Update below.
If you were hoping for meaningful healthcare reform this year, the chances just diminished, a lot.
This NYT article depicts Congressional Democrats working on healthcare reform as leaderless and in near panic over how easily the Republicans conned them on the CBO cost analysis and how quickly the Republicans misrepresented that incomplete analysis to disparage the entire health reform effort.
Was it Casey Stengel who said, "Doesn’t anyone know how to play this game?"
The article is bad news from end to end. But you have to read through to the end to discover that HHS Secretary Sebelius wasn’t off on her own when she told the AP that Obama was open to compromising the public health insurance option that, if robust enough, could have held most of his reform priciples together. Obama is saying the same thing Sebelius said, and in the process, he almost threw the Kennedy plan under the bus:
White House officials pointed out that the health committee bill was just one of several proposals and sought to keep the focus on President Obama’s larger goals.
Mr. Obama, moving aggressively on the issue, sent out an e-mail message to supporters to raise money for a grass-roots campaign in support of the health care legislation. And in an interview with CNBC and The New York Times, Mr. Obama expressed a willingness to compromise on his call for a new public insurance plan to compete with private insurers.
“We’re open-minded,” Mr. Obama said. “If, for example, the cooperative idea that Kent Conrad has put forward, if that is a better way to reduce costs and help families and businesses with their health care, I’m more than happy to accept those good ideas.”
Now, maybe Obama is just stating his usual "I’ll listen to any good ideas" mantra. But he didn’t say, "the co-op idea needs to be vetted; we need to know that it would meet the following principles and actually work, and those questions [e.g., these] need to be answered before I accept that as a viable concept, let alone a substitute for a robust public option." Instead, he sent a signal to Congress, intended or not, that this is the compromise he’s leaning towards.
So what does this mean? As I noted here, the most informed public plan proponents, like UC Prof. Jacob Hacker, have patiently explained that the co-op concept doesn’t achieve the President’s objectives, because it can’t impose genuine competition on the health insurance industry. Without either effective competition or strong government oversight and prodding, features that Conrad’s proposal explicitly withholds, there’s little chance that efficiency, cost-cutting, or health care improvements will occur. But apparently the White House doesn’t agree, or doesn’t get it.
And Ezra Klein, who’s initial take was that Conrad’s proposal "might work," explains it’s not a public plan. He observes that accepting the co-op concept as a substitute for a robust public option is already compromising in the wrong ballpark:
As Rep. Lynn Woolsey argued to me last week, to liberals, a public plan along Rockefeller’s lines is a compromise from single payer. And a public plan along Sen. Chuck Schumer’s (D-N.Y.) lines would be a compromise from Rockefeller. And a co-op plan along Conrad’s lines would be a compromise from Schumer.
In other words, the co-op idea, whatever its many merits, is not a compromise between liberals and conservatives. It is a compromise between, on the one side, conservatives who don’t want any nonprofit competition for insurers, and on the other side, Schumer’s proposal, which is already a compromise of a compromise of a compromise.
I spent 20 years in another life crafting/shepherding economic regulations through approval, and sometimes companion legislation, and I know you eventually get to where you have to swallow hard and make tough compromises. But we weren’t there yet, not even close.
This could have been, and perhaps could still be, a good fight, a worthwhile struggle to improve health care in America, reduce the outrageous behavior of private insurance companies, and extend decent health care to everyone. There are legions of us ready to make that effort.
But the White House and leading Democrats seem unwilling or unable to lead that fight, despite having overwhelming public support for a public option and government action to control private insurance behavior. I can’t think of any reason why we should support their misguided efforts unless/until we see signs that someone in DC actually gives a damn.
Update: Jane reports that we can’t even get the public plan into Kennedy’s HELP Committee bill — another brilliant strategy leaving it out of the draft — because Senators Bingaman [Update: per Jane, Bingman's office says he supports strong public plan] and Hagan have bought off on the Conrad co-op idea, while the WH looks on.
More:
HuffPo’s Bob Cesca compiles all the polls showing strong support for the public option; and read the bear ripped off my face but my insurer won’t cover me story!





44 Comments
Spotlight
Support this site!
Subscribe to the newsletter
Advertise on Firedoglake
Send
us your tips
Make us your homepage
About The Seminal
Advanced search
bernie sanders gives a damn
As I’ve said here before, name one piece of federal legislation enacted since 1974 (end of Nixon’s administration) that has benefited ordinary Americans.
Can’t do it.
Obama’s job of screwing ordinary Americans is easy. We’re well-conditioned.
“Doesn’t anyone know how to play this game?”
That assumes the game is achieving your stated goals. If the game is being forced to acquiesce, to give in on a change he has no heart for because he values “consensus” more than change, it is winning. But that would be putting tactics over substance, the short-term needs of Congressional politicians ahead of the needs of citizens. Oh, never mind.
Yes, he does.
We want George Bush back.
