Wednesday, March 31, 2010

State-Croft in the Obama Administration, cont.: the Deputies' Committee

A detailed portrait of the Obama administration's foreign policy apparatus by the FT's Edward Luce and Daniel Dombey presents a mixed bag, a work in progress.  One key facet  has an interesting pedigree: personnel from the Clinton administration slotted into a structure adapted from the administration of George Bush, Sr.  That is the "deputies' meetings":
Mr Obama’s character is also stamped on the inter-agency process, set up and managed by Tom Donilon, deputy national security adviser. The nitty-gritty of foreign policy-making is done at these frequent “deputies’ meetings”, which can sometimes consume four to six hours a day
.
Described by one insider as “the most powerful man in the White House whose name isn’t widely known”, Mr Donilon, who was an official in the Clinton administration, is the man who keeps Mr Obama’s trains running on time. And there are a lot of trains. Last year, Mr Donilon held 270 deputies meetings – a workload described as “clinically insane” by a former senior diplomat under Bill Clinton.

Monday, March 29, 2010

New coverage rules for employer-provided health plans

Most overviews of the effects of the new health reform law have suggested that it won't have a large impact on employer-provided insurance. That ain't necessarily so.

Business Insurance reports that employers "will have to redesign their health care plans to extend coverage to employees' adult children up to age 26, eliminate lifetime dollar limits and remove pre-existing condition exclusions, if any, for children up to age 19."

Historically, insurance has been regulated by the states. While many states have strict coverage mandates (and others minimal ones), employers that offer self-funded health plans to their employees have been exempt from these mandates.  Since more than half of all Americans who get their health coverage from their employers are in self-funded plans -- approximately two thirds of large employers self-fund -- that's a large regulatory loophole.

According to Business Insurance, however, the new federal coverage rules do apply to self-funded plans:
For example, few employers extend coverage to employees' children to age 26 as the legislation will require starting next year; typical cutoffs are at age 23. Many states already require such extensions, but those state laws apply only to insured plans and not to the roughly two-thirds of larger employers that self-fund their plans.

High risk pools within 3 months? How?

Considering it will take four years to get the health insurance exchanges set up, I'm a little mystified how the Patient Protection and Affordable Care Act can get a program offering catastrophic coverage for people with pre-existing conditions up and running within three months, as the law mandates. Equally mystifying: how can the budgeted $5 billion cover the program?

The basics, as stipulated in Section 1100 of the PPACA and contextualized by Kaiser Health News, are as follows. People with pre-existing conditions who have been without coverage for at least six months can buy coverage in the high risk pool at rates comparable to those available to people without such conditions. The oldest people eligible may pay up to four times as much as the youngest (as opposed to a 3 to 1 ratio in the exchanges).  Their yearly out-of-pocket expenses are capped at  $5950 for individuals and $11,900 for families.  The plans must cover at least 65% of total costs. The program is a stopgap that will end in 2014, when people with pre-existing conditions will be able to purchase insurance from the exchanges on the same terms as everyone else. It is unclear whether the Federal government will set up a single pool or whether The National Association of State Comprehensive Health Insurance Plans will adapt and expand existing state plans.  Nonprofits may also be tapped to administer the plans. 

Saturday, March 27, 2010

The delayed gratification presidency

"Patience" and "persistence" have been the Obama team's watchwords as they tout the Presidedent's victories in health care reform and an arms reduction treaty with Russia.

For months, delays in Obama's signature projects have been portrayed as signs of weakness. But the 'patience' tag is carefully chosen.  The long delays are in at least some cases a result of Obama's willingness to wait out counterparties -- and so a sign of strength.

That is the subtext of the admittedly Administration-lauding account by The New York Times' Peter Baker of the yearlong negotiations with Russia (though Baker pointedly claims Russians as well as admin officials as sources).  The narrative suggests that the Russians repeatedly tried to roll Obama and " would not resolve the big issues until they had taken his measure"; and that last month, when Medvedev introduced 11th-hour demands, Obama had to show willingness to let the whole deal fall apart.  Perhaps even more revealing, though, is this chapter:
The two sides also split over sharing missile data known as telemetry. Moscow was adamant that the new treaty not require telemetry exchange. The topic came up so frequently that Mr. Medvedev joked, “My favorite word in English now is ‘telemetry.’ ”

With those issues unresolved, Start expired in December. The Russians calculated that Mr. Obama would be so eager to have a new treaty by the time he traveled to Oslo later that month to accept his Nobel Peace Prize that he would accept concessions, so they took a hard line.

The rap on the peace prize, of course, was that Obama had no concrete accomplishments on the world stage. The temptation to seal a deal may have been strong.  But the evidence is considerable -- in health care, in setting AfPak strategy, and in "new Start" negotiations with the Russians -- that Obama is willing to appear weak rather than be so.

Friday, March 26, 2010

A more perfect speech draft: Obama edits "our" national story

Editors of the world are agog at a close-up of Obama's mark-up of a draft of the speech on health care he delivered to both chambers of Congress on September 9. It's an extraordinary window into Obama's mind.

What did Obama do to the draft? Repeatedly, he added agency, attributing acts, feelings and thoughts to specific people or groups of people.  He added nouns and pronouns and active verbs, converting verbal nouns in the original draft to active verbs with human predicates(Teddy, our seniors, members of Congress, I, we, etc.).  He drew individuals, members of Congress generally, and the American people as active agents into a joint national project of compassion and positive action.  He reminded Republicans that they had been part of this national project (extending from social security to Medicare to the current health reform) in the past.

His additions of this sort are boldfaced below. Text in blue appears neither in the typescript nor in Obama's handwritten edits -- it was apparently added later
But those of us who knew Teddy and worked with him here -- people of both parties -- know that what drove him was something more.  His friend Orrin Hatch -- he knows that.  They worked together to provide children with health insurance.  His friend John McCain knows that.  They worked together on a Patient's Bill of Rights.  His friend Chuck Grassley knows that.  They worked together to provide health care to children with disabilities.

On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience.  It was the experience of having two children stricken with cancer.  He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick.  And he was able [orig: or his ability]  to imagine what it must be like for those without insurance, what it would be like to have to say to a wife or a child or an aging parent, there is something that could make you better, but I just can't afford it.

That large-heartedness -- that concern and regard for the plight of others -- is not a partisan feeling.  It's not a Republican or a Democratic feeling.  It, too, is part of the American character -- our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise [orig: "...security and fair play that only government can ensure"].

This has always been the history of our progress.  In 1935, when over half of our seniors could not support themselves and millions had seen their savings wiped away [further edited before delivery], there were those who argued that Social Security would lead to socialism, but the men and women of Congress stood fast, and we are all the better for it.  In 1965, when some argued that Medicare represented a government takeover of health care, members of Congress -- Democrats and Republicans -- did not back down. They joined together so that all of us could enter our golden years with some basic peace of mind.  

