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WHAT HAPPENS IN THE COCOON IS NEVER VERY PRETTY


Repeat after me, boys and girls, this mantra: PROGRESS OVER PERFECTION.

I don't give a damn whether you're so liberal you wear leaves for shoes to keep from hurting cows or so conservative you recoil at the idea of a public ANYTHING...we are SOOOOOO close, guys, to literally changing history, that we cannot, we WILL NOT...blow it at this point by bickering amongst our little Democratic selves because we're not getting every single little itty bitty solitary thing we want in a health care bill or any other bill that is before congress these days.

Furthermore, what's up with trashing our own president day and night, night and day? 

Doesn't he get anough of that crap on Faux News all the time?  Hasn't he got enough enemies?  Do you really WANT a President Palin in three years?

I mean, seriously.  I'm asking you.  Do you really, really want a President Palin, or a President Conservative Republican in a few years or even a conservative congress obstructing everything President Obama tries to do because WHHHYYYY?

Because, the Independents he so desperately needs to maintain his majority and his office have been siphoned off because whenever they turned to the Democrats or to any Democratic forum, all they saw was Obama getting ripped apart as badly as they saw him getting ripped apart by the Republicans so, therefore, they decided, he must be some kind of turd.

Time to vote Republican, eh?

Wow.  It took us less than a year to destroy everything we worked for in 2008, didn't it?

And no, before you attack, let me go into some detail on WHY I think President Obama is actually doing a helluva lot better job than many of you do, and why so much of it is under the radar of most of the media attention and most of the Talking Heads' attention on both the left and the right.

I've been stockpiling articles beside my elbow since summer on this, so I'll have Links Galore, as is my wont.  Some pretty good stuff.  I think you'll like it.  And I think that, no matter where you stand on the political spectrum, unless you are a Teabagger, you will feel better at the end of this post.

It'll be loosely divided into three parts.

First:  PROGRESS OVER PERFECTION

I've only got one source on this one, but it's so good I'm going to quote extensively from him.  That would be Paul Begala, who as we all know, was a consultant to President Clinton during the last health care battle.  His piece, in the Washington Post, came out last August but is still timely and is titled, wouldn't you know?  "Progress Over Perfection."

He writes:

Progressive politics is, in my view, a movement, not a monument. We cannot achieve perfection in this life, and if that is our goal we will always be frustrated. The right has far more modest goals: At every turn, its members seek to advance their power and protect privilege. I've never seen the Republican right oppose a tax cut for the rich because it wasn't generous enough; I've never seen them oppose a set of loopholes for corporate lobbyists because one industry or another wasn't included. The left, on the other hand, too often prefers a glorious defeat to an incremental victory.

Our history teaches us otherwise. No self-respecting liberal today would support Franklin Roosevelt's original Social Security Act. It excluded agricultural workers -- a huge part of the economy in 1935, and one in which Latinos have traditionally worked. It excluded domestic workers, which included countless African Americans and immigrants. It did not cover the self-employed, or state and local government employees, or railroad employees, or federal employees or employees of nonprofits. It didn't even cover the clergy. FDR's Social Security Act did not have benefits for dependents or survivors. It did not have a cost-of-living increase. If you became disabled and couldn't work, you got nothing from Social Security.

He goes on to say that, for example, if the public option does not make it into today's version of the bill, that does not necessarily mean that it never will.  But to completely derail the entire health care reform bill, to table it flat-out, simply because one aspect of it is not included, would be a tragedy that could take decades for us to recover from, as he so painfully points out:

I carry a heavy burden of regret from my role in setting the bar too high the last time we tried fundamental health reform. I was one of the people who advised President Bill Clinton to wave his pen at Congress in 1994 and declare: "If you send me legislation that does not guarantee every American private health insurance that can never be taken away, you will force me to take this pen, veto the legislation, and we'll come right back here and start all over again." I helped set the bar at 100 percent -- "guarantee every American" -- and after our failure it's taken us 15 years to start all over again.

So I am trying to find the right blend of principle and pragmatism -- ever mindful that, aside from race, health care is the most difficult domestic issue of the past century. FDR couldn't pass it. Nor could Truman, nor Nixon nor Carter nor Clinton. Lesser presidents like George W. Bush didn't even try.

The Founders gave us a standard: "a more perfect Union." It's an odd phrase; we don't generally speak of something becoming "more perfect." I believe it means that we have a duty, every generation, to make progress. For a dozen generations we have done that, in our imperfect way. Let's hope those writing the new health-reform bill can give us something that represents historic progress -- and that those of us most passionately committed to fundamental reform can celebrate progress, not lament a lack of perfection.

I don't think that anyone could question the liberal credentials of Paul Begala.  I believe he was sincere when he wrote this piece and I have also heard long-time congresspeople echo his comments that other pieces of landmark legislation, such as civil rights legislation, came in increments.

CHANGE comes in increments.

That hairy, ugly caterpiller doesn't do a pretty little whirlagig and unfurl his gorgeous wings all at once.  He builds an ugly cocoon and holes up.  If you've ever seen a cocoon busted open before its time, it's pretty ugly.

Legislation moving its way through congress is about as pretty, which brings me to the second part:

"WHY CAN'T OBAMA BE MORE LIKE LBJ?"

I hear this all the time.  Liberals criticizing Obama because, presumably, he's not twisting arms, kicking Democratic ass and taking Democratic names like Lyndon Johnson presumably did when he got the Voting Rights Act and Medicare passed in the 60's.

I always wonder, first of all...what makes you so damn sure he's NOT?

More on that, later.

First, a quick bit of history.  Keep in mind that when LBJ first came into office--and I'm not even counting that terrible day in Dallas 46 years ago; I'm just talking about after he got elected in a landslide in 1964.  Understand that he had a great deal of sympathy behind him because a lot of what he was championing had been talked about by Kennedy, but also understand that Johnson had been a congressman and then a senator (serving as minority leader and majority leader) for many years, (decades, actually), so he had many friends in both houses AND a powerful fellow Texan as the Speaker of the House in Sam Rayburn. 

All these things gave him advantages that Obama does not have.

Also, back then, there were moderate Republicans who could be cajoled and threatened and horse-traded for votes.  It was a different era, a different time.  Even a different media--remember, back then, most of the press knew about JFK's lady friends and affairs but did not write about them.  It was an old boys' club in many ways, both for the media and the government.

That said.

Let's examine what President Obama HAS been doing, and it's waaaay more than you may think.

First of all, I hear liberals, especially in places like Huffington Post, or on shows like Ed Schultz, howl that Obama has "sold out" to Big Pharma or the AMA or some other lobbyist to get health care concessions, as if making those agreements is going to leave children shivering naked in corporate doorways somewhere.

But those criticisms are completely missing the point, as was BINGOED by no less a liberal source than Mother Jones, and no less a liberal writer than Kevin Drum, in his piece, "The Long, Hard Slog Revisited"

In it, he points out that, again, in order to win over Independents, you have to go about it in an entirely different way than you would if you were reaching out to your own partisans during, say, a political campaign:

(quoting Jonathan Bernstein)

Loose partisans and true independents aren't ideologues and are unlikely to become ideologues. What you probably can do -- what Reagan probably did -- is to teach them....But you don't do that by reasoning with them, or with inspiring them with great speeches. You mostly do that, as crude as it sounds, by winning. You do it by creating winning coalitions that put Establishment People on your side.

....The convincing doesn't happen, either in the short term or the long term, from presidential eloquence. The convincing comes when, for example, you've been a Republican main street AMA member all your professional life, and you suddenly find that the AMA is supporting health care reform while the Republicans are attacking the AMA. Even then, you may still be resistant to Obama...until you start hearing him saying the things that you're reading in the AMA newsletter (or however the AMA communicates with doctors. I don't know).

Now, there's no question that Obama and the Democrats in Congress are doing this.  They've basically coopted the insurance companies, the AMA, big pharma, AARP, and corporate interests by giving away goodies to all of them.  This isn't exactly the Schoolhouse Rock version of how a bill becomes law, but it's certainly the real-world way.  And it works pretty well as long as you can get the coalitions to stick together and keep the bribery from stinking up the joint too badly.

