Good news on the health reform front, where the President announced on Super Bowl Sunday that he plans an open meeting at the White House with Congressional leaders from both parties and cameras from C-SPAN for a conversation about improving and passing the health care bill.
If they want to take a pass on being able to provide input, let them pass. Hold the summit, ask for their ideas, let the President outmatch them once again, and pass the Senate bill and a corrective bill through both chambers, on party lines if need be.
"As I look back it was a waste of time dealing with [Snowe]," [Sen. Harry] Reid is quoted as saying about the White House in a forthcoming New York Times Magazine piece, "because she had no intention of ever working anything out."
You know, Reid sounds genuinely surprised by this. I mean...he's been in the Senate, hasn't he noticed the record-setting filibuster pace the Republicans have set? Doesn't he understand the GOP would rather savage the country by blocking crucial legislation than stay out of power?
There was a lot of talk this election of ending the partisan rancor in Washington. People dug it. Obama ran a campaign on it. Only thing is, the GOP realized by upping partisanship a notch, they won't be the ones who catch h*ll.
The answer is, and always was, to go progressive and steamroll the GOP into obsolescence.
I continue to see people screaming bloody murder over the health care legislation moving through Congress. I don't have the numbers handy, but a poll (CNN, I think) recently found a narrow plurality opposing the House legislation, with a notable portion of those opposing it for being too conservative (worth noting, of course, most opposition was actually from the right or was self-described non-ideological).
The Senate bill, by most accounts, is a more conservative bill. It is financed primarily not by an explicitly progressive tax, but by an excise tax on health plans that will hit Goldman Sachs executives for sure, but will also hit a lot of working class union members who have negotiated health benefits for years.
The subsidies for purchasing coverage in the Senate bill are lower than I would like, meaning near-term affordability isn't what I would hope (of course, it also means less of a public transfer to private insurance companies, which I suppose is OK).
With all that in mind, people have been asking me a lot lately why I'm still supportive of the bill. For me, it really cuts to a few things:
The underlying structure of the bill -- subsidies, insurance exchanges, insurance market regulations, etc. -- are the right underlying reforms to make a public/private system work. They also may take us a bit closer to single-payer and certainly do not move us further away (e.g. single-payer supporters may not get what they want in this bill, but it does not foreclose victory down the road, which is important).
There are some very smart political incentives built in. For example, members of Congress get thrown into the exchanges with a lot of the rest of us, helping guarantee that the incentive down the line is for them to maintain high quality and affordability (relatively speaking on the affordability, a lot of members of Congress happen to be very rich and all are higher income than the majority of Americans).
The biggest point of all is that the Senate bill is extremely serious about costs over the long-term. What should worry just about everyone in the healthcare debate is how completely unsustainable the current system is. It isn't just that it is expensive or that administrative costs run too high. Those administrative costs don't even begin to explain the wild inflation that occurs in America's healthcare sector. You simply cannot have costs in 17% of your economy rise at rates 5-10% faster than the economy as a whole in perpetuity.
My friend Jay Stevens wrote a while ago that his problem with the excise tax was that it penalized spending on healthcare and that we should be happy to encourage people to spend more on healthcare. If healthcare actually improved health, I'd be inclined to agree that it is worth subsidizing. But the correlations are relatively weak (and the odds that hospitalization can hurt or kill you are unfortunately high). Under these circumstances, reducing healthcare spending and allowing ourselves to spend more money on other things (perhaps sporting equipment or healthy local food, both of which can be expensive but would do more in general to improve health than more heart surgeons) would be a good thing.
Does the Senate bill do this? We don't know. But it does everything it can to "bend the curve." Is that good for progressives? Depends on what you mean by progressive, but anyone concerned that health insurance is too expensive for low-income people and tthe middle class should hope that the low- and middle-income people of 20 years in the future have better choices. That requires bending the curve. And by all accounts, the Senate bill works harder to bend the curve than the House bill.