You see, our predecessors understood that government could not, and should not, solve every problem.  They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom.  But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, the vulnerable can be exploited.  And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter -- that at that point we don't merely lose our capacity to solve big challenges.  We lose something essential about ourselves.

That was true then.  It remains true today.  I understand how difficult this health care debate has been.  I know that many in this country are deeply skeptical that government is looking out for them.  I understand that the politically safe move would be to kick the can further down the road -- to defer reform one more year, or one more election, or one more term. 

But that is not what the moment calls for.  That's not what we came here to do.  We did not come to fear the future.  We came here to shape it.  I still believe we can act even when it's hard.  (Applause.)  I still believe -- I still believe that we can act when it's hard.  I still believe we can replace acrimony with civility, and gridlock with progress.  I still believe we can do great things, and that here and now we will meet history's test.

Because that's who we are.  That is our calling.  That is our character.  Thank you, God bless you, and may God bless the United States of America. 

One addition -- not the warmest, but one that opens a window onto how Obama conceives of government -- deserves an additional spotlight. At the end of  a complex sentence, he added a clause to change this:
It, too, is part of the American character -- our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play that only government can ensure.
 To this:
It, too, is part of the American character -- our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise. 

Talk about "active government" -- you have here a seven-word active verb phrase: "has to step in to help deliver."  Note how qualified government's role is: it steps in only when it has to, and it only helps deliver on the promise that is part of the American character.  That is liberalism chastened by Reaganism -- a conservative superego imposed on a liberal id.

UPDATE: In a look at Obama's rhetoric, Jonathan Bernstein suggests that Obama defines American greatness as the capacity for creative political action:
We, in the United States, do not accept history, or live through history -- we have the capacity, Obama (and Biden) say, to make history, through collective action, whether it is in the Revolution, the Constitution, the Civil War, the civil rights revolution, or now, in tackling the challenges that face us in the 21st century.  America, therefore, is self-created, and continues to be self-creating, by political action. 
The changes noted above reinforce this theme by naming and crediting the actor. See also 'We've been here before': How Obama frames our history.

Update, 10/4/12: In a similar vein, see the changes Bill Clinton ad-libbed in his speech at the 2012  Democratic National Convention.

The Obama Rhetoric Series

Wednesday, March 24, 2010

Bracketing up: HCR, income redistribution and tax reform

David Leonhardt  points out today that the health care bill represents a significant check to the growth of income inequality over the past generation. This point about its tax impact triggered a memory:

A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000. On average, the annual tax bill for households making more than $1 million a year will rise by $46,000 in 2013, according to the Tax Policy Center, a Washington research group. Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.

The memory was this: lefty blogger speculation at the dawn of the Obama presidency as to whether Obama would seek to reengineer tax brackets. Nate Silver:
What the discussion over the top marginal tax rate ignores, however (and what Ygelsias picks up upon) is that this rate has been assessed at very different thresholds of income. In 1940, for example, the top marginal tax rate was 81.1 percent -- but this rate only kicked in once you made $5,000,000 or more in income, which is equivalent to about $75,000,000 in today's dollars.

But today, the threshold where the top tax bracket kicks in isn't $75 million, or $5 million, or even $1 million ... it's a mere $357,700. The progressivity of the tax code stops there....

Our Undemocratic Constitution, cont.: fixes from Calif. and Down Under

I generally take Thomas Friedman's enthusiasms with a spoonful of salt (especially his corporate enthusiasms). But today he retails two interesting ideas from Larry Diamond of the Hoover Institution and Stanford  (interesting that Friedman cites only Stanford) that could lead toward fixes in Our Undemocratic Constitution. First:
let every state emulate California’s recent grass-roots initiative that took away the power to design Congressional districts from the state legislature and put it in the hands of an independent, politically neutral, Citizens Redistricting Commission. It will go to work after the 2010 census and reshape California’s Congressional districts for the 2012 elections. Henceforth, districts in California will not be designed to be automatically Democratic or Republican — so more of them will be competitive, so more candidates will only be electable if they appeal to the center, not just cater to one party.

There's an element of trying to jump off your shadow in creating depoliticized commissions.  The experts are usually picked by elected officials, and no one is ideology-free, of course. But that doesn't mean that commissions don't work.  Politics can be sublimated if not eliminated. Commission members are not up for election, they are picked in a manner that balances their political propensities, those selected generally have a reputation as reality-based nonideologues, and they are forced to work together.  The base closing commission worked; the 9/11 Commission did some good, in truth-telling if not in policy results; the Social Security commission at least provided some cover or impetus for politicians to strike a deal; and the President at least has high hopes for the "MedPAC on steroids" in the health reform bill.

Tuesday, March 23, 2010

The punch that landed: Rachman writes Obama's second chapter

Eons ago, back in October, I took a bit of umbrage when the award winning columnist Gideon Rachman suggested that Obama was displaying "a failure to get things done behind the scenes," that the "notion that he was a weak leader" was spreading at home and abroad, and that he "needs to show that he can pack a punch."

I scoffed that Rachman was misrepresenting "the realities and pacing of the American political process, not to mention of international diplomacy" and forecast that "when sweeping healthcare reform, however flawed, is passed before year's end, the pace will look like lightning in retrospect; President Obama will be seen to have moved a mountain in his first year in office."

Didn't happen quite that way, did it? During the long stall-out -- not only over healthcare but in negotiations with Iran, and with Russia, and in the climate summit debacle -- I thought about Rachman's column from time to time. He was right. He didn't say Obama couldn't land a punch. He said he needs to. Boy has that been true.

Today, Rachman wrote the second chapter:

Monday, March 22, 2010

Romney is phoney but not funny

Lots of people are amused by Mitt Romney's denunciation of Obamacare, close cousin to Romneycare. Joe Klein finds it hilarious.  And there is something Onionesque in the consistency with which Romney denounces everything he said and did before 2006.

But look at what Romney said. It's not funny:

America has just witnessed an unconscionable abuse of power. President Obama has betrayed his oath to the nation — rather than bringing us together, ushering in a new kind of politics, and rising above raw partisanship, he has succumbed to the lowest denominator of incumbent power: justifying the means by extolling the ends. He promised better; we deserved better.

This is beyond disgusting and into dangerous. Betrayed his oath - that's incitement, in effect an accusation of treason against the President for effecting the passage of legislation fulfilling his signature campaign promise. It's an attempt to cast legislation that will pass through our Constitution's "triple veto" -- with a 60-vote Senate majority for the main bill, no less -- not as ill-considered but as illegitimate.

Nudging toward Bethlehem, 3: "This is what change looks like"

Speaking of radical incrementalism, here, from Obama's rather stark speech following the bill's passage last night, is Obama in a nutshell:
So this isn’t radical reform. But it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like.
Note the implicit re-education for disillusioned supporters -- closing a loop on his closing speech at George Mason last Friday:  "As long as this process is, as frustrating as this process is, as ugly as this process is..."

