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Health Care

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The Wisdom of the Elders.

“Does this rollout failure discredit the core goals of a liberal project, including that of a mixed economy, a regulatory state, and social insurance? Conservatives in particular think this website has broad implications for liberalism as a philosophical and political project. I think it does, but for the exact opposite reasons: it highlights the problems inherent in the move to a neoliberal form of a governance and social insurance, while demonstrating the superiorities in the older, New Deal form of liberalism.”

Assessing the failure of the healthcare.gov rollout, Mike Konczal makes the case for returning to the old ways. “[T]he Category B grouping, which we associate with the New Deal and the Great Society…creates a universal floor so that individuals don’t experience basic welfare goods as commodities to buy and sell themselves…My man Franklin Delano Roosevelt may not have known about JavaScript and agile programming, but he knew a few things about the public provisioning of social insurance, and he realized the second category, while conceptually more work for the government, can eliminate a lot of unnecessary administrative problems.”

Of course, Social Security had rollout problems too. And progressives at the time definitely lamented the concessions that were made as Social Security evolved from bill to law, including the exclusion of agricultural and domestic laborers [re: African-Americans] from the law. (Frances Perkins: “The whole thing has been chiseled down to a conservative pattern.”)

That being said, I think it’s important to keep this in mind every time the right starts complaining about byzantine complexities in the Affordable Care Act: We could’ve avoided many of these issues if this change-bringing administration hadn’t immediately ruled out the obvious progressive solution to the health care problem — a single-payer system of Medicare-for-all, like most other advanced industrialized nations enjoy, perhaps phased in with an immediate voluntary buy-in and a gradual lowering of the coverage age.

Instead, we adopted the Republicans’ proposal, the marketplace/exchanges plan originally conceived by the Heritage Foundation and enacted by Mitt Romney, without even including a public option to keep the insurers honest. And what’d we get for this ginormous unforced concession to the right? Nothing. Republicans still didn’t support the health care law in 2010, and they’ve screamed holy hell that it’s tyrannical government socialism for the past three-odd years — even though it was their plan to begin with.

Now, they’re deliberately sabotaging implementation of the ACA and trying to pin every misstep, including this rather sad website #fail, as a failure of the liberal project. As Konczal aptly points out, what’s failing here is the NEO-liberal project — the desire to embrace public-private, technocratic conservative ideas of a generation ago (see also: cap & trade), in the hopes that today’s conservatives will somehow be intellectually honest enough to support them too. That is a sucker’s bet every time.

One other important takeaway from this article: “[I]f all the problems are driven by means-testing, state-level decisions and privatization of social insurance, the fact that the core conservative plan for social insurance is focused like a laser beam on means-testing, block-granting and privatization is a rather large problem. As Ezra Klein notes, ‘Paul Ryan’s health-care plan — and his Medicare plan — would also require the government to run online insurance marketplaces.’”

In other words, here again conservatives are decrying exactly what they ostensibly espouse. Perhaps a better way forward on fundamental pieces of legislation, instead of playing Lucy and the football with the Republicans, is to try to enact our own ideas from now on.

Update: In Foreign Affairs, Kimberly Morgan makes much the same argument: “The real source of Obamacare’s current problems lies in the law’s complexity. A straightforward way to assure coverage would have been to extend an existing, well-worn program to more people…In the United States, [due to] political antipathy to government programs…policymakers regularly rig up complex public-private, and often federal-state, arrangements that are opaque to the public, difficult to administer, and inefficient in their operation.”

Nihilists, Dude.

“‘It’s imperative to act now, Cruz warns, before the full benefits of Obamacare kick in and Americans get “hooked on the sugar, hooked on the subsidies.’ His plan: Yoke the defunding of Obamacare to the must-pass budget bill the House will take up in September. The endgame? To force a government shutdown so painful and protracted that Barack Obama would have no choice but to surrender the crown jewel of his presidency. ‘As scary as a shutdown fight is,’ Cruz insists, ‘if we don’t stand and defund Obamacare now, we never will.’”

Another dispatch from the madhouse: In a fine piece of reporting, Rolling Stone‘s Tim Dickinson delves inside the Republican suicide machine. “Having backed the GOP into a shutdown fight that congressional leaders never wanted, the insurgents are winning, and establishment leaders are running scared. America is now careening toward a catastrophic voluntary default on our debt because no one in the Republican Party with the authority to put on the brakes has the guts to apply them, for fear of being toppled from power.”

An important point Dickinson makes here that cannot be emphasized enough: We didn’t just stumble into this crisis: Taking the government and the debt ceiling hostage was the strategy all long, and the right-wing insurgents have been planning for this for months. “They’d drawn a dangerous lesson from the previous battle: Brinksmanship works…In February, the House temporarily suspended the debt ceiling — intending to give the president’s poll numbers three months to come back to earth.”

Hey, speaking of polling numbers coming back to Earth

In any case, see also the NYT on this: “To many Americans, the shutdown came out of nowhere. But interviews with a wide array of conservatives show that the confrontation that precipitated the crisis was the outgrowth of a long-running effort to undo the law, the Affordable Care Act, since its passage in 2010 — waged by a galaxy of conservative groups with more money, organized tactics and interconnections than is commonly known.”

So we’re not in this hostage crisis by accident. The GOP even changed the House rules so they could maximize this confrontation. Republicans saw Obama fold in December 2010 on the Bush tax cuts and in August 2011 on the last debt ceiling hike. They think they can make him fold again here, and on every subsequent debt ceiling hike, and sadly, history is on their side on this. As Ted Cruz put it a few months ago: “If you have an impasse, you know — one side or the other has to blink. How do we win this fight? Don’t blink.”

Another small digression: If, like Ralph Nader this morning, you’re wondering why the right-wing of the GOP always seems to pull these sorts of stunts off while the left-wing of the Dems are usually completely marginalized, two quick answers: 1) The lefties don’t have billionaires backing their plays, and 2) we’re the People’s Front of Judea. They’re the right, they’re inherently better at the goose-stepping.

That being said, this whole episode also illustrates why it’s useless for Democrats to try to meet these fools halfway on policy: Republicans have now spent almost three years voting constantly to end the Affordable Care Act. To break a health care law originally penned by the Heritage Foundation and enacted by Mitt Romney, they have shut down the government and sent us to the brink of an economic default. So, how, exactly, would things be different if we had just passed Medicare for all, and/or a public option? They were going to lose their shit regardless, just like they did on Social Security, on Medicare, and any other progressive issue you can think of. There’s no point in trying to placate people who aren’t bargaining in good faith.

Anyway, as it happens, and as Andrew Sullivan recently pointed out, we’ve seen a minority party in America rejected at the polls try to take the entire nation hostage before. Here’s Abe Lincoln in 1861:

“What is our present condition? We have just carried an election on principles fairly stated to the people. Now we are told in advance, the government shall be broken up, unless we surrender to those we have beaten, before we take the offices. In this they are either attempting to play upon us, or they are in dead earnest. Either way, if we surrender, it is the end of us, and of the government. They will repeat the experiment upon us ad libitum. A year will not pass, till we shall have to take Cuba as a condition upon which they will stay in the Union.”