No, we don’t. I want Obama to put up a fight for decent public policy that he himself has supported. If we lose, we lose, but let’s make the fight.
You’re shocked?
He’s taken a sharp right turn ever since Hill dropped out. He used the people who he needed to use and cast them away quicker than used kleenex. I thought he was different because I wanted to believe, but after his FISA vote where he pretty much said ‘f*ck you’ to all the progressives I began to have doubts. Then had hope for him at election time, but after he named his cabinet sans progressives I knew he was nothing more than any other politician
This is par for the course
This is just Obama saying ‘f*ck you’ again, only in prettier words
We lost this battle when we accepted the “public plan” meme… not one of which ever included the entire public.
I feel like I am watching the Bush Rove-speak years all over again.
i think you are exactly right. it’s a campaign slogan, not a policy.
NO!
”Without either effective competition . . . there’s little chance that efficiency, cost-cutting, or health care improvements will occur”
time to apply that principle to the stifling monopoly that the (D) Party imagines it has on the support and loyalty of everyone left of Lieberman.
because, without effective competition, it will be more of the same.
i want obama to fight for the plan he campaigned on and i want progressives to fight for the single payer policy they were all supporting a couple of years ago.
instead almost everyone has taken a step to the right. this is a nightmare.
In a rational society, you look at the horrors of the current system, look at its unsustainable/escalating costs, count the millions of uninsured and the millions more of under/fraudulently insured, and conclude that we needed reforms to achieve universal coverage using an affordable approach that provided decent care for all. You’d then survey the systems out there and realize that most countries have solved this problem in a very different way.
Then you’d look at your own system, realize that getting from there to where you’d like to be would require a tremendous effort. You’d decide either to go for the desireable system directly, and work to deal with the transitional problems, or you’d start a longer transition to get there by putting in place each of the elements of the eventual system. I could handle either approach. But we didn’t do that, and that, IMO is where the effort went badly off the rails.
well, since bernie sanders does give a damn, i’m supporting him. if anyone want to join me, all it takes is signing his petition (he’s got a great statement at the link too):
A PETITION TO CONGRESS
Supporting Single-Payer Health Care
Over the last few months I let my auto insurance expire. Now that I am about to reinsure myself… I compared my perfect driving record and almost identical vehicle with that of my neighbors. Because I am forced by law to buy private auto insurance I will pay at least 700 percent more than him for the next six months.
Unless I remain very poor.. akin to poverty level I would imagine we are all heading to the same scenario with healthcare for the foreseeable future.
I think we need to be very prepared to say NO to all of the above as the vote nears.
“Obama is saying the same thing Sebelius said, and in the process, he threw the Kennedy plan under the bus”
Maybe Ted is regretting throwing Hillary under the bus for Obama about now….
there are a bunch of people who have been doing just that for years, people like those at pnhp, the problem was that they and their expertise were specifically excluded from the discussion.
an example of one those people is dr. david himmelstein – associate professor of medicine at harvard, coauthor with elizabeth warren on bankruptcies studies, and pnhp co-founder. (bill moyers had him on recently).
If President Nelson and President Collins can determine how much stimulus you got, why can’t President Conrad and President Landrieu determine how much health care reform you get?
That’s what Senators do.
I couldn’t agree with you more. And I can’t thank you enough for your diligence on this mess.
So please, please, please explain to me again how everything is going to be fine because of Obama’s super secret plans? The man came off of his inauguration with an unbelievable amount of political capital and public support and that led him to forcefully and decisively do . . . what?
Short sheet the economic stimulus right out of the gate, give the banksters all they could ever have dreamed of while leaving American voters in debt pain and foreclosure suffering, continue and increase the horrific Bush policies regarding the wars and the imperial executive, leave the unions high and dry, throw the gays under the bus, and now it looks like any chance of meaningful reform of healthcare is a pipe dream (which I knew the moment they named single payer verboten).
Obama is pleasant, charming, and attractive and I respect and values, his family, and his ideals. His leadership skills are missing in action and sorely wanting thus far, however, and his fetishization of bipartisanship and compromise combined with the weenie Democratic members of congress has left him vulnerable to daily, if not hourly, upheavals courtesy of the dwindling, hateful, nearly meaningless Republican party, which is actually running the show thanks to Blue Dog turncoats and Obama’s lack of ability to reign in his party or guide legislation forcefully by appealing to the American people directly. He is still betting the store on his theory of compromise and it will cost us dearly in the end. The repugs don’t play fair. End of story.
I really had hopes that he had enough spine and gumption to stand up to Washington and bring change but I am now beginning to think that I let myself be fooled. I pray I am wrong but I’ve yet to see anything tangible that shows that Obama can master the congress and legislative process for anything remotely Democratic in nature, let alone progressive.
