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There’s been a basic disagreement over progressive strategy on health reform in dealing with an overly compromising Administration. But what’s driving that is a debate over whether the resulting health reform bill is likely to end up being something that’s worse than having nothing.
On that point, it looks like Ezra Klein is (finally!) starting to see things the way Jane Hamsher does.
Jane’s argument is that the continuously compromised bill without a public option alternative will force low- and moderate-income Americans to purchase unaffordable, "junk" insurance. But there will be no means to pressure the private insurance companies to improve their products or control the relentless rise in premiums.
Judging from this Klein post, it seems he’s reaching a similar conclusion, given that the Administration is reported to be looking for ways to substantially reduce the "costs" [narrowly defined as federal budget impacts] of the subsidies:
The most likely way is to reduce the subsidies so that the individual mandate isn’t really affordable. That seems to be happening even as we speak. At that point, reformers have two options, both of them bad.
The first option is to reduce the value of the minimum insurance policy such that buying something the government considers insurance isn’t very expensive. This means policies with high deductibles and co-pays, or policies that don’t cover very much. But asking someone with a relatively low income to purchase a policy with a $1,500 deductible and significant co-pays is asking them to purchase something they can’t really afford to use. So we’re making them spend $7,000 or $8,000 a year on something they don’t necessarily want and can’t really take advantage of. That’s a recipe for a huge backlash.
The second option is to drop the individual mandate altogether. Obama, who didn’t have a mandate in his campaign plan, might be amenable to this approach. But here, too, there are problems. The young, healthy risks will hang back from the system while the older, sicker risks will flood in to take advantage of subsidies and new regulations that stop insurers from discriminating against them. The risk pool will reflect that, and health-care insurance will become even more unaffordable for the people who need it. And because it’s less affordable because of the presence of the sick, it will become even less attractive to the healthy.
So isn’t he saying Jane’s right? Ezra says the WH seems to be moving towards forcing low- to middle-income to buy "junk" insurance that, even if they had it, they couldn’t afford to use it, because they couldn’t handle the deductibles/co-pays.
That means the likely result is a huge transfer of wealth — from over $1.3 trillion in new premiums — to the private insurers, as masaccio has described, with payment enhanced by federal subsdies, but without any guarantee that the newly "insured" folks get insurance worth paying for. Why should the country support that?
Ezra then gives us some "happy news." He says we could afford to pay for adequate subsidies, but unfortunately the WH and the "centrists" in Congress (for whom the bill is being compromised) are pushing for expenditure levels far below what would be needed for adequate subsidies. This is the "happy" news?
Welcome to our view of reality, Ezra.
More:
Jordan Rau/KHN (h/t Yglesias), Health Bills Might Not Protect Some . . .
Even David Brooks thinks the White House isn’t seriously pursuing fundamental reform. "If you’ve lost David Brooks . . ."
On the debate about progressive strategy . . .
70 Comments
“the likely result is a huge transfer of wealth — from over $1.3 trillion in new premiums “
When Obama talked of income redistribution ,I thought he meant the other way around !
LOL! its like old ronnie reagan-hood is back from the dead! robbing from the poor to give to the rich.
lol or weep. You decide!
Bingo. God help us if a populist strategy by the GOP actually takes hold…
Ezra Klein may agree with Jane Hamsher’s view of reality, but neither Ezra nor Jane yet seem to agree that HR 3200 or any bill like it won’t solve the problem of mandating that people but lousy insurance at high prices. Why? Because HR 3200 won’t go into effect until 2013, an unacceptable delay for any real relief, and also because the availability of the PO is constrained in this bill, so that only small percentage of the population actually has a choice allowing them to get it. So when will Ezra and Jane, come around to the view that HR 3200 is not a good bottom line for progressives. Jacob Hacker’s PO may be a good bottom line, but it is not on the table now. And since it is not I think all progressives should line up behind HR 676, get behind that, and dig their heels in.
The point is that we’re not facing a choice between some good bill as you want it to be and something else. The emerging choice is between a seriously compromised bill that seems to make some things worse and no bill.
I don’t know why we should pretend that when the Senate of the US can’t even get 50, let alone 60 votes for a modest, limited and delayed Public Option competitor to private insurance that somehow this means we have an enhanced plausibility for a bill that displaces the private insurance industry.
That last paragraph is part of a very telling point. This thing started from the position that there would be a public option, better controls on drug pricing, and more stringent rules on health insurance. The first two of those are gone, along with a few other good ideas. Having seen that, why would anyone who’s been paying attention think that the health insurance rules will actually be enforced in a meaningful way?
Don’t forget, this is insurance we need most when we’re least able to defend ourselves from people who don’t want to live up to a contract they signed with us. If we can’t have confidence that our government will proactively enforce those rules, those rules are completely meaningless.
