Defend and Demand: The Progressive Way Forward
The 2009 health reform end game -- yes, the end of the beginning is in sight -- has been excruciating for progressives. Reforming health care in the real world in which we live means paying to include millions more Americans while fending off all of the tricks America's privileged, left and right, use to resist paying taxes; and it means finding ways to use public regulations and subsidies to put health delivery and finance on a more sustainable path for us all, while watching key mechanisms like the public option shrink and disappear to buy the votes of a few weasly "Democrats" in Congress who want to guarantee profits for private insurers.
Understandably, some progressives see what's left at the end of these struggles as not worth their support. But history tells us this is mistaken. We should take the many big steps forward that are on the table now -- above all the expanded entitlement, the regulations of private insurance, and the increased subsidies for the less fortunate -- and accept that true "health care reform" remains a multi-year, multi-election struggle. Social Security took several decades to become universal and adequate; Medicare did not include cost controls or key benefits for many years. Both programs moreover, had to be improved and defended at the same time, because conservatives attacked and tried to dismantle, even as liberals fought to improve and expand. The same will happen here.
So what should happen next for progressives? We have to DEFEND AND DEMAND AT THE SAME TIME-- and keep at it:
-- We must curb our doubts enough to celebrate what is good in the accomplishments and promises of this round in health reform, and make sure that those Congressional Democrats who fought for the best parts of this reform survive in 2010 and 2012. There is a huge amount of good in even the compromised Senate bill. It marks the accomplishment of a century-long struggle to say that all Americans deserve public help to ensure affordable health care coverage; and there are billions in subsidies to help many lower and middle-income people afford health care.
-- In any January legislative conference that follows Senate action, we are going to have to realize that much is already set in stone by the Senate. A few adjustments can perhaps be made, and let them be improved subsidies and quicker, concrete improvements for ordinary Americans. Abortion is not worth fighting about (that fight was lost with the Hyde Amendment long ago and abortion is not the major health crisis women and their families face). But getting visible improvements to millions of Americans by 2010 or 2011 IS worth fighting for, because Republicans are going to remain determined to repeal these reforms.
-- After this Health Reform is signed by President Obama, we progressives should keep pressing Democrats to look for ways to use reconciliation procedures to improve the cost controls in health care. Reconciliation and the majority Senate voting it entails is MEANT to be used on public budget issues. Once the federal government is dispursing enhanced subsidies to cover all Americans and help employers afford health insurance, price increases in private insurance become an increasingly grave threat to the public good. Any measure that regulates private insurance prices or allows public plans to force price competition surely becomes fair game in Congressional tax and appropriations decisions. One possible advantage of the half of a loaf we get in this reform may be to make reconciliation more legitimate as a tool to introduce a true public option or a real Medicare expansion later, on the ground that they cut costs to the taxpayer. Progressives have to DEMAND that Obama and the Congressional leaders take that possibility seriously.
-- Finally, instead of MoveOn and other progressive groups calling for blocking this health reform bill, let's instead start a vociferous movement of "Progressives for Majority Rule," a movement that uses grass roots and other tools to push for changes in Senate rules and customs. If, last January, Democrats had started out making it clear that all who caucus with Democrats MUST NEVER JOIN FILIBUSTERS, that the price of attending the Democratic caucus is to agree to bring measures to votes, at least after an agreed period, then we would not have faced as much extortion from a few obstructionists as we did. Senate customs and Democratic caucus rules can and must change. Millions of Americans need to become aware of the costs of obstructionism and supportive of sensible filibuster reforms -- such as requiring a steadily declining number of Senators to vote to to break a filibuster as weeks go by. Imagine how much stronger the stimulus and many other reforms of 2009-10 would have been if 55 rather than 60 were the number needed to stop a filibuster after, say, a month. That would be change we can believe in!
"We should take the many big steps forward that are on the table now -- above all the expanded entitlement, the regulations of private insurance, and the increased subsidies for the less fortunate -- and accept that true "health care reform" remains a multi-year, multi-election struggle."
Ah, screw that, Theda. We'd rather sit home and call the president a sellout, vote for a fringe third-party candidate in 2012, and then blame everybody else for the lousy state of our politics.
December 19, 2009 2:10 PM | Reply | Permalink
Your argument would be logical if the Congress had expanded Medicare setting the stage for further expansion in the future. Instead, it rejected the expansion of a progressive program and chose the corporatist expansion of the private insurance industry.
And do you like the extra special payment required for women who want to retain the option of exercising their reproductive rights? Wow! I can see how that leads us in a more progressive direction (snark)!
The cognitive dissonance needed to buy these arguments hurts my feeble brain but alas I am only a member of the weaker sex.
December 19, 2009 2:18 PM | Reply | Permalink
One thing you might consider is that one the main reason the corporate structure is remaining in place as it is is because most Americans don't trust the government to run anything effectively. Both those on the left and right have spent decades hammering the federal (as well as state and local)governments as innately feeble and corrupt. So at this stage in 2009 convincing people to turn from what (wrongly) consider the free market to government control was going to be impossible in the long run.
December 19, 2009 3:03 PM | Reply | Permalink
You're right. Expanding Medicare is nice and logical. It was and remains impossible to get done politically for exactly the reason you stated.
Americans don't like to fight wars of attrition. It's not emotionally satisfying. But that's what getting adequate health care financing is going to require. The conservatives will oppose every step forward.
December 19, 2009 3:38 PM | Reply | Permalink
Americans don't like to fight wars of attrition.
Or progressives, at least, do not like to fight wars of attrition. That's a big reason abortion rights keep getting chipped away -- the conservatives who oppose abortion have taken to guerilla tactics like ducks to water. They are always looking for an attempt to insert abortion into the debate on any legislative issue. The proponents of those other legislative issues consider abortion a distraction, and are always willing to grant concessions to make it go away, just as happened with the Stupak amendment.
I guess another way to put it is that one-issue voters have the advantage over opponents who care about a wider range of issues. It is easier for them to take hostages.
December 21, 2009 5:49 PM | Reply | Permalink
the main reason the corporate structure is remaining in place is because the corporations own the Senate, and this bill will reinforce the feedback system that sends health care money to the for profits and on to lobbyists and then into the pockets of politicians they own who will continue to provide protection to keep this scam going.
December 19, 2009 5:00 PM | Reply | Permalink
That is another main reason. But an independently wealthy Bernie Sanders willing to finance his own campaign would not fare well in many parts of this country. In a place like Nebraska, Nelson would slaughter Sanders at the ballot box. Until Senators see an actual shift in the public opinions about capitalism and government runned social and economic programs, they feel comfortable to be lead around by the corporations.
December 19, 2009 5:07 PM | Reply | Permalink
However, I have a feeling that this kind of action will also be condemned by the supposed advocates of defending while "demanding". People are in favor of all sorts of figurative pressing and demanding, as long as it doesn't involve actual pressing and demanding, since they think actual pressing is too dangerous and risk-fraught. My guess is that when they say we should "demand" such and such, they just mean that we should express our fond and idle wishes in a demanding tone of voice.
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August 4, 2010 6:28 PM | Reply | Permalink
Wrong: it's not because the public has bought the canard that gov. can't run things, it's because our government has decided that keeping on the good side of corporate power keeps them in "power". If you call being the front people for corporate interests "power". The public was gunghoe for a public option and our dedicated leaders made sure that didn't happen.
December 19, 2009 10:34 PM | Reply | Permalink
I don't buy that at all. I think if you'd sold it(and you should have started selling it 20 or 30 years ago) as an expansion of Medicare people would have accepted what centrists so adore -- incremental change -- towards the goal of universal healthcare. We'd be there by now if we'd stayed on message and had a goal we were striving to reach.
Instead we have an incomprehensible bill that corporatists and their pals in both parties will continue to undermine and we still will have to fight to maintain Medicare anyway. We'll now just have a more complicated battle to wage on multiple fronts.
December 19, 2009 11:50 PM | Reply | Permalink
Agreed. I don't know a single person in my community who trusts our government.
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August 17, 2010 4:06 PM | Reply | Permalink
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December 16, 2010 4:22 AM | Reply | Permalink
People have access to health care in America.
Bush: After all, you just go to an emergency room!
Obama: After all, you just call Aetna!
December 19, 2009 5:45 PM | Reply | Permalink
Bluebell: Yep!