Nudging towards Bethlehem, cont.

Ezra Klein on the strange beast that is the health care reform bill:

It is a comprehensive reform with an incremental soul.

Reverse that formula, and you have Barack Obama: an incremental reformer with a comprehensive soul.

Call of the year

Yes, health care reform has lost some popularity. But Democrats are past the point of no return. They have no choice but to pass a bill, and the Republicans have done them a favor by showing their hand

Jonathan Chait
September 2, 2009
"Obama's August: Not Bad, Actually"

Dingell to wavering Democrats: You have no choice

Anyone who called his or her Congressional rep and was told that the rep "doesn't like the Senate bill" will appreciate what John Dingell (who gavelled the passage of Medicare in 1965) told wavering Democrats:
There are 430 people in this place and every one of them can think of ways the bill can be improved--and every one of them can think of things that they are dissatisfied with in the bill.  But the legislative process is not about getting exactly what you want. It's about getting the best thing you can to resolve great public questions.
You have no choice. You have to go forward on this.

Sunday, March 21, 2010

The making of a great President

In his long essay Can America Rise Again? James Fallows sought for a solution to "the American tragedy of the early 21st century: a vital and self-renewing culture that attracts the world’s talent, and a governing system that increasingly looks like a joke."  Our political system has not evolved, Fallows warned, citing the unrepresentative Senate, the distortions in the House wrought by gerrymandering, and the near-impossibility of fundamental Constitutional amendment.  So what to do?  Fallows concluded that we can only "muddle through" -- in effect, trust that our society's civil and economic dynamism will continue to throw up leaders who squeeze far-sighted policies through our creaking political institutions:
America has been strong because, despite its flawed system, people built toward the future in the 1840s, and the 1930s, and the 1950s. During just the time when Frederick Law Olmsted designed Central Park, when Theodore Roosevelt set aside land for the National Parks, when Dwight Eisenhower created the Pentagon research agency that ultimately gave rise to the Internet, the American system seemed broken too. They worked within its flaws and limits, which made all the difference. That is the bravest and best choice for us now.
Tonight is a night to celebrate a muddle-through breakthrough.  One month ago,  Barack Obama framed the struggle to pass comprehensive health care reform this way: "What’s being tested here is not just our ability to solve this one problem, but our ability to solve any problem."

The country passed this test because we have a leader who understands how broken our governmental machinery is and works simultaneously to fix our politics and our policies. We elected a President who appreciates how messy democracy is and understands the manifold constraints as well as the multiple levers of presidential power.  His acknowledged errors notwithstanding, Barack Obama moved this mountain because he knows how to prioritize, strategize, execute and communicate. 

Saturday, March 20, 2010

Politico repeats a myth about Obama's post-Scott Brown HCR plans

In reconstructing how the Democrats got from the disarray following Scott Brown's election on Jan. 19 to the brink of passing comprehensive health care reform, Politico retails what I believe is a common misperception about Obama's first reaction to the debacle:
Publicly, Obama seemed to side with Pelosi over his own chief of staff, professing his commitment to comprehensive reforms at the State of the Union.

But he was also sending deeply mixed signals. In a closely watched interview with ABC’s George Stephanopoulos a day after Brown’s win, Obama expressed support for a quickly-passed bill containing only “the core elements” of reform.
Never mind the skewed chronology there. I am convinced that what Obama said in the Stephanopoulos  interview was almost universally misunderstood.  That's by definition his fault  -- he was unclear.  But when he said, "I would advise that we try to move quickly to coalesce around those elements of the package that people agree on," and later referred to the "core elements of the bill," he meant the whole shebang -- new coverage rules, individual mandate, exchanges, subsidies, funding from Medicare cuts, cost-control measures.  In fact, his whole subsequent course of action  -- re-presenting the "core elements," exposing the bankruptcy of Republican thinking, scrubbing the bill of individual carve-outs -- was laid out in outline -- faint outline -- in that interview, and then somewhat more clearly in the State of the Union a week later.

Never let a noncrisis go to waste

David Remnick has posed a fundamental question about Netanyahu that is resonating through the internets:
The essential question for Israel is not whether it has the friendship of the White House—it does—but whether Netanyahu remains the arrogant rejectionist that he was in the nineteen-nineties, the loyal son of a radical believer in Greater Israel, forever settling scores with the old Labor √©lites and making minimal concessions to ward off criticism from Washington and retain the affections of his far-right coalition partners. Is he capable of engaging with the moderate and constructive West Bank leadership of Mahmoud Abbas and Salam Fayyad, and making history? Does there exist a Netanyahu 2.0, a Nixon Goes to China figure who will act with an awareness that demographic realities—the growth not only of the Palestinian population in the territories but also of the Arab and right-wing Jewish populations in Israel proper—make the status quo untenable as well as unjust?

Remnick is not alone in posing this question.  In Israel, on 3/17 Haaretz columnist Carlo Strenger framed the challenge at greater length, with greater intimacy, and with Israeli as opposed to an American model (also noting that Netanayu's  character "has been analyzed time and again"). I'm excerpting at length, because the  capsule political bio here is of a piece.
Netanyahu is coming toward the end of his midlife. Presumably he knows that his place in history will be carved in stone by the present term. He may not get another chance to be prime minister, even in Israel's unfortunately very static political landscape. Hence he faces the one big question: will he continue his pattern of basically stalling, or will he muster the courage for a bold move?

Friday, March 19, 2010

How HCR will change lawmaking: Stern vs. Ezra Klein

Andy Stern to Ezra Klein on how the long struggle to get health reform passed has changed the political process, maybe forever:
The bill isn't law yet, but while I have you on the phone, what have been the lessons of this effort?
First, the longer you wait, the harder it gets and the worse it gets. Time for deliberation is appropriate, but indecision and delay are counterproductive to getting something done. The choices don't get easier over time. They get harder.

Second, people have to decide whether people in the same party will use procedural tricks to trip up their teammates. Or whether parties, particularly the Democratic Party, appreciates that the special deals and earmarks that might traditionally have been part of the process no longer work. Politicians used to bring kickbacks home to their district, but now people think the system is corrupt.

Governing honestly and openly and voting based on what's good for the country rather than for your election actually means something right now. It's really dangerous right now to be seen being corrupt in a corrupt system. Ben Nelson used to look like an honorable person in a corrupt system. Then he flipped to looking like one of the corruptors.
Has anyone noticed that for all the agony of this process, the intense fire and scrutiny has actually forced the Democrats to account for every detail in the bill and so write a better bill?