If there’s a point that hasn’t been hammered home enough, it’s that.
Yep. I haven’t seen a credible federal regulatory system sufficient to take on the mega national insurers. And part of the problem is that there is not acknowledgment that give the highly concentrated industry, we should be thinking in terms of full cost-of-service reguation of rates and service — and that requires a huge federal regulator with lots of staff, resources and statutory protection from Congressional interference — in States, for example, public utilities commissions are sometimes protected by state constitutions, so that the legislature can’t unduly interfere in their decisions. That’s to protect both the utilities and rate payers from political influence, and even that isn’t enough sometimes.
Great point Scarecrow. If we emphasize it enough perhaps people will get the point that the only “real’ thing to do here is to get rid of the insurance companies — middlemen who provide no value-added to health care.
Hi scarecrow
We don’t have to “pretend” that the Senate will pass it.The object here is to get it passed in the House. not the Senate. Why “pretend” that it can pass the House? Perhaps because ordinary people can understand HR 676 easily and will be able to get in back of it and support those Congressman who vote for a bill that is clearly anti-insurance company? Perhaps because it’s a bill progressives can believe in and go to the mat for? Perhaps because ordinary people don’t know what the PO means, don’t believe it will free them from the insurance companies which they overwhelmingly hate, and therefore don’t support the PO with the intensity necessary to get their representatives afraid of voting against it.
Now let’s just assume for a moment that HR 676 did pass the House. It wouldn’t pass the Senate. But I doubt that the Senate would then pass a bill with a lousy public option that has no chance of passing the House or surviving in conference. In any event, whatever bill the Senate passes, asuming it passes one would go to conference. Say Pelosi plays it tough and selects the conferees from Jerry Nadler, Dennis Kucinich, Anthony Weiner and John Conyers, then what happens in the conference? Something good, I think.
Especially if Reid appoints the conferees from the Senate HELP committee rather than from finance. What could dispose him to do that? Obama. Why would Obama do that? Because if HR 676 ever gets through the House along with strong statements from Pelosi that the House will reject any health insurance reform bill that departs greatly from HR 676, the President will have to negotiate if he wants a bill, and he will do anything to get a bill, won’t he? That negotiation will involve pressuring Reid to come out against any bill coming out of the Baucus committee and to support the bill coming out the Senate HELP committee.
What’s to prevent a filibuster in the Senate of the Senate HELP bill? Well, it would actually be pretty easy for Reid to do that. He could threaten to pass a reconciliation bill extending Medicare/Medicaid to the whole population including subsidies for those under 65 to buy into it, and higher taxes for high income people to replace it. But, of course, no mandates, no subsidies, and no regulatory features that would place the bill outside of reconciliation. The insurance industry would be very fearful of such a bill, and when confronted with a choice between that and getting their supporters to end a filibuster of the HELP bill, they will support cloture and passage of the HELP bill.
This scenario ends with the group of liberal conferees from the Senate compromising with the House Democrats on a much stronger PO bill than we now have in the Senate bill. When that goes back to the House progressive Democrats could agree to such an honorable compromise. As for the Senate the Blue Dogs and Republicans would have to vote for the conference bill, since if they did not leaders in both houses could always come back with a reconciliation bill extending Medicare/Medicaid to all, along with subsidies, and higher taxes for those with high incomes.
It’s a moot point so I really don’t care to debate it, but I don’t think 676 does what a lot of people seem to think it does and the math almost certainly fails to work. It may be possible to design a single payer model that works but 676 isn’t it.
Blub, That’s OK. I’m happy to support bills that are an improvement. How do you like S 703, Bernie Sanders” bill?
I like it better in some respects. First of all, unlike HR676 it is not limited to public or not for profit providers, which I felt would run the risk of creating a bifurcated system, one for the poor and one of the rich. I would like to suggest that it should go further and force ANY provider to accept the government policy. Secondly, I like the idea of the National Health Corps in S702, with the caveat that participants should be forced to accept government salaries. Thirdly, I also like the idea of the Community Health Clinics, but I don’t think these should be restricted to rural areas. If they’re everywhere, as a competitive service option (effectively VA for all) then they might play a role in helping to contain healthcare costs. S702 could be turned into something that works but only if it contains strong cost containment and budget cutting measures. I also really don’t like the state administration bit. The plan should be national.
OK. I’ll certainly think about your comments.
I realize you think that would work, but to me it looks like pure fantasy. To me, it comes across as:
Assume a can opener.
Assume your friends control the can opener.
Assume the Senate is a passive can.
Apply can opener to can.