December 19, 2009 10:29 PM | Reply | Permalink
Again, it looks like someone got her marching orders. Theda Skocpol in June:
If at this remarkable juncture Obama and the Democrats cannot enact a robust health care reform -- with a strong nationwide public option, cost controls, and nearly universal coverage -- I would not want to be in charge of fundraising and mobilization for them in the 2010 and 2012 elections! Most of us who supported them last time will of course not vote for a Republican.. But if Obama and the Democrats cannot act now on a once in a half century challenge and opportunity, they are not worthy of extra energy. And those of us who wrote big checks last time will tell the Democrats -- especially in the Senate -- to hold pharmaceutical fundraisers instead.
http://tpmcafe.talkingpointsmemo.com/2009/06/24/robust_health_care_reform_is_the_moment_of_truth_f/
And now you post this? Wow. If David Axelrod is going to grace TPM with his talking points, he should at least have the decency to do so under his own name.
December 19, 2009 2:44 PM | Reply | Permalink
The landscape has changed in 6 months. That's pretty obvious, no?
And the legislative history of Social Security and Medicare aren't talking points.
December 19, 2009 2:51 PM | Reply | Permalink
Yes, 6 months ago 70% of folks were in favor of a public option. The majority of people are STILL in favor of a government run public option. What people are not in favor of an individual mandate for health care when there are no controls for bringing down premium costs now or in the future. The only people infavor of the Senate bill as it stands are the insurance/drug companes and democrats who are so enamored with Obama and being able to claim a victory that they will pass a bill harmful to genuine healthcare reform.
Make no mistake,this bill will be unpopular with Republicans, Independents and a good number of democrats. It is politically suicide to madate people to buy insurance they cannot affod and still get saddled with 40% coinsurance/high deductibles when they need to access to healthcare services. Yes, the bill will bass. And yes, it will suck big time for everyone but the insurance companies and the people who are newly covered by Medicaid. And years from now when the Democrats and Obama are campaigning and the populist GOP teabaggers are calling the Democrats the party of Wall Street, PhRMA and Insurance cos instead of the party of the people, I really will not be able to disagree with them.
December 19, 2009 3:02 PM | Reply | Permalink
grr apologize for the many typos. Just got inside from the cold and the fingers are not at full capacity yet :)
December 19, 2009 3:04 PM | Reply | Permalink
Oh, that's okay
December 19, 2009 8:24 PM | Reply | Permalink
Even the end product of HCR this year is not going to be the final product. It's just the platform for improving the financing of health care in America. But the problems will quickly become obvious, and since fixing them will not change an entire system radically the enemies of change and improvement will find it much harder to mobilize to prevent action.
The thing is, once the additional people are covered, no one will be able to take that away from them. The ONLY solution to the problems in this program will be to fix them. The Republicans understand that. When this is implemented, they can't take it back to the current absence-of-a-system. That's why they are so desperate to the extent of being irrational.
It's really time to put on your waders, hold your nose and support what we could get this time because it means the future can be much better than the present. Otherwise we get what Clinton America got in 1993 - we have gone backwards since then.
December 19, 2009 3:52 PM | Reply | Permalink
"The majority of people are STILL in favor of a government run public option. What people are not in favor of an individual mandate for health care when there are no controls for bringing down premium costs now or in the future.'
You sure know a lot about what people want. Most people I know want Cadillac services from their government, yet don't want to be taxed a penny more than they are now, and also don't want government services to go to any person that they cosider unworthy, meaning most people with black or brown skin.
But bonus points for attributing bad faith to Ms. Skocpol. Most people love that too.
December 19, 2009 5:15 PM | Reply | Permalink
I can read a public opinion poll. http://act.boldprogressives.org/cms/sign/natpollresults121809/
And FYI, most of the people you know suck. Can't say that surprises me too much :). Most people I know are not angry about expanding healthcare to more people (regardless of color). They are angry that we are subsidizing the insurance companies and getting very little back from them to bring down health care costs. The subsidies are not enough to make health care affordable. And for the folks who are working poor (up to 400% of poverty) and have health coverage through their employer, there's no subsidy at all unless your employer insurance costs you personally more than 9.8% of your income. So for those folks still lucky enough to be employed, your premiums will continue to rise and you will get zero relief or even subsidies from this bill. Hooray for shitty health care reform!
http://healthreform.kff.org/SubsidyCalculator.aspx
December 19, 2009 11:49 PM | Reply | Permalink
"act.boldprogressives.org"
Now there's an organization name that doesn't betray it's bias.
Pretty much all polling questions that show support for a public option frame the question as "would you like the government to give people free health care." Not surprisingly, people answer "yes." It's when they get into specifics that the public's approval drops.
Take a look at this columns, for example:
http://blogs.chicagotribune.com/news_columnists_ezorn/2009/11/pollvault.html
Good luck finding any coherence in these poll results.
December 20, 2009 1:40 PM | Reply | Permalink
hahaha. Next time at least click on the link:
"Would you favor or oppose creating a public health insurance option administered by the federal government that would compete with plans offered by private health insurance companies? (Wording of CNN poll)"
"Would you favor or oppose a health care bill that does NOT include a public health insurance option and does NOT expand Medicare, but DOES require all Americans to get health insurance?"
"Would you favor or oppose a health care bill that does NOT include a public health insurance option and does NOT expand Medicare and does NOT require all Americans to buy health insurance -- but DOES provide significant subsidies to low- and middle-income families to help them buy insurance?"
The poll shows that MORE people support increasing subsidies (even if they don't qualify for the benefit) than mandating everyone to buy insurance. I'm more inclined to believe that based on polling than the ridiculous theory you pulled out your ass: people opposing health care reform because they hate minorities and poor people. What they don't support is being forced by the government to buy insurance they can't afford. And even if they are able to pay the insurance premiums, how will they afford copays for medicine, annual deductibles, 40% coinsurance. They'll be paying for insurance they still can't afford to use or face tax penalties. Wow, this "victory" will be great selling points in 2010 and 2012... for the Republicans.
December 20, 2009 2:02 PM | Reply | Permalink
It sounds like the Repubs already have your vote.
December 20, 2009 2:12 PM | Reply | Permalink
It would take a super duper liberal/moderate Republican to win my vote, but I will support a progressive primary challenge to Obama in 2012. I don't think they make many of those than can survive the Republican primary. But the political reality is this bill is harmful to the Democratic brand, not to mention it's damaging to real health care reform. If both the Democrats and Republicans have proved they are pwned by Wall Street, PhRMA and the Insurance cos, maybe a third party movement can be viable. We'll see.
December 20, 2009 2:20 PM | Reply | Permalink
Which Bill, Dija?
December 20, 2009 2:51 PM | Reply | Permalink
The Senate bill which will pass through conference without a public option or expansion of Medicare, but will include mandates. Does anyone really believes this bill will be substantially changed in conference? Sure, like we'll after we passed the stimulus we'd pass a separate bill to force cramdowns to prevent foreclosures through bankruptcy court. Or we'd pass the FISA bill, but under Obama there would be accountability for the previous administration's shredding of our civil liberties. Fool me once, can't get fooled again.
December 20, 2009 3:38 PM | Reply | Permalink
I'm absolutely with Dijamo on this, Dorn but I want to emphasize, especially because it's you, that I like and respect you both.
You ask a legitimate question -- don't you know that things have changed in 2009?
Have they ever. Some is not anyone's fault. The first quarter of 2009 were lowest depths of the Great Recession (I hope) but some things were out fault -- our administration, the one we elected for change, followed the Bush/Paulson plan (more accurately the Paulson plan) for dealing with the financial industry crisis. That means that our president helped preside over a huge transfer of wealth from main street to wall street.
His popularity is not what it was, that's for sure. The 2010 elections should be a time for us to gain, not lose, seats.
The fall in Obama's popularity and the misfortunes that face the Democrats didn't just happen. Obama and the Democrats made mistakes and they made them at a time where voters seem to be very, very impatient about getting things fixed.
This health care bill, as it stands, might be another of those mistakes. Passing it as is could well compound our problems. I think, as people see their insurance premiums rising anyway year after year that we will be forced to own America's dissatisfaction with this reform.