The Senate bill isn't just deficit neutral. Over the next twenty years, by CBO's (rough) estimates, it will reduce the deficit by three-quarters of a trillion dollars. That, as they say, is real money. It does that by long-term holding federal spending on healthcare steady even as massively expanding federal assistance to help low-income and middle-class Americans purchase insurance.
Even better news: CBO has at times been known for being woefully pessimistic. They overestimated the cost and underestimated the impact of tradeable permits for reducing SO2 pollution (which helped clean the air in my (and Dennis Rehberg's) hometown of Billings -- maybe "cap and trade" ain't such a bad idea, Mr. Rehberg). They overestimated the cost of Medicare's prescription drug benefit. And they routinely admit that they can't "score" the cost of key provisions of health care bills that may further reduce spending because these are experiments and folks like CBO approach experiments conservatively.
A couple months ago, a "meme" flew around Facebook as millions of social networkers changed their status to read "No one should die because they cannot afford health care, and no one should go broke because they get sick." Both the Senate and the House legislation accomplish these goals. If we want to establish additional corollaries, such as "No insurance executive should make money" or "No brain surgeon should make more than $250,000 per year," we could have done that. But those goals aren't really as important, either policy-wise or politically.
Soon, we'll pass a bill that should effectively end medical bankruptcy in America and guarantee baseline health care access for all citizens (too low a bar, I agree, for a variety of reasons). Over the long-term, this bill will likely ensure that we need not ever turn back on that promise and that we may even expand on it, just as we did over time with the promises of the civil rights acts and Social Security.
Mike Dennison has a good and informative story out this past weekend with the short version of what health reform will do for most Montanans in difficult situations: make their lives better even if it is hard to know precisely what will improve until 2013.
For some folks, this is another major black eye for an already deeply flawed bill. For many of us, though, this is simply another foreseen frustration inevitable with major system changes in a huge sector of the economy.
The health care bill will have a handful of immediate changes. Although the structure of the national high-risk pool is currently unclear, it should provide some near-term help for the currently uninsurable. In the slightly longer term, the exchanges and the subsidies and insurance regulations should make coverage affordable for basically everybody and near-universal coverage will be the standard in the U.S. And we'll also put some key systems in place to actually bend the cost curve on health care -- which eventually will mean fewer procedures, devices, and drugs that aren't improving our health.
What marked me most about the Dennison piece wasn't the sadness of the young woman at the end when she hears that no help is coming for three or four years, it is that based on these five (representative?) stories, help is actually on the way. It's been a long time since anyone could say that on the health care front.
Here's some heartening news for Montanans: Max Baucus, who had voted against two public option amendments in committee for fear that they would induce a filibuster, is back on board coming out of the negotiations he participated in with Senators Reid and Dodd and the White House:
I included a public option in the health reform blueprint I released nearly one year ago, and continue to support any provision, including a public option, that will ensure choice and competition and get the 60 votes needed to pass the Senate. Success should be our threshold and I am going to fight hard for the 60 votes we need to meet that goal this year.
As Talking Points Memo notes, this statement leaves Max some wiggle room. But Max has always been the negotiator creating wiggle room on this stuff. That's been his job -- to make sure the bill passes.
Right now, we're on track to get a bill passed with a public option while overcoming a filibuster. I know there are still naysayers in comments (and as I wrote below, I still want improvements on the employer provisions and the affordability) because the Eeyore wing of the progressive movement is alive and well, but this is a victory.
What's more, it is a victory that would not have been possible without this whole insane hand-holding process. How do we know that the White House and Max bent over backward far enough seeking GOP support? Newsweek's Howard Fineman is calling it pointless. When the conventional wisdom becomes that Republicans obstructionism is worthy of being dismissed, we're in good shape.
We're closer now than we've ever been to passing systemic health care reform. It's a massive down payment on fixing this system. I, like many others, have gotten frustrated during this process, but damn if we don't keep getting the ball down the field at the crucial moments.
