Sep 18, 2009

Yell At Obama If You Have To (And You Have To)

There seems to be a mistaken assumption among many supporters of President Obama that criticizing him on this or that policy, or this or that tactic, is a mistake because he is already getting hit quite hard (and quite unfairly) from folks on the right. I don't buy that in the slightest. Much of what Obama has done so far as president has undoubtedly been disappointing if not point-blank awful, and folks who voted for him but are now not happy should say so—loudly.

This is former New Left journalist Robert Scheer's basic argument in his recent column in The Nation. After rightfully pointing out that Obama "has blundered into a deepening quagmire in Afghanistan, has continued the Bush policy of buying off Wall Street hustlers instead of confronting them and is now on the cusp of bargaining away the so-called public option, the reform component of his health care program," Scheer points out that
Those are not happy sentences to write for one who is still on the e-mail list of campaign supporters urged to back the president in the face of attacks that are stupidly small-minded. But to remain silent about his errors, just because most of his critics are so vile, is hardly an example of constructive concern for him or the country.
I think that hits the nail on the head. As Obama seems on the verge of trading away the public option on health care just to get a deal passed, dissent on his left will inevitably get louder. That's a good thing (even if it comes too late to get a health care reform bill with some teeth in it).

To the extent that any president actually ever does anything semi-progressive (which is truly a rarity, to say the least), they do it because a mass of people forced them to do so, not because their supporters sat back, listened to pretty speeches, and waited for the big guy to do the right thing. Obama needs strong criticism and pressure from supporters, fellow travelers, and radical opponents on his left flank in order to make even halfway decent policy choices, and so far we simply are not doing our jobs in that respect.

Sep 16, 2009

Daschle and Bob Kerrey on Health Care Reform

Earlier tonight I attended "An Evening with Senator Tom Daschle", a "President's Forum" hosted by president of The New School (and former Senate colleague of former senator Daschle) Bob Kerrey (whose tenure at the well-known NYC university has been nothing if not controversial).

I discussed Daschle in less-than-flattering terms back in February when he stepped aside as Obama's nominee for secretary of Health and Human Services and overall health care "czar" amidst a sea of controversy. The nature of the controversy is described in the earlier post so I won't get into it here.

Former Democratic senators Bob Kerrey (left) and Tom Daschle

To put it mildly, neither of these gentleman are considered great progressive champions, either while serving in the senate or afterward. But the conversation was more interesting than I would have expected, and I think it's worth it to report on some of the key points, particularly since Daschle—while not a member of the administration—remains a key Obama adviser on health care with deep connections to top White House advisers.

The discussion took place the same day that Senator Max Baucus introduced his much awaited "compromise" reform bill (actually not even a bill—just a rough plan). The bill was met with a decidedly lukewarm reception from all sides and, despite supposedly representing a compromise, found absolutely no support from Republicans. However the Obama administration said it represented a good step forward and the health care industry certainly seemed to like it, leading The Washington Post to call it "a bill that may weather the blows" and end up as the basis for whatever passes eventually.

Daschle did not seem to care for at all for the Baucus plan in his remarks this evening. On several occasions he pointedly praised the four other health care reform bills—three from the House and one that came out of Teddy Kennedy's Senate HELP Committee—while leaving out any reference to the Baucus plan or explicitly referring to it as problematic.

I'm not sure if he's just out of synch with the White House on this one (for now), or if the White House is actually luke warm on the Baucus plan and wants to change it significantly, whilst mouthing relative approval in the meantime. Daschle specifically praised Kennedy's bill (actually drafted by Chris Dodd) which includes a (possibly weak) public option (according to Physicians for a National Health Program, as of a month ago there was not even a bill number for the HELP committee bill, much less a copy that could be read by the public). At any rate I was a bit surprised how down Daschle seemed on the Baucus plan given that Obama seems to be thinking of it as the main way forward.

In the above clip (apologies for video quality in both of these, I filmed them on a little camera) Daschle responds to Bob Kerrey's concern that all of the Sturm und Drang of August and beyond (death panels, townhalls, Sarah Palin, etc.) represented a failure of democracy in some fashion. Daschle basically dismissed that, blithely referencing the "noise of democracy," a dismissal which I think is wrong for two reasons. First, the Democrats and Obama lost the political momentum in a major way in the last couple of months, even for the limited reforms they were proposing, and let the crazies (Glenn Beck et. al.) take over the conversation for awhile. Second, and this isn't even what Kerrey was really getting at since he was talking about ignorance dominating the debate, the entire health care reform process is undoubtedly a failure of democracy in that large stakeholders like Big Pharma and the insurance companies have already had a huge say while the popular single-payer option was never even discussed. Daschle's treacly civics lesson above cannot paper over the basic corruption of the legislative process—particularly anything relating to a behemoth industry like health care.