On the the other hand, the process has demonstrated that relentlessly misinforming the public and whipping up a frenzy of opposition on false premises pays off, at least in the short term.  The Republican memes -- government takeover of heatlhcare, back-room deals, death panels, adds to the deficit -- have clearly taken hold.  In phone outreach, I heard most of them.

Cool whip

Begging your indulgence, dear reader, an updated reposting from earlier this week:
---
Ever since Scott Brown's election on Jan. 19 seemingly blew the Democratic caucus into pieces, Nancy Pelosi has been a rock. While acknowledging some tactical uncertainty in the immediate aftermath, she never wavered in her assurance that Democrats would find a way to pass comprehensive reform.

On Jan. 21, she caused some anguish by acknowledging that she did not have the votes to pass the Senate bill as is. She did glance at the possibility of piecemeal reform. But the dominant chord even then was that a path to meaningful reform would be found. Note the refusal to panic:
"There's a recognition that there's a foundation in that bill [the Senate bill] that's important. So one way or another those areas of agreement that we have will have to be advanced, whether it's by passing the Senate bill with any changes that can be made, or just taking [pieces of it]," Pelosi said.

"We have to get a bill passed -- we know that. That's a predicate that we all subscribe to."

When will that happen? Who knows!

"We're in no rush," Pelosi said.

On Jan. 28, she took heart from Obama's defense of comprehensive reform in the State of the Union address and responded to his call to Congress to get it passed:
“You go through the gate. If the gate’s closed, you go over the fence. If the fence is too high, we’ll pole-vault in. If that doesn’t work, we’ll parachute in. But we’re going to get health care reform passed for the American people.”

Thursday, March 18, 2010

FT triptych: a "multilateral web" for China

Six weeks ago, I 'collated' the thoughts of a two China-watchers who advocate a multilateral approach to attempting to moderate China's de facto protectionism. To recap: Aryind Subramanian of the Peterson Institute argued in the FT 
It is time to move beyond the global imbalance perspective and see China’s exchange rate policy for what it is: mercantilist trade policy, whose costs are borne more by countries competing with China – namely other developing and emerging market countries – than by rich countries. The circle of countries taking a stand against China must be widened beyond the US to ramp up the pressure on it to repudiate its beggar-thy-neighbourism. But progress also requires that the silent victims speak up.

Looking to the longer term, Jeffrey Garten of Yale made a complementary argument (also in the FT) not only that broad groupings of nations need to cooperate to help move Chinese policy, but that they need to do so by institution-building --  strengthening existing multipolar organizations like the WTO in the short term and building new ones over time:

What has it got in its pocketses? What's on Stupak's List?

Bart Stupak is a real alpha dog, isn't he? He hangs with those major power brokers the Catholic bishops, and like his puppet masters dismisses the authority of the heads of almost every major order of nuns in the United States:
Congressman Bart Stupak, D-Mich, responded sharply to White House officials touting a letter representing 59,000nuns that was sent to lawmakers urging them to pass the health care bill.

The conservative Democrat dismissed the action by the White House saying, "When I'm drafting right to life language, I don't call up the nuns." He says he instead confers with other groups including "leading bishops, Focus on the Family, and The National Right to Life Committee."

Stupak also maintains that he still has a solid group of 12 House Democrats who will go along with him and vote against the reconciliation package if there isn't a ban on taxpayer-funded abortion.

He met with them Tuesday and said the White House has not successfully peeled off any of them.

The Michigan lawmakers carries the list of the 12 lawmakers allied with him in his pocket, "K Street thinks they know who is on the list. They don't. There are some surprises on there.

Never mind that many of the nuns represented by the letter are on the front lines of this country's broken health care system:
As the heads of major Catholic women’s religious order [sic] in the United States, we represent 59,000 Catholic Sisters in the United States who respond to needs of people in many ways. Among our other ministries we are responsible for running many of our nation’s hospital systems as well as free clinics throughout the country.

We have witnessed firsthand the impact of our national health care crisis, particularly its impact on women, children and people who are poor. We see the toll on families who have delayed seeking care due to a lack of health insurance coverage or lack of funds with which to pay high deductibles and co-pays. We have counseled and prayed with men, women and children who have been denied health care coverage by insurance companies. We have witnessed early and avoidable deaths because of delayed medical treatment.

Never mind too that the nuns find the Senate bill's restrictions on federal abortion funding satisfactory, or that Stupak's longtime Congressional ally Dale Kildee, who spent six years studying for the priesthood, is "convinced that the Senate language maintains the Hyde amendment, which states that no federal money can be used for abortion,” or that Stupak has been caught lying about the Senate bill's adherence to the Hyde Amendment, or that there is strong evidence from Massachusetts and worldwide that expanding health insurance access reduces abortions. 

Stupak has a list in his pocket.  So did Joe McCarthy  -- an entirely fictional one. Stupak does have pro-life colleagues who stood with him when he negotiated his anti-choice amendment to the House bill, some of whom have indicated that they are with him still. But does he have them in his pocket?  If I were a member of the alleged Stupak 12, I'd feel as belittled by him as the nuns were.

Here's hoping that Stupak's political capital proves to be as much sham as his moral capital.

With God -- okay, CBO -- on their side

Ezra Klein tweets the scoop: the CBO has given the health reform package a brilliant green light:
Dem source: CBO score says bill cuts deficit by $130 bill in first 10, $1.2 trill in second 10. Costs $940 billion in first decade.

Wednesday, March 17, 2010

Stupak coalition crack?

Rep. Dale Kildee (D-MI), a key Stupak ally, has stated the obvious: the abortion language in the Senate bill is restrictive enough for any sane pro-lifer (e.g., American nuns), so he will vote for the HCR bill.
For those who know me, I have always respected and cherished the sanctity of human life. I spent six years studying to be a priest and was willing to devote my life to God. I came to Congress two years after the Hyde amendment became law. And I have spent the last 34 years casting votes to protect the lives of the unborn. I have stood up to many in my party to defend the right to life and have made no apologies for doing so. I now find myself disagreeing with some of the people and groups I have spent a lifetime working with. I have listened carefully to both sides, sought counsel from my priest, advice from family, friends and constituents, and I have read the Senate abortion language more than a dozen times.

He added, “I am convinced that the Senate language maintains the Hyde amendment, which states that no federal money can be used for abortion.”
Per Jonathan Bernstein's note about how skillfully Kucinich has played the press in trumpeting his 'yes' vote, I'm a bit mystified why the news of Kildee's decision isn't front-of-blogosphere news.  If the bulk of the Stupak 12 break, it's game over. Kucinich is a party of one. 

Tuesday, March 16, 2010

Is 'deem-and-pass' an irredeemable boondoggle?