Or assume the House can do what seems implausible given the size of the Blue Dog caucus and others not in the progressive caucus. Assume Harry Reid thinks like Nancy Pelosi, and is not running for reelection, behind in the polls to no-name Republicans. Assume the Senate leadership is in on the plan that less than 40 of them would even remotely support. Assume Obama can change 20 votes or so, including Ben Nelson, the Arkansas twins, Landrieu and Lieberman, plus the Mainers, the best of which is only willing to postpone a modest PO until after some trigger is pulled in the future. Assume everyone behaves differently from how they’ve ever behaved. If you make lots of assumptions like that, you can come up with interesting scenarios. But it’s not real.
Look, it’s not sufficient to have a scenario in which people do things you’d like them to do, and every thing is solved. How did they get there? You still haven’t described a credible scenario in which 30-40 people do something they adamantly oppose now, just because we might think it would be a great policy. Being right isn’t enough. It would be nice if things were different, but you haven’t convinced me they are.
And Obama hasn’t persuaded us he can convince himself to do the right thing, let alone convince anyone else who has little incentive to follow him just because he asks. We have a seriously dysfunctional Congress and a weak President staffed by people who agree with the centrists in Congress, while trying to minimize the influence of liberals, not carry out their wishes, and we’ll be lucky if we get out of this with only a poor bill, rather than an awful one or nothing at all.
scarecrow, I’d like to take this thread in two directions. The first is to go back to the first portion of our exchange. I’ll address the second portion dealing with the assumptions I’ve made or have not made in another comment. To refresh everyone’s memory I said:
You replied with:
In my previous replies I focused on a scenario where support for HR 676 could lead to an enhanced PO bill that was much better than we have now. But I didn’t emphasize the futility of continuing with what we’ve been doing, which is supporting the idea of the PO. Most of our major progressive organizations, i.e. the ones that are sending us e-mails asking for contributions, petition signings and e-mails are digging in their heels for the PO. But the strong PO of Jacob Hacker is already off the table, so why should we continue to try to get people on the line for that, when they don’t even really believe in that alternative. The most we’ll get out of that, as you suggest, is “a seriously compromised bill that seems to make some things worse,” like HR 3200, and it’s likely that any final compromise will be even worse than HR 3200.
So, in my view doing more of what we have been been doing is exactly what we should not do, because the result is likely to make things worse for people than now, and also worse for progressives and Democrats who will have to bear the responsibility. Now, I don’t want to give money or sign petitions for that, because someone tells me that it’s the practical thing to do. Especially when the very people telling me that are the people who have had such a singular lack of success so far in getting us to either a good PO or Medicare for All bill out of a major Congressional committee.
That is, at this point, I have not a reason in the world to think that those continuing to advocate support of the PO have any better sense of the practicalities than I have, and also lots of reasons to believe that their capability for practical reason is seriously inadequate. Many here, other than myself, have been saying in recent days that we should have never have allowed HR 676 to be taken off the table, but they don’t always go on and say that now it should be put back on the table. To me that last corollary is quite obvious. What’s happened is that many progressives offered a pre-compromise to the opponents of health insurance reform. The opponents have now made clear that they reject the pre-compromise.
Fine, then I say take it off the table, and go back to the original position full bore. That’s the right negotiating position. No further negotiations should occur until all sides realize that there will be no bill without negotiations.
At that point, those who must have a bill, mainly Democrats who have to worry about re-election next year, will come to the table and will be prepared to negotiate for the best that they can get. If the supporters of HR 676, and S 703 most of whom come from very safe House and Senate Seats stand firm, they can get a much better deal than HR 3200, because the blue dogs need a deal more than others whose seats are safe. In saying this, I think I’m echoing some things that Jane has said many times in the past. What’s different in my position is the insistence that the progressives withdraw their pre-compromise because it’s been a non-starter and has compromised nothing except their ability to negotiate.
That ends my first comment, I’ll now move on to my second dealing with assumptions.
OK. Getting to assumptions now. Arguments from analogy can be treacherous. I said nothing about can openers or cans or offered any mechanical analogies whatsoever. Nor did I make any such assumptions. So trying to discredit my scenario this way has no logical connection to what I said.
My argument began by suggesting that if we supported HR 676 we might be able to get it through the House. In suggesting this, I offered some rhetorical questions in support of the view that trying to get it through the House might be worth the effort. Specifically, I said:
In your reply, I didn’t see you address any of these. And, I also think that the thrust of your comment is to imply that I said that HR 676 would get through the House if we did support it. But I never contended that.
Instead, I offered a scenario conditional on the assumption that we could get it through the House. In other words I wanted people to go through a thought experiment about what could happen if the assumption was fulfilled. If I assumed anything implicitly here, it is what I focused on in earlier messages in this thread, namely that a PO promotional strategy had failed and that an HR 676 promotional campaign might get better results than continuing what we are doing now including, perhaps, gettig HR 676 through the House.