The second clip here is a bit more encouraging, with Daschle arguing forcefully that "a public option is inevitable--it will happen," either now or at some point in the future, simply because it has to happen—i.e. some sort of competition from a government plan is necessary. He might be right, but a failure to get the "public option" now might also doom it for years to come and preclude further discussion of expanding governmental coverage of health care to any degree, much less to the point of a single-payer system.

Both Kerrey and Daschle threw out some interesting points in the course of the 90 minute discussion (including Q & A). Kerrey suggested that all members of Congress should be forced to participate in Medicare, both so that they would see that government funded care actually works pretty well, and have a personal interest in keeping it sound. Daschle, citing the chronic shortage of primary care physicians in the United States, suggested providing full-ride medical school scholarships to any students who agreed to work as a PCP after school, thus alleviating a student's need to go into more lucrative (but less important) medical fields in order to pay off student debt. Daschle also pointed out, in what was unfortunately one of the only references to single-payer, that over half of the doctors in the U.S. support a single-payer system, yet oddly for some reason we don't consult these key health care providers on how they think we should best change the existing system (such as it is).

Finally, as an aside, Daschle got the biggest laugh of the night when he commented, in reference to Republicans' aversion to government and government spending on anything other than defense, that the GOP members of congress will "fund anything that explodes." That was pretty funny for a former senator from South Dakota, but of course it's true of most Democrats as well.

For example, former "anti-war" candidate Obama budgeted $527 billion for defense spending in 2010, an 8% increase from 2009, and the same amount estimated as necessary by the Bush administration before it left power. It might be easier for Obama and his Democratic friends in Congress to scrounge up some money for health care if the United States was not fighting two unnecessary wars and budgeting half a trillion for the military, but that's a topic for another post.

Sep 12, 2009

Health Care Fail/Harry and Louise Redux

Back in 1993, Bill and Hillary Clinton famously tried to reform the health care system. Their idea wasn't very good, and obviously it was completely scupered in the end. One contributing factor in the defeat of that reform effort was the series of infamous Harry and Louise advertisements paid for by a major health insurance industry lobbying group known at the time as the Health Insurance Association of America.

Fast forward to the summer of 2009 and Harry and Louise are back (see above), this time shilling for "Obamacare", as reported by The New York Times and other outlets back in July and August. Why the switch for this whitebread fictional suburban couple invented by an ad executive? Well after the Obama White House made a behind-the-scenes deal (HuffingtonPost claimed to have tracked down a memo outlining the specifics) with the Pharmaceutical Research and Manufacturers of America (aka PhRMA—the industry trade group for the drug companies, against whom Obama railed during the campaign), the drug industry agreed to spend as much as $150 million dollars advertising in favor of Obama's plan. The new Harry and Louise spot is a joint effort by PhRMA (truly among the most heinous interest groups in the entire solar system) and the pro-health reform group Families USA (who specialize in "strange bedfellows" relationships with pro-industry groups as a means to reform the health care system).

This little tidbit—reported for a couple of months now, but still little discussed—is just one example of why the Obama health care reform effort will likely end up in failure (if not disaster) even if a bill is passed.

For an excellent general rundown of why that is, see Matt Taibbi's recent article in Rolling Stone. Taibbi's writing style is notoriously, uh, strident, but the details are well worth reading. The key general argument comes toward the beginning.
The bad news is our failed health care system won't get fixed, because it exists entirely within the confines of yet another failed system: the political entity known as the United States of America.
Strident! (also he swears a lot). But true I'm afraid. Health care in the United States is deeply, profoundly broken—most people understand that. The American system of government (like most all systems of government) does not fare so well when trying to deal with deep-seated policy problems. No government has ever accomplished a more radical (and necessary) change than Lincoln's did when it helped bring slavery to an end, but that never would have happened had not the country been divided in two and locked in civil war. Part of the hope that progressives had for Obama was that the economic crisis (like past crises, particularly war and depression) would give the popular president enough running room to shake things up fairly severely and push policy further to the left than would normally be possible in the United States. It's not clear whether or not he actually has (or had) that running room, because so far he hasn't even tried to take it—on health care or any other major issue.