December 19, 2009 5:07 PM | Reply | Permalink
Social Security is also paid for with a regressive tax. Fifty years after the original passage of this regressive tax, the payroll tax was raised to a level that allowed reduction of the income tax (the only truly progressive tax in the US) on the wealthiest individuals. We now have another major social benefit paid through another major regressive tax (that is what the mandate is). How long until it is perverted and we have no progressive taxation at all?
December 19, 2009 2:46 PM | Reply | Permalink
How long before we have no progressive party at all? It seems to me that the lack of the progressive party might have something to do with the lack of progressive legislation.
December 19, 2009 11:55 PM | Reply | Permalink
There's something I keep thinking about when watching the progressive blogosphere this year. It was something Dave Barry said when he was invited to a wine tasting once. He was talking about the incredibly elaborate way the wine enthusiasts at the tasting approached their wine, that they would swill it around and sniff it and sip it slightly and evaluate its qualities and spit. Whereas the way Dave approaches wine, as he described it, was the way he approaches beer:
- Drink it
- Look around for some more.
And what I've seen all years is reform on the table-- reform more progressive than anything we've had in years, hell, in a lot of cases reform more extreme than anything we've seen happen in my lifetime-- and all people want to do is swill it around, evaluate its qualities and critique the taste. And I don't get it, because my approach to reform is like Dave's approach to beer: Drink it, look around for some more.
December 19, 2009 2:55 PM | Reply | Permalink
Didn't make you a second class citizen, did it?
How fast would you have been to vote for it if it said that states could opt out of providing full access to health care for Asians? That's what they did to women
December 19, 2009 5:39 PM | Reply | Permalink
That's what the Hyde amendment already did... If anything this opt-in is actually a WORKAROUND the Hyde amendment. It has moved from zero federal funding for abortions to states opting in for coverage for them.
December 19, 2009 6:37 PM | Reply | Permalink
You are confusing having Federal funds pay for abortions and having access to the exchanges to purchase your own insurance. If you want to purchase abortion coverage, the states can now force you to have to go outside the exchanges where everybody else is.
That's not in Hyde: it sets up a nice little ghetto for women to make their purchases in -- nice little back alley. Try forcing men to have to make a separate insurance purchase -- not part of the exchanges for Viagra.
This is a sell out.
December 19, 2009 7:00 PM | Reply | Permalink
I think you make good points, Theda. What you call "half a loaf" I would be more inclined to call "three quarters of a loaf", considering the magnitude of changes unrelated to the insurance components of the package. In addition, the last minute changes engineered by Harry Reid appear to be unwelcome in some aspects, but desirable in others, including further cost control on insurers, and the elimination of a loophole regarding annual caps on insurer benefits.
For perspective, it's probably worth keeping in mind the enormity of benefit that will ensue to the more than 30 million currently uninsured who will gain coverage, particularly in the light of the Harvard study indicating that lack of coverage is responsible for tens of thousands of deaths annually.
Finally, the reforms will spend more than $800 billion over the next ten years to expand Medicaid and subsidize insurance premiums for other low incomes families, while requiring the insurers to spend at least 80 percent of their revenues to actually pay for medical services. Even without a public option, desirable as that might have been, the prospective gains from this package are very substantial indeed.
I expect that over the next few years, the public will be pleased with the result, and reward the Democrats with support they might otherwise have enjoyed. Don't take my word for that, though. The 40 Republican Senators who are desperately trying to sink the effort appear to have reached the same conclusion.
December 19, 2009 3:05 PM | Reply | Permalink
The government should not spend any money at all on insurance premiums. If someone is too poor to buy insurance, the government should just pay their medical bills. End of story.
I suspect, Fred, that you must have some connection to the big insurance companies, since you defend them so consistently and insist that more people paying them more money is a really good thing. I don't buy it.
And more people buying insurance does not necessarily translate to more people getting health care. There is still the issue of deductibles and copays, and if you are broke, you won't want to spend that money either.
December 19, 2009 3:46 PM | Reply | Permalink
"American politics has often been an arena for angry minds . . . I call it the paranoid style simply because no other word adequately evokes the sense of heated exaggeration, suspiciousness, and conspiratorial fantasy that I have in mind . . . Of course this term is pejorative, and it is meant to be; the paranoid style has a greater affinity for bad causes than good. But nothing really prevents a sound program or demand from being advocated in the paranoid style. Style has more to do with the way in which ideas are believed than with the truth or falsity of their content.
The paranoid spokesman sees the fate of conspiracy in apocalyptic terms—he traffics in the birth and death of whole worlds, whole political orders, whole systems of human values. He is always manning the barricades of civilization.
As a member of the avant-garde who is capable of perceiving the conspiracy before it is fully obvious to an as yet unaroused public, the paranoid is a militant leader. He does not see social conflict as something to be mediated and compromised, in the manner of the working politician. Since what is at stake is always a conflict between absolute good and absolute evil, what is necessary is not compromise but the will to fight things out to a finish.
The enemy is clearly delineated: he is a perfect model of malice, a kind of amoral superman
The situation becomes worse when the representatives of a particular social interest—perhaps because of the very unrealistic and unrealizable nature of its demands—are shut out of the political process. Having no access to political bargaining or the making of decisions, they find their original conception that the world of power is sinister and malicious fully confirmed. They see only the consequences of power—and this through distorting lens—and have no chance to observe its actual machinery. "
Richard Hofstadter, the esteemed Marxist historian, "The Paranoid Style in American Politics", Harper’s Magazine, November 1964, pp. 77-86.
December 19, 2009 4:08 PM | Reply | Permalink
On the subject of deductibles and copay you are right. They are a major element driving people into bankruptcy. But as I skimmed that manager's amendment that was added today, I saw a provision requiring that the insurance companies report exactly how much the deductibles and copay are, along with such other provisions the Secretary requires.
We may not get coverage of those things in this bill, but the problem becomes visible to everyone. That report is going to be on the Internet. It isn't going to just be some arcane study by one or two professors no one has ever heard of from podunk U. It will be something taht every corporate buyer of health insurance reviews before buying a product. It's going to be covered in the business journals, not just the academic ones, because the data is going to be sitting there in easily retrievable and manipulatible forms.
The number of people the copays and deductibles effect will be quite obvious. That makes it a problem that will be fixed. Just not on the day the current bill is signed into law.
Things don't have to all be fixed at once, nice as that would be. This bill sets a process into motion. It just doesn't solve everything all at once.
December 19, 2009 4:19 PM | Reply | Permalink
Thanks for the details. For whatever reasons (I have my theories) there was energy in the public against government control than against the insurance industry. A little surprising, yes. But once the rhetoric dies down around the HCR bill, it will be nearly impossible for the teabaggers, Hannity, et al. -- the free market populists -- to blast the Dems from going after the insurance companies armed with data.
December 19, 2009 4:44 PM | Reply | Permalink
since they can collude with out fear of the justice department, I sincerely don't understand what you think you are gaining from being able to read on the internet they are deciding together to charge you.
December 19, 2009 4:50 PM | Reply | Permalink
As remarkable as it may seem, there is not enough support nationally to dismantle the "free-market" organizations that make up the health insurance industry. Once the data becomes easily avaliable, attempt to regulate intensely the industry in favor of the citizens will be much more easy. Right now, the reform is difficult because not a single Republican is breaking ranks and crossing the aisle. In the coming months, some in the less red areas might break on regulations meant to deal with the actual injustices conducted by these corporations.
December 19, 2009 4:59 PM | Reply | Permalink
so it is your opinion that average americans want the insurance industry excluded from anti-trust laws?
December 19, 2009 5:03 PM | Reply | Permalink
There is a difference between asking the average citizen about whether they're against insurance companies and anti-trsut laws and how they feel about the actual legislation that would be necessary in order to open the insurance industry to free market competition. Given the complexity of the matter of state-based legislation that makes cross state-line offers a nightmare, thus leading to the public option from a federal government, we get back to average American distrusting the federal government's efficacy in dealing with such matters.
So the average citizen when asked about anti-trust laws, would say that were against the insurance companies being exempt, but when they are also split when it comes to the possible alternatives at this time. That split allows those on the right to dig in their heels, and give power to the likes of Leiberman and Nelson.
December 19, 2009 5:15 PM | Reply | Permalink
you should see the polls on how people feel about the senate plan next to how they feel about the public option. Dems and indie favored the public option. They don't like what the senate has cooked up.
the people aren't stupid. They'll see the mandates, and the rising costs of premiums and know exactly which party and president to blame.
