Category: Health Care

Obama’s Bizarre Moves to the Right

Earlier this morning, I tweeted: “Someone needs to tell Obama that he’s allowed to break McCain’s campaign promises.”

John McCain proposed an excise tax on health care benefits as a means of paying for health care reform legislation. Obama campaigned against this. And yet, the current health care legislation in the Senate and the version supported by the President include taxes on health care benefits. In some cases, this tax may hit CEOs’ plans that include coverage for plastic surgery. But most of the time, the excise tax will hurt working, middle class Americans who have collectively bargained for health care benefits in lieu of wages. Coincidentally, Obama also pledged no tax increases on the American middle class.

To put this a different way, Obama is going to look a lot like George H.W. Bush who campaigned on a pledge of no new taxes (if you read his lips), but did increase taxes anyway.

John McCain also campaigned on a federal spending freeze in response to the economic crisis. Obama, wisely, opposed McCain’s proposed spending freeze.  And now we see Obama proposing a three year spending freeze on discretionary spending. Naturally it will be more limited in scope than what McCain proposed, but that doesn’t make the idea any better.

Stopping federal spending growth during an economic crisis is a tried and true recipe for prolonged economic crisis. The most natural comparison and the one that Obama will most likely seen his move drawn to is Herbert Hoover. But Jed Lewison points out that FDR made the same mistake — and it is universally regarded as a mistake — of cutting federal stimulus programs and thus crashing the US economy again.

I don’t know why Obama thinks pulling out John McCain’s playbook is a good idea. Nor do I get why Obama and his administration think replaying the moves of George H.W. Bush and Herbert Hoover, two one-term Republican presidents, is a good idea. Because from where I sit, these moves make zero sense from either a policy sense or a political sense. And if I look really closely, it looks like Obama is triangulating against the Democratic base in an effort to prove that liberal ideas, Democratic ideas are bad during times of crisis. And thus a three year spending freeze doesn’t look that different from a three year freeze on the Obama administration identifying itself as Democratic.

The Absence of Leadership

Frank Rich:

Obama has blundered, not by positioning himself too far to the left but by landing nowhere — frittering away his political capital by being too vague, too slow and too deferential to Congress. The smartest thing said as the Massachusetts returns came in Tuesday night was by Howard Fineman on MSNBC: “Obama took all his winnings and turned them over to Max Baucus.”

Worse, the master communicator in the White House has still not delivered a coherent message on his signature policy. He not only refused to signal his health care imperatives early on but even now he, like Congressional Democrats, has failed to explain clearly why and how reform relates to economic recovery — or, for that matter, what he wants the final bill to contain. Sure, a president needs political wiggle room as legislative sausage is made, but Scott Brown could and did drive his truck through the wide, wobbly parameters set by Obama.

Ask yourself this: All these months later, do you yet know what the health care plan means for your family’s bottom line, your taxes, your insurance? It’s this nebulousness, magnified by endless Senate versus House squabbling, that has allowed reform to be caricatured by its foes as an impenetrable Rube Goldberg monstrosity, a parody of deficit-ridden big government. Since most voters are understandably confused about what the bills contain, the opponents have been able to attribute any evil they want to Obamacare, from death panels to the death of Medicare, without fear of contradiction.

This is as good an explanation of the consequences of President Obama taking a back seat during the last year’s debate on health care.  His leadership could have prevented the public from being vulnerable to rightwing lies about reform. But in his absence, the legislation became a cipher for every fear Republicans wanted their base to project onto it. Clearly this has not gotten us to a place that makes passage of a comprehensive, powerful reform bill likely. And Obama remains culpable for that.

Obama & The Overton Window

There are all sorts of post-mortems on the Massachusetts Senate race today and what it means for health care reform. But Peter Daou, former Clinton internet operative, has a must-read post on the larger questions of how the Obama administration has failed to achieve its goals after one year. Daou concludes:

Progressive bloggers have been jumping up and down, yelling at their Democratic leaders that the path of compromise and pragmatism only goes so far. The limit is when you start compromising away your core values.

This is really key. Compromise is not a path to victory, nor is bipartisanship. Going out and starting a panel to cut social security and entitlement programs is not what the doctor is ordering. Passing health care reform, improving it immediately through reconciliation, and then moving on to a strong jobs and infrastructure package, on the other hand, is what is needed. The administration and Congressional Democrats need to show America what successful Democratic governance looks like…and that answer can’t be “similar to Republican governance.” They have to draw contrast, move the Overton Window to the left, and find new ways to make this country work.