Now, you objected to the feasibility of the notion that HR 676 could pass the House by saying:
This is fair enough certainly, but I think that if progressives hold firm on HR 676 and vote no on anything else, then everyone is looking at no health care bill this year, and then other Democrats will have two options if they must have a bill. First, either they can try to get help from the Republicans to pass a bill that will “bail-out” the insurance industry, or second, they can move left with the progressives and agree to HR 676. Since I don’t think the Republicans want any of the blame for this bill, I think it’s very implausible that they will be able to get any help from the Republicans. So, if they do want a bill out of the House, it’s HR 676 or nothing. There’s a paradox here, I think. That paradox is that Republican stubbornness coupled with the insecurity of blue dog seats enables the progressives much more in the House, if they will only grasp the power potential they have. It is because of this potential power that I don’t think it is so far-fetched to at least entertain scenarios that begin with the passage of HR 676 in the House.
Moving on to some of your other objections, you also said:
But, where did I assume that? I assumed that Obama would coerce Reid into doing the things I said he would do. How can Obama do that. Well, Reid may have to win a primary and then his re-election. How will he do that without SEIU support, and without Obama campaigning for him? I don’t think he can. So, what I’m assuming is that the union and Obama can bring him around, not at all that he thinks like Nancy Pelosi.
Next you said:
I’m not assuming that people are in on any plan. I’m assuming that if HR 676 should pass the House that would be a game changer. Clearly, if the Senate wants a bill this year it needs to offer something good to the House in that scenario. If Obama and Harry Reid have to have a bill, they need to produce one that can get out of conference committee. The parameters of the situation are very different in this scenario. The Senate would be facing an aroused mass movement against the insurance companies. Obama and Reid would be talking about the need to get a bill through. They can deliver the threats I mentioned in my scenario. The Republicans are still on the sidelines. The heavy majority of the Democrats in the Senate will support HR 676 as opposed to no bill at all as a negotiation position. Negotiations will then go on, to get something through, by reconciliation if necessary with the threat of no bill at all hanging over the blue dogs heads. If everyone behaves in the same way they behave now they’ll move to cover their own butts. In the new environment I’ve sketched out a good CYA position is the Senate HELP Bill or some variant which can be passed through reconciliation, and so that is what will go to conference.
Notice that this scenario is only a possibility if Republicans don’t join with blue dog Democrats to pass something. But I don’t think this will happen because the Republicans aren’t “playing bipartisanship.” They want the Democrats to hang themselves. That gives the 35-40 Senators in pretty safe seats enough leverage to get something like the Senate HELP bill into the conference committee, where the rest of my scenario can occur.
Finally, I repeat that I’m not saying that this scenario will happen. It is likely that the house progressives will continue their support of the PO position, especially whe everyone talking to them is telling them to do that and emphasizing how powerful the blue dogs are with the President. But if they do, the present legislative dynamics will continue, and their pre-compromise will get them a very poor bill that will lead to a Democratic defeat in the next two elections
This all seems to be about how bad a bill it’s going to be. We should either go with HR 676 and junk HR3200 or junk HR3200 and pass a small bill prohibiting some of private insurers worst practices.
I’m beginning to think we should do none of the above if we can’t get what we know is necessay. Instead, we should push to pass HR1583 without any amendments to protect insurers.. which hopefully won’t be that difficult because people will be out for insurance company blood. Then work to prevent any subsequent legislation that benefits the insurers from passing, and sit back and watch as every state government, every citizen denied coverage or refused compensation, everyone who’s ever been dropped, and the USAG all sue the now naked insurers in Federal court. And or course we’ll be out there constantly making sure the whole world knows exactly who’s the blame as things start to fall apart. The insurers will respond in the only way they know how – massively raise rates across the board… even corporate policies. Everybody will be angry, and the system will be in crisis in one or two years max… not the slow but inevitable death over a decade or so that it faces right now. Then we and the progressive caucus will dictate whatever bill we want. Scorched earth.
Blub, I’m all for it.
Nice idea, except that now that HR 676’s actually coming up for a vote, its sponsors are running away from it. That result will not change, not with industry lobbyists spending a million and a half per day. The only plan that can pass and would eventually lead to single payer is the public option.
For It Is Written:
cast out all the doubters!
only by forcing mandated enrollment in crappy insurance policies can we elect more and better Democrats until, one day, they suddenly change their spots and renounce all the corporate lobbyist loot and pass Single Payer, when they are good and ready, with no nagging from pesky unSerious grassroots outsiders.
2 small problems: the paltry, defective-by-design, fig-leaf known as the Public Option probably won’t pass.
and even if it did, it wouldn’t lead towards Single Payer, but away, notably by vastly enhancing the insurance cartel’s profits, and by tying the President’s and the Democrats credibility to preserving the botched reform plan they managed to pass.