How the conservatives were able to get democrats to do their work for them is beyond me.
December 19, 2009 5:33 PM | Reply | Permalink
I do look at the polls* and I've watch the support for the public option slip over time, with some polls showing basically a dead even split. At best right now the public option has a 55% to 44% favorability. Of course, these questions don't ask whether they would be willing to increase their personal tax burden in order to make it happen, which is where the rubber meets the road on this issue.
And in places like Nebraska, the polls show a different reality. So what Nelson do? Follow the majority of the country or follow the majority of his constituency?
I agree this is much to find distasteful in this bill, but there are improvements to the status quo. Given the Senators we have to work with, it is best we can hope for at the moment. And maybe getting this passed and tweaking it will help those who need help better than scrapping it. Because the enlightened Senate that would craft something different isn't there and never was.
(*They also show broad disapproval of federal funding for abortions so I guess we need to be Nelson's side when it comes to that issue, eh? Not to mention favoring lessing the kind of abortions that are legally accessible).
December 19, 2009 6:00 PM | Reply | Permalink
wow. you are quite the apologist. The PO had support. The mandates do not. The senate bill doesn't. Polish away.
December 19, 2009 6:40 PM | Reply | Permalink
I'm not trying to polish anything. I'm trying to be realistic. I'm for the public option and wish it was in there. Actually I want a single payer system. And I think the system we get from this bill in comparison sucks.
But based on the polls, the majority that the PO has is weak. When nationally it sits at 55% favorability that means there are large swaths of the country where it is not popular at all. The Constitution has set it up so that places Arkansas and Nebraska have as much power in the Senate as California and New York. This set up leads to the current situtation. So yes, there is national support for the PO, but are the Senators from those deep red states suppose to disregard their consitutents? Until there is the mandated single-term Senator, getting re-elected is going to play into decisions.
And we really start to get in a murky place when we demand that each Senator vote according to polls. Nelson may be voting to please his insurance overlords, but it also is aligned with his constituency.
Of course, when the polls are showing favorability approaching 70% nationally, I am sure you will see some Republicans and conservative Democrats joining the progressives. Until then, we have to work with what we have.
December 19, 2009 7:02 PM | Reply | Permalink
polish polish polish
Watching the democratic party fan out and try to convince people that up is down and abortion restrictions are good, and mandates without cost controls are awesome, and an industry outside of anti-trust laws is just all right
is just sad.
December 19, 2009 10:50 PM | Reply | Permalink
No one is saying that they're awesome. It sucks. Okay. But given the composite of the current Congress this is the best we're going to get. The progressives tried to rally the public but it wasn't enough to scare the likes of Nelson to voting against their buddies in the healthcare system. So let's take this and move on. And try to figure out how we can actually get a sizeable swath of those in the public (and not just in the areas that currently vote Democratic) against the PO to back it in the future. Then maybe we might get something approaching real reform.
December 21, 2009 9:43 AM | Reply | Permalink
again, the public option was popular all ready. POlled well with Indies and Dems.
Fight isn't even over, and you're all ready done.
Not to mention, all signs point to an ideal being struck with industry early on. Why you'd champion such a tactic is beyond me. The senate bill entrenches the what is wrong with our healthcare system, it doesn't help. It throws money at the problem.
December 21, 2009 1:46 PM | Reply | Permalink
"Average Americans" don't have a clue what that even means. Anti-trust? These are the same people who glommed on to the "Death Tax" not knowing that it only applied to people like Paris Hilton and would never have anything to do with them.
December 19, 2009 8:35 PM | Reply | Permalink
Well maybe it should be explained to them Jan. And how how repealing it would mean much more competitiveness in the marketplace and much lower insurance premiums. I would prefer repealing their anti-trust exemption over a public option. It would force competition...
December 19, 2009 8:43 PM | Reply | Permalink
you opinion of people sucks,
but it does help to make the democratic parties current take on people and trying to dupe them make more sense
December 19, 2009 10:53 PM | Reply | Permalink
Well, my opinion of "people" is colored by the fact that so many of them manage to blame the recession, job losses and the deficit on Obama. Are these people informed? No.
Do they have strong opinions? Yes.
BTW, my opinion of you is not that hot either
December 20, 2009 12:45 PM | Reply | Permalink
yawn
December 21, 2009 1:43 PM | Reply | Permalink
The health care industry has had major imput into any/all of the pending versions of a health care reform bill. To believe that any final rendition of a bill will not directly benefit the industry is naive - and foolish.
As with Medicare Part D, a bill basically written by big Pharma to their advantage and our disadvantage, it will be years before, if ever, that bill is superceded and thus it will be with whatever big Health Insurance Consortia put together. (In the meantime, we're needlessly dying out here.)
December 19, 2009 3:08 PM | Reply | Permalink
Regardless of how true of what you say is, we are unfortunately not that progressive of a country. Places like Nebraska exist, and because of the Constitution, they get to send two senators to D.C. One of them by chance has a D next to his name, even though he is more conservative some Republicans. Not only that he was a insurance insider before going into politics. But he is the only reason the Dems have 60 votes, without which not one bit of reform, progressive or otherwise, would see the light of day. This is our reality. Until people in Nebraska and places like Nebraska start to wake up, this is the best we can hope for right now.
And after this is passed we can begin to tweak it for the better. Without it, we won't see any reform for many years to come.
December 19, 2009 3:24 PM | Reply | Permalink
How do you think Republicans defeated the party of FDR? They sold Reaganism. You have sell them a message! Why do you think FOX is in business. The other side never forgets for a second that they have a message to sell. Instead, we go out and say "we're not a progressive country". We've so internalized their message that we sell it for them!
December 20, 2009 12:03 AM | Reply | Permalink
We are not conservatives. We know that the world is not black and white.
it is not simply good vs. the corporations. the world is much more complicated than that, we of the reality based community should know better.
The industry of course got things in they like. But there are also things in it they fought like hell against. and many of the things they got in are compromises from their point of view.
Medicare part D. hate the give away to pharma, but I because of it my mother's medicine did not bankrupt my family.
Plus this bill fixes most of the donut hole, which my wife's grandfather just fell into.
December 19, 2009 3:45 PM | Reply | Permalink
"...price increases in private insurance become an increasingly grave threat to the public good."
Once this is passed, then the light can be turned up bright on the insurance agencies, where their tactics begin to impact the taxpayer, who is never in a good mood. Minor additions of government involvement in providing options to private insurers would get a much more receptive audience. Success here will begin to build the trust that doesn't currently exist for the federal government to run a massive program in this arena in the health care system.
December 19, 2009 3:32 PM | Reply | Permalink
Nasayers, take some time, stop hitting refresh on the huffpost headlines and read what the bill does.
Via Klein here are of the newest things:
"Sentences I am happy about in the Senate bill: Part I
Page 12:
Each hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups.
Pricing transparency!"
December 19, 2009 3:39 PM | Reply | Permalink
What are you going to do? Get price estimates before heading to the emergency room? If they all collude to charge the same high price for ridiculous items, you have no recourse. Besides, you get the same itemized bills now after you are discharged, at least in New York.
December 19, 2009 3:45 PM | Reply | Permalink
Your argument makes no sense. Cost transparency allows for consumer protection in the same way that truth in advertising laws impact commercial purchases. You know that.
December 19, 2009 6:43 PM | Reply | Permalink
I don't get your point. Truth in advertising works because there is an element of consumer choice. Hospitals don't have to be dishonest. They let you know they are screwing you over. What are you gonna do about it, go somewhere else? Unless hospitals are required to put up the rates charged to every single insurance plan for every single procedure, it won't help consumers to make better health care choices.
In New York (and many other states), hospitals must give itemized bills and you get an explanation of benefits from the insurance company (if you are lucky enough to be insured). The purpose is to catch errors or fraud after the fact. That I see as useful health care transparency on a federal level. Wonder if that is in the bill? I am sure the insurance lobby is keeping it out.
December 19, 2009 11:28 PM | Reply | Permalink
And I should also note that there are few people even eligible for the national insurance exchange that could do such shopping. Most people will be under their employer plan. No choice at all.
December 19, 2009 11:33 PM | Reply | Permalink
Joh-a typical example of a worthless rule
Each hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups.