MA Senate & Health Care Legislation

Chris Bowers is right – the process with moving the health care bill can be fouled by the results of the Massachusetts Senate special election to fill Ted Kennedy’s seat. Bowers predicts another 14-18 days before a bill is signed at best and since the MA election is on January 19th, it is hard to imagine the winner not be seated prior to the completion of a health care bill in the Senate.

There are three possible ways that this can play out.

If Democrats are not confident that both a bill can be completed prior to the seating of the winner of the Massachusetts election and that Martha Coakley will defeat Republican Scott Brown, the process could be sped up by the House taking up the Senate bill, as passed, and vote on it. That bill would then go to the President’s desk and would become law about as quickly as the House could pass it. The Senate would not have to take up the legislation again, but it would mean the House has to swallow a vastly inferior bill in the process.

The process can continue as it is — with the leaders of both chambers in negotiations with the White House — and maintain the same pace. This won’t really affect much if Coakley’s win is likely, something that has generally been confirmed by polling but is certainly a little close for comfort. If the pace is maintained, the MA special election will not influence the content of the bill, but will be determinative of whether or not a new piece of legislation passes the Senate.

Finally, if Coakley goes on to lose to Brown and the House does not pass the Senate bill as written, then it is highly unlikely that anything will again pass the Senate, at least without being written primarily by Collins or Snowe. This is the feared outcome of the Massachusetts special election really determining the outcome of this legislative fight.

It’s scary stuff and even more troubling that there’s the slightest chance that the election to fill Ted Kennedy’s seat could result in dramatically altering health care legislation and even stop it from passing.

Rebutting the Ideological Purity Argument

I strongly agree with both Bob Herbert and Glenn Greenwald, who successfully endeavor to rebut the sophistical argument against progressives who aren’t supportive of the current health care bill as arriving at that position solely or primarily out of a quest for ideological purity.

Herbert and Greenwald both focus their argument on the fact that the Senate’s excise tax, which is marketed as a tax on “Cadillac” plans, is in fact a tax which predominantly will hit lower-middle and middle class workers. Herbert cites the Congressional Joint Committee on Taxation as predicting this will affect 20% of households with incomes of $50,000-75,000. As Marcy Wheeler frequently notes, it’s not a Cadillac tax — it’s a Chevy tax and it’s aimed at the backbone of the American middle class, particularly union members.

I believe there are many good arguments to be made in favor of passing a health care reform bill like the one that will likely come out of whatever process is used to merge the Senate and House bills. But pretending that there are no good faith, logical, substantive, or non-ideological reasons to oppose the bill is incredibly dishonest. Hopefully those who are publicly supporting whatever legislation comes forward will take Herbert and Greenwald’s pieces to heart and stop pushing the canard that parts of the Left, particularly the online progressive movement, is only opposing the Senate bill because they are pursuing ideological purity within the Democratic Party.

Finally

The Senate is set to vote on final passage of the health care bill, which should pass with something less than 60 votes. Separate from everything else, I’m glad that this is finally happening. A step in a long, long process…and hopefully one that doesn’t represent the final product of the health care bill.

Where Should Progressives Be on the Senate Bill?

Roger Hickey of Campaign for America’s Future, a leading progressive policy and advocacy organization, has what I think is one of the best arguments in favor of progressives supporting health care reform legislation. Unlike many people urging progressives to support the legislation despite its shortcomings, Hickey is respectful and acknowledges the validity of criticism from the left.

So President Obama can celebrate his victory and momentum, but he had better not pretend this legislation is all the health fix we need. A better way to frame it would be to talk about a first step. (Or Sen. Harkin’s image of a “starter house” that can be added onto.) President Obama – and our growing movement – should take credit for getting us here and then declare that we will monitor the performance of the insurance and drug companies carefully, enforcing regulations and strengthening them when necessary. Already, progressives are campaigning for new laws to force drug companies to lower their prices through competition – far beyond the Senate or House health reform acts.

…

Our movement should see this health care act as just one step toward real health reform.

I’m not 100% sold that looking at this legislation as a first step is necessarily the right way to think. There will be immediate efforts by the GOP to roll back these reforms and since many won’t take affect until 2012 and beyond, they will have a couple bites at the apple. It’s hard to imagine that there will be many steps taken in the right direction between now and 2014. While Hickey may be right to assert this as the beginning of a policy process, I’m not sure politics will allow it to progress in a linear path towards improvement.

That said, treating health care reform as a movement does make sense. To do so requires long-term vision and seeing how you get from here to there. Hickey is right that this is a big first step, it’s just an outstanding question of whether a movement can emerge to take the subsequent, necessary steps.