On every issue that is important to me Obama and his administration have moved to the right. Let’s face it our government is no longer responsive to the people. They are bought and paid for by corporate America and they will only pass legislation that helps corporate America. Our DOJ no longer cares about the rule of law. It was politicized under Bush and from what we’ve seen so far it’s politicized under Obama. I wish we could get 500,000 people to march on Washington and stay there until we get a criminal investigation of Bush & Co. and until we get REAL health care reform. If Iranians can risk death to protest what the hell is wrong with us?
Thanks for the link to the petition, Selise. I signed it but to be honest I don’t think the powers that be give a damn how many people sign. They are hell bent on not reforming health care and unless we can figure out a way to scare the heck out of them we are doomed.
Barack the Cowardly Lion strikes again. sigh.
If Obama and the DEMs fail to get a public plan, I doubt Obama and the DEMs will have much support next time around. He promised us a public plan in the campaign. We expect to honor this promise.
Nightmare? Didn’t you get the memo. It’s “pragmatism.”
Considering only the topics which are inside the sphere of consensus to ensure that incrementalism only incrementally promotes the status quo. It’s just smart politics headed by a truly strident master politician.
13 people were willing to get arrested (including some doctors and nurses) at senator baucus’ hearings. imo, the least we can do is have their back.
pragmatism and savvy:
pragmatism and savvy ARE my nightmare.
To pursue Bush-era policies and prerogatives without taking the beating in public opinion that Bush did, and even get whole scads of “liberals” to join in on the fun?
I’d hardly say his leadership skills are lacking. Just look how quickly he managed to get his supporters to outright abandon all their purported positions exactly like he did.
I see we’re thinking of exactly the same condition :-)
three years ago single payer was at the center of the sphere of consensus in the progressive blogosphere. now it’s not even acceptable in the circle of legitimate debate. to anyone who has been paying attention, it’s really clear how that happened.
http://journalism.nyu.edu/pubz…..ation.html
We have to stop saying that Obama loves bipartisanship. He doesn’t. He’s a conservative, plain and simple. Also, he lied. There’s nothing much more to be said about him. (Well, if you insist, he’s a Tony Blair-style “Third Way” pollie, which is basically a conservative who doesn’t hate gays and hippies, but certainly isn’t going to do anything for them.) He’s not the answer. The Democrats are not the answer.
Here’s the youtube
http://www.youtube.com/watch?v=jS7hi6N0K4s
Single payer is off the table because the “progressive blogosphere” isn’t even close to progressive. It’s chockers with well-meaning centrists who have health insurance.
Yep, same essay I had on my brain.
I’m not really sure I see why it is that the blogosphere has electively re-atomized itself; other than this weird peasant mentality Americans have, so long as it’s perceived that “their team” is in power.
What’s your take on how single-payer got shoved outside legitimate debate by the very same people who have spent years promulgating it?
btw, dr. david himmelstein (see my comment @17) doesn’t think a public plan can work. and neither does nick skala. from skala’s presentation to the house progressive caucus:
it was done by ignoring single payer (bills, research, etc), by treating advocates as stupid or extremists and by using the language and branding of single payer to confuse and conflate it with the “public option”
the question i have is why. some background here (see especially links at the bottom):
http://www.healthcare-now.org/…..ding-hcan/
and here:
http://www.pnhp.org/blog/2008/…..stened-to/
I wonder.. will Americans still be going bankrupt from healthcare costs when all is said and done this year?
if we are, i expect david himmelstein and elizabeth warren will still be studying it.
http://oxdown.firedoglake.com/diary/5607
Recalling Kennedy’s glee over signing No Child Left Behind into law, I feel really let down in reading the HELP committee bill. It was left to Sen Burr to bring up Obama’s letter urging the public plan option, none of the Dems did that. Burr also spoke about the ERISA components in the HELP bill. I wondered why that was applicable…guess it’s in there to put employers in some type of strait-jacket. Aarg, there’s a lot for the committee to straighten out in the days ahead.
It means we’re f*cked. Because everyone who can do something is either out here in the cold with us, or bought by the insurance companies.
signed it yesterday, when i got the email.
thanks for spreading the word.
As I see it Pres. Obama is offering a fig branch and saying, “If we allow co-ops, then we still have to do more to lower costs. How?” I think it means Republicans have to offer more ideas or accept more of the Dem solution.
I propose using virtual groups (somewhat like a co-op) created automatically when a sufficient number of people sign-up for a plan via the Exchange and a ‘public option’ to subsidize people’s purchase of coverage from private firms (no gov’t-run plan) via the Exchange. I’d also like to see the gov’t define minimal plans the larger insurers would have to offer to entice more people to get coverage.
As you can see I don’t exactly approve of the gov’t forcing people to do things.
I read the Kennedy plan would only cover about 11M people. How’s that the right way to go?
Selise, Amen on Bernie’s proposal. Sent my vote already. Thanks for spreading the word.
Scarecrow, Glad to see the affirmation on Bingaman.
But so what; if in the end it’s all hopeless.
For those of us who are advocates for individuals in the local arena, it’s all the more reason to lose heart and say screw it.
Blessings to all