The Democrats cannot even extricate the country from George Bush’s costly, failed immoral wars in Afghanistan and Iraq, they certainly would not want to repudiate their arduous insurance reform fight of 2009.
PW, that may be true. But, unfortunately, if we act as if it is true, it is quite unlikely that we can get a good PO. See the scenario I described in my reply to scarecrow.
Also, note Hugh’s “or.” That is, if they’re stupid enough to run away from HR 676, then pass a minimalist bill of the kind Hugh proposed and “wait ’till next year.”
There’s a middle way and that’s to pass a series of bills in sequence as prescribed here. If the middle way won’t work, however, then I think you’re right. Pass a regulatory bill outlawing the insurance companies’ worst abuses, without including mandates or subsidies.
I thought we established yesterday that Ezra’s about 8 years old… in which case why does his opinion matter?
You got me!
Yeah, I’m only 6 years older than him and I have more sense than that. HR 676 should be what everyone backs. Or maybe we can just take Japans model and scale it up. They have more than 3000 private insurers, with a set price for their products. It would be great to be able to pick whatever insurer you want (but doctor would be better) and still pay the same price no matter what.
seriously…in some states this is the first year Ezra’s even old enough to rent a car.
That is what we back isn’t it? The problem this hasn’t been explained to anybody watching TV. Keith, Maddow, only Ed says the word “Single Payer” constantly but he never brings up HD676, nor this Wiener.
HR676 is simple to explain, its almost TOO simple because there’s nothing to demonize which makes me think both parties are the largely the problem. Dems don’t know how to explain things and Repubs come out shooting with the simplest nonsense – Death Panels, Kill Granny, Funding Abortion (it always comes back to Abortion with the RIGHT doesn’t it?)
So it was a FAILURE when they didn’t say “HR676 or NOTHING” at the start.
The Public Option (HACKERS) is the COMPROMISE, at least they’ll stand there ground on this. It will pass on the House side no matter what, take the trigger out of it though (2010 its LAW). Depending on what you read or listen too they say the numbers of Dems in the Senate that would vote for it is around 51-55, not quite enough to stop a filibuster, but I thought all we needed was a simple majority? Isn’t 51 simple? Didn’t they pass the Stimulus with 53 votes???
Anyway I say the House votes and passes HR676 let that be the line in the sand.
I’m slowly loosing faith in anything getting done and mandates of insurance would be what everybody thinks “Christmas” for the Insurance Companies, robbing those of us who can’t afford it and give to those that don’t need it.
Succinctly put.
w00t!
I think I can hear Abba in the background?
-G
Nobody has been able or willing to explain why or how Ezra became The Oracle on matters HCR Related, and his constant apologetics for the Obama “plan” — of which we know nothing because there isn’t one — should have long ago consigned him to a severe exile.
But here we are again: “Ezra says! Ezra agrees! Ezra’s on Our Side!”
1) Ezra’s on Ezra’s side.
2) What he says and what or who he agrees with, should have little or nothing to do with what progressives want or support. He has shown himself, repeatedly, to be something… less… than advertised.
I really don’t understand these personal attacks on Klein. He’s not 8 years old. He’s very bright, very knowledgeable, a hard-working blogger on health care reform issues and reports information/interviews often before others. He’s also widely read on health issues by DC folks who need to have stuff explained, and he generally does a decent job on that.
So when he posts arguments that challenge or relates to, e.g., the efforts FDL and others have been making to enhance progressive influence, it warrants a response.
Maybe I just don’t understand the blogospheric devotion to Ezra.
When he started beating the “We don’t need no public option” drum, and then we heard it from all over the punditocracy and lots of bloggers too, it was a pretty good sign, wasn’t it, that Ezra had other fish to fry.
His knowledge and opinions can be useful, agreed. But tell me how, exactly, he is helping in any way to formulate and advance a productive progressive health care reform agenda. I’d say he’s been doing his best to retard it.
It’s not “devotion.” It’s simply recognition of a level of influence. So if he writes something that seems to be undermine something I care about, I’m inclined to respond, rather than leave that perspective unanswered. I also respond to David Brooks, or George Will, or . . . not because of “devotion” but because they’re widely read and warrant a response from a different perspective. Isn’t that part of what blog posts are for?
Good to know that there’s a growing recognition of Ezra’s shall we say limited utility as an Oracle. For years, his word was practically definitive on all matters HCR. And other matters, too. Consequently, his declaration that the “Public Option” really wasn’t all that important in the vast, eternal scheme — to be followed by so many others saying the same thing — was disruptive to say the least.