Cruickshank on the White House & Movement Building

Robert Cruickshank, who does incredible work as the Courage Campaign’s policy director, has a must-read post at The Seminal on FireDogLake. Here is a large excerpt:

The collapse of support for the bill reveals a deeper and growing divide, an unwillingness of most Americans to embrace a flawed process. In particular, progressives – activists and voters – need a clear, signal victory in order to avoid complete 1994-style demoralization. Something big and bold, something clearly progressive that forced moderates and conservatives to concede something important, something that will give more people a reason to rally to Obama’s defense when he is in a difficult place.

Comprehensive immigration reform along the lines of the Grijalva proposal would achieve this. Repeal of Don’t Ask, Don’t Tell would achieve this (and repeal of DOMA would be a grand slam). Firing Geithner and Summers would achieve this. Breaking up some of the big banks would achieve this. And yes, a public option of some kind would have achieved this.

Instead we have a White House and a Senate Democratic leadership that still believes we live in the 1990s, where the “left” is weak and has little popular support. They’ve not understood the transformative effect of the 2000s and Bush in particular, who helped create a genuine American left with real and widespread popular support for the first time in 40 years.

The White House does not view progressives as equal partners, as people who have legitimate concerns and priorities that need to be included in any deal. They still take the Clintonian view that the “left” can be appeased either through a few nice words in a speech, and if that fails, can be crammed down by being told they’re wreckers, being told this is the best progressives can get, being told that progressives are irrelevant (even while the WH’s defensive actions show they’re anything but irrelevant).

The White House hasn’t yet grasped that some basic and timeless rules of politics still apply: that you have to deliver something to your supporters to keep them on board. Something that excites them, something that gets them motivated. Ever since 1993 Democratic presidential Administrations have assumed those rules are in abeyance, where supporters will stay on board out of fear of Republicans, unwilling to act on their beliefs or frustrations out of an internalized belief that America is a conservative place hostile to progressive values.

The Bush years destroyed those internalized frustrations. Congressional Democratic support for the Iraq War destroyed what existed of progressive acceptance of that Clintonite strategy, and freed the left to actually feel confident in asserting its own values regardless of what the Democratic leadership says, because any trust in that leadership was destroyed in 2002. Obama understood this out of necessity during the primary, when he had to embrace this to defeat Hillary Clinton. But once that was achieved, he went right back to the old Bill Clinton strategy of appeasing the center-right and assuming progressives would simply go along with it – and once elected, Obama surrounded himself with old Clinton hands who espoused the same basic view of politics.

Powerful stuff. But I think the most important piece of writing by Cruickshank comes at the end, where he echoes a sentiment that I have been writing about here for the last few weeks:

Until he sees progressives as genuine partners, Obama will face declining political fortunes. That’s his problem, something he and his team should and eventually will address. For our part, progressives should concern ourselves with how to further build up our own institutions and power, instead of wasting time trying to prop up a weak president who views us and our views and our work with contempt.

The added bonus to focusing on building progressive infrastructure and power is that doing so makes it harder for the progressive base to be rolled by the  party establishment in the future. We will be better suited to affect our goals and make sure that elected officials do not turn their backs on the base after our donations, volunteerism, and writing help carry them into office. And, eventually, this infrastructure building, along with internal leadership cultivation, will bring us to a point where the progressive online movement can regularly and successfully field our own candidates for often and stop projecting our values onto people who do not share them.

Interesting Trend

Jake McIntyre has a post on Daily Kos in which he points out that parallels between supporting the Iraq war and supporting health care reform as it stands now:

Has anyone else noticed that the split in the progressive blogosphere between those who are saying “it’s a good bill in spite of everything” (Kevin Drum, Matt Yglesias, Ezra Klein, Josh Marshall, to name a few) and those who just can’t bring themselves to support Liebercare (Markos and Digby come to mind, among bloggers who have been at it since 2003*) is eerily similar to the split between those who grudgingly backed the invasion of Iraq and those who fought against the war seven years ago?

I’m not sure that Jake is being totally fair, but the point is certainly persuasive and he makes it well.

The challenge, to me, is where the third category of people fit in. I would include myself and Chris Bowers in this group and think of it as a sober activist set (which isn’t to say that other activist bloggers are not sober, but that we see less room for any positive political outcome for progressives). Bowers writes:

If you oppose the bill at least partially because you believe it will result in negative political consequences for Democrats, well, you are probably correct in that assessment.  However, don’t delude yourself into thinking that defeating it somehow makes for a better political outcome.  It won’t, because there is no good political outcome at this point.

