By Dave
We've been back in school so updates have been few and far between but much of this blog has been dedicated to following the health care reform debate. Tonight that debate has been laid to rest.
President Obama has been criticized by all sides over the last year and while we can't know the counter-factual, we do know that many have tried before and have failed. This history makes tonight all the more impressive. The House of Representatives acted boldly and courageously. It wasn't an easy vote. We don't know what November will bring although it is not hard to predict some Democratic losses, as almost every incumbent party loses seats during a midterm election.
So in the face of political repercussions, our elected representatives chose to do what was right instead of what was good for their individual reelection chances. That doesn't happen often. I'm really proud of them tonight and I plan to call my representatives tomorrow to personally let them know. I hope you will do the same.
Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts
Monday, March 22, 2010
Tuesday, January 26, 2010
The Memo House Dems Need To Read
By Dave
Steve Benen from the Washington Monthly wrote a memo to House Dems saying pretty much everything we've been saying for the last month. It's well worth a read. He recounts this useful piece of history:
Steve Benen from the Washington Monthly wrote a memo to House Dems saying pretty much everything we've been saying for the last month. It's well worth a read. He recounts this useful piece of history:
Kristol, however, noticed that his party lacked direction, and offered his vision as a way forward. His memo offered a simple and clear response: the GOP had to kill the Clinton reform plan at all costs. The merit of the reform proposal and its ability to improve the lives of Americans was deemed largely irrelevant — Kristol argued that a successful reform effort would position Democrats as the "protector of middle-class interests," a fate the GOP could not allow. The Republicans' principal goal, Kristol added, should be to focus on handing the White House a "monumental setback." (He declined to use the word "Waterloo," but the sentiment was hardly vague.)Yep. Sounds familiar.
The memo became the basis for the GOP strategy in 1994 — it remains the guiding principle of the Republican Party today — and was integral in killing what was thought to be the best chance at passing meaningful reform since the days of Truman. Clinton's approval ratings suffered dramatically; Democrats developed a reputation for being unable to deliver on their own agenda; and less than a year later, Democrats lost their congressional majority. Republicans, far from being punished for their obstructionism, reaped the rewards of health care reform's demise. (Indeed, the public blamed the White House and the Democrats for overreaching, grinding on for months, and having little to show for it — a task made easier when Democrats blamed each other in ways that played into the Republican narrative.)
Monday, January 25, 2010
Dear Dems...
By Wade
This letter's specifically for those Democrats and other folks who consider themselves left-leaning and have reached the top-tiers of our national government.
Firstly, please point the guns away from your feet, stop pulling the triggers, and set them down.
It is amazing to me the reaction that the past week has garnered from the lot of you. Dave and I were discussing this, and here's something important to think about: When you all won in 2006, remember how the Republicans all immediately hung their heads in defeat, shuffled across the aisle to you, and admitted in penitent voices that, "you guys were right all along."? No? THEN WHY ARE YOU SHOUTING IT FROM THE ROOFTOPS ABOUT THEM!?
The Republicans have proven over and over again that they don't care how much the country suffers as long as they're able to deny your legislation and make you look bad in the process. They are unwilling to cooperate or compromise. Every single play they make is a running-out-the-clock move. In the upcoming elections, they don't want you to be able to proudly say that you helped thirty million (30,000,000, look at all those pretty zeros) Americans achieve better health. They don't want you to be able to say that you helped tear down the Berlin Wall of pre-existing conditions. You are playing brilliantly into their hands with every in-fight, with every concession, every back-room deal that you think will maintain the favor of your constituents. I say look to Ben Nelson's example. Look at how his political game-playing has served him. Do you think he has a chance at re-election after the stunt he pulled with the health care bill?
The Republicans broadcasted their intent long ago: Waterloo. This entire thing has been their campaign against your collective re-election. You think the party of Strom Thurmond likes seeing President Barack Obama sitting in the Oval Office? How many times do they have to spit in your eye when you reach out for a handshake for you to realize what they're about?
Yes, this last week has been bad. Yes, the Fox Propaganda (and we have propagandists on the left as well, it is not in and of itself a bad thing) network has been your own personal Nostradamus, predicting doom, doom, DOOoooOOOoooOOOM! Don't lose sight of your strengths, your diversity of support, and the overwhelming mandates you've received in the last four years from your country. That should tell you, "Yes, we do support you." "Yes, we want you to succeed." "Yes, we believe that you can make our beloved country even greater."
Most of all: "Yes we can."
This letter's specifically for those Democrats and other folks who consider themselves left-leaning and have reached the top-tiers of our national government.
Firstly, please point the guns away from your feet, stop pulling the triggers, and set them down.
It is amazing to me the reaction that the past week has garnered from the lot of you. Dave and I were discussing this, and here's something important to think about: When you all won in 2006, remember how the Republicans all immediately hung their heads in defeat, shuffled across the aisle to you, and admitted in penitent voices that, "you guys were right all along."? No? THEN WHY ARE YOU SHOUTING IT FROM THE ROOFTOPS ABOUT THEM!?
The Republicans have proven over and over again that they don't care how much the country suffers as long as they're able to deny your legislation and make you look bad in the process. They are unwilling to cooperate or compromise. Every single play they make is a running-out-the-clock move. In the upcoming elections, they don't want you to be able to proudly say that you helped thirty million (30,000,000, look at all those pretty zeros) Americans achieve better health. They don't want you to be able to say that you helped tear down the Berlin Wall of pre-existing conditions. You are playing brilliantly into their hands with every in-fight, with every concession, every back-room deal that you think will maintain the favor of your constituents. I say look to Ben Nelson's example. Look at how his political game-playing has served him. Do you think he has a chance at re-election after the stunt he pulled with the health care bill?