So too here: This time the scalp the GOP wants is the Affordable Care Act, or the Ryan budget, or social insurance cuts, or Malia Obama. “‘The girl. Bring us the girl,’ said Congressman Steve King (R-IA)..’The bill may pass, but the firstborn shall be ours.’” It’ll be something else the next time and the time after that.

That’s why John Judis is calling this “one of the worst crises in American history“, and why Jon Chait wrote that “Allowing Republicans to default on the debt now is better than trading something that allows them to threaten it later.” Because if Obama buckles this time — and, let’s remember, we already gave the GOP their sequester-funding-levels — the Republicans will just keep taking the American government and economy hostage to get whatever they want. And quicker than you can say he-said, she-said, the rest of the lazy Beltway media will come to treat this sort of hostage-taking as politics as usual. It has to end here, or it never will.

Adjuncting Gets Even Worse.

“Allison G. Armentrout, an adjunct instructor at Stark State College, doesn’t get paid by the hour. She earns $4,600 to teach two English composition courses…On a recent week, she spent three hours preparing for her lectures, close to six hours in the classroom, and 16 more grading assignments for a grand total of about 25 hours. So she can breathe a sigh of relief because she won’t lose her job: She came in under the college’s new 29-hour-a-week wire designed to keep her ineligible for health-care coverage under the Patient Protection and Affordable Care Act.”

Leave this academic factory, you’ll find me in the matinee: Compounding life in the Nine Circles of Adjunct Hell, more and more college and universities are trying to game the system so they don’t have to pay for adjuncts’ health care coverage. Because if you’re going to exploit your desperate, over-educated workforce like it’s a Gilded Age factory floor, why not go all the way?

“What is happening — and I’m finding this even with just two classes—because of the grading load, I’ve been put in a position twice this semester where I’ve just had to lie about the number of hours I actually worked. I don’t want to have to make a choice between having a job or not.”

The Doctors Get Paid.

“This is basically never mentioned in the US health care policy debate but the reason why foreign prices are lower is not mysterious — they have laws forcing the prices down. The fact that we allow such high prices is why health care in America is hard to afford. The high prices make private health care extraordinarily expensive to patients and employers, and the same high prices make it difficult for the government to cover everything through public sector insurance. Canada, where the prices are lower, manages to have a more robust welfare state without higher taxes for precisely this reason.”

As Matt Yglesias points out, one of the many reasons health care is so expensive in the United States: doctors are paid way too much. See also: 21 graphs that show America’s health-care prices are ludicrous. And after that: The Serpent on the Staff.

Along with pretty much always being on the wrong side of reform, the American Medical Association has contributed heavily to this problem. First, by working to artificially limit the supply of doctors for decades, and thus helping to ensure the doctors we do have are burdened with crushing amounts of debt. Second, by pushing for a cap on Medicare-supported residencies in 1997, further decreasing the US supply of doctors — They’ve since reversed course on that. And third, by continually skewing Medicare payment models and reimbursement rates. Don’t expect this issue to be resolved anytime soon.

Better Living through Virology.

“[Above] is a look at the past morbidity (how many people became sick) of what were once very common infectious diseases, and the current morbidity in the U.S. There’s no smallpox and no polio, almost no measles, dramatically less chickenpox (also known as varicella) and H. influenza (that’s not flu, but a bacteria that can cause deadly meningitis.” How Vaccines Have Changed Our World in One Graphic.

Braaaaaiiiiiiiiiins.

“‘Every dollar we invested to map the human genome returned $140 to our economy — every dollar,’ he said. ‘Today our scientists are mapping the human brain to unlock the answers to Alzheimer’s. They’re developing drugs to regenerate damaged organs, devising new materials to make batteries 10 times more powerful. Now is not the time to gut these job-creating investments in science and innovation.’”

President Obama makes the case for federal investment in the Brain Activity Map Project. (You heard it here first, tinfoil hat people. The tyranny of the Kenyan socialist will not stop at your precious bodily fluids — He’s going to read your brainwaves too!) Seriously, though, investing in basic scientific research like this is, er, a no-brainer. It creates jobs while advancing the frontiers of human knowledge in all kinds of unanticipated ways. We’d be stupid not to support this — which means, of course, the jury’s still out on whether we will.

Update: “BAM is an acronym you’ll probably be hearing a lot in the weeks and months to come — so let’s talk about what the BAM project is, what it isn’t, and why it’s raising both interest and eyebrows throughout the scientific community.” Io9 has more.

Rolling the Clocks Back.

[T]his new method changes everything. To start with, it uses normal adult blood cells from the patient, so there’s not need to keep umbilical cords in storage. It also doesn’t use any virus reprogramming, so it’s completely safe. It’s also very efficient: researchers successfully transformed about 50 to 60 percent of adult blood cells into embryonic stem cells that can then be turn into any type of cell—a heart muscle cell, a bone cell, a nerve cell, anything.

By way of Dangerous Meta, researchers figure out a way to manufacture embryonic stem cells without an embryo, thus clearing the path for future research in that direction unhampered by abortion politics. “The discovery could be the key to cure the incurable – from heart attacks to severed spinal cord to cancer—and open the door, some day, to eternal youth.

Akin is the New Normal.


So, Todd Akin. I must say, it’s heartening to see some of the Taliban-like tendencies of today’s GOP finally drawing condemnation in the culture at large. But the thing is, what Rep. Akin said is very much within the mainstream of his party. This was not a one-off event: They actually believe this tripe, and they’re constantly voting like The Handmaid’s Tale was meant to be aspirational.

In their very first month back in power, Paul Ryan, Akin and the gang — 225 Members, in fact — were trying to define rape down — “House Speaker John Boehner (R-Ohio) has dubbed [it] a top priority in the new Congress.” — and that bill passed the House(!)

Yes, today’s Democrats have their own serious problems — our leaders prostrate themselves before the phantom deficit gods, look the other way on Wall Street malfeasance, and have been actively terrible on the civil liberties front, and our policy playbook (individual mandate, cap-and-trade) has too often been cribbed from the Republicans of the ’90s. But it’s a difference in kind, not in degree. Akin is not an aberration in the GOP — He’s the new normal. Not that anyone who comes around here still does this sort of thing, but if you vote Republican, have no illusions about what you are doing: Ayn Rand and Akinism is basically what you’re voting for. Seriously, these guys are cray-cray.

(By the way, the great facehugger pic above is from From Talking to Doctors — worth checking out.)

Deregulating Rape.

With this legislation, which was introduced last week by Rep. Chris Smith (R-N.J.), Republicans propose that the rape exemption be limited to ‘forcible rape.’ This would rule out federal assistance for abortions in many rape cases, including instances of statutory rape, many of which are non-forcible. For example: If a 13-year-old girl is impregnated by a 24-year-old adult, she would no longer qualify to have Medicaid pay for an abortion.