Kind of like some of Krugman’s observations about Obama during the campaign. But not quite like David Brooks or George Will… ! Maybe when he’s older ;-)
Ezra’s ersatz health care plan…
Yeah . . . that would be someone such as I. My insurance company has finally forced me to become uninsured. They are raising the premium 26% — to $3600 a year — for a policy with a $7500 deductible and a 50% co-pay after that.
I’ve tried to be responsible, so have carried this individual policy for over 10 years (without receiving a dime in benefit payout), but my income is such that I can’t afford it anymore. And, yes, should I have a claim large enough to meet the deductible, my savings are wiped out anyway after the deductible and co-pay.
I’ve been seeing a frightening number of stories just like yours. Good luck, or good health. I wish the news were better.
Thanks, Scarecrow. Good health to us all, and I pray for Obama’s enlightenment. Soon.
FWIW …
http://seminal.firedoglake.com/diary/7843
libby
Here’s the comment I left on the Whitehouse website this morning. More of the same might just concievably help…
Dear Mr President,
As one who supported your presidential campaign from the very beginning, and contributed all the money and time I could afford towards putting you where you are today, I’m starting to wonder if I’ve been played for a fool. If you give away the public option in your speech on Wednesday then I’ll reluctantly conclude that this is in fact the case.
I’m certain that you’re aware, not least because I’ve heard you articulate the argument yourself, that health reform won’t work without a credible incentive for the insurance and healthcare delivery industries to provide high-quality, cost-effective care. The threat of losing market share to the public plan is that incentive, but not until it’s in place, and it’s working.
Nebulous notions of “triggers” or increased regulation won’t hurt the current healthcare business models any more than I could protect my property with a sign on the front door saying “If you keep robbing me, I might lock the door one day.” This is especially true in an environment where the legislative scales are firmly tipped in favor of corporate over individual citizen’s interests, and where an army of lobbyists is doubtless working tirelessly to insert regulatory loopholes large enough to drive a shipload of taxpayers cash through.
Although you created the movement which you rode to victory, it will only be yours to command for as long as you are demonstrably committed to it’s core imperative – Change. Allowing your signature issue to be turned into yet another saprophytic corporate feast on the financial carcasses of both the US treasury and the American middle class, would be about as far from the kind of change we are looking for as one can get.
Yours Sincerely
…etc
Good letter.
Very articulate. Well done!
Nice note, epiphyte, but I’m afraid that his movement already is no longer his to command. He betrayed it long ago. Now, I think we’re all from Missouri when it comes to Obama.
saprophytic!
absolutely not for the squeamish
biological metaphors are very potent.
As libbyliberal mentions in the link above:
the ‘public option’ embedded in a terrible bill that is essentially a massive bailout to the insurance cartel is like a slightly less malignant fungus – hard to rally the grassroots for the Least Worst parasitic destroyer, even if it means that the other fungus does not get the kill.
instead, it feels right to fight for what one honestly wants, what the peoples of Europe and mild-mannered Canada have, a plan that is simple to explain and proven to work.
Libbyliberal – an eloquent and compassionate voice on this. It will indeed be interesting to see what mobilization occurs ahead of the HR 676 vote.
I* read all of this BS.
Probably all of the above agree with me.
As a Canadian, all I read is BS.
How can you deny 45+ million citizens health care? How can you deny basic care? For anyone?
If the US is a Christian nation, Why is this argument here any way?
Unless you are Christians who follow another Bible.
I guess that “Love thy neighbour” means something else in the Bible.
It doesn’t mean Canada? Uh oh.
Thanks Kimmy. I always welcome comments from Canada, America’s best friends of all.
I understand what constitutes a “moderate Republican”: That would be someone who favors forcing Obama out of office by any means necessary, but who does not want him to be assassinated.
But what the hell is a “moderate Democrat”?
Probably a “moderate Democrat” is a legislator who wants to perpetuate the existing healthcare system, but who balances this by voting for an enormous giveaway to the insurance companies.
When a centre-right greasy-pole climber like Ezra Klein is leading “progressive” opinion, you know that change you can believe in will be restricted to fairyland, and not coming to America any time soon.
Obama isn’t dropping the individual mandate! It looks a lot like the individual mandate was the point of the whole show. He conned you rotten. You thought you were voting for FDR, but you were buying Tony Blair, an unprincipled pollie whose only concern is acquiring and expressing power. And lol at commenters suggesting that he’ll only have one term! He’ll skate in for the second term. Yeah for many paying for terrible insurance that actually covers nothing and leaves them pretty much where they are but with wages garnished for the privilege, it’s going to suck, but the papers will laud him as the great reformer, he’ll turn on the bullshit spigot and the same people, the Kleins, the Yglesiases, the Kossacks, will line up to tell you that he had it tough in the first term, but now he’s won a battle or two, the REAL change is coming in term two. And he’ll win huge. My, how we’ll laugh when he privatises Social Security when he “reforms” that.
health care reform was always the great self-delusional ignorance of the obama fans: HRC had a passion for real reform from her 1990’s debacle; for obama it was yet another thing to be middle of the road muddling, another platform to bury in grand oratory devoid of practical meaning, substance, or reality-based values.
