pafro's link-
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Responding to Snowe's comments, Schumer spokesman Brian Fallon said the Democrat will continue to seek a consensus with Republicans but believes there must be a public option that "is available to all Americans from the first day."
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Now if only Chuck could convince the senior Senator from California.
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And to be fair Snowe said the public option should be available should the insurance industry not reform.
That's a bad idea, coming back to this issue later to add a public option would be as difficult if not more difficult than dealing with it now. Also by what matrix do we decide whether the public option is needed "down the road"?
Still she at least gives lip service to the idea rather than shouting about Socialized Medicine. -
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Insurance reform is a bit like skiing in Sierra Leone. It might be very nice, but would you bet on it happening? The only way health care is going to work is either a strong public plan - which the public would almost certainly find much better than the existing profiteers paradise, or else radical legislation that coerces the insurance industry to a degree previously unimagined. Given how much success financial services reform has enjoyed, I would suggest that the former option is more credible. You'll have to have a truly vicious fight anyway, so you might as well do the job properly, once and for all. If Obama really works the Democrats, and sells the public plan as he can, we have a decent chance of getting it. If not, it will be knockdown drag out fight time, probably half-assed failure as a result, and a big fat gift to the GOP propaganda machine, plus lots of donations from the medical malefactors.
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RE th' Snowe interview...
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Don't employers WANT to be gettin' rid o' employer-based health insurance? Be tha' not a way fer them t' be cuttin' costs an' savin' money? Why NOT be "underminin" it?
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An', wha' exactly, be workin' wi' th' system we be havin' t'day, b'sides providin' lots o' nice juicy profits fer Premium Collection Corporation shareholders?
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Arrgh! -
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Here's what liberals need to do: STOP LETTING CORPORATE WHORES CO-OPT YOUR AGENDA.
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My advice to liberals in Congress is to stop fighting the Blue Dogs. Let the Blue Dogs/centrists/corporatists come up with a reform package and make them own it.
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I'd like to see the health care "reform" they come up with without any pressure from liberals. No single-payer? Fine. No public option? Fine. No mandates? Fine. No serious regulation of insurance companies? Fine.
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Here's my bet. After a year or two of reform that doesn't actually reform anything, the public pressure to pass an actual reform bill will be overwhelming. -
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"The great paradox of the age is that Barack Obama, the most riveting of recent presidents, is leading us into an era of Congressional dominance. And Congressional governance is a haven for special interest pleading and venal logrolling.
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When the executive branch is dominant you often get coherent proposals that may not pass. When Congress is dominant, as now, you get politically viable mishmashes that don't necessarily make sense."
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Oh, for Christ's sake. As if the Bush Administration wasn't the biggest corporate giveaway of government in a century (KBR/Halliburton anyone?). I believe that they mostly decided how much Wall Street would be regulated while it sucked at Treasury's teat (how's that "coherence" working out for you?). And, if I can manage to remember back that far, most of their other policies were about as incoherent as unnecessary disastrous wars based upon already disproved rationales and global economic catastrophe based upon cartoonish socio-economic dogma. Please spare us, if we want David Brooks' supposed wisdom about government we know where to try to look for it.
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As it stands, Congress makes the law, regardless of how much of it is written by their corporate owners. So it's all the same war: the 0.5% power elites against the other 99.5% of us. -
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square1, it's impossible to make the Blue Dogs do much of anything, except whine sanctimoniously and preen for the cameras. They specialize in being "moderate" which means that they never have to articulate a coherent position;instead, they just split the difference and call the resulting mess the American way to behave. You might as well try nailing Jello to the wall, as hope that the Blue Dogs will ever be good for anything except seeking out plunder and self-promotion.
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OT - th' EPA were just approvin' California's emissions standards - I be hopin' now th' other States involved (includin mine) be able to go ahead now wi' their own, tighter standards, too!
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A wee victory, bu' we be havin' t' celebrate when we can, me hearties!
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Arrgh! -
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State Supreme Court rules for Franken, 5-0
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http://www.startribune.com/politics/national/senate/49520987.html?elr=KArksLckD8EQDUoaEyqyP4O:DW3ckUiD3aPc:_Yyc:aUac8HEaDiaMDCinchO7DU -
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Me own advice be, come up wi' th' plan - a public option phasin' in single-payer o'er a few years, an' sell it hard, sell it clear, sell it loud, an' stick by it - no f-in' compromise! If it be goin down in flames, a' least it be clear who really be on th' side o' th' 99.5%!
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Since th' subject o' breakfast were comin' up in JNS' thread, I be sayin' we ought not t' be lettin' congress be makin' any more waffles!
.Arrgh!
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