On the principle that, as per MLK, “in the end, we will remember not the words of our enemies, but the silence of our friends,” I post more often here these days about issues I have with our own, ostensibly-lefty party. But, as Dangerous Meta reminds me: Just in case anyone forgot how crazy the Republicans are these days, the GOP Congress has, for pro-life purposes, actually fashioned a bill that defines rape down. “House Speaker John Boehner (R-Ohio) has dubbed [it] a top priority in the new Congress.” There are no words.

Anatomy of a Tantrum.


This is the public option debate all over again. So I pass a signature piece of legislation where we finally get health care for all Americans, something that Democrats had been fighting for, for a hundred years – but because there was a provision in there that they didn’t get…somehow that was a sign of weakness and compromise.

“Now, if that’s the standard by which we are measuring success or core principles, then let’s face it, we will never get anything done. People will have the satisfaction of having a purist position, and no victories for the American people. And we will be able to feel good about ourselves, and sanctimonious about how pure our intensions are and how tough we are…That can’t be the measure of how we think about our public service. That can’t be the measure of what it means to be a Democrat.

As I’m sure most of y’all know by now, the president decided to indulge in some cathartic lefty-bashing at his tax cut deal press conference earlier in the week. [Transcript.] At this point, the fact that Obama feels this way about progressives is not at all a surprise, and I feel like I’ve already responded to his appalling penchant for this sorta thing at length. So, here’re just a few numbered points about this latest sad window into Obama’s “pragmatic” mindset:

1) Alex Pareene at Salon cut right to the heart of the fallacy on display here: “[Obama] continues to imagine that his liberal critics are upset with the idea that compromises need to be made in order to accomplish progressive policy goals. Some of them are that stupid. But lots of them are actually critics of the White House’s legislative strategy, and their apparent willingness to preemptively compromise before the negotiations have already begun.Yep.

2) See also Paul Krugman: “Leave aside the merits for a moment: what possible purpose does this kind of lashing out serve? Will activists be shamed into recovering their previous enthusiasm? Will Republicans stop their vicious attacks because Obama is lashing out to his left? It was pure self-indulgence; even if he feels aggrieved, he has to judge his words by their usefulness, not by his desire to vent…[W]hat we really don’t need right now is a president who blames everyone but himself, and seems more concerned with self-justification than with sustaining the alliances he needs.

3) As I noted on Twitter, the president’s argument here is inherently contradictory. He began his presser by saying he had to make a bad deal because the Right, however wrongheaded, held stubbornly to their convictions. Then he verbally abuses the Left for…holding stubbornly to their convictions. Uh, it seemed to work pretty well for the GOP.

4) Speaking of Twitter, the Twitterverse response to the presidential presser is well worth perusing for gallows humor and hard truths. Take for example, “Obama: This is like the public option fight all over again where I caved and opposed the thing that reduced the deficit.

5) As many have pointed out now, the president is also wrong on his New Deal history. In the presser, he claimed Social Security was only for widows and orphans. Wrong. He’s thinking of the civil war pension system, circa 1862. I know that law degrees are considered the be-all, end-all of our civilization these days, but an ostensibly progressive president not understanding the origins of Social Security is sort of a big effing deal. (And he didn’t just misspeak — He’s said it before.)

6) As historian Thomas Ferguson noted several weeks ago, this is not the first time the president has badly screwed up the history of the New Deal in a way that was ultimately self-serving. (As an aside: Given they they chose to structure a major policy speech around a fake Lincoln quote, his communications staff isn’t much better.)

7) As Dan Froomkin pointed out, Obama’s argument about the public option is also contradictory. He argues that Social Security and Medicare started out small, than belittles the public option because it “would have affected maybe a couple of million people,” i.e. it would’ve started out small.

8) Obama also no longer seems to understand how the public option was supposed to work. Here’s Froomkin: “What the president conspicuously disregarded was that the central point of the public option was that its existence would exert enormous competitive pressure on the private insurance system. The goal was not to serve a particularly large number of people directly — that would only happen if the private offerings were terribly inadequate. The goal was to keep the private sector honest. So no matter how many people it enrolled, ‘the provision,’ as Obama put it “would have affected” tens of millions.” In other words, the public option was designed to be a yardstick. So, even in terms of recent history, there are some serious revisions going on.

9) Politico’s catty analysis of the president’s relationship with Chuck Schumer offered more insights on Obama’s thinking today: “Obama himself warned Schumer that the millionaire strategy could sink the stock market. When a vote on the millionaire plan came up short last Saturday, the administration gloated.” The vagaries of the stock market? Is that really what we’re basing our tax policies on these days? (Also, I don’t think Chuck Schumer, of all people, needs to be informed of when and how Wall Street will balk. I think he has his finger pretty solidly on that pulse.)

10) A day after the president’s remarks, Larry Summers solemnly informed us that not passing the millionaire tax cut would lead to a double-dip recession. This is basically the economic equivalent of the terror, terror, terror, 9/11, 9/11, 9/11 argument. And, as David Dayen and Jon Walker both pointed out: If the economy is resting on that sort of knife’s edge, why’s the White House just reduce purchasing power by announcing a federal worker’s pay freeze? Something does not compute.

11) Obama at the presser again: “Look at what I promised during the campaign. There’s not a single thing that I’ve said that I would do that I have not either done or tried to do. And if I haven’t gotten it done yet, I’m still trying to do it.” Um…do we really want to go there? Because I’m sure this would be news to Maher Arar. In any case, as a friend pointed out, this isn’t kindergarten — You don’t get a gold star just for “trying.”

Anyways, so, yeah, Obama doesn’t like “the professional left” very much. And, at this point, it’s safe to say the feeling is mutual. As for myself…well, these days I just feel like a sucker.

Minority Report.


Imagine for a moment you are president of the United States.

You were just elected in the midst of a worsening economic crisis, one that demands bold action and decisive leadership to confront. Fortunately, you enter office with an historic wind at your back: You enjoy unprecedented enthusiasm and goodwill from millions of new voters, a clear mandate for change, and, most importantly, sizable majorities in both the House and Senate.

You also know that the political opposition — who hold a long and storied record of being ruthless, craven and despicable to get what they want — will try to prevent your agenda by any means necessary.

And, being a student of history, you know that, particularly in the face of a poor economy, this political opposition is very likely to pick up congressional seats in the next election (with a few notable exceptions, one of which I’ll get to in a moment.) In other words, a pendulum swing against you is highly probable, and so the majorities you have are probably as big as they are ever going to get.

Basically, you have two years, and likely two years only, to do pretty much anything you want in order to grapple with this economic crisis. Do you [a] take a page from FDR’s 100 Days, go big, and push hard for the progressive agenda you laid down in your election campaign, which has the added benefit of enthusing the “rising American electorate” that got you elected? Or do you [b] try to ingratiate yourself with people who will always hate you, water down your signature legislative initiatives from the outset, and seemingly go out of your way to depress the lefty base that got you elected?