But does this actually move public opinion at the same time?  Maybe! 

...There's no question, though, that winning is indeed a powerful aphrodisiac.  Healthcare reform might be controversial right now, but if Obama gets a bill onto his desk and signs it, it will become a huge triumph almost overnight.  Support for both the bill and for Obama will rise steadily, and Democrats of all kinds will reap the benefit of being seen as tough enough and savvy enough to get it passed.  This is the fundamental reason that I'm optimistic about healthcare reform.  Every Democrat in Congress knows that if reform fails, they'll be viewed as losers and they'll pay the price at the polls in November.  They have to pass something if they want to remain in power.  That's a prospect that concentrates the mind powerfully.

I hate to put it in simplistic terms like "winning" and "losing" but America seems to be on this reality TV streak these days, and they see a lot of things as winners and losers.  And they know more about what's going on in Washington than the wingnuts would have you believe.  If health care dies, the majority of Americans will know that the Republicans killed it, but they will also know that the Democrats let it die.

That the Democrats lost.

And they won't trust us with anything again.

We've got to keep the momentum going, and get health care passed.  We can work out some of our more passionate details later, as we had to do with Medicare, Social Security, civil rights, and other landmark legislation.  Would have been a damn pity not to have passed those at all just because they weren't perfect in their original form.

Win.  Lose.  It's a CHOICE.

And it's more up to us than you might think, but more on that later.

Another criticism I've seen is that Obama has not been specific enough on the bill, that he's left entirely too much up to congress, that he has not "owned" it, that he's stayed too much in the background.

But a longtime denizen of Capitol Hill sees it in far more realistic terms.  Writing for the Washington Post, Norman J. Ornstein of the American Enterprise Institute posited back in September that he was seeing from the administration "signs of savvy, not weakness."

Ornstein put his finger on the the fickle mood of the public when he pointed out that:

Without some guarantee that reform thus defined will be enacted for the vast majority of Americans, the likelihood has always been that the closer government gets to enacting change, the more nervous voters would get about embracing the devil they don't know. And the closer one gets to broad change affecting 16 percent of the economy and a hefty slice of the workforce, the more those whose incomes depend on the current system will fight to keep their share.

He then went into the obvious--that there IS no broad bi-partisan leadership support OR broad bi-partisan majority in either house, in any political universe, and reminded readers that this is similar to what faced Clinton in 1994; only today, the filibuster lines drawn in the sand make every issue a 60-vote battle.

How to prevail under these difficult circumstances? The only realistic way was to avoid a bill of particulars, to stay flexible, and to rely on congressional party and committee leaders in both houses to find the sweet spots to get bills through individual House and Senate obstacle courses. Under these circumstances, the best intervention from the White House is to help break impasses when they arise and, toward the end, the presidential bully pulpit and the president's political capital can help to seal the deal.

He goes on to make his final case--as did Paul Begala--that

The odds remain reasonable that a solid, if not dramatic, health reform bill can make it through this process and become law. Any bill, under these conditions, will be a major accomplishment. The odds have been improved, not damaged, by the president's approach.

Again, though, there are those who want to know why President Obama is not more the arm-twister like LBJ, and AGAIN, I ask...How do you know he is NOT?

Several articles I've come across indicate that the president is doing far, far more behind the scenes than most of us realize.

An in-depth profile of Obama's team, called "Taking the Hill," by Matt Bai, published in the New York Times magazine back in June of 2009, set up how Obama structured his White House to organize for various legislative battles.  I'll go into that first, and then, a short piece in the Times from back in September, by Sheryl Gay Stolberg, "Taking Health Care Courtship Up Another Notch," more or less demonstrated that team in motion as it worked the phones, the restaurants, the meetings, even the gyms, during the committee process to garner votes to get the bill out of the Baucus Finance committee. 

Both are highly instructive as to how the Obama White House is far more active, alive, and energetic in the legislative process--quietly and behind the scenes--than most people realize. 

It is, in fact, a brilliant strategy, because it enables the towering egos of the House and Senate to get their moments before the cameras, their home-town papers, and their constituents, while quietly building one of the biggest legislative achievements of the past century for their president.

If, as he hopes, they are able to get this health care reform legislation passed, in its entirety, in time for his State of the Union speech in January of 2010, it will be a triumph not just for him, but for the American people.

In Matt Bai's Times Magazine piece, he points out that Obama's White House "methodically assembled the most Congress-centric administration in modern history."

Obama seems to think that the dysfunction in Washington isn't only about the heightened enmity between the parties; it's also about the longstanding mistrust between the two branches of government that stare each other down from twin peaks on either end of Pennsylvania Avenue.

And it's not just his choice of Rahm Emmanuel as his chief of staff, who everybody by now knows was a congressman who was largely credited with helping to build the current congressional Democratic majority and who was on the fast-track to make Speaker of the House--that was key to this strategy, but also his choice of Joe Biden for vice-president.

"I'm a Senate guy," Biden told me bluntly when I visited him a few weeks ago in his West Wing office. "It's been my whole life, and I'm incredibly proud of it. Other presidents I've worked with, they view Congress almost as a constitutional impediment, you know?"

Not only have former congressional aides been hired at the White House and used extensively for their access, but from the beginning, Obama and his team have searched for creative ways to include congressmen and women, and their families, at White House events, both formal and informal, (as of mid-May, when the article was being prepared, more than 300 congresspersons and 80 senators had visited the White House), and it has paid off.

When Matt Bai asked Sen. Baucus his impression of President Obama, he gave this thoughtful response:

"How do I say this delicately?" he asked. "President Bush, he liked being president. You know, there are be-ers, and there are doers. And I think he liked being president, as opposed to doing." Obama, on the other hand, strikes Baucus as a doer. "You've really got to work at it, rather than just enjoying the job," he said.

Rahm Emmanuel has been known to give out his cellphone number to every Democratic senator (and some Republicans too), and, like Biden, often works out at the congressional gym.

And it's not just that senators meet with the president that is important.  It's HOW they meet with him:

Obama is not the schmoozer that Clinton was, nor does he bestow nicknames like Bush. Rather, he has impressed lawmakers with a direct, businesslike manner and an outward deference to the legislative branch. As Obama mulled whether to nominate Sonia Sotomayor or some other jurist to the Supreme Court last month, he called every member of the Judiciary Committee personally, taking the "advise" part of "advise and consent" to a level that impressed some longtime senators. "This is the first time I've ever been called by a president on a Supreme Court nomination, be it a Republican or a Democrat," Charles Grassley, the Republican senator from Iowa, told Peter Baker and Adam Nagourney of The Times after Sotomayor's nomination was announced. A hallmark of Obama's style, in these early months, has been to meet with key senators alone, without the phalanx of aides who almost always attend Oval Office meetings. Three senators with whom I spoke, including Baucus, had been impressed by this tactic; it implies equality between the branches of government and enables Obama to establish personal relationships more quickly than he otherwise might. ("You been hunting lately?" Obama asked Ben Nelson when the Nebraska senator walked into the Oval Office and found himself, much to his surprise, alone with the president.)[emphasis mine] 

All these meetings have actually angered some on the left, who claim that it does no good to try and compromise on things like the public option or the Stupak amendment, because it will only water down the bill to basically nothing; that we should simply ram it through on reconciliation with 51 votes exactly as we please. 

Simply do as Bush did with his tax cuts and get on with it.

But Sen. Baucus cautions, and President Obama has also mentioned on the stump, that the dangers of reconciliation are that a future Republican administration could far more easily dismantle the program. What the president and the Democratic congress want to do is put into place a reform package that will stay in place for the ages, even if it has to be done in increments.

(There are other, procedural problems with reconciliation that I'm not going to go into here because I've already taken up too much space for most of you to keep reading, as it is.)

In Stolberg's piece in the Times, which was published on September 27 (link up above), during the committe process when Susan Collins' vote was being heavily wooed by the White House, there are a number of people besides JUST Rahm Emmanuel who the White House sent to talk to Sen. Collins, including Health and Human Services Secretary Kathleen Sebelius, Tom Vilsack, the agriculture secretary, Gary Locke, the commerce secretary, White House budget director Peter Orszag, and on and on.