Interesting story this morning as negotiations have apparently wrapped up in the Senate. Multiple outlets are now reporting that the Senate bill moving to the floor will have a national public option with a state opt-out clause. Interestingly, this is happening despite apparent reservations from...the White House.
So Harry Reid and Nancy Pelosi appear to be showing some decent spine in the last couple weeks.
On a worse front, the bill appears set to feature an employer pay or play provision that penalizes the hiring of low-income individuals by small businesses. It also isn't clear what subsidy levels will be like.
But still, we've got some progress.
Update - Two other thoughts:
I'd prefer no opt-out clause. with what is happening in the House, we may get a straight national public option -- that'd be good.
Still, worth keeping in mind that Medicaid is actually an opt-in program -- and all 50 states have Medicaid.
Al Franken was declared the winner of the 2008 Minnesota Senate race. Democrats now have 60 seats in the Senate. A "supermajority": enough votes to effectively avoid a filibuster. Right?
The persistent absences of two veteran Democratic senators because of serious illness, the varied ideological makeup of the Democratic caucus and the willingness of individual senators to break with the party if they do not get their legislative way make the new mathematical might of the Democrats a bit illusory.
"We have 60 votes on paper," Senator Harry Reid, the majority leader, said Wednesday in an interview. "But we cannot bulldoze anybody; it doesn't work that way. My caucus doesn't allow it. And we have a very diverse group of senators philosophically. I am not this morning suddenly flexing my muscles."
But for a party and a majority leader that has been whining that it can't get anything done because it doesn't have 60 votes -- well, now it does. In other words, that excuse is now laid bare. I mean, remember how we had to be nice to Joe Lieberman because he got us closer to 60? We laughed at that logic because he didn't get us closer to shit. He would still vote with Republicans half the time, whether inside our caucus or outside it.
So yeah, I know that the "60" mark is arbitrary, and like I said in that MSNBC appearance, a new invention since it didn't exist in the Bush years. In fact, no one has promoted that notion more than Harry Reid himself, afraid to be held accountable for the actions of his caucus. Well, he's no longer got cover. Any failures from here on out will be at his feet, and his feet alone.
Right now, of course, Democrats own health-care reform. If it fails, they lose. If it passes, but it's watered down, and it doesn't fix at least some of the problems everyday Americans are experiencing with their health care insurance, they lose.
The key to healthcare reform is that it be popular with the public. The Medicare prescription bill, for example, was generally popular because it provided a clear and concrete benefit. Broader healthcare reform, however, is going to have a harder time. If there's no public option, for example, and most people simply keep the employer-based healthcare they already have, then what's the selling point? Most people will just see higher taxes funding better coverage for the poor, and you don't have to be the world's biggest cynic to understand that this isn't going to be overwhelmingly popular. Helping the poor is all well and good, but like it or not, most of us want to know what's in it for ourselves if our taxes are going up. That's just life.
Right now, we're running the risk that the answer is "not much." Healthcare reform needs a little more obvious sizzle if it's going to survive the coming tsunami of conservative agitprop, and the bills wending their way through Congress don't have much of that left...
Just a reminder to Democrats everywhere. Yes, it's sporting to find a "bipartisan" solution - but then the Republican party's strategy to make you fail. Yes, it's quite popular with newspapers to appear as a "moderate" by working with major institutions, like the health-insurance and health-care industries. Yes, I know you're always running scared, thinking about the next election, thinking about what your Republican opponent is going to say about you. But the bottom line is, you must pass health-care reform that's effective and meaningful for everybody.
Or else you'll lose.
You've now got the means. Use it, even if you have to bloody your knuckles to do so.
A couple of brilliant in-depth analyses came out in the past couple of days, examining why Democrats are threatening to retake the Rocky Mountain West from the herefore tenacious grip of the Republican party.