I think you see where I’m going with this.

First things first, let’s be clear about why the Republicans took back the House so decisively two days ago.

1) It’s the Economy, Stupid. Though it may be mostly Dubya’s fault, the economy is obviously still in terrible shape. The official unemployment rate hovers just under the double-digits, and real unemployment and underemployment levels are much higher. Household incomes are down, consumer debt is up, millions of homeowners are stuck with underwater mortgages, and millions more feel in danger of slipping under. As everyone knows, when economic times are bad, the party in power suffers.

Compounding the situation, families are feeling under the gun at exactly the same time that those same wealthy few who precipitated the Great Recession are now rolling in dough. Having evaded pretty much any and all serious consequences for the meltdown they created, the Big Brains on Wall Street are instead giving themselves record bonuses, and trying to profit from even more rampant corruption on the foreclosure front. To no one does this ugly sight look like change we can believe in.

2) Republicans voted, Democrats didn’t. Again, not rocket science: Democrats lost because Republicans came out and Democrats stayed home. Look at the breakdown of exit polls: As per the norm in midterms, the 2010 electorate was older than the population at large. (23% of the vote versus 13% of the population.) And 57% of those seniors, worried that the threat of Creeping Socialism might somehow interfere with their federal retirement security and universal health care, pulled the lever for Republicans.

Conversely, 29 million Obama voters did not show up to vote. “Hispanics, African Americans, union members and young people were among the many core Democratic groups that turned out in large numbers in the 2008 elections…In 2010, turnout among these groups dropped off substantially, even below their previous midterm levels.” Take voters under 30, for example, who vote Democratic at about the same rate seniors vote Republican. They went from 18% of the electorate in 2008 to 11% this year. Obviously, that’s a problem.

So, working back from these factors — economic performance and voter turnout — it follows that the two best things the administration could have done to improve Democrats’ standing this year would have been to get the economy moving again and to get the Democratic base fired up and ready to go. So what happened? Let’s look at the tape.

The Economy: As Paul Krugman has already pointed out, much of the story of this election was written way back in February 2009, when the Obama administration chose to settle on a stimulus package that was watered-down to appease Republicans who would never, ever vote for it. In fact, thanks to Larry Summers, the stimulus was low-balled from the start — Summers made sure Christina Romer’s higher-end projections for the amount needed never even made it to the president’s desk.

So the crystal was in the steel at the point of fracture, and mainly because Obama, doing the President Goldilocks routine that would become a trademark, watered down the Recovery Act early-on to appease an opposition that was unappeasable.

By late 2009, the warning signs that ARRA was probably too small were all over the place — not the least in the growing state budget crises seen all across the country. But even as Republicans throttled congressional attempts to remedy the situation, the Obama administration remained mostly passive…or, in the case of food stamps, worse. Many in the White House took up the standard of the deficit witchhunt. (Yes, there was some rhetorical urging of the tsk-tsk variety eventually, but that, as on so many other fights, was after the chips were already down.)

Going along with this frustrating passivity was the increasing sense over time that this administration, elected to be change we could believe in, was more than a little cozy with the Wall Street yokels who caused the economic disaster in the first place. Yes, TARP was originally Dubya’s baby — not that very many voters seemed to remember that fact. (And it’s hard to blame them when folks like Geithner keep touting its merits.) Still, acceding to the $700 billion bailout for Wall Street — with little to no strings attached — was an extraordinarily inopportune way to kick off an administration theoretically premised on fundamental change.

I have to confess that, at the time, I thought TARP was unfortunate but probably necessary. Two years later, I’m thinking I probably just just got railroaded, and didn’t know what I was talking about. (Hey, it wasn’t the only thing I was wrong about in 2008.) But, even back then, I argued that TARP had to come with game-changing restrictions on Wall Street’s behavior. Those, clearly, were not forthcoming.

Yes, Congress did pass financial reform — But let’s remember, Team Obama worked openly to weaken the bill, and even now certain admin folks are clearly trying to derail Elizabeth Warren, the best chance the financial reforms, however tepid, have at working as intended for consumers. (Or, to quickly take another example, there’s the matter of the HAMP foreclosure program, which, as David Dayen has documented, seems more concerned with recouping money for lenders than helping families in trouble.)

As on the finreg bill, so too on other fronts — and this is where we get to the suppressing turnout issue.

On health reform, which thank god eventually passed, we now know that the administration cut deals early on to kill drug reimportation on behalf of the pharmaceutical industry (even after Sen. Dorgan reintroduced the idea) and, more egregiously, to kill the public option on behalf of AHIP and the hospitals. Looking back, the president signaled the public option’s expendability in his September 2009 health care address, another classic example of the wait-too-long-then-try-to-swoop-in-and-save-the-day legislative strategy usually preferred by the White House. And by the eve of the midterms, he was openly mocking public option supporters at fundraisers.

But, even those fundamental breaks with real reform aside, the entire health care process got badly screwed up when the administration, in a misguided attempt to curry bipartisan favor for reform, let Max Baucus dink around for weeks on the Senate Finance Committee. While Republican Senators Snowe and Grassley played Lucy to Baucus’ Charlie Brown and kept moving the football, the Tea Party August of 2009 took shape, and almost a year in legislative time was lost. And, by the time Baucus finally released the durned thing, the bill had once again been watered down to gain imaginary Republican votes that were never, ever going to be forthcoming.

The litany of Obama’s other sins by now are well known. As noted before, this administration has been absolutely egregious on civil liberties, all the while telling us to “look forward, not backward” on Dubya’s torture regime. (But different rules for everyone else, it seems.) Meanwhile, Gitmo is still open, and DADT is still enforced. Immigration reform did not happen. Nor did energy reform, despite House Democrats going out on a limb to pass a bill way back in June of 2009. (Yesterday, Obama the “shellacked” buried this bill for good.) And so on.

If all these compromises and capitulation — which were never political necessities so much as unforced errors — weren’t enough to depress the base, the administration’s press arm continued a steady diet of hippie-punching. “Left of the left“, pajama-wearing bloggers, the “professional left” — time and again, “senior advisors” and press flaks went out of their way to scorn the people who sweat blood and tears to get them elected. I already mentioned Obama ridiculing public option supporters — Well, where did folks ever get the notion that a wonky, badly-named fix like the public option was the ground to fight on anyway? Because the president told us it was important.