We are set-up by obama to get the worst of the worst: no practical improvement in health care access and care that robs from the poor to give to the rich useless plutocrat run insurance companies. obama will surely stick the health care reform label on the pig he passes while crowing about the good work he accomplished, but the needy will be worse off than ever, and the nation will be further weakened and lose competitiveness.
Has Ezra recovered his soul?
I for one certainly hope so.
Yes, I am a middle class peasant. I know my station in life. I also know all about PPO’s, HMO’s, etc. HR3200 or whatever number they want to signify as change is not change. It is not reform, nor is it Health Care for all.
From everything I see in the HR3200 bill it is no more than a glorified Participating Provider Plan. Oh yeah, it gives those physicians that will participate cash rewards. I’m all for doctors making money. What I am not for is money standing in the way of legitimate health care.
This is a new script for the same old dance. Nothing new here. Obama promised a strong public option plan and single payer plans. That is what America is expecting.
Hi PP, It;s not a question of expecting it. It’s a question of insisting on it, or voting them out either through primaries or a new party.
“I said nothing about can openers or cans or offered any mechanical analogies whatsoever.”
True, not literally, but then what is this?
“I’m not assuming that people are in on any plan. I’m assuming that if HR 676 should pass the House that would be a game changer.”
That’s the can opener. Then you assume Obama and Reid would willingly use this can opener to pry open the Senate. There is no evidence they would do this.
You seem to think this White House and the Senate leadership would gladly support the virtual replacement of the entire private insurance industry, if only the House passed a single payer bill. There is zero evidence that Obama or the Senate leadership would accept this or actively work for it. They don’t believe in it and instead of using it as leverage, they would actively work against it.
Obama has never believed he’d like to replace the existing system with single payer. Obama believes in incrementalism and doing only what the public is fully ready to do, and only when it is ready for that step.
But he also has said he wants to preserve the employer-based insurance system. He doesn’t want to replace it; he wants to protect it. That’s why conceptually, he was willing to put the choice of a public option out there, for people not currently insured, but limit access to it only to those not covered by the employer-based system.
Moreover, nothing Obama has done in any sector suggests that he sees radical challenges to the private corporate structure as essential, or desireable, let alone an achievable goal. Obama didn’t propose a single payers system because he doesn’t believe we should (1) radically change the existing structure, (2) replace the employer-based system (3) force Americans to drop what they have for something else, whether or not it might be better.
I respect your perseverence. I wish things were different and that better outcomes seemed plausible. But it’s not persuasive.
just a quick drive by on one small point….
i don’t know what obama believes and i’m guessing that you don’t either. but we do know what he said in 2003 (youtube at the link):
Yes, and you know that he’s said if he were starting from scratch, single payer is preferred . . . but since we aren’t, then . . . he wants something else. You give me a 2003 statement and ignore what he’s said the last two years. That’s the current reality.
scarecrow, i was responding to what you wrote @58 above (my bolds this time):
if you had written something like obama “in the last two years has never said he’d like to replace the existing system with single payer” i wouldn’t have made the comment i did. as it is, i stand by attempt to correct your statement.
I stand corrected.
scarecrow, you indicated that he didn’t believe in single-payer. Selise showed you a quote suggesting that this is not so. You then come back with a statement saying that he doesn’t believe it because we’re not starting from scratch. But my point is that we can change the reality that Obama has to cope with, in other words, the starting point for negotiations, if we turn around and pass HR 676 in the House. Then the question becomes what would he do in that changed reality? My contention is that he would maneuver for a stronger PO than we have now, which means supporting the Senate HELP bill at least.
Thanks selise for the quote, and your continuing contributions to the debate.
I think you’re right. We don’t know what he really believes and that’s because he’s always doing something that seems contrary to what he previously said he believed.
I think we can conjecture with some confidence that he does believe in getting re-elected, and that, as a result, we can get much more out of him, if we threaten that re-election in various ways than if we support him uncritically or have faith in him. He’s shown us that we can’t have faith in him. That we have to instead maneuver him into doing things that are more acceptable to us. Right now, with respect to Health care, that means taking the God-damned PO off the table in the House and passing HR 676.
this reminds me of a point you’ve made several times wrt soro’s reflextivity: that some of the assumptions we make are wrong and our wrong assumptions can influence what is possible.
please correct me if i have that wrong or stated it badly.