(1) When people go to the hospital they usually do not know all the conditions or diagnoses that they have-
(2) They do not know what tests they may need-
(3) They do not know the ins and outs of insurance/medical terminology of the procedures or diagnoses they may require-
(4) They do not know the IV or oral meds they may need-
(5) they do not have the time to review or compare all this data even if they did know most of the above.
December 19, 2009 7:31 PM | Reply | Permalink
. . . the hospital’s standard charges for items and services provided by the hospital . . . .
Would those "charges" be the rates they bill the uninsured or the rates they bill Medicare or BC/BS or Aetna?
Not a (snark) -- I don't know the answer. Anyone?
December 19, 2009 8:42 PM | Reply | Permalink
Vote the current set of clowns in Washington out. Vote for a Green or Independent. If the repubs get control...fine...maybe, maybe, maybe the country has not been in enough pain to actually get some sense for a change. Maybe after 8 more years of pain and misery they will wise up.
C
December 19, 2009 3:42 PM | Reply | Permalink
Bub, you must not really understand pain and misery. Obviously this is just all a game to you. For example, just of the top of my head, you must think that extension of SCHIP to 3 million more women and children is . . . well who knows, do you even know what SCHIP is? Have you actually spent anytime looking at what this administration has done!?
All the jackasses who were making these arguments in 2000 obviously didn't understand the fundamental differences between a Democratic Administration and Republican Administration. Invading Iraq was the tip of the ice berg, try the complete dismantling of our country's health, environment and safety regulation regime? Try conservative judges that are going to be around for a generation knocking down consumer protection, reproductive rights, so on and so on.
Quite frankly its disgusting how you can throw around such a callous argument. It only shows you are extremely uniformed, or have a seriously short perspective, maybe inhuman or you are completely insulated by wealth and comfort to understand the true consequences.
December 19, 2009 3:58 PM | Reply | Permalink
I got a clue for you. I know pain and misery. I lived dirt poor for years. Scrimping and scratching. Doing what ever I can.
No it is NOT a game. It is serious. But constantly trying to "save the country from it self" simply does not work.
Sometimes people have to hit dead bottom before they are willing to claw their way back. Before they are willing to change.
Before they get any sense.
C
December 19, 2009 4:16 PM | Reply | Permalink
When we look at the more enlightened European approach to healthcare and social policy, this came in large part I believe out a generation that found themselves in the ruins left behind by WWII. Ruins that make what Americans faced during the depression pale in comparison. As a nation we really haven't suffered.
So what will make the voters of Nebraska get some sense? Right now the country is getting the HCR that it voted for. And if the polls are any indication, we're on a path that will lead to more less progressive Congress after the 2010 election (even if people such as you and I vote Democrat).
Of course there are some who deserve our support, like Rep. Weiner. If we lose Nelson, maybe that will be better in the long run, just like it was jettisoning the Dixiecrats. But hopefully we, as a whole, be like the voters in 2006 who jettisoned Sentor Lincoln Chaffee. Had he still been around in 2009, he would have been one Republican who would have crossed the aisle to vote for real HCR.
December 19, 2009 4:38 PM | Reply | Permalink
What kind of dickhead are you exactly?
December 19, 2009 4:29 PM | Reply | Permalink
Ahh....first class ??
C
December 19, 2009 5:11 PM | Reply | Permalink
Your venom is misdirected and entirely unjustified. How sad that it's suddenly a sin to hold progressive opinions in the Democratic party. Keep treating smart, informed, interesting and nice people like this and see where it gets you.
December 19, 2009 4:55 PM | Reply | Permalink
I don't get your problem with Jon-P's comment. Maybe you missed the comment he was responding to, but CM was basically making the extremely tired argument that, if we allow the Republicans to further run the country into the ground, oh well, maybe then we'll get a truly progressive government.
I am not willing to take that chance, and there's a million dead Iraqis that would like the chance to agree with me.
I don't know how many times progressives have to learn the lesson that staying home is not a viable option, but I share Jon-P's disgust at the cavalier nature of that argument.
December 19, 2009 5:25 PM | Reply | Permalink
Your disgust would be better aimed at the people who claim to represent progressive thinking Americans, who take their money, depend on their support and do it all fraudulently.
And really... you can't lay a million dead Iraqis at the feet of people who voted for third party candidates or who stayed home. Both parties in congress supported the war in Iraq so it's certainly the case that no Nader voter in 2000 need was their hands of that. Unless you have evidence of some weird Green Party drive to invade Baghdad that the rest of us have never heard about.
December 19, 2009 6:02 PM | Reply | Permalink
I can pretty safely say that Gore would not have invaded Iraq. He would have likely maintained the sanction and no-fly zones that were killing hundreds of thousands of Iraqis, but Gore would not havr abrogated international law to invade a sovereign nation that did not attack us.
The Nader run was a bad idea and cost us dearly. Nader's philosophy still haunts the left in this country. He put the system on trial at a time when the stakes were crucial, and I lay part of Bush's legacy at his feet. I will say he sobered me up something fierce... The Green Party immolated itself by going the celebrity route.
December 19, 2009 6:52 PM | Reply | Permalink
Would Nader have invaded Iraq? Nader voters are not Bush voters. Don't treat them as if they're the same. And if it's legit to imagine what Gore would have done as president it's obviously and equally as legit to imagine what Nader might have done.
December 19, 2009 9:21 PM | Reply | Permalink
Ah, the old "Both parties in congress supported the war in Iraq so it's certainly the case that no Nader voter in 2000 need was their hands of that" argument.
You conveniently ignore that fact that our president-but-for-the-Naderites was opposed to Iraq from the getgo, strongly suggesting that we wold never have entered into that debacle had Gore been president.
Third-party advocates are responsible for the George W. Bush presidency. And now they are threatening to sabotage the Obama presidency. And yet they claim that they are progressives who truly, madly, deeply care about working and middle class Americans.
Good luck squaring that circle.
December 20, 2009 2:10 PM | Reply | Permalink
Of course Gore never would have invaded Iraq. Neither would Nader. So if you voted for either of them you were right. Not much of a circle that needs to be squared there.
Hard to see how any third party advocate is sabotaging Obama's presidency. Obama is a choice not an obligation.
December 20, 2009 6:52 PM | Reply | Permalink
If a vote for Nader was a good-faith attempt to elect a viable alternative to the two major party candidates and not merely the symbolic, nihilistic protest of a bunch of holier-than-thou, so-called "progressives," you'd have a point.
But it wasn't, so you don't:
"This research estimates the likely voting behavior of Nader voters if he had not been a candidate in the presidential race. Bivariate analysis of ANES data suggests that Nader voters fit the profile of likely voters and have a distinct preference for Democratic candidates...The results suggest that Nader voters closely resembled the typical voter in educational achievement, and therefore it is likely that a majority of these individuals would have participated in the 2000 election if Nader had not been a candidate. In addition, it is likely that these individuals would have voted for Al Gore over George Bush. However, these Nader voters were younger, less partisan, and were more likely to express feelings of political alienation, so it is quite possible that the absence of the Nader candidacy would have kept a sizeable minority of them at home on election day."
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W64-4CPDFW8-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1142436916&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a84755ff19dbd96ed911b85b6eae6c9c
December 20, 2009 10:00 PM | Reply | Permalink
What you mean we Kemo Sabe ?
C
December 19, 2009 10:33 PM | Reply | Permalink
Your last point cannot be emphasized enough, imo. Progressives need to push hard for Senate rules reform, and try and make it part of the Democratic party platform.
Change the rules, change the game. (Eventually ...)
December 19, 2009 3:46 PM | Reply | Permalink
I agree.
But there is work to be down with the public. A recent CNN Poll found 56% to 39% in favor of the use of the filibuster. The question used the current HCR reform as a lead in: As you may know, the filibuster is a Senate procedure which has been used to prevent the Senate from passing controversial legislation or confirming controversial appointments by the President,
even if a majority of senators support that action.
http://i2.cdn.turner.com/cnn/2009/images/11/17/rel17f.pdf
December 19, 2009 3:53 PM | Reply | Permalink
It would certainly have to accompanied by a PR campaign explaining what the filibuster is, and why it is undemocratic.
December 19, 2009 4:39 PM | Reply | Permalink
And how egregiously the protection is affords is being abused.