To be clear: I am not arguing that Obama hasn’t accomplished anything (although, in almost all cases — including health care reform, much more credit should really go to the very unfairly maligned Speaker Pelosi — she’s the one who made it all happen.) But, at every point down the line, for every piece of legislation that did pass, you have to factor in the opportunity costs that were lost. And consistently, this administration has pursued the politics of the lowest common denominator. To quote the prescient Drew Westen once again:

I don’t honestly know what this president believes. But I believe if he doesn’t figure it out soon, start enunciating it, and start fighting for it, he’s not only going to give American families hungry for security a series of half-loaves where they could have had full ones, but he’s going to set back the Democratic Party and the progressive movement by decades, because the average American is coming to believe that what they’re seeing right now is ‘liberalism,’ and they don’t like what they see. I don’t, either. What’s they’re seeing is weakness, waffling, and wandering through the wilderness without an ideological compass. That’s a recipe for going nowhere fast — but getting there by November.

And, hey, look what happened.

Remember how I mentioned a midterm outlier way up at the beginning of this post? That was 1934 — when, in an economy even worse than the one America faces now, Roosevelt managed to pick up seats in both the House and Senate. FDR gave us the 100 Days, a flurry of political activity we haven’t seen before or since. Now, granted, the Roosevelt team did not have to contend with either unfettered money corrupting the system or a pathetic Fourth Estate in a death spiral — both severe problems with our current political culture that must be addressed. Still, when elected in the midst of a similar economic crisis, with similar expectations, this administration did not bring about a 100 Days. It gave us Three Months of Max Baucus dicking around to appease intractable Republicans.

So why did the 2010 shellacking happen? Because of the economy, yes. And because of low turnout, yes. And also because of troubling trends like corrupting money everywhere and a national press in severe decline — The fact that the media followed Christine O’Donnell more than any other 2010 candidate tells you all you need to know about that broken-down disaster we call the Village these days.

But, nonetheless, all of these determining factors were exacerbated in the wrong direction by the administration’s fatal addiction to the Fetal Position fallacy. As I said of this year’s State of the Union address, “people were not looking to President Obama for this sort of deficit tsk-tsking and small-bore, fiddling around the margins. You’d think we Dems would have learned this by now. But curling up into a fetal position and mouthing moderate GOP-lite bromides will not stop the Republicans from kicking us, ever.

Some argue politics is the art of the possible. That’s true, but I believe much, much more was possible if this administration had actually deigned to fight for it.

Some say the president can only do as much as Congress lets him — he needs 60 votes, yadda yadda yadda. I’d say that he had 60 votes, and even then did not push to make things happen as much as he could. I would also argue that the presidency of the United States is actually a remarkably powerful position these days, that Obama has showed no inclination to act progressive on crucial matters like civil liberties that are totally in his bailiwick, and that, even now with a Republican House, the administration could move forward with a progressive agenda, if it so desired.

Some — such as pathetic, DLC-brand fortunate sons like Evan Bayh and Harold Ford — say progressivism was tried and found wanting. I would argue progressivism was not even tried.

Some say it is time to go for the Dems to embrace a more “centrist”, GOP-lite Third Way from now on. I think we’ve been experimenting with that sad sack of failure for decades now — it’s our First Way — and it’s been proven over and over again not to work. (Just ask the Blue Dogs, who got eviscerated on Tuesday. Why vote for Republican-lite when you can have the real thing?)

Basically, it comes to this. Without vision, the people perish…and vote GOP. And because this administration did not go big, because it did not produce the change people so desperately desired, and because it forsook the possibility of real progressivism early and often to indulge their fantastical belief in the magical unicorns of High Broderism, the Democrats have now lost the House — ironically the one branch of government that, under Speaker Pelosi, actually tried to get done what had been promised.

Now, matters are worse.

The Deficit-Witchhunt: The Long Depression.


We are now, I fear, in the early stages of a third depression. It will probably look more like the Long Depression than the much more severe Great Depression. But the cost — to the world economy and, above all, to the millions of lives blighted by the absence of jobs — will nonetheless be immense. And this third depression will be primarily a failure of policy.

They used to tell me I was building a dream…In the NYT, Paul Krugman calls out the deficit peacocks one more time before the wheels come off around the world. “[This is] the victory of an orthodoxy that has little to do with rational analysis, whose main tenet is that imposing suffering on other people is how you show leadership in tough times. And who will pay the price for this triumph of orthodoxy? The answer is, tens of millions of unemployed workers, many of whom will go jobless for years, and some of whom will never work again.

In very related news, from the bowels of the Fed comes a taxpayer-paid response to Krugman, DeLong, and others sounding the alarm about the deficit witchhunt: Quiet, you nasty bloggers! You have not sufficiently mastered our economickal arts! “[W]riters who have not taken a year of PhD coursework in a decent economics department (and passed their PhD qualifying exams), cannot meaningfully advance the discussion on economic policy…[T]here is extremely low likelihood that the speculations of the untrained, on a topic almost pathologically riddled by dynamic considerations and feedback effects, will offer anything new.

Having spent much of the past decade in academe, I’d like to point out that this is a pretty classic overreach by the writer here. I mean, you spend all those years chasing down a degree that’s not particularly useful anymore…there must be some upside to it, right? Am I not now part of the intellectual — in this case, macroeconomic — Elect? No, Mr. Athreya, I’m afraid not. Sometimes people spend so much time examining, say, the myriad variances in an oak leaf (or worse) they miss the forest for the trees.

Update: In an attempt to move past the entitlement-cutting hysteria out and about in DC at the moment, the Center for Economic Policy and Research offers up handy tool: The People’s Deficit Calculator. “The budget options in the calculator include ending the wars in Iraq and Afghanistan, adopting a carbon tax, reduction in the size of the health care subsidies created by the health care reform bill, progressive price indexing of Social Security, adopting a financial speculation tax and others.

Update 2: James K. Galbraith reads the riot act to the deficit witchhunt tribunal. “You are plainly not equipped, either by disposition or resources, to take on the true cause of deficits now or in the future: the financial crisis.

Better Late than Never.

There are a lot of people who have trouble coming to terms with that because they see marriage as traditionally between a man and a woman. But I also know that, you know, when couples are committed to each other and love each other, that they ought to have, I think, the same sort of rights that everyone has.” In the midst of her book tour, former First Lady Laura Bush confesses to being pro-choice and pro-gay-marriage. “Bush [also] said abortion should “remain legal, because I think it’s important for people, for medical reasons and other reasons.’” It would’ve been nice to hear her say as much a decade ago, of course, but I’m still glad that she’s made her feelings known.

Madam Speaker.


Late one night in January, as congressional leaders and White House officials tried to narrow their differences on the cost of the health-care bill, Rep. Henry A. Waxman (D-Calif.) gave Obama credit. ‘I don’t speak for the House, but this is a good offer,’…’Henry, I agree with you about two things,’ Pelosi interjected. ‘The president put out some numbers, and, number two, you don’t speak for the House.’

The WP‘s Paul Kane profiles the inimitable Speaker of the House, Nancy Pelosi. “Some historians list her alongside Rayburn and his successor, John W. McCormack, as among the most influential speakers in the annals of Congress.” (What, no love for Joe Cannon? C’mon now, American history doesn’t start in 1945.)