That said, there are some things happening out here that really should be recognized by the national party as it considers building on what is bound to be an extremely successful election year. That's because there are some long-term shifts that a few smart politicians--Brian Schweitzer and Jon Tester, to name two--grasped early on and have been building upon. That kind of forward thinking will be key to building our majority down the line and gaining and holding the White House. The 2008 national mood, I'd argue, is still throw the bums out--gains made by Democrats this cycle are going to come as a result of us not being them. While the promises of "change" are compelling, for any gains made in 2008 to hold and increase in 2010, 2012 and beyond, there has to be some delivery in the next two years.
There are two highly connected issues that top what Westerners are concerned about leading into 2008--Iraq and the economy....What voters are figuring out in the West is that the economy sucks largely because of the war, and we're in this war largely because of oil. It's not a situation they are particularly happy about.
Update: MtSentinel in the comments reminded me that the "nuclear option" was threatened only for judicial nominations... So there is no such option available to the Senate Democrats to pressure the GOP to abandon its scorched-earth policy...
* * *
Remember all the brouhaha about the AMT patch? Congressional Democrats wanted to increase taxes on hedge fund managers to offset the patch; Congressional Republican not only balked at the increase, but wanted to lay an additional four tax cuts on top of the patch - so a compromise was reached in the Senate: just the patch, no offsets, no tax cuts.
In fact, the Senate Republicans are so accustomed to blocking measures that when the Democrats finally agreed last week to their demands on a bill to repair the alternative minimum tax, the Republicans still objected, briefly blocking the version of the bill that they wanted before scrambling to approve it later.
For the Democrats, it was a perfect example of why they have taken to calling the G.O.P. the "grand obstructionist party." The Democrats send out daily tallies of the number of Republican filibusters, which the Democrats say will set a record.
I opposed the "nuclear option" - ridding the Senate of the filibuster - when Republicans proposed it: but that was before the GOP used it as a hyper partisan attack tool designed to drive down Congressional approval ratings. When Senators start using the filibuster to block bills they already agreed to, we've got a problem.
In any case, Harry Reid should at least threaten to go nuclear. That should get some Republicans' attention, and allow Congress to resume its business of passing legislation.
In all the hubbub of local and state news, let's not forget Senator Tester. A report on Tester appeared in the Billings Gazette today. In it, the leader of Senate Democrats, Harry Reid, reiterated his promise to give Tester a seat on the Appropriations committee.
You might remember the flap: before Tester's election, Reid promised Tester a seat on Appropriations to blunt the loss of incumbent Conrad Burns' seat on said committee. Only Tester didn't get the seat. Some of us were a little ticked off at the time, state Republicans tried to make hay out of the issue, but the reality is that Appropriations is a very popular committee, and Jon will just have to wait until a spot frees up.
So, when will a seat free up? Good question. Taking a look at the membership of the committee, there's two Senators who are up for election and whose seats are somewhat in danger. And they're both Democrats: Tim Johnson of South Dakota and Mary Landrieu of Louisiana. Basically, if either of those Democrats lose their re-election bids, and Democrats hold onto their majority, then, if Tester is next in line, he'll get a seat.
And that premise is actually very plausible if today's political atmosphere holds up. It's a very good year for Democratic hopes in the Senate (and even better now than in February when that post was published), as a host of unpopular Senate Republicans in hostile blue areas are up for re-election - like Sununu of New Hampshire. And Landrieu is seen by many as the Democrat most likely to lose her seat, followed closely by Johnson.
So there's a scenario you could root for in the 2008 elections. Although hanging on to Johnson and Landrieu's seats would be helpful in overcoming Republican obstructionism in the Senate. So there's that.
The report also shows that Tester is going ahead with his promise of an ethics audit for his first year in office. Good news for us, Tester, and the federal government. I expect he'll pass with flying colors.
I know Matt's already written about the Senate's impending "true" filibuster happening tonight, but I just wanted to kick in my two cents: what a frickin' brilliant idea!
Bog Geiger has an excellent description of what to expect:
Reid could hold the Senate in continuous session overnight Tuesday and into midday Wednesday unless Republicans agree to a simple-majority vote on Reed-Levin.