Getting health care reform through the House via "deem-and-pass," a parliamentary move whereby the House "deems" the Senate bill passed as it votes in favor of a package of fixes via reconciliation, may indeed be a foolish strategy, as HCR stalwarts Ezra Klein, Jonathan Chait, Jonathan Bernstein and Kevin Drum are all lamenting. Drum nicely captures the consensus:
Like it or not, process has become a big issue as healthcare has dragged along into its second year, and the public really does seem to have grown weary of endless procedural wankery. What's more, there's no benefit. Any Democrat who thinks that Republican attacks this fall are going to be blunted even a smidge because, technically, they voted for the package of fixes, not the main bill, is living in fantasy land.


Still Kicking: Nancy Pelosi

Ever since Scott Brown's election on Jan. 19 seemingly blew the Democratic caucus into pieces, Nancy Pelosi has been a rock. While acknowledging some tactical uncertainty in the immediate aftermath, she never wavered in her assurance that Democrats would find a way to pass comprehensive reform.

On Jan. 21, she caused some anguish by acknowledging that she did not have the votes to pass the Senate bill as is. She did glance at the possibility of piecemeal reform. But the dominant chord even then was that a path to meaningful reform would be found. Note the refusal to panic:
"There's a recognition that there's a foundation in that bill [the Senate bill] that's important. So one way or another those areas of agreement that we have will have to be advanced, whether it's by passing the Senate bill with any changes that can be made, or just taking [pieces of it]," Pelosi said.

"We have to get a bill passed -- we know that. That's a predicate that we all subscribe to."

When will that happen? Who knows!

"We're in no rush," Pelosi said.

On Jan. 28, she took heart from Obama's defense of comprehensive reform in the State of the Union address and responded to his call to Congress to get it passed:
“You go through the gate. If the gate’s closed, you go over the fence. If the fence is too high, we’ll pole-vault in. If that doesn’t work, we’ll parachute in. But we’re going to get health care reform passed for the American people.”

Monday, March 15, 2010

Pascrell on board for health care reform?

An update on my recalcitrant Congressman, Bill Pascrell, Democrat of District 8 in New Jersey, who told Politico and Fox News in the aftermath of the Massachusetts election that Democrats should scale back their health care plans and just pass scraps of reform, and that he was working on rounding up colleagues intent on doing just that. Back then, he pronounced both the House and Senate bills dead. On March 2, in an open letter to the President, he published a weak excuse for a reform package   (however worthy some component parts may be) - tort reform, a patient's bill of rights, antittrust exemption repeal.

A week ago Friday, Pascrell's aide told me that he "doesn't like the Senate bill" -- e.g., the excise tax, the relatively stingy subsidies. Today he told Politico, "I don't think we should simply assume Mr. Reid has 51 votes...I don't know what the hell is going on over there in the Senate." Apparently he's of the school of House Democrats who believe, as Dick Durbin put it yesterday,  "The Republicans are our opponents, but the Senate is the enemy."

But it would appear that he's on board. David Dayen's whip count at Firedoglake, which identifies all known Democratic no's and maybe's by name, does not name him, and so has him in the definite yes category by default. An Organizing for America email last week asked members in this area to call Pascrell and "thank him" for voting for the House HCR bill in November; there was no direct mention that he might be squishy now.

Today, Pascrell's his aide told me that he "needs to see what's in the bill"  and remains uncommitted. When I cited Dayen's count, though, and said that I assumed that he would vote for the bill in the end, she acknowledged that that's probably what will happen. 

I took two whacks at Pascrell in op-eds in local media, here and here.

Sunday, March 14, 2010

Durbin to House Democrats: We are not the enemy

As the reconciliation drama has unfolded in the wake of the Massachusetts Senate election, I have been repeatedly astonished at evidence that many House Democrats seem more concerned about getting rolled by the Senate than about getting rolled by Republicans -- as if an HCR bill that looks more like the Senate bill than they would like would be a worse defeat than failing to pass comprehensive reform at all.

Today, on Meet the Press, Dick Durbin articulated this sentiment, put it in historical context, and made a bid to defuse it:
SEN. DICK DURBIN (D-IL):  Tom, when I served in the House, we used to say in the House Democratic Caucus, "The Republicans are our opponents, but the Senate is the enemy." So I can understand the built-in skepticism and lack of trust.  But I'll tell you this, we're in the process of actually contacting every single Democratic senator.  When Nancy Pelosi goes before her House Democratic Caucus, it will be with the solid assurance that when reconciliation comes over to the Senate side, we're going to pass it.

Netanyahu's "weakness"

A casual observer might ascribe the the Israeli government's announced approval of 1600 new housing units in East Jerusalem in the midst of Biden's visit to Israel as a sign of the Netanyahu government's aggressive contempt for U.S. attempts to influence Israeli policy (notwithstanding Netanyahu's claim to have been blindsided).

That's not how Israeli opposition leader Tzipi Livni -- defeated by Netanyahu by a razor-thin margin in the last election -- is casting it. Haaretz reports:
Opposition leader and Kadima chairwoman Tzipi Livni on Sunday cast her own criticism of Netanyahu regarding the recent row, saying his weakness to his coalition partners was costing the government its stability.

"The coalition agreement is not a substitute for a set path and a vision," Livni said, adding that "we have a prime minister who does not know what he wants and this weakness is leading to a political landslide."

"Israel is paying the price for the fact that her government is not making decisions and it will continue to pay for it," Livni added.
"It is not God's decree for the world to be against us," said the opposition leader. "We can change the reality, but for this we need a prime minister who has a clear policy and strategic path, who doesn't place national security in the hands of [Interior Minister] Eli Yishai.

Friday, March 12, 2010

I feel very exhilarated...

when Nancy Pelosi is exhilarated:

Again, I feel very exhilarated by a Caucus meeting that we had this morning in terms of the questions that Members have. We spent a good deal of time on the substance, but then some on the process as well. We stand ready to stay as long as it takes to pass the bill. I think Members are eager to pass the bill. And again, it won't be long before we'll be making a real difference in the lives of the American people.

Michael Mukasey's bait-and-switch: 'al Qaeda 7' for Yoo and Bybee

Turning to the op-ed page of the WSJ on Wednesday -- always a dangerous enterprise if you support the rule of law  -- I noted with satisfaction an op-ed by former attorney general Michael Mukasey titled, "Why You Shouldn't Judge a Lawyer by His Clients." It appeared that Mukasey was joining other Bush Administration attorneys and principled conservatives in denouncing the vicious smears of Liz Cheney against Justice Department lawyers and other attorneys who have defended Guantanamo detainees or otherwise worked to uphold the rule of law in the treatment of detainees.