In any case, from my ringside seat here in the belly of the beast, it’s pretty clear: Speaker Pelosi gets things done. “After Scott Brown’s special-election victory…some pushed for a scaled-down version of health-care legislation to draw Republican support. Pelosi balked. In a moment that has come to define her speakership, Pelosi mocked a scaled-down bill as ‘Eensy Weensy Spider’ health care.

HCR: Where’s My Stuff?

Since I was talking to old friends on Facebook yesterday and realized once again that few folks outside of DC have a good sense of what’s actually in the recently passed health care bill, here’s a handy interactive graphic that delivers the what-for for the first year. There’s also a handy embed code there for wider distribution (but sorry, the death panel protocols are still classified. You’ll learn them when they come for you.)

Blunt Rebuke.

‘Access for kids who have pre-existing conditions, who would be against that?’ Blunt asked a group of health care professionals in Springfield, MO. ‘But access for adults who’ve done nothing to take care of themselves, who actually will have as I just described every incentive not to get insurance until the day that you know that you’re going to have medical expenses–that’s a very different kind of story.‘”

Thanks, Roy! Republican congressman and ostensible chair of the “GOP Health Care Task Force” Roy Blunt actually comes out in favor of repealing the ban on denying coverage for pre-existing conditions, one of the few provisions in the recent health care law that usually garnered bipartisan support. For its part, leukemia declined to comment.

Here’s to our Health.

“As our colleague John Lewis has said, ‘We may not have chosen the time, but the time has chosen us.’ We have been given this opportunity, an opportunity right up there with Social Security and Medicare: health care for all Americans. I urge my colleagues in joining together in passing health insurance reform — making history, making progress, and restoring the American dream.”

So, as you may have heard, the House passed the health care bill 219-212 late last night. It was a long and busy weekend, and a long and busy week is ahead, formulating the death panels and whatnot. Still, we’ve been talking about this bill since I got here last July, so it feels quite good to finally get this done. Now, let’s make it better. (Pic via here.)

Update: Here’s what goes into effect right away, and here’s what it means for you.

Madness — Our House.

(Sorry about the bad pun in the title, but I needed a new earworm in my head to help kill off the segwaying chimp ditty.) Anyway, so, yes, it’s that time of year: The madness is upon us once more. (FWIW, I picked Syracuse to win over Duke in the Final, but have zero confidence in my bracket this year.) Unfortunately — or fortunately, if you consider the past ten months — I’m missing my usual annual reunion of college friends, as it’s gonna be a work weekend

Broken-Hearted? Just Make a New One.

“To start with, only simple tissues, such as skin, muscle and short stretches of blood vessels, will be made…[H]owever, that the company expects that within five years, once clinical trials are complete, the printers will produce blood vessels for use as grafts in bypass surgery. With more research it should be possible to produce bigger, more complex body parts. Because the machines have the ability to make branched tubes, the technology could, for example, be used to create the networks of blood vessels needed to sustain larger printed organs, like kidneys, livers and hearts.”

Also in the Brave New World dept. and by way of a friend, The Economist takes a gander at new “bioprinter” technology. “As for bigger body parts, Dr Forgacs thinks they may take many different forms, at least initially. A man-made biological substitute for a kidney, for instance, need not look like a real one or contain all its features in order to clean waste products from the bloodstream.

The Wages of Citizens United: The $$$.

“The Chamber spent much of its money in 2009 on campaigns that worked — it scared the Senate away from considering a version of the Waxman-Markey cap-and-trade legislation, and an argument can be made that its cutting ads on health care (with money taken from some insurance companies) helped to undercut support for the legislation.” You think? In a shape-of-things-to-come moment even before Citizens United goes into effect, the Chamber of Commerce outspent both political parties in 2009.

“According to The Center for Responsive Politics, the U.S. Chamber of Commerce and its national subsidiaries spent $144.5 million in 2009, far more than the RNC and more than double the expenditures by the DNC.” But corporate spending isn’t a problem or anything.

Brownian Motion.


So, slow news evening, eh?

Well, first off, thanks, Massachusetts! To my many friends from the Bay State, I say this: Speaking as a son of South Carolina, I never, ever want to get the “you-hicks-are-keeping-us-back” routine from y’all again, thanks much.

So, yes, Scott Brown defeated Martha Coakley for Ted Kennedy’s Senate seat. And thus, in a truly bitter irony, a man who spent his life trying to achieve health care reform for all Americans has now been replaced by a guy sworn to kill the health care bill and armed with the 41st vote(?) that could potentially make it happen. (Yes, Virginia, it’s true. In our system, 41 > 59.) Well, in Brown’s defense, he has a nice truck.

Why did this happen? Well, everybody has a theory. Here’s mine, which boils down to two reasons.

1. Martha Coakley. I didn’t watch enough of the MA race to determine if she was a lousy candidate through-and-through, although I have my suspicions. Nonetheless, Ms. Coakley was undeniably a gaffe-prone standard-bearer. From calling Curt Schilling a Yankee to misspelling the name of the state in a political ad to, weirdly, insulting the very idea of glad-handing in public, Coakley was an out-and-out gaffe machine. Couple that with a lackadaisical campaign and the inexplicable decision to take an extended vacation in the heat of the race, and you have a recipe for disaster. There’s a reason we’ve been telling the story of the Tortoise and the Hare for a couple thousand years now.

2. Change. In fending off Rahm Emanuel’s charge that she’s at fault for this fiasco, pollster Celinda Lake aptly summed up the main problem here: ““If Scott Brown wins tonight he’ll win because he became the change-oriented candidate. Voters are still voting for the change they voted for in 2008, but they want to see it.” Put another way: All across the country, the current occupants of the White House tapped into a deep and strongly-felt yearning for a transformative presidency in 2008…and then spent pretty much the entirety of their first-year in office playing the same old tired in-the-Beltway reindeer games that made people ill in the first place. This is not change voters believed in, and it has made voters angry, or depressed, or both.

Equally demoralizing is the neverending spectacle of a stalled-out health care bill. If I’d hazard a guess, most voters aren’t really delving into the ins and outs of this all-consuming debate, particularly by Month Eight or whatever it is. But they can see just from casually following along that the Democrats are really struggling to get this done, that the White House has been letting the bill get bogged down and eviscerated in the Senate — first in August, and again in November/December — and that, from the Big Pharma deal to the disappearing public option to all of the Lieberman/Stupak/Nelson/Snowe shenanigans on display, the usual Washington rules are in full effect right now. Once again, this is not change people can believe in. With each passing month that the bill has languished, we Dems have looked weaker and weaker. And if you continually force voters to choose between venal and incompetent, they’ll tend to gravitate toward the former.

Now, the good news: 1. First, and this cannot be stressed enough, we have an 18-seat majority in the Senate. It’s 59-41 people…most presidents can only dream of having that kind of majority, Dubya included. So there’s really no good reason — none, zip, zero — that we shouldn’t see more progressive accomplishments from this administration in the year to come. It just takes an act of will. I don’t remember the Republicans getting all kerfuffled about operating with 51 votes. Nor did Hubert Humphrey and the Johnson Senate have any problem with blithely ignoring the Senate parliamentarian when it got in the way of legislation.