Yes selise, you’re exactly right. That’s what I said earlier.
We’ve been immersed in a progressive problem of reflexivity from the start. Because many progressives assumed HR 676 wasn’t feasibility, that became the reality.
And because they won’t abandon that assumption now, even if some of them now accept that it was a mistake initially, they’re still continuing to make the same mistake again and again. When will these folks learn that the only way to test the assumption of unfeasibility, is to go all the way for HR 676 and see how far that can carry you? Look at the cost of assuming the opposite. The idea that HR 676 wasn’t feasible has been, and still is, a self-fulfilling prophecy. And the idea that the PO is feasible brings the result that we may not even get a PO at all.
scarecrow,
I never said it was a can opener; I said it was a game changer. That may not seem like much of a difference to you, but it’s an important one because a game changer doesn’t guarantee success, a can opener pretty much does.
Moving on to
No, I’m not assuming they’d be willing. I’m conjecturing that they’d rather do that as opposed to having no bill at all. Also, I’m assuming that Obama is the primary actor making this judgment, and that he would coerce Reid into doing his bidding. Given that HR 676 passes the House and that we have a changed atmosphere, I think Obama’s options are then severely restricted and that he would find it most convenient to manipulate the situation to get the Senate HELP bill passed. At that point that’s a lot better choice for him than having a Max Baucus bill pass the Senate in defiance of the House and the PO. So, I think that’s what’s most likely to happen if and only if the HR 676 passes.
You say there’s no evidence to think this. But I think there’s plenty of evidence to suggest that Obama does what he thinks is practical and that he reasons that the perfect is the enemy of the good. Faced with HR 676 and House Democrats on the warpath, and House conferees including strong supporters of HR 676, I think there is no way he won’t compromise at least as far as supporting Senate HELP and getting it out of the Senate.
Remember that Obama is most motivated by the need to get a bill, any bill. He is not principled about this. And we can use that to our advantage.
You also say:
I agree with a lot of this, but will point out a few things:
1) Obama has, in the past, supported single-payer; so I think the evidence is that we really don’t know what he believes about this down deep
2) If he ends up supporting Senate HELP in the scenario I’m proposing. he’s not supporting Medicare for All or getting rid of the insurance companies.
3) The most likely outcome of a conference committee would be a strong PO, so again Obama won’t have to approve Medicare for All, and finally:
4) I think he’ll approve whatever bill he can get out of Congress that he can say is consistent with the principles he’s articulated. Certainly, a Jacob Hacker-type is PO is consistent with those. So, why would he not just declare victory and move on?
Finally, contrary to your last comment, I am not saying that the result or the scenario I’ve outlined is likely given the present array of forces and the present thinking of people. What I am saying is that if that thinking changes, which btw, means deciding not to believe in your argument, and, as a result, progressive congress people just refuse to accept anything but HR 676 or an improved version of it, then the scenario I outlined becomes much more likely.
I don’t say “plausible,” because plausibility is basically psychological and subjective. I say “likely” instead, because the passage of HR 676 will constrain the situation in such a way that scenarios similar to the one I outlined become much more likely than they are now.
Yesterday I emailed the president. This is nothing new, as I do it quite often. Not that I believe he actually pays any attention to any of our emails. This time, however, I actually begged him to take health care reform off the table altogether. If health care reform passes in the form in which it appears to be going at this time, we will be worse off than ever. We will have mandates requiring that we purchase insurance from the same private corrupt insurance companies, that have enriched themselves at our expense for quite some time. It will in fact be license for insurance companies to do whatever they want with impunity. I did remind the president that many of us worked hard to get him elected, and to provide congress with a substantial majority of Democrats. If this was all for naught, the only way we can actually express our displeasure is to return the reigns to the Republicans, no matter how much we may despise and hate them. What other language do politicians understand than the threat of losing control? Yes, it would be mighty distasteful for me to actually vote Republican, and I may need a strong drink or two before doing so, nevertheless it is the only threat the Democrats understand, voting for a third party has been useless in the past, and I doubt that we have enough time, and most of all money to establish our own party before elections. Unfortunately I believe that the president believes that this is only an idle threat, and that none of us would be actually able to force ourselves to do this. Maybe I will just sit out any elections in the future. I’m losing hope rather rapidly, whereas despair is growing immensely.
Gabriele, we can primary and defeat unprogressive Democrats. It may be easier to do that than it is to start a new party. Also, these days it may be quicker to start a new party since we have social media tools to help us. I have a feeling that if we don’t get a good health care bill, we will see people starting to do this. If they look like good people, I’ll help them get going. I can’t remember being so disappointed in Democrats, not even during the Clinton Administration.
Thank you. I appreciate your comment, and it comforts me to know that there is still hope.