While it should have been obvious to any rational person that Obama was not going to bring the kind of "hallelujah!" change his campaign seemed to promise, what many of us have been surprised by is Obama's seeming unwillingness to use his mandate to actually, you know, attempt to implement some truly progressive solutions to big problems. As Taibbi points out with respect to the health care reform fight:
Even though the Democrats enjoy a political monopoly and could have started from a very strong bargaining position, they chose instead to concede at least half the battle before it even began.
The main example here relates to the "single-payer" option, which was never even brought up for discussion in various health care forums held by Obama or key members of congress like the pro-industry Democrat Max Baucus of Montana. Taibbi argues that:
Once single-payer was off the table, the Democrats lost their best bargaining chip. Rather than being in a position to use the fear of radical legislation to extract concessions from the right — a position Obama seemingly gave away at the outset, by punting on single-payer — Republicans and conservative Blue Dog Democrats suddenly realized that they had the upper hand. Pelosi and Senate Majority Leader Harry Reid would now give away just about anything to avoid having to walk away without a real health care bill.
I think this is precisely right, and why Obama and the Democrats chose this course completely mystifies me. Even most single-payer advocates (including myself) would have admitted that single-payer was not going to pass (not because it isn't popular—it is). But why on earth would Obama not want single-payer floated (by liberals in the House and Senate, and by a large network of groups in favor of it outside of government) such that it could be the big-bad boogeyman for conservatives, and then a more limited "public option" could be put forward by Obama as the "compromise?" As a matter of pure political strategy that seems a wise course given that Obama is on-record as being in favor of a public option, and that we are now almost certainly not going to end up with it in the final bill (or will get an incredibly inadequate version of it).

The entire health care reform effort has been incredibly disheartening to date—even for someone like me who was highly skeptical of Obama on this issue. And we're not even at the end yet. While Obama has already angered a lot of his supporters and sympathizers on the left over this and a number of other issues, many folks who voted for him are still willing to give him a lot of latitude on health care on the assumption that he has a master plan and will do the right thing (or as close to it as he can) in the end.

Liberals and progressives need to disabuse themselves of the notions that the administration is going to end up with a good health care bill, that Obama has our backs on this one, and that we should therefore trust him. They won't, he doesn't, and we shouldn't.

Sep 9, 2009

Concluding Thoughts on Obama's Health Care Speech

So simply as a speech, I thought Obama did quite well tonight. He really is an exceptional speaker, and it's clear his administration views that ability as their ace in the hole. He did a fine job articulating some of the key problems in the American health care system—problems of which most every American is well aware. As predicted, he reiterated his support for a public option, but left the door wide open for heavily modifying (or perhaps even ditching) that if that's what he needs to do to compromise. I imagine a lot of progressives and supporters of Obama will be heartened by this speech, though I'm not sure they should be. It was also very clearly directed at the 535 members of congress in the room, and the section on Teddy Kennedy was quite well done in that regard given how many friends he had across the aisle.

In terms of what will actually get passed, I don't think the speech changes much. The goal will still be to get one or two Republicans on board (maybe just Olympia Snow from Maine) and craft a compromise that all Democrats in the Senate and most in the house are okay with. That's still a very difficult prospect, and it's likely that any "compromise" will be far more deficient than it need be. It's possible Obama's fighting words (if you try to block this I'll steamroll over you) could be interpreted as a willingness to pass key parts of the bill by "reconciliation" (which requires only 50 Senate votes instead of the 60 needed to break a filibuster), but it's clear the administration would rather not go down that route.

While much of the talk tomorrow will inevitably be about Rep. Joe Wilson (his Wikipedia article is already protected because it has been vandalized so frequently) and his ridiculous (but soon to be lucrative in terms of contributions from hardline conservatives) outburst calling the president a liar, President Obama also played the "liar" card—a very strong one—just prior to that.

In the above clip, he is in one sense speaking directly to Sarah Palin. I think it was good to be that firm with respect to the "death panel" absurdity (and with all of the fear-mongering in general), but it also might well make Palin happy just because it shows she is influencing the debate. Regardless, lots of "liar" name calling for a presidential address to Congress.

In the end the key thing about this speech is that Obama has, as he inevitably had to do, put himself squarely in the driver's seat on health care reform. He also is clearly to some extent staking his presidency (or at the very least the midterm elections) on getting something done with health care. The problem is that "getting something done" (as perceived by voters and the media) can and probably will be quite different from actually dealing with the problem of health care square on—at least to any extent that warrants all the grandiloquent language about history and seizing the moment found in tonight's speech. If a bill passes there will definitely be some good stuff in it, but my fears that it will be far less than what is actually needed, and quite a bit less than may have been possible, were not allayed by anything Obama said tonight.