It was courtship by committee.

Call it what you will, it worked.

So...what were you saying about LBJ?

And last part, HOW CAN WE BE THE CHANGE WE WANT TO SEE?

In Anna Quindland's powerful cover story for Newsweek, "Hope Springs Eternal" (which appeared on the cover as "Yes He Can: A Liberal's Survival Guide"), she goes straight for the jugular when she makes the visceral point that there is, indeed, a big difference between campaigning and GOVERNING.

From time to time the American people participate in a mass delusion about how their government works. Such a delusion took place exactly a year ago, when a 47-year-old African-American who had once been accorded little chance of prevailing was elected president of the United States.

History will judge Barack Obama over the long haul. But we've learned something in the short term that is simple, obvious, and has less to do with him than with the Founding Fathers. This is a country that often has transformational ambitions but is saddled with an incremental system, a nation built on revolution, then engineered so the revolutionary can rarely take hold.

Checks and balances: that's how we learn about it in social-studies class, and in theory it is meant to guard against a despotic executive, a wild-eyed legislature, an overweening judiciary. And it's also meant to safeguard the rights of the individual; as James Madison, president and father of the Constitution, once said, "I believe there are more instances of the abridgement of freedom of the people by gradual and silent encroachments by those in power than by violent and sudden usurpations." But what our system has meant during the poisonous partisan civil war that has paralyzed Washington in recent years is that very little of the big stuff gets done. It simply can't.

She goes on to detail promises that President Obama made during the campaign that impatient progressives fault him for not having fulfilled yet in his mere nine months in office, as if all he had to do were to wave his magic wand and POOF! it would take place.  (And although, yes, there are some things that he can cause to happen in just that way through executive order, he must also weigh the relative wisdom of such a course of action versus going about it in another, albeit slower method--again, that would be less likely to be dismantled later.  It doesn't mean it will never happen.  It just might take a bit longer.)

The president is a person of nuance. But on both ends of the political number line, nuance is seen as wishy-washy. There's no nuance in partisan attacks, soundbites, slogans, which is why Barack Obama didn't run with the lines "Some change you might like if you're willing to settle" or "Yes, we can, but it will take a while."

That's really how our government works, by inches...

Americans point to events ranging from the Emancipation Proclamation to the Voting Rights Act to show that America knows how to think--and act--big. But a stroll through actual history, as opposed to the cherry-tree-chopping sort, provides a different narrative. Many abolitionists decried Lincoln's executive order, which freed few slaves and failed to make the buying and selling of humans illegal, while conservatives thought it was radical and unwise. In other words, it was a smallish, moderate, middle-ground measure. And while it has become gospel that Franklin Roosevelt utterly transformed the public weal through the New Deal, he was so frustrated by the opposition of conservative members of his own party that he proposed to Wendell Willkie that the liberal Democrats and the liberal Republicans join together to create a liberal party.

She then goes on to quote Doris Kearns Goodwin, a historian who actually worked for LBJ, who stated that LBJ was able to accomplish what he did, in part, by promising Congress that they would be making history, and that, "This Congress has never known the joy of that accomplishment.  They haven't ever been part of an institution that moves collectively to change history for the benefit of the American people."

Which brings me to my final point:

 She also notes that the presidents who have made real change have always done so in the same way: "Each of them had the country pushing the Congress to act, the people and the press both. The pressure has to come from outside." So if the American people want the president to be more like the Barack Obama they elected, maybe they should start acting more like the voters who elected him, who forcibly and undeniably moved the political establishment to where it didn't want to go. After all, in our system, even great, audacious change is never as audacious as it seems: calls for a national health-care system can be traced all the way back to Roosevelt--Teddy Roosevelt, in 1912. When Sen. Olympia Snowe, Republican of Maine, broke with her party to vote a health-care bill out of committee, she said, "When history calls, history calls."

Now, this is the thing, my friends.

We've been making a fine noise on this health care reform business, but mostly, we've been making it amongst ourselves, bickering and arguing back and forth with each other, blasting our own president for not doing this or doing too much of that, threatening to boycott this or not vote for that--and that goes for our own members in the House and Senate!

What the hell is WRONG with us?

WE CAN'T DO THIS NOW!

Not NOW.

We are too close.

WE ARE IN THE MAJORITY AND WE HAVE TO FIGHT FOR HEALTH CARE REFORM EVEN IF IT DOESN'T CONTAIN EVERY SINGLE LITTLE THING WE WANT.

My daughter is 29 years old.  She works so hard she can barely walk sometimes but she does not have health care right now.  I want her to be able to have health care.  I would love for her to be able to choose from a public option, but that may not be possible.  I would hope that, at least, with millions more consumers, with checks and balances and regulations provided, that she would be able to find an affordable plan through health care reform.

She won't even have THAT option if we don't stop fighting amongst ourselves, Democrats.

Some of us don't even care, as Charles M. Blow points out in his op-ed, "Health Care Hullabaloo."  He wrote it last August, but he said that even though 8 in 10 Democrats favored health care reform, it was the right-wingnutters who were dominating the airwaves because THEY were the ones who were jumping up and getting active about it.

Now, I know many many Democrats who called congresspeople, some who went door to door or called neighbors or donated to Organizing for America or blogged or did whatever they could, but I knew about ten times as many who barely paid any attention at all, and in the time being?

The nutcases started winning over the Independents.  May not seem like that big a deal right now, but it will in a few years, trust me.

But I'll give the final word to Bob Herbert of the New York Times, "Changing the World."

It's so easy to criticize Obama because, hey, he promised CHANGE and he hasn't done it yet, eh?

But he can't do it without us.  WE are the change.  He needs us to have his back, not for us to stand around throwing rotten tomatoes at him because he's not working fast enought to suit us, or because what he's doing is not perfect enough or because he won't show us what is going on inside the cocoon, right?

Herbert writes:

One of the most cherished items in my possession is a postcard that was sent from Mississippi to the Upper West Side of Manhattan in June 1964.

"Dear Mom and Dad," it says, "I have arrived safely in Meridian, Mississippi. This is a wonderful town and the weather is fine. I wish you were here. The people in this city are wonderful and our reception was very good. All my love, Andy."

That was the last word sent to his family by Andrew Goodman, a 20-year-old college student who was murdered by the Ku Klux Klan, along with fellow civil rights workers Michael Schwerner and James Chaney, on his first full day in Mississippi -- June 21, the same date as the postmark on the card. The goal of the three young men had been to help register blacks to vote.

The postcard was given to me by Andrew's brother, David, who has become a good friend.

Andrew and that postcard came to mind over the weekend as I was thinking about the sense of helplessness so many ordinary Americans have been feeling as the nation is confronted with one enormous, seemingly intractable problem after another. The helplessness is beginning to border on paralysis.

He goes on to point out some of the more obvious problems facing our nation: the wars in Iraq and Afghanistan, unemployment and foreclosures and homelessness, the H1N1 flu virus, suicide bombings, and so on, and then

Americans have tended to watch with a remarkable (I think frightening) degree of passivity as crises of all sorts have gripped the country and sent millions of lives into tailspins. Where people once might have deluged their elected representatives with complaints, joined unions, resisted mass firings, confronted their employers with serious demands, marched for social justice and created brand new civic organizations to fight for the things they believed in, the tendency now is to assume that there is little or nothing ordinary individuals can do about the conditions that plague them.

This is so wrong. It is the kind of thinking that would have stopped the civil rights movement in its tracks, that would have kept women in the kitchen or the steno pool, that would have prevented labor unions from forcing open the doors that led to the creation of a vast middle class.

This passivity and sense of helplessness most likely stems from the refusal of so many Americans over the past few decades to acknowledge any sense of personal responsibility for the policies and choices that have led the country into such a dismal state of affairs, and to turn their backs on any real obligation to help others who were struggling.

Those chickens have come home to roost. Being an American has become a spectator sport. Most Americans watch the news the way you'd watch a ballgame, or a long-running television series, believing that they have no more control over important real-life events than a viewer would have over a coach's strategy or a script for "Law & Order."