While Mukasey's piece does defend those who defend "clients that were or became unpopular," the piece is a bait-and-switch, built on a false and dangerous equivalence that is sure to become a Republican talking point.  After noting perfunctorily that Bernie Madoff's lawyer was reviled, Mukasey turns to his true passion:
More recently, we've witnessed a campaign to impose professional discipline on two former Justice Department lawyers, John Yoo and Jay Bybee, for legal positions they took as to whether interrogation techniques devised and proposed by others were lawful—a campaign that also featured casual denunciations of them as purveyors of torture.
After then noting the denunciation of Justice Department attorneys who in private practice represented terrorist suspects or upheld their rights, Mukasey makes his move:

Thursday, March 11, 2010

A whip for Rep. Pascrell on HCR

My own Congressman, Democrat Bill Pascrell of New Jersey's 8th District, publicly opposed comprehensive health care reform in the immediate aftermath of the Mass. election and still has not committed to voting  for the Senate bill and reconciliation package.  In the piece below, running in today's News-Record of Maplewood and South Orange (NJ), I ask my neighbors to push Pascrell into the yes column:

If You Support Health Care Reform, Call Bill Pascrell

In a speech presenting his final health care reform proposal on March 3, President Obama laid it on the line.  It’s time to pass comprehensive reform, he told Congress and the country:

I, therefore, ask leaders in both houses of Congress to finish their work and schedule a vote in the next few weeks.  From now until then, I will do everything in my power to make the case for reform.  And I urge every American who wants this reform to make their voice heard as well --- every family, every business, every patient, every doctor, every nurse, every physician’s assistant.  Make your voice heard. 
If you live in New Jersey’s 8th Congressional District (covering much of South Orange and Maplewood) and you want to answer the President’s call, then talk to Representative Bill Pascrell -- who has been running the other way.   

When the Democrats lost their filibuster-proof Senate majority in the Jan. 19 Massachusetts election, supporters of  comprehensive health care reform quickly realized that there is just one viable path: have the House pass the Senate bill, which the Senate passed with a 60-vote majority in December, while negotiating to accommodate some House goals  through a process known as reconciliation, which allows budget-related legislation to pass the Senate with a bare majority.  The President’s health care proposal consists of a package of such fixes, such as limiting the excise tax on expensive plans and improving subsidies for middle class buyers of insurance.

In late January, Rep. Pascrell was having none of this. He told Politico that he is “tired” of the health care reform process and wants to end it. “The people in Massachusetts sent a clear message,” he said. “If we didn’t get it in New Jersey or Virginia, we should’ve gotten it, certainly, Tuesday.” He indicated that he wanted to scrap comprehensive reform and pass whatever scraps of reform can garner a few Republican votes.

Trouble with the children of Israel

During the years when peace negotiations between Israel and the Palestinians were a live hope, I recall periodic bloodcurdling stories about the indoctrination of children on the West Bank, inciting hatred of Israel and antisemitism.  A far-from-disinterested but well documented precis (dated 2001) is here.

Now comes disturbing news from the other side of the divide -- not of systematic indoctrination, but of a progressive hardening of attitudes after decades of war. From the Jerusalem Post:
A new Ma’agar Mohot poll has produced somewhat disturbing findings regarding the attitudes of Jewish Israeli schoolchildren about Arab Israelis.

According to the poll, taken among 536 15-18-year-olds, 50 percent of Jewish Israeli schoolchildren believe that Arab Israelis should not be granted rights equal to their Jewish counterparts.

Furthermore, 56 percent of Jewish Israeli schoolchildren surveyed said Arab Israelis should be prevented from running for Knesset, while 50% of the Jewish youngsters who defined themselves as religious said they believe the “Death to Arabs” slogan was legitimate.

The Minister for Minority affairs expresses distress, but also unwittingly frames the perhaps unresolvable paradox of a democracy that places a premium on ethnic/religious identity: 
....Avishai Braverman called the results of the survey “most severe.”

“I believe that it’s the result of ignorance and a campaign of incitement that has been with us a long time,” he said, calling for “meaningful” educational activities to allow the different ethnic communities in Israel to better understand each other. “We came here to set up a Jewish state, but it’s also a state for all its citizens."
Well, that's an interesting idea, but I don't know whether people in the region will go for it.

Wednesday, March 10, 2010

Zogby: Voters' "hearts" are with the Dems on health care reform

The results of extended campaigns to sway public opinion such as Obama's advocacy for comprehensive health care reform from the day after the Massachusetts election forward can take a long time to come into focus. But since mid-February -- a few days after Obama proposed the health care summit -- the polling gap between those who say they're opposed to the Democrats' health care reform effort and those in favor has narrowed steadily to a virtual dead heat at present.

And there are interesting undercurrents. Zogby polled just before the summit and then a week after and did not found no movement in the percentages of people who said they were for or against Obama's plan. But they did find two surprises. Zogby, sharing a byline in today's FT with Bush Administration assistant secretary of defense for health affairs S. Ward Cascells, reports:
First, we were surprised to find Americans exactly evenly split between Mr Obama’s plan and that of the Republicans. Well aware that the way the question is asked can determine the result, in our surveys just before and after the summit, we used Mr Obama’s name and listed the main provisions of both plans. In previous surveys we had asked respondents to choose between the House or Senate Democrats’ plan and no bill, or starting over, and they always preferred no bill, or starting over. [snip]

Ted Williams advises Dems on HCR

Word comes that Jim Bunning has a message for House Democrats: beware passing the Senate health care bill, because the reconcliation "sidecar" could fail, in which case the unaltered Senate bill will become law. That means voting for the unweakened excise tax, relatively stingy subsidies for middle class families, etc.

House Democrats will doubtless be touched that Jim Bunning has their best interests at heart.  Presumably, too, they won't note that the odds of that Senate bill will pass the House and that no reconciliation bill will also pass both chambers are approximately equal to the odds that all 41 Republicans will vote in favor of the reconciliation bill.

If House Democrats need a psyche-up (and they do, they do!), they should take one from the late great Ted Williams, who knew how to deal with Bunning.  I'm surely not the only observer who recalls this scene from Jim Bouton's baseball memoir Ball Four every time Bunning comes snarling into the national news:
Ted Williams, when he was still playing, would psyche himself up for a game during batting practice, usually early practice before the fans or reporters got there.

He'd go into the cage, wave his bat at the pitcher and start screaming at the top of his voice, "My name is Ted fucking Williams and I'm the greatest hitter in baseball."

He'd swing and hit a line drive.
"Jesus H Christ Himself couldn't get me out."

And he'd hit another.

Then he'd say, "Here comes Jim Bunning. Jim fucking Bunning and that little shit slider of his."

Wham!

"He doesn't really think he's gonna get me out with that shit."


Blam!

"I'm Ted fucking Williams.",

Pow!

Nancy Pelosi, you're on deck...

Tuesday, March 09, 2010

The sun never sets on the British blazer

Apropos of nothing, I enjoyed this opener to a column by the FT's Michael Skapinker:
One of the curiosities of travelling from the UK to Australia is that you spend more than 24 hours flying over evermore remote and exotic locations only to emerge, exhausted and aching, in a place so immediately familiar. The similarities are everywhere: the cricket grounds, the striped school blazers, the newspaper worries about knife crime.