My main difference with Chris is that while the political outcomes may not look great, there is certainly still room for movement building through organizing around health care. This can take the form of trying to stop bad parts of the legislation, or simultaneously include efforts to strengthen the bill through improvements. The act of organizing around this high profile issue, building coalitions between advocacy groups, online progressives, and progressives in elected office is valuable and potentially something that can lead to sustainable  movement growth. This sort of movement building is what can be the breakwall that stops political damage from this fight reaching too far into the future.

It’s a complex case and the lack of clear paths to a positive outcome certainly speaks to how poorly the last year has been handled by leadership. I can’t imagine the next number of days and weeks is going to be a fun time to be a progressive activist. But maybe what comes out of this will be salvageable, either as a particular piece of policy or as the movement on whole.

Aravosis on Bush v Obama

I’m traveling for work this week and totally booked in meetings, so my blogging is going to be very light.

But I wanted to flag John Aravosis’s post from earlier today, “The GOP had at most 55 Senators during Bush’s presidency.” Aravosis is providing an important reminder that legislation, even controversial legislation or legislation relating to life and death, war and peace, can be passed in the absence of a super majority. Obama and Reid are dealing with more seats in their caucus than Bush ever had.

Aravosis  writes:

What the GOP lacked in numbers, they made up for in backbone, cunning and leadership. Say what you will about George Bush, he wasn’t afraid of a fight. If anything, the Bush administration, and the Republicans in Congress, seemed to relish taking on Democrats, and seeing just how far they could get Democratic members of Congress to cave on their promises and their principles. Hell, even Senator Barack Obama, who once famously promised to lead a filibuster against the FISA domestic eavesdropping bill, suddenly changed his mind and actually voted for the legislation. Such is the power of a president and a congressional leadership with balls and smarts.

How did they do it? Bush was willing to use his bully pulpit to create an environment in which the opposition party feared taking him on, feared challenging his agenda, lest they be seen as unpatriotic and extreme. By going public, early and often, with his beliefs, Bush was able to fracture the Democratic opposition (and any potential dissent in his own party) and forestall any effort to mount a filibuster against the most important items in his agenda.

It’s not about the votes, people. It’s about leadership. The current occupant of the White House doesn’t like to fight, and the leadership in Congress has never been as good at their jobs, at marshaling their own party, as the Republicans were when they were in the majority. The President is supposed to rally the country, effectively putting pressure on opposition members of Congress to sit down and shut up. And the congressional leadership is supposed to rally its members to hold the line, and get the 51 votes necessary for passing legislation in a climate where the minority is too afraid to use the filibuster. When you have a President who is constitutionally, or intellectually, unable to stand for anything, and a congressional leadership that, rather than disciplining its own members and forging ahead with its own agenda, cedes legislative authority to a president who refuses to lead, you have a recipe for exactly what happened last night. Weakness, chaos, and failure.

This is a pretty brutal assessment.  But the difference is stark. Bush showed unflinching conviction that his agenda was the right course and he made damned sure Congress was with him, at least during his first term. Obama has not forced or led Congress to be where he needs.

Of course, this also gets at the Democrats’ fundamental inability to use procedure to their advantage. We got whipped under Bush and now are getting beat at a game in which the same rules apply. We just never used the rules we had to strengthen the minority when we were in the minority. As a result, looking at 2000-2009, there is a real contrast to what counts in the Senate. It only takes 51 votes to pass a piece of Republican legislation, while it takes 60 votes to pass a piece of liberal legislation. Because their leaders know how to play the game and our leaders want to rise above the game in glorious, yet unattainable, post-partisan unity.

There is plenty to put at the feet of Obama and Reid in the failures of the health care fight. But many of these problems are more systemic. It’s not that Aravosis is wrong, it’s that he’s talking about a dynamic that extends to liberal Democrats going all the way back to the early 20th century efforts to pass civil rights legislation. The left has always been out-maneuvered in the Senate and now is no different.

Actually, the difference is now Democrats are in a position that should assure them victory with even the most minimally savvy legislative plan of attack. This strategy has not been found. I don’t know if it’s because it’s a simple lack of understanding of legislative procedure, a lack of understanding of the real situation in a caucus that includes Lieberman, Lincoln, Landrieu, and Ben Nelson, an absence of actual liberal beliefs by Obama, or a refusal to lead with conviction by Obama.

The result is that despite massive electoral victories in 2006 and 2008, the Democratic Party has miles upon miles to go before they will defeat the ghosts of incompetence past and the insidious damage a lack of memory inflicts upon their efforts today.