With that kind of attitude, Andrew Goodman would never have left the comfort of his family home in Manhattan. Rosa Parks would have gotten up and given her seat to a white person, and the Montgomery bus boycott would never have happened. Betty Friedan would never have written "The Feminine Mystique."

The nation's political leaders and their corporate puppet masters have fouled this nation up to a fare-thee-well. 

See, that's what I'm thinkin', guys.  I'm thinkin' that much of the past eight years, especially amongst the Democratic side, left us with this residual feeling of trapped helplessness that we only halfway got out of with the campaign.  I say, "halfway," because so many of us imbued President Obama with some kind of Superman powers, where we sort of expected him to leap tall buildings with a single bound, so to speak.  

We relaxed.  We thought, Go for it, man. Go fix the world.

But it doesn't work like that.  He needs our help.  He can't do this alone, gang, and he for SURE can't do it with us griping and whining and arguing and bickering and finding fault with every little thing the man does, criticizing him so much on our side that people in the middle, who can't decide what to think, look to us, then look over to the right, and then think, I guess this Barack Obama guy doesn't know WHAT he's doing.

What the hell.  Sarah Palin's kinda cute...

Right now, we're soooo damn close.  Let's close ranks, get behind our president, fight for what's right, get this thing passed.

Bob Herbert writes:

We will not be pulled from the morass without a big effort from an active citizenry, and that means a citizenry fired with a sense of mission and the belief that their actions, in concert with others, can make a profound difference.

It can start with just a few small steps. Mrs. Parks helped transform a nation by refusing to budge from her seat. Maybe you want to speak up publicly about an important issue, or host a house party, or perhaps arrange a meeting of soon-to-be dismissed employees, or parents at a troubled school.

It's a risk, sure. But the need is great, and that's how you change the world.

It doesn't take a whole lot.

You can donate a few bucks to Organize for America, for TV commercials.  If you can't do that, you can call your senators, let them know how important health care reform is to you.  You can talk about it to your neighbors, you can fact-check viral e-mails that cross your desk and let family and friends know the truth about health care reform.

You can stand up for the president you elected and show the world you're still proud of that vote.

You can do what you can.

You can still change the world.  It's just gonna take some time, is all.  


66 Comments

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Fabulous essay, Deanie.

So if the American people want the president to be more like the Barack Obama they elected, maybe they should start acting more like the voters who elected him, who forcibly and undeniably moved the political establishment to where it didn't want to go

Yup...there are several of us who have been saying this a lot lately, and frankly, I've been getting a little tired of feeling like I need to defend him amongst our own here...

I'm sick of the whining and sniveling (and been chastised for saying that) about what he isn't doing, and I want to start spending more time pointing out the areas where our country has just gotten so screwed up and start a groundswell of support for fixing it, item by item. Sitting around complaining isn't going to accomplish anything.

I just wrote this morning that we can't expect him to do the heavy lifting himself...it is just too heavy for one person...he needs our help.

I am SOOOOO glad you agree, and have made the case so eloquently, as usual!

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Ditto. A terrific piece.

For those interested in further informing themselves I recommend a text on legislative process. This is one (the price a bit steep, but that is true of all law texts). It is easily readable for any intelligent adult who has an appreciation for excellent writing -- and nuance:

Legislative Law and Process in a Nutshell (St. Paul, N: West Publishing Co., Paperback, 1986), Jack Davies.

Again, a terrific piece.

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"I need to defend him amongst our own here..."

Check the start dates and bios for some of our resident naysayers, and you may not be so inclined to include them in "our own."

It started after the 2006 election, and has been getting more sophisticated AND desperate as the right loses more ground.

It is one thing to criticize Obama, but to criticize him EVERY TIME suggests something other than a shared ideology with the eggheads who hang out here.

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In shorter terms:

If all one sees are attacks on President Obama, and on "his" agenda based upon predicting the future, then one isn't looking at one who supported Obama in the first place.

I recall the noise here from last year, during the campaign -- it drove me away -- in which there was hate being spewed by between some Hillary and Obama supporters, and by others against both them, and both major parties in behalf of unachieveable pie-in-the-sky.

Than add in the wingnuts who have nothing better to do than indulge their self-destructive hate-spewing.

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I'm sick of the whining and sniveling (and been chastised for saying that) about what he isn't doing, and I want to start spending more time pointing out the areas where our country has just gotten so screwed up and start a groundswell of support for fixing it, item by item. Sitting around complaining isn't going to accomplish anything.

Oddly enough, it is possible -- for most of us anyway -- to walk and chew gum at the same time. I'll leave the tendentious characterizations regarding "whining and sniveling" for another day.

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Deanie, your efforts here are so very much appreciated. A masterful message to us all. The quotations you provided are just the tonic I've needed. Yes, I'm impatient, and yes, I want the government to be mightily involved in whatever health care reforms come our way, but you and the others are absolutely right: It'll come in small steps, not giant leaps.

My problem with the way its going now is twofold:

1. I hate the idea of the insurance industry benefiting from our efforts instead of taking the punishment they so richly deserve.
And
2. I hate the idea of the Republicans having any say in a health care bill that they've arrived at kicking and screaming, and fighting tooth and nail to keep from happening at all.

But having said that, I'm duly chastised after reading the above. I will sleep on this and if I wake up in the morning having come to an epiphany that changes my views on the subject, it won't be the first time.

Thanks.

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On #1:

Regulation of the insurance industry is in the pipeline, some being in the Senate bill. (I want repeal of their monopoly protection -- and the taxpayer subsidies to them reduced to $0.00).

As is reregulation of Wall St., a bill to do that having already been produced in the House.

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(I want repeal of their monopoly protection -- and the taxpayer subsidies to them reduced to $0.00).

J, isn't it a wonder that the only place we ever read about those egregious legal loopholes is here in the comments sections of a news blog?

As I have said so often, the MSM is a tool of Big Money, NOT the vaunted 4th Estate. They are not about to publicize how much pernicious protection our Bush era lawmakers provided the insurance companies, particularly the monopoly protection.

Like no-bid contracts, anything akin to a monopoly should make the capitalists among us outraged.

But too many of these supposed capitalists are just monopolists at heart, seeking to control, not compete, they want to use free enterprise to buy up a whole industry so they can eliminate any and all competition.

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It's certainly laughably amazing that the Republicans are the party of competition, competition, competition -- but are horrifiedly agog at the prospect that health insurance reform might result in . . . in . . . um . . . in . .

COMPETITION!

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"every single little itty bitty solitary thing we want in a health care bill"

You mean like actual healthcare reform?

There is very little in the insurance subsidy and mandate bill before Congress that helps the average citizen in the long run. Getting caught up in the idea that passage of anything, no matter how rotten is progress is a huge error both from a strategic point of view and from a policy point of view. Saddling ourselves with a poor substitute for healthcare reform the primary effect of which will be to further enrich the most parasitic healthcare interests is a bad idea. It isn't quibbling over not getting "every little bit". It's about being sold out and getting almost nothing.

Both bills presently before the Congress deserve to be defeated and I hope they are unless very substantial changes take place. One item over which the bill can and should be killed is the public option. If the public option remains as weak and tepid and unable to succeed as the versions in the two bills before Congress then that alone is enough reason to kill the bills and start over in January.

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That's what the abolitionists said of the "Emancipation Proclamation".

And it's true: Lincoln didn't free the slaves. But he got the ball rolling, set in motion the process that did free them.

But you've obviously not yet read Deanie's article, which is why you don't know what you're talking about.

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Actually, there were a few "contraband" slaves in rebel controlled areas that were freed, but you are
correct that the Emancipation Proclamation did free all of the slaves. Lincoln knew he needed an amendment for that.

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you surely meant "the Emancipation Proclamation did NOT free all of the slaves."

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yep - NOT should be in there - these things are too darn hard to edit.

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And there were blacks who fought on the Confederate side (see Ang Lee' "Ride with the Devil").