The rest of the article is well worth reading, too. It's a cautionary tale: a stimulus program offering people incentives to insulate their homes was a major balls-up.  Lots of substandard work, creating fire and electrocution hazards.

Monday, March 08, 2010

"Enemy Belligerent" lawmakers: McCain and Lieberman

The Enemy Belligerent Interrogation, Detention and Prosecution Act of 2010, a legislative monstrosity produced by John McCain and Joe Lieberman, goes further than any Bush-era legislation in abrogating the core principle of Anglo-American justice: that a suspect is innocent until proven guilty. While the bill is deplorable in every detail -- it denies terrorist suspects their Miranda rights and codifies indefinite detention without trial -- one particular provision effectively ends the presumption of innocence for all of us. That provision codifies the President's right to define any criteria he chooses to deliver any individual into the legal Twilight Zone defined by the bill.

The bill authorizes the President to establish an "interagency team" to make a "preliminary determination of the status" of an individual "suspected of engaging in hostilities against the United States or its coalition partners through an act of terrorism, or by other means in violation of the laws of war, or of purposely and materially supporting such hostilities."  That team will determine whether the suspect shall be accorded a preliminary designation as a "high value detainee" (a.k.a. "unprivileged enemy belligerent" -- the bill makes no coherent distinction between these terms).  A final status determination is to be made by the Attorney General and Secretary of Defense; the President can only weigh in if these two disagree.  Incredibly, the entire procedure from capture to final status determination is to be completed within 48 hours. 

The provision that removes all discretionary limits to this secret determination of status is in the Criteria for Designation of Individuals as High-Value Detainees. That section creates an initial impression that such "determinations" are subject to the rule of law by laying out specific criteria, beginning with "(A) The potential threat the individual poses for an attack on civilians..." (B) the potential threat the individual poses to United States military personnel..." etc. But the final criterion (E) zooms to infinity: it is simply "Such other matters as the President considers appropriate. " 

Saturday, March 06, 2010

The name of the game is the finger game...

The Times has an A1 story coming out tomorrow about "fingers pointing" at David Axelrod for the President's perceived communications failures. I guess we've turned the page from the clutch of stories blaming Rahm Emanuel for the alleged failure to maintain Camelot, which in its turn succeeded roughly a year's worth of stories blaming Timothy Geithner.


This predictable sequence reminds me of a dimly remembered shock from early childhood. In an afterschool program for (I think, roughly) 5 year olds, our little group generally had one member designated, whether by common consent or the acclamation of a self-appointed opinion leader or two, "the dummy."  I seem to recall accepting it as part of the natural order of things that someone held this honorific, and that it wasn't me. Until the day when a beefy loudmouth announced to a standing circle, "X isn't the dummy any more!" He pointed at me. "He is! In soccer, before you can throw the ball in bounds, he's kicked it out of bounds!"

My memory is that this charge was completely fabricated (or imagined). Whether I vigorously defended myself, stood gaping in stunned silence, or managed something in between I can't recall. I'm pretty sure that the title didn't stick for more than a minute or two. I wish I could say that I'd stood up for a prior or subsequent designated dummy, but I can't recall that either.  All I know is that the story comes to mind whenever the scapegoating finger makes its mindless progress through a series of public figures.

As for the administration's alleged failures of communication, strategy and policy: of course there are many. At the same time, the unemployment rate is 9.7% and the President's approval rating hovers at 50%. Reagan's approval rating at the one year mark was essentially identical -- 49% -- after a year in which unemployment had climbed from 7.5% to 8.5%  By December 1982, unemployment had spiked to 10.8% and Reagan hit his polling nadir, 35%.  Bottom line: the administration's "failures" as assessed by public opinion are almost entirely a function of the economy Obama inherited. That will not be true forever, but it's true now. And luck will play a large part in future fluctuations -- if not, ultimately, in his performance over the long haul, and future generations' perceptions of it.

Friday, March 05, 2010

Tom DeLay undercuts Republican high dudgeon

As Republicans kick up the histrionics about "back-room deals" in the health care reform bill, it's refreshing to revisit a September 2009 forecast/confession by none other than Tom Delay, perhaps the most uninhibited abuser of Congressional norms in modern history:

"The Democrats will do exactly what we always did, rewrite the bill over and over until they give all the members what they need to get to 218 votes. The Senate will do the same thing." It will, he predicts, be a straight party-line vote, and "maybe a few Republicans voting for it, but not many" (my emphasis).
The irony is that there were actually relatively few single-state or district-specific giveaways in the Senate and House HCR bills, and the most notorious Senate carve-outs are being purged via the reconciliation patch. As ever, the Republicans are shameless, and the Democrats easily shamed.

Update: DeLay will be on CNN's State of the Union on Sunday. Somehow I doubt he'll be quite as candid as he was in September.

A muff on the Mitt watch

It's fair to assume that whatever the post-2006 Mitt Romney says about a given issue will contradict something he's said or done on the same issue in an earlier incarnation.  Nonetheless, Steve Benen misfires somewhat in this round of Mitt Hypocrisy Watch:
"The president has been disingenuous trying to lay this at the feet of the health insurance companies," he said. "Nobody believes that health care is expensive in America because of insurance companies. Health care is expensive because we use a lot of health care treatment."
Yes, Mitt Romney wants to a) defend universally-reviled health insurance companies as they jack up everyone's premiums while reaping huge profits; and b) thinks health care would be a whole lot cheaper if we'd all stop getting treatment for our ailments.

I'm tempted to ask him, by way of a follow-up, why health care costs in the United States are vastly more expensive than any other country on the planet -- per capita -- even as people in other countries seek treatments for their ailments, but Romney would probably just pretend reality doesn't exist and change the subject.

Actually, health care is more expensive in the U.S. than in any other wealthy country partly because of administrative and marketing costs imposed by for-profit insurance companies, and partly because doctors prescribe and patients demand a lot of unnecessary treatment, but mainly because all payers in the United States pay doctors and hospitals far more per treatment than payers in other countries.

Our system is hugely wasteful -- myriad insurance companies each with their own coverage rules and payment schedules jack up providers' administrative costs and therefore the price of treatment. But at the same time, insurance companies lack the pricing power that governments in other countries arrogate to themselves (including countries like France, Germany, and Japan which use private but nonprofit insurers) and so in large part they just pass through the inflated prices that doctors and hospitals are able to charge.

The worst damage imposed by our insurance delivery system is in our failure to impose uniform coverage rules -- what is covered, what is not, how much insurers are allowed to charge. That can't be fixed without an individual mandate to widen the risk pool. And our system won't truly approach the effectiveness of that of other industrialized countries until the government assumes price control over treatment.