Live Blogging the Obama Health Care Speech (part III)

8:32 Getting rid of the "pre-existing conditions" problem is indeed a big deal, but we'll have to see to what extent insurance companies find way around it.

8:35 Nice reaction by McCain to getting props from Obama.

8:36 Regarding those who choose not to go without insurance, Obama says that's irresponsible "if there are affordable options." Right now there are not, and it very much remains to be seen whether whatever we end up with will change that.

8:38 Going after the controversies and misinformation is a good idea, and indeed necessary.

8:38 Sarah Palin you're a liar! (Without using her name of course).

8:39 Did someone just call Obama a liar? A bit rude.

8:44 "Wall Street's relentless profit expectations" as a huge part of the problem of insurance companies seeking not to provide care. This is a real progressive argument, but of course Obama does not take it to its logical conclusion.

8:45 Here we go with the public option. Good basic defense of it. Problem is Obama's version is basically a non-profit, unfunded by the government. That is, it's not like Medicare or a mini-single-payer system.

8:46 "Driving idea" behind progressive reforms of health care has not been, as Obama says, ending insurance industry abuses. The driving idea (since Truman and even before the war) has been for a government financed single-payer system. This is simply revisionist history on Obama's part, and is not an accurate portrayal of the views of progressives.

8:48 No plan that adds one dime to our deficits? Well good luck then, because that's pretty damn necessary. This is a classic example of how Obama is not willing to spend any political capital on this or (it seems) any other issue. He knows damn well deficit spending is necessary now, but it's unpopular so he speaks against it.

8:50 Trying to get old-folks on his side, many of whom have been particularly resistant to reform. Good line of attack, pointing out folks fear mongering on his plan don't give a damn about Medicare.

8:52 Obama is extremely good at sounding reasonable and measured. But again, "reasonable sounding" solutions are not necessarily good ones.

8:54 Obligatory "medical malpractice" outreach to GOP. I highly doubt anything (much) will come of that, but it's a nice little nugget to thrown in there.

8:55 I'm sure they were desperate to keep the total cost of the bill under the total cost of the Iraq and Afghanistan wars just so they could use that line.

8:58 Hard nosed approach—if you've played politics and want to kill reform, I won't talk to you, and I'll call you out for it. This section will be most heartening to Obama's supporters, but we'll see whether these are just words or whether Obama really goes to the mattresses (including passing reform with no Republicans if necessary).

8:59 Obviously Ted Kennedy was going to be in this speech. Obama is clearly "using" the late senator's legacy and relationships with congresspeople as an emotional lever, but I doubt Kennedy would have minded being used in this way.

9:01 This Kennedy bit is extremely effective in rhetorical terms.

9:03 Overall there's a lot of history in this speech. The invocation of Social Security and Medicare, of 1935 and 1965, is smart. Most people support these things, and the far right who do not will likely be sucked into attacking these programs more vociferously which is good for Obama as it makes it easier to portray them as extremists.

9:04 Ends with a final appeal to history which was good, though it makes me wish what we are actually discussing in terms of reform was about ten times more meaningful.

Live Blogging the Obama Health Care Speech (part II)

8:03 One important point even before the speech starts is that, in excerpts from the speech released to the press today, there is no mention of the public option. Presumably it will be mentioned in the full speech, but obviously a failure to release remarks related to the public option prior to the speech suggest the administration is not interested in highlighting it.

8:09 Why is he so late? It's just like Bill Clinton, who was also always late! And Bill failed at health care reform! Somewhere in the blogland someone will mention that, which will be dumb.

8:19 Early applause lines about economy are not bipartisan, but there's very little he can say that would be.

8:20 "I am not the first President to take up this cause, but I am determined to be the last." While I appreciate a bit of historical perspective here, the last half of this statement is absurd. Absolutely nothing which has been proposed to date—even the public option plan—is a long-term, permanent solution to the problem of health care in the United States. No matter what happens in the end with this reform effort, we will be here again at some point in the near or not-too distant future.

8:22 This diagnosis of the general problem (it's the uninsured, but it's those with insurance too who are suffering and not getting care) is good and is basically the Michael Moore Sicko take on the problems.

8:26 Puts single-payer and far right models together as being peas of a pod, there are "good arguments" for both but ultimately neither are good. Nice politics when you want to move to the center, but it's complete nonsense. There are terrific arguments for single-payer, and absolutely no good arguments for completely privatizing everything about health care, thus giving more power to insurance companies. This is a disappointing line of rhetoric by Obama, who even 5-6 years ago was on record in favor of single-payer.