Then again, they'd been denied the right to learn, so it shouldn't surprise that they'd be uninformed of the particulars. And that some, having been terrorized for generations, played it safe by staying with the familiar.

I recommend "Ride with the Devil" to those who cite the fact that some blacks fought on the Confederate side, as justification for the revisionist whitewash the "South shall rise again" bigots swallow as legitimate history.

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That is a false statement. It's not at all what abolitionists said though they would have preferred he free all slaves immediately. It was clear at the time to everyone that slavery was, as a practical matter, was finished with the proclamation because where the proclamation allowed it to continue it could not sustain itself for long. There is absolutely no correlation between that situation and the complete sell out of the people's interests by the President and Democrats in Congress on healthcare.

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Jnagarya's spot on here, Oleeb, Lincoln's baby steps eventually broke into full strides that lasted until the South took back Congress and the Supreme Court after the Civil War.

Obama's brought health care further than any of us might have thought just a couple short years ago. If you think any plan will ever satisfy the majority, and you too, you are either naive or a concern troll.

Thanks, Deannie, good to read your words again, and I hope you offer more, as often as possible.

I agree, our arrogant House of Lords will ignore the public will as usual, but at least the issue is on the table and not on the shelf.

Oleeb, if you really believe your opinion should become law, run for office, but stop writing as if you are an authority.

You have an opinion, we all get the benefit of it, and we will decide if you deserve our respect, you certainly can't demand it.

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No, this is not true. He has brought a healthcare bill that benefits industry farther than anyone else. Big deal. This bill is not analagous at all to emancipation of the slaves. If anything it is the opposite. This bill will trap the American people into a bad system for years to come. It's as easy to see as was the foolish mistake of going to war in Iraq but once again people just fantasize that what is clearly before them isn't real and that their wishes are.

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Would love to hear your thoughts on the Atlantic piece linked on the Front page which disputes your total certainty that this bill is a sellout.

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I see it primarily as yet another Washington insider's viewpoint and an apology for a bill that does little to improve the lot of the common people.

Look, it is becoming increasingly clear if you listen to the voices of those who want change that is beneficial for our people that the bills before Congress are odious. Howard Dean is doing his best to be a team player and he cannot avoid pointing out that the bills are so bad and watered down at this point that they are very close to unacceptable. I suspect his private opinion is far more harsh and that he actually believes that neither bill is worth passing in their present forms. Bernie Sanders has made clear that his vote is by no means secure in favor of either bill and that means he disapproves of the shadow of a public option (which is clearly designed to fail) that is being held out as compensation for all the industry giveaways. Kucinich voted against the House version precisely because it is such a capitulation to industry interests. Anthony Wiener and Alan Grayson have become very, very silent in the past couple of weeks as all the progressive features of both bills are slowly destroyed or rendered useless. There's just very little to support if you are actually in favor of doing something to reform our healthcare system in ways that benefit our people.

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It's funny how two people can read the same thing and come away with completely different opinions about it. I read that Brownstein piece, and I understand now that the death panel cries had a legitimate basis.

I was concentrating on the Medicare portion there, though, and you probably are too young to care about what they're doing to medicare. Take a look at this:

The Finance Bill proposed automatic reimbursement reductions for doctors who order up the most care for Medicare recipients...
That sounded kinda bad so that rewrote that portion of the bill to establish a "values based payment modifier", which instead pays the frugal doctors more and the other doctors less. They thought this sounded better and "It will, we believe, have the same net effect [as the original proposal]," said the Democratic aide. "It should change behavior around that threshold."

So, as a Medicare recipient, I get less care and the privilege of paying more for it because of Obama's side deals with the hospitals and insurance companies. My cost for days 1-6 in 2009 for hospital stay = $150/day. The same cost in 2010 = $255/day.

I can totally see where the death panel threat came from and why seniors in particular say keep you hands off my medicare. Unfortunately some of the damage has already been done.

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You are nothing if not consistent, oleeb. Your absolute certainty disturbs me.

I hate the health care bill. I hate that the repubs have watered it down and still won't vote for it. I hate that we can't build a public system from the ground up with unanimous support. I hate that after decades of the repubs being in power and doing NOTHING to provide affordable health care for all, now all of a sudden now they say they have this great plan, if only we would listen. I hate that the dems are in bed w/ the trial lawyers and won't even consider tort reform...

But we have accomplished nothing towards universal health care in 50 years. This is the closest we've ever come. It isn't perfect, it isn't even good, but it is a start...an actual start, and unfortunately, today, that is all we can do. It is better than nothing.

If you are so frickin' smart and know just how to get a better plan through the whorehouse on Capitol Hill, then YOU run for office and do it.

Meanwhile, the rest of us idiots will just work with what we can get. Then keep working at improving it until some day we finally have universal health care.

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You aren't an idiot, but you are willfully naive and you have admitted repeatedly that you prefer not to acknowledge the reality in front of you. You have said time and again that you prefer to impute the best of intentions to our leaders. Well that is a major league mistake and one our corrupt political system banks on you making.

How can one be certain? Easy, because this sort of sell out isn't new. It has been happening for years. Just as one example, remember how NAFTA was going to be good for American workers?

You and many others are being suckered into supporting this pile of crap with the use of the same tired arguments they always role out when they sell the people's interests out. 1. We "have to" have some kind of bill or we will pay for it next year in the elections because we failed. So what? How would "we" pay for it? By some blue dogs losing re-election? Who cares? They are Republicans in all but name. "We" the people lose nothing except the opportunity to be saddled with a rotten system for another generation. The losers in next year's elections would be the corrupt Democrats who failed to do the right thing. Not the people. It is doubtful the Republicans would retake either House or Senate, but for the average person who would that really be different for them when the Democrats are maintaining so many of the horrific policies of the Republicans? I know and agree that there are plenty of policies and positions that would be affected, but here I'm talking about the immediate impact in the lives of the citizens. The truth is, they don't see much difference between the two parties and they aren't that far off when it comes to some of the most important issues like the Wall Street bailout, the two wars, torture, climate change (both get nothing substantive done), etc... 2. The other big argument they use to keep people in line behind a bad bill is that once this HCR passes we can "improve" it and make it better down the road. Yeah, right. That's going to happen right after the Republicans come on board and Obama keeps his promise to restore the rule of law and stop unnecessary spying on the American people. This is, in short, a lie. Bad legislation enacted will set the course for many years to come. Just look at the horrendous Medicare drug bill the Republicans passed. it stinks and it hasn't been changed yet even though Democrats have been in a position to do so for a while now. That was a bill sold as a benefit to seniors that was really a benefit to the drug companies and bad deal for everyone else. If a bill is fatally flawed (as this legislation so clearly is)we will be unable to free ourselves of its defects for years and years and years. We are, in effect, screwing our own kids and grandchildren. That is unacceptable to me and on a fundamental level immoral. My view is that it is better to delay covering more people under a bad bill than it is to take perhaps a while longer and get it right or improve the legislation dramatically. There's little, if any, hope of the two albratrosses in Congress being much improved.

Take a look at this legislation and ask yourself if it is really worth the extraordinarily high price tag we are being asked to pay to fail to achieve the objective which is dramatic reform of our healthcare system and to finally provide for ourselves what the citizens of every other major nation on earth have had for decades: universal, not for profit, comprehensive healthcare. The failure of the Democratic leadership to start this process with a real solution and then to capitulate on almost any request made by those who are implacably opposed to any reform has created not a "historice first step" but instead exactly what the opponents are warning everyone of: an unwieldy, expensive bureaucratic nightmare that does not really bring any reform at all. The "smart" tactic of conceding in advance produced in the healthcare reform bill the same bad results it always produces. What a shock!

We are now being asked to believe that by mandating that people buy the for profit health insurance that is universally condemned by Democrats and most citizens as costing far too much and delivering far too little and by subsidizing the same that this is an improvement worth having. That's a bill of goods nobody with any sense ought to be willing to buy. It does not yield anything like the kind of changes necessary to improve the system for our citizens.

The bills under consideration benefit the parasitic insurance and other healtcare industry interests far more than it benefits the people and it locks in this nightmare for decades to come. It hamstrings future reform it does not facilitate it. It is a bad deal for the American people. Your desire to believe our leaders wouldn't sell out our interests is belied by the very clear facts before us.

