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Public Option

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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.”

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.

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.

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.

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.

Dog Woof, Cats Meow, Wags Tweet.

Hey all. As we approach the decade mark next month, the readership around here at GitM continues to dwindle, which is primarily my fault for not updating as much as I’d like. Nonetheless, if and when it gets quiet ’round here, I encourage you to also check out my Twitter feed, which is easier to update in the midst of more frantic weeks like last one. (Memo to myself: Columbus Day, and three-day-weekends in general, will mean a lot of speechifyin’ in Congress’ home districts.)

Yeah, I was skeptical about Twitter earlier in the year, but I’m definitely coming around. Within an hour of news of President Obama’s Nobel prize win, for example, (which I’m neither here nor there about — it seems goofy, yeah, but I was already down on Nobel anyway), there were dozens of wry and amusing quips going around the twitterverse. My favorite two were variations on “Obama, I’mma let you finish but Bono has been working his ass off for this!” and “Uh…did the Nobel committee just miss the fact that Obama bombed the f**king moon?!”

Another good example: the Baucus committee tanking the public option in late September brought on a similar flurry of bon mots: “Senators should be required to make the little cash register ‘ka-ching!” noise when they vote.” “Well the insurance Industry is looking forward to its Baucanalian Orgy.” “75% of Americans support #publicoption, but only 35% of the Senate Finance Cmittee support it.” “Health care industry must pay capital gains on Senate Finance Committee members this year as investment is cashed out.” Etc., etc.

Its immediate posting benefits aside, Twitter has definitely grown on me as a fertile hothouse environment for exactly this sort of choice, top-shelf snark.

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