Thursday, March 04, 2010

Reconciling the press to reconciliation

In the weeks since the Massachusetts election, Jonathan Chait and Ezra Klein have quite rightly been driven bats by news accounts that fail to make clear that the Democratic leadership is not trying to pass a complete health reform package through reconciliation, but rather to use the process only to amend the Senate bill. They have both spelled out the distinction clearly enough for a child to understand more than once.

Schooled by Chait, Klein, Jonathan Cohn and the sources they link to --particularly a short  piece by Brookings' Henry Aaron finding that using reconciliation to adjust the funding and spending in the Senate bill is precisely in line with the process's intended purpose --  I have been on a bit of a campaign, writing directly to reporters and editors when articles appear online that fail to spell out that reconciliation will be used only to patch the Senate bill (if hcr passes at all).  These letters have so far induced three national and international publications to clarify and amplify their explanations.

In addition, I took Factcheck.org to task (in a blog post and letter) for obscuring the distinction by citing an April 2009 Brookings paper exploring the possible use of reconciliation to pass the entire HCR passage to imply that the reconciliation 'patch' now contemplated would be "the most ambitious use to date of this filibuster-avoiding maneuver."  In its "mailbag," Factcheck has acknowledged the point -- and so has Brookings:
FactCheck.org responds: We spoke to Thomas Mann, co-author of the Brookings/American Enterprise Institute report we cited, and he agrees. "We argued last year that reconciliation legitimately could be used for health reform, but that it would be ambitious, difficult and partial, given the constraints of the process," Mann told us. "Its much more limited use this year, adding amendments after the bill itself has passed following a successful cloture vote, is very modest and unquestionably legitimate." We have updated the story accordingly, and Brookings plans to update its article within a few days.   

Meanwhile, as Obama has removed any doubt that he wants the Democrats to move forward with the House passing the Senate bill with a reconciliation patch, stories that fail to clarify how reconciliation may be used are getting much rarer.

Wednesday, March 03, 2010

You'd think Obama wrote the damned bill

Not to be subtle, here's the keynote of Obama's re-presentation of the Democrats' health care plan, boldfaced below.
Now, the proposal I put forward gives Americans more control over their health insurance and their health care by holding insurance companies more accountable...

 Essentially, my proposal would change three things about the current health care system... 

Second, my proposal would give uninsured individuals and small business owners the same kind of choice of private health insurance that members of Congress get for themselves...

Senate HCR bill today; public option tomorrow

Jonathan Bernstein provides crucial perspective on the public option: it is a battle that can be won another day, if only Democrats have the courage to win now by passing the bill that's currently on the table. Commenting on Blanche Lincoln's primary challenger Bill Halter's support for the p.o., Bernstein (guest-blogging on Andrew Sullivan's Dish) writes:
I expect virtually every Democrat in contested primaries during this and (if still not enacted) the next campaign cycle to support the public option, at least in any district in which Democrats have a chance to win.  The main exceptions will be incumbents such as Lincoln who already voted against it...and I won't be shocked if she switches.  In a Democratic primary, I don't see any potential downside.  Liberals love it, and for better or worse Democrats don't believe that it will be a general election liability.
 
The other part of this is that the public option should be eligible for a reconciliation bill, so it won't take sixty Democrats to get it done.
 In a comment string on Kos last week I made a similar point, minus the perspective on the effect of primary challenges:
I don't think putting the public option into the reconciliation patch is genuinely on the table - nor should it be. Rockefeller had it right. Putting it in would knock out the House blue dogs who might come aboard because the Senate bill is more conservative than the House's, offsetting some of those who might vote no because the Senate bill weakened the Stupak abortion prohibition.  I'd like to see a strong PO passed through reconciliation at a later date - perhaps when the pendulum swings back toward Dems in 2012 or 14.  The exchanges won't be up until 2014 anyway.  Better to get the framework up -- it can be jiggered through reconciliation forever after. Per TR Reid's book The Healing of America, country's with effective health care systems, like France and Germany, are forever tinkering with them.
Obama is right to tweak the bill rightward now to increase its chances of squeaking through. As always, he takes a long view, and he has been consistent from the start about the "core elements of the bill" that are interdependent and that provide a foundation for expanded access and cost control.  The public option might vastly strengthen the new system on both counts, but it's at the top of second-tier priorities. It can be added later.

Tuesday, March 02, 2010

Obama bends over backwards, and does not yield

Obama's post-summit bid for a comprehensive health care bill, unveiled in a letter to the Congressional leadership, extends his paradoxical  approach to Republican intransigence: bend over backwards/do not yield.  That is, keep suggesting -- and trying to showcase -- the meme that Repubicans can be right at the margins but are missing the big picture.

The White House blog stresses that the President is proposing to include "even more Republican ideas" (!) and the revised plan incorporates several proposals voiced by Republicans at the summit. Yet at the same time, Obama's letter insists "that piecemeal reform is not the best way to effectively reduce premiums, end the exclusion of people with pre-existing conditions or offer Americans the security of knowing that they will never lose coverage, even if they lose or change jobs." In other words, the damn bill -- a blend of the bills passed by House and Senate Democrats -- will pass. 


Monday, March 01, 2010

1995 redux

Today was a 1995 flashback, with Jim Bunning shutting down core government functions, sneering, growling and flipping the bird to a reporter, while Jim Kyle pronounced that unemployment benefits make people unwilling to work (cf. banker Potter in in It's a Wonderful Life: home mortgages breed "a discontented, lazy rabble instead of a thrifty, working class"). What Democrat doesn't smell overreach?  On the same day, an IRS building is evacuated and a Hazmat team called after a suspicious substance is found -- two weeks after an anti-government Kamikaze flew a plane into another IRS building.

Today's apparent attack may have been illusory - the latest report claims that the substance in question was not hazardous -- and Joseph Stack's paranoid rage was politically heterodox.   But one needn't tag these assaults -- or pranks, or even mirages -- as coherent political acts to catch a wave of Gingrich-era deja vu.


In April 1995, the Gingrich Congress was in full flush of its "First 100 Days" when Timothy McVeigh blew up the Federal Building in Oklahoma City -- and Clinton reasserted himself as Consoler-in-Chief and started talking about the fires of anti-government rage stoked by hateful talk radio. A few months later came the government shutdown,  when Clinton faced down Gingrich, Dole et al and forced them to back off what he called "cruel" cuts to Medicare,  Medicaid, education, the earned income tax credit, etc. (helped by Gingrich's public boast that he'd shut down the government because Clinton snubbed him and Dole on Air Force One, seating them at the back). Clinton's poll numbers soared in 1995 and basically never came down.  


Of course, Clinton only regained his moxie after failing to reform health care and losing the House and Senate.  He was never able to pass major legislation thereafter. Is it too much to hope that Obama has suffered his Dunkirk early?  That right now the latest bout of anti-government fever will break, Democrats will breathe and pass health care reform, and go on to weather normal midterm losses?