Last night Jane Hamsher was on the Maddow show and was asked directly whether she and other progressives were willing to scuttle this rotten bill if it didn't substantially improve and she said yes. That is a prudent position, but as a practical matter there is no way the bills they are looking at will be improved in any substantial way. The public option provisions suck and are worthless features designed to fail if, indeed, they even are included in the final bill and it will take years and years before the first step is taken toward implementing a public option of any kind. In other words, it's a joke. We don't need a joke. Without a public option that is available to all the people the bill isn't worth passing.

What we need is a national health policy that makes sense first and foremost for the average citizen and the profits of the healthcare industries must take a back seat. In the current bills we have the opposite. Profits clearly come first in both the bills being considered and the people's interests are so far at the end of the list they are barely visible. How can Democrats, in good conscience support such a flim flam? If it looks like a duck, walks like a duck and quacks like a duck: it's a duck. The rotten bills before Congress couldn't be quacking any louder.

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I am well aware of what we need, oleeb. I am also painfully aware that we don't have nearly enough votes to get it.

But, I don't think "nothing" is appropriate. We are getting hosed on this. There is no doubt about it. In the short term, the price we are going to be asked to pay is high, maybe too high. But in the long run, it is a platform that we can launch from. Where we are right now is not.

Your best bet, oleeb, is to start working on your opposition candidate now. I will be anxious to see who it is, and what their answer to this mess is. I will be waiting with bated breath to see how THEY would come up with 60 votes for frickin' anything in this climate.

I am an inhabitant of the real world, and all I can deal with is what is. Given what is, this bill, in whatever form it takes, will be better than what we have now. I don't want to wait another 15 years before it gets addressed again if it is defeated. There are too many people that don't have that kind of time.

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In the interest of full disclosure, I HAVE one of those so called "Cadillac" health insurance policies, along with an association that will go to bat for me if they deny coverage. I also have the financial where-with-all to absorb a significant increase in the cost of my insurance and still be fine. The status quo, for me personally, would be just fine. But I am an American, and what hurts my fellow citizens hurts me. The letters I write and the e-mails I send threaten to disrupt my cushy little world, because I don't think the care I would get under single pay would be as good as what I have now. But I am willing to lesson my position to increase the likelihood others will get care.

I just don't see how holding out for the distant possibility that we might someday be able to come up with single pay from the get go rather than starting with less and continuing to work for that eventual outcome is realistic. WE AIN'T GUNNA GET SINGLE PAY IF WE ARE HAVING SO MUCH TROUBLE EVEN GETTING THIS.

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"I hate that the dems are in bed w/ the trial lawyers and won't even consider tort reform..."

That is corporate/Republican talking point horseshit.

The percentage of medical malpractice actions is in reality infinitesimal. "Tort reform" means:

Closing the courthouse door against the poor and injured.

The vast majority of court cases in the Federal courts are captioned:

Mega-Corporation v. Mega-Corporation.

Tort reform isn't aimed at and wouldn't have any impact on those cases -- or on the trial lawyers involved with them.

Where the tort reform is needed concerning medical malpraictice actions is in the medical industry: if that industry would clean up its own house, instead of protecting malpraticing doctors, the trial lawers and their injured clients wouldn't have to do it for the medical profession.

Instead, the medical profession spends mega-millions lobbying for tort reform -- closing the courthouse doors now barely open to redress for their fuck-ups -- in order to save not only a mere dime but also the asses of those malpracticing doctors.

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It's a nice essay in defense of the system we have in place, whereby Republicans take 3 giant steps backward, then Democrats nervously take one baby step forward, after which Republicans take 3 giant steps backward...

You get the picture.

This Kevin Drum quote from above is priceless: "They've basically coopted the insurance companies, the AMA, big pharma, AARP, and corporate interests by giving away goodies to all of them."

It's like, hey, that bully over there, you know, here's how you can pwn him. Give him what he wants!

Wow, why didn't we think of that sooner? The more we give them, the more they will be in our power. As soon as we've given them everything we'll have them just where we want them.

Nothing could be more brilliant.

No, actually. When influential players demand war, and get it; demand the freedom to rape the land, and get it; demand guarantees so they can play, risk free, with trillions of dollars of credit default swaps, and get it; demand privatization of what should be public services, like prisons, armies, waste disposal, schools and much more, and get it; when we give all this to them, we don't make them weaker, we make them stronger.

This isn't a difficult concept to grasp.

Health care reform is the new President's first big test. So far, it's a bill that protects Pharma, funnels new billions to private insurance companies but does little to regulate them, delivers an insignificant public option designed to fail, forces everyone to buy private insurance or pay a fine, pays lip service to health care quality, sets back women's reproductive rights and still doesn't cover everyone. It's questionable whether that can really be defined as progress.

In the middle of the end game, what does Obama do? He announces that he's not going to comment until the game is over. You say we have to have his back, but we can't find it, because he's not out front, where he should be. Or, perhaps, he's just content to feed the hand the bites him.

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Not out front? I seem to recall Obama traveling the country giving town halls, speeches, interviews, and a speech before the joint sessions of congress, and then being accused of being "overexposed" in the media. I, for one, saw him interviewed on just about every major network and some not so major. I saw him working his ass off, both in front of and behind the camera.

But that's okay. Some people prefer their bitter blindfolds to truth, any day of the week.

Health care reform, flawed though it may be, on DAY ONE, would protect people from being rejected for preexisting conditions, would protect people from having caps put on their lifetime coverage, would protect people from losing their health insurance because they lose their jobs, would enable young people to remain on their parents' policies until the age of 27--a terribly important aspect in this shakey economy--ALL OF THESE WOULD TAKE EFFECT ON DAY ONE; and all of these are CRUCIAL REFORMS, but that's okay, they don't matter because they don't fit into a liberal diatribe.

Me, I'm a pragmatist, and I have a daughter who could, pragmatically, benefit by more than one of those provisions, on day one, and THAT, my friend, matters to ME, and that is what health care reform is all about.

It's PERSONAL, it is not ideological.

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Deanie, it's personal to me, too. I have family members who could benefit and deserve to. But how is saying we've got to pass this abortion of a bill so I and mine can benefit so different from a Senator saying to himself, we've got to pass this mess so I can get more insurance PAC money?

No denial for pre-existing conditions? That's a very good thing. But there's nothing to keep insurance companies from doubling your premiums if you have such a condition, either, and that's a very bad thing. And that's the way this bill runs - more for the insurance companies, more for the drug companies, and sops for the people.

I think Obama's working hard, too. I admire and respect the man, and, of course, the tone of the White House has changed. I don't measure his leadership based on the time he spends on TV or in town hall meetings. I do expect him to stand up for the principles he articulated, the ones that gave us reason to elect him.

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Yeah, I remember that tour too where he refused to take any sold position, dropped the phrase healthcare reform from his lexicon and started calling it insurance reform and repeated at every opportunity that the public option was not essential to his plan and not even a major feature. I think of it as "the sold out tour."

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Sorry, should read "solid position" and not sold position.

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Fabulous Deanie, thank you so much for posting this. A while back I read something similar to what you have quoted from Mr. Begala (it probably was him but I can't remember) and it totally changed me about the debate. I also read someone getting so excited after the house bill passed because it was the closest we had come in a 100 years to health care reform and it got me excited. I have to keep reminding myself what Obama has said many times - he is the president of ALL Americans. I know that I sometimes think that the past 8 years were ALL rightwingernuts, ALL the time so now it's the progressives turn. I hope everyone that comes to TPM reads your post and reads about the history of SS. We are getting there. If we don't continue to support Obama who will? The republicans? Stop and think a minute (I promise that is all it will take) about what Shrub did the whole 8 years he was in office besides wage war? ONE thing people in 8 years - No child left behind. What is it you want Obama to do in 10 months?

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Actually, the George and Dick show accomplished so much more than just occupying Iraq and bogging us down in Afghanistan.

They stole an election.

They privatized everything in sight.