The structure of the Senate also needs to be reformed to give the populous states more weight than they now carry. Except that Senators are now elected rather than appointed by the governor or the state legislature, the Senate today is structurally even less democratic than it was in 1789.
December 21, 2009 6:20 PM | Reply | Permalink
"American politics has often been an arena for angry minds . . . I call it the paranoid style simply because no other word adequately evokes the sense of heated exaggeration, suspiciousness, and conspiratorial fantasy that I have in mind . . . Of course this term is pejorative, and it is meant to be; the paranoid style has a greater affinity for bad causes than good. But nothing really prevents a sound program or demand from being advocated in the paranoid style. Style has more to do with the way in which ideas are believed than with the truth or falsity of their content.
The paranoid spokesman sees the fate of conspiracy in apocalyptic terms—he traffics in the birth and death of whole worlds, whole political orders, whole systems of human values. He is always manning the barricades of civilization.
As a member of the avant-garde who is capable of perceiving the conspiracy before it is fully obvious to an as yet unaroused public, the paranoid is a militant leader. He does not see social conflict as something to be mediated and compromised, in the manner of the working politician. Since what is at stake is always a conflict between absolute good and absolute evil, what is necessary is not compromise but the will to fight things out to a finish.
The enemy is clearly delineated: he is a perfect model of malice, a kind of amoral superman
The situation becomes worse when the representatives of a particular social interest—perhaps because of the very unrealistic and unrealizable nature of its demands—are shut out of the political process. Having no access to political bargaining or the making of decisions, they find their original conception that the world of power is sinister and malicious fully confirmed. They see only the consequences of power—and this through distorting lens—and have no chance to observe its actual machinery. "
Richard Hofstadter, the esteemed Marxist historian, "The Paranoid Style in American Politics", Harper’s Magazine, November 1964, pp. 77-86.
December 19, 2009 4:09 PM | Reply | Permalink
I know you are some kool-aid drinking shill for the DNC. I'm glad you dropped the out and out blatant requests for money, because we don't have any.
I was just wondering how much you get out of the fundraising? A nickel a click? What?
Low expectations tends to lead to poor results. Go tell your masters we expect more, and they'd better back away from Wall Street and deliver, or they'll be out on their ass. In the cold. No more Brooks Brothers suits, Starbucks, and fancy cars. Sorry. That is over.
Thanks.
December 19, 2009 4:33 PM | Reply | Permalink
December 19, 2009 5:11 PM | Reply | Permalink
Go ahead, be the victim of low expectations.
December 19, 2009 5:45 PM | Reply | Permalink
That was not a response to you, although it does look like it.
December 19, 2009 6:45 PM | Reply | Permalink
more turd polishing in the TPM Cafe. Woohooo!
December 19, 2009 4:47 PM | Reply | Permalink
Woo-Hoo, everyone plus the government ensures the profits of the private corporate insurers, they then send money to the Senators, who get re-elected, and everyone wins!
December 19, 2009 5:25 PM | Reply | Permalink
But why do they get re-elected? Where is the responsibility of the American voting public? This is who we have collectively voted for, so if it's a turd, it's a turd we derserve. All politics is local, and maybe we need to work on our neighbors so regardless of the amount of campaign dollars in their treasure chest, those getting elected are the one that will actually put the citizens interests to the forefront.
So going forward, what's next? As a progressive where do we put our energies. Trying to scuttle this bill and returning to the status quo? Trying to work with public perceptions so we can quickly begin significant tweaks to this bill once it is signed into law? The latter of course requires us to point out the flaws in this bill, but maybe not to the point of scrapping it.
December 19, 2009 5:41 PM | Reply | Permalink
why is there a self imposed time limit on this bill? For an election? For a SOTU speech? If there was a little less concern about industry money and elections, we might be able to get something better this time.
December 19, 2009 5:48 PM | Reply | Permalink
I agree that it would be nice if there was less concern about elections and the money, etc. but that is the reality of our politics. The majority of voters are too easily swayed by a good tv commerical or robocall. And in a non-presidential election, the situation is even worse, where single issue voters, etc. can sway an election so the representatives are not aligned with the sentiments of the majority.
We don't have mandated single-term Senators, so those from places that lean red are going to balk and drag their heels against real progressive reform. And the reason we have the magic 60 is that we broaden the tent to include these more conservative regions into our caucus. So right now, I just do see anything better as a possibility, that unless places like Virginia and Nebraska and Arkansas suddenly have a great progressive awakening.
December 19, 2009 6:10 PM | Reply | Permalink
By the second sentence:
"in the real world" - Ooh, subtle.
"paying to include millions more Americans". how can one say this in a way that will penetrate? FORCING someone to buy insurance is not INCLUDING them. Subsidies that will bring the price of that insurance to "only" 9% of gross income are not sufficient to make it affordable for many, many people.
You are not PROVIDING coverage. You are DEMANDING coverage. Feel as morally superior as you like, insult anyone who disagrees with you as much as makes you happy. It won't change the facts.
"fending off all of the tricks America's privileged, left and right, use to resist paying taxes" - first off, "left and right"? Are there distinct left wing privileged tax avoidance strategies? Really. Name three. Here I thought it was just rich people and the Congress that works for them. But surely, this can't be some kind of reflexive distancing trope to establish yourself as an unbiased, above-the-fray reporter of Things As They Are In The World Today or anything like that.
And how exactly does this legislation in any way "fend off" those tricks? By taxing the insurance plans of union members? By stripping out any public alternative to private insurance? Please elaborate on your intriguing theory.
TPM really needs to find someone with something new to say. Well, they don't *need* to, I suppose. It would just be more interesting.
December 19, 2009 5:03 PM | Reply | Permalink
I think she meant that the priviledged, whether they claim to be of the left or right, seek to avoid personal sacrifice when it comes to seeing more people covered. Not that there are specific strategies for the priviledged left, as opposed to strategies used by the priviledged right.
And while there might be some acting morally superior and insulting with those who disagree, I don't get that from her blog at all. That is unless you feel taking a stand on issue by its very nature being morally superior and insulting. In which case, you're being morally superior and insulting. Which I don't think you are.
I think this blog points out the basic split on the left: do we take something that isn't perfect in the hopes of making it better, or do we scrap it and stick with what we have now, waiting for another day to try to push through some reform.
I guess it boils down to that. Because what we got is what we're going to get thanks to a Republican party that that seeks nothing but a filibuster and 60 "Democratic" senators that includes the likes of Nelson and Leiberman. Anything better out of this Senate was probably never a reality.
December 19, 2009 5:32 PM | Reply | Permalink
I think she meant that the priviledged, whether they claim to be of the left or right, seek to avoid personal sacrifice when it comes to seeing more people covered. Not that there are specific strategies for the priviledged left, as opposed to strategies used by the priviledged right.
Actually they seek to avoid personal sacrifice with regards to anything. That is precisely the reason we no long have a military draft, why we have only ever fought in foreign wars, why we have never used nuclear weapons, why everyone is so uptight about Iran getting nuclear capability and Pakistan having it.
The only thing the privileged elite gives a wet slap about is their own continued privileged survival.
C
December 19, 2009 5:55 PM | Reply | Permalink
This is true. And whether they claim to be left or right, they are the ones that tend to be in the seats of visible power as well as the ones behind the scene. The ones who takes over these visible seats not of this class tend to, but not always, become corrupted and morph into this elite class.
Real change comes when there is an overwhelming change of perspective from below, or at least the beginning of such a surge. Such surges led to the Civil Rights Act in 1964. Right now, the lacks such an uprising or potential uprising with health care. There is frustration but it is not focused enough and intense enough to force those in power to undo the basic corporate structures.
December 19, 2009 6:16 PM | Reply | Permalink
We've never used nuclear weapons???
I do agree that privilege hoards, expands and protects privilege. We are perennially at a disadvantage. Language is too loose and most peoplr are not sufficiently educated in order to pursure enlightened self-interest.
I don't know. I groked the state of affairs when I was a child. Parents are dictators. Bosses are dictators. The government is a dictatorial apparatus. Most media is invested in dictation. There is very little exchange on this planet. We are born as infants and we live as subjects. Only the abstract/creative plane saves us, and even that plane is dominated by our repressed urges to destroy this black iron prison.
But I will say that the system is maintained by the common man. Our energy and acquiescence is what perpetuates this state of affairs. We believe thay our intent to rebel would be stifled by authority and neighbor. The entire system is based on consent of the governed.