8:29 "Best ideas of both parties?" Seems more likely we'll end up with the most "moderate" ideas of both parties, which all too often is confused as being "best."

Live Blogging the Obama Health Care Speech (part I)

For progressives and other supporters of a "single-payer" health care system (which has never even been on the table or indeed even part of the conversation on health care reform), tonight's speech is all about what the president says about the so-called "public option." Pre-speech articles suggest that Obama will be, as he has been for some time, "supportive, but not insistent" when it comes to the public option. The New York Times likewise says Obama will "talk about the advantages of a public-insurance option in his address, but he will not insist on it."

The folks at TalkingPointsMemo (linked above) wonder if a "nod tonight from Obama" would "save" the public option, "if it's emphatic enough, it will be a welcome sign to reformers that the public option will fight another day."

I'll have to wait to hear the language, but I'm guessing there will be little cause for celebration among progressives in the days and weeks ahead when it comes to health care, and we should not let whatever Obama says tonight make us think otherwise. To not say something positive about the public option would simply be insane—it is Obama's stated position that he is in favor of it and he has never changed that. He has angered his base a great deal by backing away from it in basically every statement and leaked comment in the last few weeks, but why on earth would he enrage them now by leaving it out of the speech completely? Some progressives might come away a bit more energized by a couple of nice sentences from the president about the public option, but it seems almost certain this is only an attempt at temporary mollification and an effort to keep his grassroots troops on the battlefield as he enters the final round of this fight.

I'd like to be proved wrong, but I'll be watching carefully to see the manner in which Obama qualifies his support for this key part of the plan, and the number of words he devotes to embracing it, among other issues. Real, live blogging to follow!

Palin Logic

Sorry. I went and forgot to blog for almost five months there.

It's amazing how difficult it is to get back into blogging once you take a hiatus. I guess it's somewhat like going to the gym in that regard, except you burn slightly less calories while blogging. But I've been meaning to get back into this for awhile, and decided live-blogging President Obama's important health care address tonight would be a good way to do that. I'll spend some time catching up on the general state of politics in the U.S. and the goings on in Obamaland in the posts that follow. Hopefully I'll be able to get some readers back as well!

But before live-blogging in an hour or so, I wanted to do a quick one-off post inspired by Sarah Palin's recent Op-Ed in the Wall Street Journal. Of course the former governor had much more of an effect on the health care debate than anyone would have imagined as her "death panels" canard struck quite a chord and dominated most of the month of August, despite the obviously specious nature of her argument.

And even in today's WSJ, and after it has been widely debunked by most every mainstream news outlet, she continues to advance the "scary death panels" meme. That fact is not the interesting part since it's par for the course with Palin, rather what's interesting is how she does it. After referencing an Obama comment about outside expert groups weighing in on health care cost issues, Palin opines "Given such statements, is it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by—dare I say it—death panels? Establishment voices dismissed that phrase, but it rang true for many Americans."

The last sentence is key, both for how it is framed and for what it really says. It is framed in us vs. them terms, the average people vs. the elite, with the latter dismissing the legitimate concerns of the former. What it really means is, "the notion of death panels may have been dismissed (and may not even be true) but it rang true for many of us, and that's all that matters."

This logic, such as it is, lives at the core of the (surprisingly strong) movement opposing Obama on health care, on spending—even questioning his status as a U.S. citizen. As I remarked in an earlier post, many Americans cannot agree on basic reality, particularly in the political realm. As I suggested there, Barack Obama's personal biography has exacerbated this split, with millions of Americans now viewing him as figuratively (or in some cases literally) the devil incarnate (strong as hatred of Bush was among liberals and the left, for the most part it did not reach the level of vitriol we see directed at Obama).

Palin is now the de facto leader of a mass movement of conservatives who have decided the Barack Obama is a socialist trying to destroy America because he wasn't even born here. Facts and civil discourse are quite irrelevant to them, and there is little or no point in engaging with their arguments. Everyone knew this segment of the voting populace was out there, but their influence has been more widely felt than I would have guessed, and it keeps Sarah Palin on the scene as a valid 2012 contender when that should be an impossibility. Her ability to drive outrage over "death panels" with one Facebook posting was rather remarkable, and while it's impossible to misoverestimate her ineptitude, many have made the mistake of underestimating how much she is perfectly in sync with (and therefore adored by) the core of the Republican party.

Beyond the health care debate, this is an important phenomenon which bears watching. One of the Obama administrations many failures to date lies in having no idea how to respond to it effectively. Admittedly though, it's hard to respond to folks who are more interested in believing what "rings true" than what is actually true.