They deregulated everything they couldn't privatize.

They cut taxes for themselves and all their friends.

They turned the Justice Department over to Regent University.

They gave wing-nuts on the Supreme Court a durable majority.

They stacked every government agency and the Federal courts with right wing ideologues.

They accelerated the shipment of jobs overseas and the decline of the middle class.

They cheered on the so-called "sub-prime" debacle because it pumped bogus profits into so many friendly pockets.

The left our earth so much worse off than they found it.

So please don't think George Bush only accomplished one thing. He was, after all, a revolutionary President.


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Read the The Republican War on Science. A blow by blow account as to how the Bush administration made anti-science policy a directive as well. They used language like "junk science" to discredit anything that they didn't like.

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Right, and oh, I left out the legitimization of torture.

Actually, now that I think about it, George Bush was an extraordinarily effective president.

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Former Democratic National Committee (DNC) Chairman Howard Dean said Monday that Senate Democrats' healthcare legislation is so diluted it threatens the party's 2010 chances.

Appearing on MSNBC, the former Vermont governor and outspoken proponent of healthcare reform charged Democrats were "playing with dynamite in terms of dividing the party.”

"The big problem is the policy. This thing has been pretty watered down," Dean said during the interview, noting the House bill was "better" than the "decent" Senate bill. "Right now, it's about as watered down as it can get and still be a real bill. For example, there's really no insurance reform in this bill, already."

http://videocafe.crooksandliars.com/heather/howard-dean-democrats-are-going-rue-day-th

please note, the further watering down is just beginning in the Senate, and then further so in conference.

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Well then, let's water the thing and watch it grow.

We have to get something passed and get the ball rolling. I'm all for pressuring for reforms to keep a viable public option alive. So let's keep up the pressure to have real reform. But let's not short-circuit it. It's the 'all or nothing' mindset that's so maddening.

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Water it down further. Watch it grow. This can only be a good thing. Woohoo.

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OK, maybe it was a stupid expression, but derailing everything would be a catastrophe. Thanks for the derision, that really brings the conversation further along doesn't it? Do you feel better now?

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It is easier to add an amendment or change an existing law than it is to create that law in the first place. That is the point.

Once "healthcare reform" has a foothold in law, it can be augmented as time passes, more progressive lawmakers are installed, and this strange anti-Americanism all wrapped up in a red and white striped flag has passed into the dark night of forgotten history.

From the distant future we will look back in wonder at how we let such a small minority of our population rule the rest of us, and subject us to their pernicious economic Darwinism, the "survival of the fattest."

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are you implying that there are no current laws concerning healthcare, drug companies, or the insurance industry? Why aren't these laws simply amended?

or is it just the mandate that is important?

in changing these laws, once they are enacted, couldn't they be changed to an even worse configuration or repealed all together when someone who is against all govt programs is in office or the majority?

Sincerely, I'm curious about your opinion.

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Agreed, Indie Pro. The insurance companies, Pharma and their lobbyists will work 24/7/365 to further undermine whatever passes. Remember, there are regulations to write and supervisory agencies to staff and enforcement efforts to design.

Once we pass a weak bill, no matter what it says, our attention will wander on to the next thing and the health care industry will dig in for the long haul.

After all, we have laws on the books and treaties and even a constitution that outlaw torture. But we do it anyway.

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Hey Indie Pro. Thanks for the Dean link. I saw that too, and I was not encouraged at all by what he was saying. Then of course, I just read Brownstein's article newly linked on the TPM front page, and my head is spinning yet again....

http://politics.theatlantic.com/2009/11/a_milestone_in_the_health_care_journey.php

Check it out and let me know what you think about his take on the details. At the moment I'm still leaning toward thinking the Senate Bill is good enough to be worth passing.

I totally disagree with the idea we should fall in line and eat a shit sandwich served up by Lieberman and Nelson, etc. in return for a cloture vote. Sherrod Brown and others should be threatening the exact same thing from the other side (as the Progressives in the House are admirably doing) should Reid cave to those shitheels.

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Gong back to what I was saying yesterday, how is this not the "small steps" worth taking toward a far-off goal?

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I read it.

There is nothing in the pending legislation that ensures that any long term cost savings will be passed along to consumers (if there is, please point it out in the bill). The industry could just gobble up any savings. (the House had a provision that stated that something like 80% of premiums must go towards paying for actual healthcare, but that ends when the exchanges begin.)

The article seems to be a bolster to Baucus and conservative ideas concerning reform.

Conservative concerns are receiving plenty of attention in both bills. That seems to be the main concern.

Then there is this bit from the article:

No one can say for certain that these initiatives will improve efficiency enough to slow the growth in health care spending. Some are only pilots; others would affect only a small portion of providers' revenue from Medicare.

I believe something will get passed.

By passing something, the democrats will own any rising healthcare costs (Obama will all ready be into his second term when alot of this goes into effect, so his reelection will not hinge on its entirety). I think it behooves the party to think about that before they pass it, and worry a little bit about how this will affect everyone. Because if portions, like affordability and the PO are done poorly, why would the public look to the democratic party for the solutions to the problems brought on by bad (but incremental) legislation. It is noble to fall on your sword for a good cause, but you won't be around later to fight.

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Politically we will own the rising costs and the shitty economy in 2010 anyway. I think at this point scuttling the bill would do more harm than good, even if it is little more than a warmed over pile of poo.

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I understand your position.

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No, we really do not "have to" get something passed. The corrupt politicians who are selling our interests down the river "have to" get something passed and they "have to" make us believe that what is bad for our interests will be good for us someday, many years from now. Bah!

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Deanie,

I agree that we are much better off with Democrats in power than we would be with Republicans in power.

However, if progressives don't pressure the Democrats, we wind up with troop increases in Afghanistan, no ending of "don't ask, don't tell", no single payer, no public option, no ending of "too big to fail," Goldman Sachs types running our bailouts, a stimulus that's not big enough, etc. So respect and appreciate Obama - but yell like hell!

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I'm in your Amen Corner, tlees2.

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I agree wholeheartedly, but the best way to accomplish what we speak of here, to foment REAL change in the face of stilted reform, the upcoming 2010 election is the perfect venue for it.

FIND A PROGRESSIVE CANDIDATE WHO SHARES YOUR VIEWS AND VOLUNTEER FOR THEIR CAMPAIGN!

Whether they win or lose matters less than the pressure it puts on the very issues and how they are weighed and balanced by the general public.

The more we support candidates with progressive values, the more it moves the fulcrum towards the real center, instead of the imbalanced version we have now, that leverages Republican votes with so much more weight than Democrats, despite their majority.

I think Jnagyara's got the key in a comment above, we need to find candidates who will be willing to EXPOSE rather than cover-up the health insurance industry's malicious, pernicious Republican enabled advantages.

EVERY progressive candidate needs to make this a primary talking point, so the general public gets this message that is now relegated only to the blogs.

Sometimes, just a little Truth can clear up a whole cloud of deceit. If our candidates act as information providers, the public can only benefit.

FIND A PROGRESSIVE CANDIDATE AND VOLUNTEER FOR THEIR CAMPAIGN!

You will be glad you did.

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it's the best way to "yell like hell!"

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Good ideas, but we progressives (or liberals, in my case) ALWAYS think we're supporting candidates who believe as we do. That's because they tell us they do--before they get elected. Something happens when they start to drink the D.C water. Everything changes. They think "compromise" means giving in, and no amount of noise from the chattering classes is going to be heard.

They turn into their worst enemies, it becomes "politics as usual", and any thought of heroics or even idealism is locked away somewhere, pulled out only when needed for soundbites or for show.

And here we are. So where ARE those candidates? The ones who will carry with them the materials to help fix this country, and who won't drop them, break them, hide them, abandon them?

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Deanie - You deserve enormous thanks for your thoughtful, incisive, and compelling essay. It is particularly revealing to review the history of past transformational events in American society, whether they involved the end of slavery or the beginning of a new manifestation of social consciousness and caring in the form of Social Security to appreciate how primitive and incomplete were the initial achievements we now characterize as great and noble.