2. It’s January of 2010, i.e. almost a full year before the “real” election day. In other words, this Brown victory is really just a shot across the bow. And if the administration course-corrects now, we may even end up gaining a year in time — and several seats we might well have lost — had this lazy centrist drift continued on until next November.

Of course, that’s only good news if the administration and the Democratic Party draw the right lessons from yesterday’s defeat. Suffice to say, this afternoon, it does not look good: Enabled, as usual, by the Serious People™ who comprise the broken-down wreck we once called beltway journalism, all the usual suspects are currently blaming Coakley’s loss on “the Left,” or more specifically the hippie-liberal cast of Obama’s administration thus far. Uh, say what now?

It’s hard to answer this ridiculous charge any better than did the estimable Glenn Greenwald this afternoon: “‘In what universe must someone be living to believe that the Democratic Party is controlled by ‘the Left,’ let alone ‘the furthest left elements” of the Party? As Ezra Klein says, the Left ‘ha[s] gotten exactly nothing they wanted in recent months’….The very idea that an administration run by Barack Obama and Rahm Emanuel and staffed with centrists, Wall Street mavens, and former Bush officials — and a Congress beholden to Blue Dogs and Lieberdems — has been captive ‘to the Left’ is so patently false that everyone should be too embarrassed to utter it.

Truer words and all that. If we want to stop seeing these sorts of Brownian upsets in the future, the answer is emphatically not to curl up within the usual GOP-lite protective camouflage and hope the flak dies down. People see through that malarkey immediately. (As Harry Truman is rumored to have said, “In an election between a Republican and a Republican, the Republican wins every time.“) No, the answer is to move forward from this point with the courage of our convictions, and to start delivering to American families the real and fundamental change they were promised a year ago. It’s just that simple, folks.

Still Mad as Hell (with Truths to Tell.)

“It’s one thing to recognize capitalism for the powerful economic tool it is and to acknowledge that, for better or for worse, we’re stuck with it and, hey, thank God we have it. There’s not a lot else that can produce mass wealth with the dexterity that capitalism can. But to mistake it for a social framework is an incredible intellectual corruption and it’s one that the West has accepted as a given since 1980–since Reagan…People paid a much higher tax rate when Eisenhower was president, a much higher tax rate for the benefit of society, and all of us had more of a sense that we were included.”

By way of DYFL, Vice Magazine publishes an extended interview with David Simon on The Wire Treme, writing, political economy, health care reform, and other important matters. “Of course it’s socialism. These ignorant motherf**kers. What do they think group insurance is, other than socialism? Just the idea of buying group insurance! If socialism is a taint that you cannot abide by, then, goddamn it, you shouldn’t be in any group insurance policy.

The Perils of LCD Politics.

“I don’t honestly know what this president believes. But I believe if he doesn’t figure it out soon, start enunciating it, and start fighting for it, he’s not only going to give American families hungry for security a series of half-loaves where they could have had full ones, but he’s going to set back the Democratic Party and the progressive movement by decades, because the average American is coming to believe that what they’re seeing right now is ‘liberalism,’ and they don’t like what they see. I don’t, either. What’s they’re seeing is weakness, waffling, and wandering through the wilderness without an ideological compass. That’s a recipe for going nowhere fast — but getting there by November.

I already said my piece about this last week, and was going to let it drop for now. But this long essay by Drew Westen on the problems with Obama’s leadership so far is right on the nose and well worth-reading. “[W]hat Democrats just can’t seem to understand is that the politics of the lowest common denominator is always a losing politics. It sends a meta-message that you’re weak — nothing more, nothing less — and that’s the cross the Democrats have had to bear since they ‘lost China’ 60 years ago. And in fact, it is weak.

The Myth of 11-Dimensional Chess.

“Obama supporters are eager to depict the White House as nothing more than a helpless victim in all of this — the President so deeply wanted a more progressive bill but was sadly thwarted in his noble efforts by those inhumane, corrupt Congressional ‘centrists.’ Right. The evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives. The administration is getting the bill which they, more or less, wanted from the start — the one that is a huge boon to the health insurance and pharmaceutical industry.

A day after Senate Democrats kill Byron Dorgan’s non-importation amendment in order to preserve the administration’s back-door deal with Big Pharma, the indispensable Glenn Greenwald takes the Obama administration to task for the final Senate product on health care, which, suffice to say, is looking pretty far afield from the House bill. (And all the while, the bought and paid for Joe Lieberman grins like the Cheshire Cat.)

I was going to wait until year-in-review post week to put this up, but now’s as good a time as any: From civil liberties to this Senate health care fiasco, it’s hard to think of any arena where this administration’s first year hasn’t been a tremendous disappointment. (Regarding the former: I didn’t mention this here earlier, but the brazen audacity of this passage from the president’s war-is-peace Nobel Prize speech made me blanch: “We lose ourselves when we compromise the very ideals that we fight to defend. And we honor — we honor those ideals by upholding them not when it’s easy, but when it is hard.” Uh, your Justice Department is not upholding them, remember? Is the president even aware of his own civil liberties record?)

Anyway, I keep being reminded of this line from my Obama endorsement of January 2008: “There’s a possibility — maybe even a strong possibility — that he’ll end up a Tommy Carcetti-like president: a well-meaning reformer outmatched and buffeted to and fro by the entrenched forces arrayed against him.” Well, welcome to the Carcetti presidency, y’all. The only surprise so far for many of us is in how little he’s actually even tried to enact meaningful reforms. But I guess once the president surrounded himself with the exact same GOP-lite people we’d spent months trying to defeat in the Democratic primary, the writing should have been on the wall. This will not be change we can believe in. A New Day is not dawning. And the president is not really with us — We’re going to have to do the heavy lifting for reform next year without him.

Things I Learned from the Death Panels.

The ‘death panel’ episode shows how the news media, after aiding and abetting falsehood, were unable to perform their traditional role of reporting the facts. By lavishing uncritical attention on the most exaggerated claims and extreme behavior, they unleashed something that the truth could not dispel.” In the NYT, Rep. Earl Blumenauer (D-OR) reviews the sad, sordid tale of Death Panel fear-mongering by the GOP this past summer.

In very related news, it seems the Republican National Committee’s health insurance plan, contra all their rhetoric on Stupak, has not only covered abortion services for the past eighteen years — it includes end-of-life counseling, a.k.a. the “Death Panels” of Sarah Palin’s nightmares. These folks really have no shame.

The Lobby Echoes.

“In the official record of the historic House debate on overhauling health care, the speeches of many lawmakers echo with similarities. Often, that was no accident. Statements by more than a dozen lawmakers were ghostwritten, in whole or in part, by Washington lobbyists working for Genentech, one of the world’s largest biotechnology companies.”