So it sounds well and good on the internet to advocate for BALLS and hate privilege, but it is manufactured rage... Full of sound and fury, signifying nothing.
December 19, 2009 7:06 PM | Reply | Permalink
What you mean we Kemo Sabe ?
C
December 19, 2009 10:32 PM | Reply | Permalink
About the moral condescension - looking at it again, I have to say that yes, you're right. I was responding more to other comments than to the original post, and I was wrong to imply otherwise.
December 19, 2009 6:42 PM | Reply | Permalink
This post uses various strong and assertive words like "demand", "press" and "make it clear" and "must". But I have to say that I know longer know what these words mean nay more. What kinds of actions do these words signify?
December 19, 2009 8:00 PM | Reply | Permalink
One is let your representatives know where you stand. Obviously the current group of resisters to real progressive reform don't fear stripping out the PO, etc. In other words, right now there is not sufficient support (no matter what poll numbers you can pull up) for progressive reform.
December 19, 2009 8:43 PM | Reply | Permalink
Well, yes acamus, I have let people know I am on a strike against donating money to the Democratic Party. That's the only way I understand of pushing, pressing or demanding. As I see it, unless one communicates actual negative consequences for a politician's failure to perform, no message will get through.
However, I have a feeling that this kind of action will also be condemned by the supposed advocates of defending while "demanding". People are in favor of all sorts of figurative pressing and demanding, as long as it doesn't involve actual pressing and demanding, since they think actual pressing is too dangerous and risk-fraught. My guess is that when they say we should "demand" such and such, they just mean that we should express our fond and idle wishes in a demanding tone of voice.
Or maybe we should hold a vigil. We can vigil the health care industry into submission.
December 19, 2009 8:59 PM | Reply | Permalink
I think Dan's right. And I find the notion that we are going to "demand" anything and see it done is fairly nauseating wishful thinking (Theda).
Maybe it's not fair to want to stick Theda with a pin after reading this "let's get fired up!" epistle (I especially like the part where we should just cheerfully jettison abortion rights) but that's how I feel.
Every cheerleader here, whether upbeat or rueful is glossing over the glaring tragedy of this bill: our government has institutionalized private healthcare - dug us more deeply into a system that is both immoral and inappropriate at its core - and a system that has us collectively paying almost twice what others pay around the world.
It was glaringly evident throughout this process that industry lobbyists were writing the legislation. That, in itself, is utterly, profoundly disturbing.
The Pres and congress could have achieved better outcomes a hundred different ways than the way they chose. There is nothing to celebrate here.
December 19, 2009 11:05 PM | Reply | Permalink
Dan K has it right - "demanding" would be supporting Democratic primary challenges to those who compromised the bill away.
Comparing this current vision of health care reform to Medicare and Social Security is like comparing Enron to a public utility - they reflect fundamentally different philosophies about how public needs should be served. It's less likely the public could "demand" regulations that cut into health care industry profits than that a Republican-controlled government could eliminate them altogether.
December 22, 2009 10:05 AM | Reply | Permalink
The progressive way forward...WTF??!! Cheering on a reform that, with the Stupak amendment and/or the Nelson compromise, relegates women to second class citizens again? I really am getting the warm progressive fuzzies...NOT!!!
No, not a chance. This HCR Frankenstein is becoming more hideous and grotesque with each passing day, No this isn't progress and is completely unacceptable on multiple levels.
December 19, 2009 8:02 PM | Reply | Permalink
So we should stay with the status quo?
December 19, 2009 8:40 PM | Reply | Permalink
If progress means telling 51% of the people in America they have to give up their rights? Yes.
Let women keep their constitutional rights, then let the health care system implode under its own rotting weight and take up reform at that point.
December 19, 2009 8:47 PM | Reply | Permalink
This bill doesn't deny the right, it denies government financial support to engage in that right. No one, at least not me, is saying that the non-support for abortion is progressive. Personally I support federal tax dollars to support abortion, but the majority of Americans don't. So at this stage in history it ain't going to happen.
I'm not willing to let some movement toward the better be scrapped so in order to stand on some principle about choice, especially when those women aren't getting financial support with the status quo. But hey, you keep on high horse. Just because we're supporting passage doesn't mean we're calling it a progressive heath care reform bill.
December 21, 2009 9:53 AM | Reply | Permalink
So let me get this right...since it only applies to women who take government supported health care it is alright? It is an acceptable trade-off? And since there is going to be a mandate by the US government to buy insurance, and many women (up to 300% of poverty and maybe more) will be getting subsidies for their health care from the federal government, this means how many women will have their rights infringed upon? You are very cavalier in negotiating away the rights of other people...
Truth, justice and the neoliberal way...
And don't worry about us progressives. We will continue to be a pain in the ass to anyone, left or right conservative or neoliberal, who defends the rotting status quo.
December 21, 2009 10:08 AM | Reply | Permalink
I give up -- old Meursault has won me over.
Yes; the act will be an albatross* around the neck of liberals but failure to enact a bill after devoting nigh unto a year of the legislature's time to it will further erode the public's confidence in Democratic party control.
Do we really want Repugs back in the driver's seat.
* Maybe it all depends on how soon the bird begins to stink -- next year and the year after as uncontrolled medical costs rise? or in 2013/2014 when the act goes into effect?
December 19, 2009 8:58 PM | Reply | Permalink
Et tu, Ellen?
That beating is gonna leave a mark and set the movement back for years but if it takes an epic fail, I guess so be it, but that is gonna be a heavy price to pay. The thing that pisses me off is the feeling that even when the 'left' (center-left?) recovers from this they will not have learned a thing and in the future will be already be condemned to repeat the mistakes of the past...Que sera, sera, whatever will be will be.
December 19, 2009 9:37 PM | Reply | Permalink
The lesson learned should be you couldn’t serve two masters.
(Matthew 6:22-24) 22 “The lamp of the body is the eye. If, then, your eye is simple, your whole body will be bright; 23 but if your eye is wicked, your whole body will be dark. If in reality the light that is in you is darkness, how great that darkness is!
(The Democrats allowed the bill to become not simple, but convoluted, corrupted, sinister.)
24 “No one can slave for two masters; for either he will hate the one and love the other, or he will stick to the one and despise the other. YOU cannot slave for God and for Riches. . .
The Democrats have proven they serve riches, casting aside the God like qualities of compassion and mercy.
I suppose because a few were served, somehow they should receive the glorious accolades, WE WON, We got Health Care reform. YIPPEE
We were in the heat of battle; and instead of refreshing water; you give me warm water. Thanks, but no thanks.
We fought to bring you to power and this is our reward, Republican-lite
You played your Good cop/bad cop routine to the max, and in the end you sellout Democrats served your masters well.
Problem is you spineless Democrats, you’re masters have further subjected us to crumbs.
I originally thought to write; the Democrats have just shown the American people; they will not and cannot lead.
Problem is they did lead, they led the American people down a path of compromise, they didn’t want to upset they’re masters.
Next Election!!
The Fascist’s will do what ever it takes, while the Democrats sit around singing Kum Ba Yah". ... Can’t we all just get along?
Bernie Sander’s had it right; we should have gone to reconciliation. Taken the lead. Instead of asking your enemies “what do you think”?
In reply I say to those without principles. NO there is no getting along with someone looking for the opportunity to cut your throat, to bury you, to subject you.
It is said the Tea party may very well be the straw that broke the camels back,
Fascism sees the opportunity, it smells the blood, and it will seize its prey.
The progressives will be heard saying we told you so. The Democrat Kum Ba Yah". ...crowd, will beating their chests. WOE is WE.
The Republicans if given enough time, would have killed this bill. As it is, they will inflict a thousand cuts, every time it is shown the Healthcare bill was rushed.
“See we told you so” will be their chant, every election cycle where the citizens will have to keep tinkering with the present HCR reform act, because the weeds were cast among the wheat.
The harvest of the good that could have been, will be choked by the weeds.
Way to go stupid Democrats you thought you could serve two masters and now both sides are disgusted with you.
That’s just my opinion. My feelings
December 19, 2009 9:23 PM | Reply | Permalink
Great post Theda. I especially like the notion of "defend and demand." And I like your details on what to demand.