I use the word "transformational" advisedly, because the pending healthcare reform legislation, if implemented, and even if implemented in a further diluted fashion, would indeed be transformational in moving this nation toward a truly universal and affordable system of high quality health care of the kind most other major democracies have already achieved. It would be a triumph of enormous political and social consequence - one that would be literally lifesaving for thousands of Americans.

I say this having spent many dozens of hours familiarizing myself with the proposals, and dozens more learning about the nature of U.S. healthcare and the character of healthcare systems elsewhere around the world. The proposals have faults - many of them - but the virtues greatly outweigh the faults. I understand the frustrations of those whose hearts are in the right place, and who lament the imperfections and weaknesses in what is proposed, but I also believe that if these individuals were willing to spend another thirty to forty hours reviewing the evidence, they would recognize the transformational character of what we are on the threshhold of achieving.

One reason I recommend reviewing original materials - e.g., reading the House of Senate bills rather than what someone else claims about them - is that much secondary information is slanted or misleading. The insurance reforms proposed are a huge step toward correcting current inequities - they eliminate exclusions for preexisting conditions for example (and despite some claims attributed to Howard Dean, prohibit the charging of discriminatory rates to individuals with those conditions). They prohibit arbitrary recisions, excessive deductibles or copays, lifetime or annual caps on coverage, or insurance packages deficient in essential medical benefits. And they take a major step toward universal coverage, with its promise to preserve health and lives now lost from the lack of insurance.

A public option, if included, would add value to the insurance reform, but its importance has been substantially overstated in my view by those who have converted it from a policy into a religion. I hope a reasoable public option remains in the final bill, but reform without it would remain transformational.

The bills take only modest steps toward correcting the largest problem with U.S. healthcare, which is not within the insurance sector but within healthcare itself - a chaotic, disorganized, duplicative, and overpriced health delivery system that is setting us on an unsustainable course towards unafforability for most Americans. The steps include a variety of bundling mechanisms, including accountable care organizations, "medical homes", various other contractual arrangements as alternatives to fee for service, as well as a shift in emphasis away from specialty referrals to primary care and preventive medicine. The proposed steps are limited in their extent, and this, rather than insurance reform weaknesses, represents the most serious inadequacy within the proposals. Nevertheless, they are a fine start, and can be expanded once the bills become law. We're almost there, and it will be important not to let impediments prevent us from completing the task.

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What about the very real concerns that this bill will do nothing to control costs in the short term, leading to a bad day for the Democrats next November, and possibly beyond?

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Basically, is this shit sandwich going to show enough benefits in the near term to be worth all this political heartburn?

Doesn't seem like it, but what else is there to eat?

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Not sure the taste is shit. Close. More "plastic" I think. Kind of tastes like old dollar bills too.

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That's a good point, Dorn76. Healthcare costs are rising much faster than inflation, and even if "cost control" were to operate in the short term, we would still see rising costs, except that they wouldn't be rising as fast - not a great political slogan to run on. And you're right - in the short run, we wouldn't even see much cost control, because the insurance Exchange, with or without a public option, would not begin until 2013 (House version) or 2014 (Senate version).

The more important elements of cost control - constraints on the overpriced cost of healthcare itself (hospitals, physicians, drugs, laboratory tests, etc.) will only proceed incrementally over more than a decade and will also remain relatively inconspicuous in the short term, even though their implementation would start immediately after reform becomes law.

In essence, the benefits of reform will not soon be apparent to most people in regard to costs. On the other hand, we would quickly see an improvement in the availability of adequate healthcare coverage for millions of Americans in the form of high risk pools that are designed as interval measures until the establishment of the insurance Exchanges. We would also perhaps experience a political benefit in the sense that most people would become aware, even before reform is fully implemented, that coverage in the future would no longer be at the mercy of arbitrary insurance industry caprice, but would be guaranteed, and that sense of security would be a benefit.

Finally, as Deanie suggested above, the passage of significant healthcare reform legislation over the resistance of fierce Republican opposition would be seen as making the Administration and Congressional Democrats into "winners" in a nation that admires winning. Maybe that would offset the lack of obvious evidence that much was happening to keep costs down. If the economy itself is rebounding and unemployment is receding by the next election, the combination could be good news for Congressional Democrats. If the economy is still very bad...

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Oh Fred, I can't thank you enough.

I've been plowing through the comments, wondering for a time there how we got off onto the Emancipation Proclamation, and then wondering how it is that the comment section somehow turned into an entire blogpost on the Obama presidency itself, re torture, the war in Afghanistan, domestic spying, and so on...and then we meander on back to the topic at hand, and the debate is stimulating, but predictable in many ways, and then you come along.

Of all the comments I've read, not just here, but over at my own blog, Blue Inkblots (http://deaniemlls.com) and on FaceBook and other places where this post is showing up, I'm told, this is the most thorough and informative, because you went straight to the source.

Consequently, you really made my case for me, in that, yes, it may be flawed, but OMG--LOOK WHAT WE HAVE GOT anyway!

This IS a major achievement, flaws and all.

It is not that I don't feel the anguish of progressives everywhere--do I not have the heart of a progressive myself? Geez, I wish we had a FRENCH health care system for Chrissake! I saw Michael Moore's movie! My daughter lived in London for a year, and when she got sick, she saw a doctor, no problem, even though she was not a British citizen, and it cost her nothing. OF COURSE I wish we could have that here!!!

But what we have is appalling, and this is the closest we've come in 70 years to having anything better. This is the sad, pragmatic truth of it.

If we kill this thing now because it is not all we'd hoped, it will not be resurrected again for an entire generation, I guarantee that, and everyone here on this comment section who is so bound and determined to fight for perfection would, I guarantee also, live to regret that we lost our only chance for something, somehow, that would have made at least a small difference.

I know this because of what Paul Begala and Hillary Clinton and all the rest have said.

They lived to regret it.

We cannot do so again.

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I'm with you, Deanie...I just don't see how scrapping everything we have and taking our marbles home in hopes of coming back with single pay next year is anything but a pipe dream...If we don't have the votes now, we sure as heck aren't going to have them next year or the year after.

I can't figure out how these "gotta have it now" folks think it can be done. There just aren't enough of us. And we're doing better now than we've been in a long time, with the wolves at our heels...In all likelihood we are going to lose seats next year, and more two years later. We have our foot in the door. I don't think we can pull it out now.

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Good God.

Yeah, supporting Obama's present agenda is JUST like Rosa Parks... and Andrew Goodman... and Betty Friedan.

Come on down to Andrew Goodman's House Party!

Bleah.

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Don't call me "boys and girls." I can read without your condescending attitudes.

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"I don't give a damn whether you're so liberal you wear leaves for shoes to keep from hurting cows or so conservative you recoil at the idea of a public ANYTHING...we are SOOOOOO close, guys, to literally changing history, that we cannot, we WILL NOT...blow it at this point by bickering amongst our little Democratic selves because we're not getting every single little itty bitty solitary thing we want in a health care bill or any other bill that is before congress these days."


You don't give a damn not only for shoes, leaves and cows, you don't give damn for people that have cancer, can't afford their diabetes medicine, lost their house after the operarion.

Right. You don't give a damn. And fixing these "little itty bitty" things is just some whim. Right?

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That's clearly not what Deanie said. She clearly provides a broad historical overview and therefore is looking at the longer term.

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Kali Star, I'm sorry if you thought I was being condescending or patronizing in any way; that was not my intention.

HOw on earth you took those comments to mean that I did not care for people with cancer, diabetes, or who had lost their homes is a bit mystifying to me, however. You assume a great deal. You assume, for example, that I have had no illness in my own family--perhaps if you'd read the post, you'd have seen that my daughter does not have health insurance.

You are assuming that our family has not been touched by the combination of illness plus no health insurance.

You would be wrong. Now who is being condescending?

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P.S. Just for the record, our daughter is happy, healthy, and strong.

But there have been times in the past that our family has indeed been touched by one or another of our members not having health insurance and going through serious health crises; this is very real to us, and to me.

I dare say if you interview just about any family in this country you would find the same thing to be true.

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Deanie Mills

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