As a speechwriter in the House, I’m sort of a rare bird…but perhaps I shouldn’t be: An estimated 42 Members — 20 Dems and 22 GOP — get caught lifting industry talking points for the health care debate. Suggested TP’s make the rounds all the time, of course, but they’re usually meant to be guidelines, not taken word-for-word. Oops.

225-220.

“[L]ives are what’s at stake in this debate, and moments like this are why they sent us here — to finally meet the challenges that Washington has put off for decades; to make their lives better and this nation stronger; to move America forward. That’s what the House did last night when it brought us closer than we have ever been to comprehensive health insurance reform in America.”

After many months of work and a long Saturday of debate (not to mention quite a few flagrant and ridiculous GOP lies along the way), the House passes the Affordable Health Care for America Act 220-215. (Joining 219 Dems was one solitary Republican, Anh Joseph Cao of William Jefferson’s old seat, and he voted after the bill had already crossed the 218 threshold.) And, much thanks to the people who have fought for it all this time, H.R. 3962 passed the House with the public option bloodied but still intact.

Alas, the skeleton at the feast was a successful gambit by the heretofore unknown pro-lifer Rep. Bart Stupak to use the necessity of health care reform to fundamentally alter the status quo on abortion. (Best tweet of the day, btw: “‘Stupak’ sounds like a political action committee for morons.”)

Stupak forces like to say they’re just upholding existing law with this amendment, which already states that federal funds will not be used to pay for abortions. But, in fact, this amendment goes further — it prohibits not only the public option but private insurance companies who operate in the exchange from offering abortion services to people who receive subsidies. Or, in other words, low-income women are going to be S.O.L. for starters, with mission creep ultimately denying more and more women reproductive choice and/or necessary medical procedures. (Stupak to women — don’t miscarry.)

On one hand, the good news is that Stupak’s gambit is pretty much dead in the water in the Senate — even the GOP isn’t warming to it. (And, while maintaining the usual “above-the-fray approach”for now — big surprise, I know — Obama has telegraphed he’s not a supporter of the idea.)

On the other, the Stupak situation shows one of the problems we now have as the majority party. Here we have a scion of the “Family” on C-Street playing shenanigans with critical Democratic legislation at the eleventh hour…and he was joined by 63 other Dems in getting the amendment passed. In fact, many of these look to be CYA votes by ostensible pro-choicers to shore up their moderate bona fides.

Even more troubling, 21 of the final 39 Democratic votes against health care reform voted for Stupak — i.e., they voted to screw up a bill they had absolutely no intention of supporting in the end. (Conversely, twenty Dems in GOP-leaning districts did the right thing — they voted against Stupak and for passage. They are listed here.) Simply put, these 21 are why primary challenges were invented.

Until congressional Democrats learn that bucking their left is just as — if not more — dangerous than prostrating themselves before the right, they’re going to continue to play these reindeer games. (To be clear, in almost all cases, it’s not like these holdouts’ issues with the bill came from the left.) And until these often craven middle-of-the-roaders feel the wrath of the stick as well as the carrot, we are going to remain locked in this dismal feedback loop where important bills are in danger of being endlessly watered down into “moderate” mush. (See also: no Single Payer, no Medicare +5.) And that’s just not change we can believe in.

Aside from the Recovery Act, the House hasn’t held as important a vote all year. And, if certain Dems can’t find a way to support critical Democratic legislation — legislation tempered to meet their approval, in fact — when the time comes, then don’t expect the progressive base to have their back just because they have a D by their name. The time to suffer such fools has passed.

In any event, Round 1 completed. Round 2, the Senate…

Hacker: Still Alive.

“In short, it’s no time to be despondent about the fate of the public insurance option. For sure, pegging rates to Medicare and obligating Medicare providers to accept these rates would be far preferable, and a public plan with negotiated rates may do less to keep the insurers honest and drive down costs. But it’s still immensely valuable to give Americans an out — another choice — to let the insurers feel the heat of not being the only game in town. The fierce and continuing opposition of the insurance industry suggests that they think that a public option will prove a serious counterweight in an increasingly consolidated private market.”

In TNR, Jacob Hacker and Diane Archer make the case anew for a public option, specifically the one that made it into H.R. 3962. If all goes well, the House bill — recently endorsed by the AARP and the AMA — will get a vote tomorrow. (Yep, it’s a work day.) Update: Or later. Here’s the hold-up.

The Progressives Made Us Do It.

“‘We’ve spent countless hours over the last few days in consultation with senators who’ve shown a genuine desire to reform the health-care system,’ Reid said. ‘And I believe there’s a strong consensus to move forward in this direction.’” Yer damn skippy. The Senate health care reform bill will include an opt-out public option, mainly because Senate progressives demanded it. “Reid and the leadership faced this basic math: There is only one Snowe and there are 60 members of the Democratic caucus. If just a few Democrats abandoned the bill, it would fall short even with Snowe’s support.

Also worth reading, Nate Silver’s concise ten-point summation of why a public option made the Senate bill. Note #1: “The tireless, and occasionally tiresome, advocacy on behalf of liberal bloggers and interest groups for the public option. Whatever you think of their tactics — I haven’t always agreed with them — the sheer amount of focus and energy expended on their behalf has been very important, keeping the issue alive in the public debate.” Keep up the good fight, y’all. This ain’t over yet.

Update: To wit, Senator Lieberman is up to his old antics: “I told Senator Reid that…if the bill remains what it is now, I will not be able to support a cloture motion before final passage. Therefore I will try to stop the passage of the bill.” Let’s remember. Lieberman — who played this same game back in 1994 — was allowed to keep his chair last November mainly on the pretense that he wouldn’t hold up important Democratic legislation. One would think this counts.

“I’m a Scorpion, It’s My Nature.”

From the California Nurses Assoc., the largest nurses union in the country: ‘Our legislators should respond to this bullying and stop coddling a useless industry whose sole function is to make enormous profits from the pain and suffering of patients while providing little in return.’ From the AARP: The AHIP report is not ‘worth the paper it’s written on.’”

Wow, who saw this coming? The insurance industry turns against health care reform — even the middling Senate Finance Committee version put forth by Max Baucus — by publishing an obviously bogus report that prophesies of impending rate-increase doomsday should reform pass. Hmm, well. I’m just gonna throw this out here, but I think it can be reasonably assumed from the start that any industry making money hand-over-fist from a broken system would eventually turn against meaningful reform of that system. So, maybe next time we shouldn’t give away the store to keep these swine at the negotiating table? Just a thought.

Anyway, the insurance industry isnt the only strange bedfellow (inadvertently) making the case for the public option of late. Both Bill O’Reilly and FOX’s Shepard Smith have made impassioned pleas for the public option recently. And — though they’ve been backpedaling like mad ever since — both Bill Frist and Bob Dole have called out their party for desperate and heedless obstructionism in recent days. So, even though we’ve taken the long way to get here for no particularly good reason, I feel confident right now that the public option is very much back in play.

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