Senate Democrats will then be prepared to take to the floor and speak all night and, if their Republican colleagues do not remain in the chamber, invoke ongoing quorum calls and other procedural maneuvers to force GOP members back to the Senate floor.
With the whole specter of cots being dragged into Senate cloakrooms and the pure theatrics involved, I'm hopeful this will shine a white-hot spotlight on the Senate's Republican leadership and show Americans how the GOP doesn't truly support helping troops and their families at home or extricating them from pointless involvement in the Iraqi civil war.
Cots in the cloakroom! The ringing bells of quorum calls! Bleary-eyed Senators discussing policy into the wee hours of the night! Finally! A little action in Congress!
Seriously, though. This is not only a great political gambit, it?s just a good idea. Finally, a discussion by our representatives about the Iraq War. Let everyone state their position. Let heads roll and reputations be made.
The Senate considered the so-called Feingold-Reid amendment this week. The measure would have basically forced the President's hand. Now, it was never really likely to pass or survive a veto, but it was an issue of going on the record and realizing a few things -- that this President does not respond to criticism at all (hence, we still can't say "former Attorney General Alberto Gonzales") and that for the War in Iraq to end, his hand must be forced.
Now, Max Baucus and Jon Tester both voted against Feingold-Reid. They're in a different place than me. That's fine. I ain't happy about it, but it's understandable. I suppose if I'd spent a long life living in a world where people would actually work together, I'd probably fail to see it when I entered a situation where the most powerful douchebag on the planet refuses to work with the opposition at all.
"It's time for a change of course in Iraq, and I'm committed to working together with my colleagues on a solution," Baucus said in a prepared statement. "However, I'm not for pulling the rug out from under our brave military men and women serving in Iraq. I cannot support cutting off funding while they're fighting on the frontlines overseas. It just wouldn't be right."
[and]
"I am doing everything in my power as a U.S. senator to end the war in Iraq, but I will not cast any vote that I believe compromises the safety and security of our troops on the ground," Tester said, also in a prepared statement.
"I have said for two years that the president needs to develop a plan to get us out of Iraq," Tester said. "The Congress and the American people have spoken; the president needs to start listening."
There's a couple problems with this -- first and foremost, it's misleading. As a staffer from one of their offices told me himself, there's this whole false understanding that passing Feingold-Reid would literally mean that tanks in Iraq would start running out of gas and the like. That's simply not true -- and it's not how our government actually operates. Our Senators shouldn't perpetuate myths.
Second, they're both using common right-wing attacks to undermine progressive Democratic leadership. They could have both simply said, "My position is that the President and the Pentagon need to come up with a plan. This bill doesn't accomplish that." Instead, they threw in a gratuitous, "Leading members of my own party want to 'pull out the rug' on our troops in a way that 'I believe compromises the safety and security of our troops on the ground.'" Those are Mitch McConnell's talking points.
Third, they've effectively locked themselves in. If this vote was simply out-of-line with their current position, they could move based on new evidence. But they've now said anything like Feingold-Reid is tantamount to voting against the troops -- something that will no doubt be used against them if they change their position down the road as it becomes clear that President Manchild refuses to do anything about the mess he's gotten our country in.
Your thoughts?
An Addendum -- I should add a point that Atrios makes a lot, which is the trap of playing President. A lot of the supposed solutions to the quagmire in Iraq involve the President taking a different approach. All of those solutions are based on a faulty premise -- that this President is willing to adjust anything based on what some inkling body called Congress tells him to do. Even worse, there's a fairly large (roughly 30%) share of the electorate that seems to believe they elected a God or a King, not a President -- and they'll tell him to fight like Hell for the right to keep spilling Iraqi and American blood.
It's time to stop assuming or pretending that there is good faith on the part of the executive and to instead focus on every possible avenue that can be undertaken. That's not radicalism -- it's realism. And people just need to wake up to it.