I'd like to float something out there. I wonder if we could form a private insurance company which works directly with the community centers envisioned by Bernie Sanders. The company could be run only in order to continue running. That would put extreme pressure on the insurance companies already in existence to lower costs.
If progressives feel screwed then we could always invest time and labor into such a company. It would function identically to a public-option only it wouldn't be government-run. It would be a choice for subsidized-insurance-buyers and non-subsidized-insurance-buyers. A grassroots and netroots health insurance company would compliment the bill as is and bend the cost curve much more quickly.
December 20, 2009 12:53 AM | Reply | Permalink
Know what, if you can't fight 'em, join 'em. Buy Insurance and Big Pharma stocks come Monday!
December 20, 2009 1:36 AM | Reply | Permalink
Always buy stocks in industries that receive giant subsidies. Suddenly Aetna is too big to fail!
December 20, 2009 10:59 AM | Reply | Permalink
Destor, it's so easy to make money! Look!
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Investors buy into health care sector as Senate moves on bill
By Kate Gibson, MarketWatch
NEW YORK (MarketWatch) -- After much trepidation, investors on Monday embraced the health care sector, with large insurance companies rallying as the Senate moved towards passage of an historic bill to overhaul the nation's health care system.
December 21, 2009 11:35 AM | Reply | Permalink
The mandate needs to be removed from the bill until such time that anyone subjected to a mandate has real competitive 'choices' which because of the health insurance monopolies must be some form of public choice.
The bill still sucks without the mandate and hopefully it can be improved in conference.
When the mandate is removed it will ensure that health insurance reform will be revisited. We need to tie 'acceptance of a mandate' to some meaningful form of public choice for 'everyone' that it applies to.
December 20, 2009 10:04 AM | Reply | Permalink
Exactly. This is such a simple thing. Either add a public option open to everyone or drop the mandate. That people are arguing against the idea that if you have one you need both is really surprising to me.
December 20, 2009 11:01 AM | Reply | Permalink
What is it about people at TPM Cafe that they'd rather be "right" than win anything. Sometimes I think there is a kind of perculiar moral cowardice that demands a impossible perfection that will never happen. Never happening, no one has to take any responsibility for what does happen. It's better to be the one right person in the universe than to do anything at all. Safer, too.
December 20, 2009 11:59 AM | Reply | Permalink
"Sometimes I think there is a kind of perculiar moral cowardice that demands a impossible perfection that will never happen."
Those of you insisting that opposition to this bill are "demanding perection", etc. are not making an argument. You are simply repeating a catch phrase.
December 20, 2009 6:40 PM | Reply | Permalink
Thanks for the voice of sanity. Given the long history of nearly a century of failure to move toward universal health insurance in the United States it is mind-boggling that so many progressives would rather opt for failure again. It's one thing to dislike some insurance companies, quite another to fight to make certain that tens of millions of Americans never ever get health insurance.
December 20, 2009 8:46 PM | Reply | Permalink
I feel much better after reading all these comments than I did after reading comments on another post. It seems there are more rational people around than I thought. I say rational rather than educated because I'm convinced that education and intelligence, while necessary, are not sufficient attributes to consistently adopt correct or enlightened opinions.
A love for fact based, rational deduction of arguments is the only way to overcome the human propensity to invest ourselves emotionally so deeply in an ideology, a peer group, a persona, that reasoned arguments have no effect on us whatsoever if they threaten our constructs. Drew Westen puts the number of people who are free from these emotional shackles at 15% of the population. I assume that the majority of that 15% uses that ability to manipulate the other 85%, rather than to try to enlighten them.
I believe it is a very small minority that dares to speak the truth and for good reason, they are or soon become outcasts, hated by all sides for pointing out their errors and not going along with their fantasies. From time to time they are recognized for their courage and contribution, usually long after they are dead. I believe we owe everything that is good on this earth to a very small percentage of all the people who have ever lived. The rest just get manipulated for good or ill.
December 21, 2009 1:20 AM | Reply | Permalink
Theda's historical perspective is invaluable.
There's a tendency to think that reforms such as Social Security and Medicare somehow sprang full-blown from the heads of FDR and LBJ.
Wrong!
Both programs required decades of tweaking, with improvements made by fits and starts. Something as apparently non-controversial as automatic COLAs for Social Security recipients wasn't enacted until 1972--37 years after the program began! And Social Security wasn't even a Roosevelt Administration to begin with. It was a belated response by the New Dealers to a teabagger-type populist movement founded by a slightly wacky doctor in Southern California named Francis Townsend.
So by all means, let's turn up our noses at this imperfect product of legislative sausage-making and be filled with outrage over the abject failure of Barack, Harry and Nancy to walk on water.
December 21, 2009 7:30 PM | Reply | Permalink
The Obama Pom Pom "squad" tells me that this Senate POS bill will be improved after it becomes law.
But exactly what would prevent the insurance companies from weakening that law? (Like, for example, lobbying to rase the mandate penalty from 2.5% to 3%, 4%, or even 5%?)
December 22, 2009 8:26 PM | Reply | Permalink
From "The Golden Rule", by Thomas Ferguson.
1. The investment theory holds that voters hardly count unless they
become substantial investors. When the ranks of significant investors
are limited to relatively small numbers of elite actors commanding
disproportionate shares of politically mobilized resources, mass
voting loses most of its significance for controlling public policy.
Elections become contests between several oligarchic parties, whose
major public policy proposals reflect the interests of large
investors...
2. Investment theory takes care never to confuse investors/employers
with politicians/employees.
3. The investment theory expects very modest moves toward the public
on all issues affecting major investors, rock-like stability toward
the vital interests of these investors, and many efforts to adjust
the public to the parties' views rather than vice versa.
December 23, 2009 6:06 AM | Reply | Permalink
The UK National Health Service is an expensive massive overblown bureaucratic nightmare - lets hope the US "version" gets it right.
January 21, 2010 11:35 AM | Reply | Permalink
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February 27, 2010 12:57 AM | Reply | Permalink
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Defend and Demand: The Progressive Way Forward
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I do agree that privilege hoards, expands and protects privilege. We are perennially at a disadvantage. Language is too loose and most peoplr are not sufficiently educated in order to pursure enlightened self-interest.
I don't know. I groked the state of affairs when I was a child. Parents are dictators. Bosses are dictators. The government is a dictatorial apparatus. Most media is invested in dictation. There is very little exchange on this planet. We are born as infants and we live as subjects. Only the abstract/creative plane saves us, and even that plane is dominated by our repressed urges to destroy this black iron prison.
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But I will say that the system is maintained by the common man. Our energy and acquiescence is what perpetuates this state of affairs. We believe thay our intent to rebel would be stifled by authority and neighbor. The entire system is based on consent of the governed.
So it sounds well and good on the internet to advocate for BALLS and hate privilege, but it is manufactured rage... Full of sound and fury, signifying nothing.
September 24, 2010 10:53 AM | Reply | Permalink
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The number of people the copays and deductibles effect will be quite obvious. That makes it a problem that will be fixed. Just not on the day the current bill is signed into law.
December 17, 2010 1:11 AM | Reply | Permalink
I am sure you will see some Republicans and conservative Democrats joining the progressives. Until then, we have to work with what we have.
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December 17, 2010 2:00 AM | Reply | Permalink
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December 20, 2010 3:47 PM | Reply | Permalink
I agree with you that we should take the many big steps forward that are on the table now -- above all the expanded entitlement, the regulations of private insurance, and the increased subsidies for the less fortunate -- and accept that true "health care reform" remains a multi-year, multi-election struggle.
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December 21, 2010 11:32 AM | Reply | Permalink
There are so many people in the U.S. that do not have health insurance that need it. It will definitely benefit more people then it will hurt people. I support it all the way.
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December 22, 2010 5:51 PM | Reply | Permalink
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December 23, 2010 8:36 PM | Reply | Permalink
So by all means, let's turn up our noses at this imperfect product of legislative sausage-making and be filled with outrage over the abject failure of Barack, Harry and Nancy to walk on water.printing bags custom print hats
December 23, 2010 8:58 PM | Reply | Permalink
But I will say that the system is maintained by the common man. Our energy and acquiescence is what perpetuates this state of affairs. We believe thay our intent to rebel would be stifled by authority and neighbor.
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You must consider the polls on how people feel about the council plan next to how they feel about the public option. Dems and indie like the public option. They don't agree on what the senate has made.
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