The Republicans broadcasted their intent long ago: Waterloo. This entire thing has been their campaign against your collective re-election. You think the party of Strom Thurmond likes seeing President Barack Obama sitting in the Oval Office? How many times do they have to spit in your eye when you reach out for a handshake for you to realize what they're about?
Yes, this last week has been bad. Yes, the Fox Propaganda (and we have propagandists on the left as well, it is not in and of itself a bad thing) network has been your own personal Nostradamus, predicting doom, doom, DOOoooOOOoooOOOM! Don't lose sight of your strengths, your diversity of support, and the overwhelming mandates you've received in the last four years from your country. That should tell you, "Yes, we do support you." "Yes, we want you to succeed." "Yes, we believe that you can make our beloved country even greater."
Most of all: "Yes we can."
Saturday, January 23, 2010
Failure is Not an Option
By Dave
A plethora of health care opinions, all making the case for why we need to pass HCR, and all saying it better than I could:
William Galston
A plethora of health care opinions, all making the case for why we need to pass HCR, and all saying it better than I could:
William Galston
The Founders designed a representative republic, not a plebiscitary democracy. Officials are elected to make judgments on behalf of the people, and the people get to judge those judgments. Large changes are always more uncertain than is the status quo, which is why change is so hard. At some point, elected officials have to tell their constituents, “I’ve done my best to think this issue through, and this is the conclusion I’ve reached. Now it’s your turn.”Greg Sargent
But if Dems don’t pass reform, they will never have a chance to sell a completed package to the public — and to try to convince the public that they were right, and Republicans were wrong. People will never have a chance to decide that their fears about reform were unwarranted.Kevin Drum
Not passing reform won’t stop Republicans from attacking Dems for trying to jam an unpopular bill down the public’s throat. And failure would give Republicans more ammo, not less. It would allow the GOP to take credit for blocking the proposal, to present itself as an effective and relevant opposition, and to paint Dems — accurately — as ineffective and unable to lead.
This really is a defining moment for both Obama and the Democratic Party more broadly. So far both have failed miserably: the party is in a state of meltdown, surrendering completely to a resurgent Republican narrative, refusing to fight for anything it believes in, and caving in to a truly toxic combination of electoral fear and narrow interest group parochialism. For his part, Obama seems either unable or unwilling to rally his troops. I'm not sure which. But the American public really needs to hear some conviction from him, and so far they haven't. He's remained aloof from the healthcare upheaval, pivoted on financial regulation in a way that looks driven more by politics than by core beliefs, and has just generally sounded more chastened than reinvigorated.Think Progress
This really needs to turn around fast. Another week like this — hell, another day or two like this — and we might as well start measuring the Oval Office drapes for the upcoming Cheney/Palin administration. It's time for everyone to take a deep breath and grow a pair. Today would be a good time to start.
Trying to pass a scaled-back version of reform would drag out the process, fail to substantially lower costs or improve access, and do so without any assurance that it will be any more popular in Congress. Democrats therefore have two choices: pass an improved version of the Senate health care bill or abandon the effort altogether. If Democrats chose the latter, millions more Americans would go without health care and health care costs would continue to skyrocket. Politically, the Democratic Party will be ridiculed for talking a big game but delivering no results. They will lose their progressive base and outsource their agenda to the Republican minority — all simply because their supermajority of 60 shrank to 59.Paul Krugman
First of all, the strategy of playing Republican-lite, and hoping that you’ll be left alone, has been tried — and failed disastrously. Remember 2002?
Second, David Axelrod is right: the campaign against HCR has been based on lies, and the only way to refute those lies (and stop them from being rolled out again and again) is to pass the thing, and let people see it in action. It’s too bad startup is delayed under the Senate bill — but even so, that’s what you have to do.
Finally, Democrats have to realize that politics isn’t just about where you stand on issues, it’s about perceptions of a party’s character. The rap on Dems has always been that they’re wimps — and giving in on such a central part of the party’s agenda, emerging from two years in power with nothing major to show for it, will play right into that perception.
Just do it — pass health care. Then move on to confronting the bankers.Andrew Sullivan
This is about more than health reform and we have to see it in that context. This is about a cynical nihilist attempt to break this presidency before it has had a chance to do what we elected it to do by a landslide vote. It is an attempt to destroy a majority's morale, to break a president's foreign policy autonomy, to prevent engagement in the Middle East peace process, to stop action on climate change, to restore torture, to increase tensions with the Muslim world, to launch a war on Iran. We cannot delude ourselves that if Obama fails, this is not the alternative. It is.
And we have to re-engage as powerfully as we did in the campaign to fight back against these now emboldened forces of reaction. I think this is true not just for the sake of the country but also for the sake of the GOP. The nihilist obstructionism and rhetoric they have embraced makes constitutional democracy close to impossible. Their total lack of any workable alternatives to dire problems is a form of degeneracy we have to avoid empowering.
So fight, Mr President. And to the House Democrats who won't go along with the only way to salvage health reform: this is the only sure-fire way you will lose in November. If you pass this bill, you may also go down in this climate. But you will have done something you can be proud of. Politics cannot always be about narrow self-interest. If it always is, nothing important can get done.
Do your duty. And grow some. Fight back. Explain why you're right. Tell the liberals they can always come back later to reform the bill. Just get this passed.
Defending the Senate Health Bill
By Dave
A reader responds to this post:
Barney Frank is right and Dave is wrong. The Senate bill mandates everyone buy insurnace from the companies who have messed up the system and transfers about a trillion dollars to those companies. If this were to happen, I doubt the voters would look favorably on the Democrats.
The Senate Dems need to change the cloture rules so that business can be conducted with a simple majority and then pass progressive legislation.
Yes, the House Bill creates a public option for insurance. But it is exactly that, an option. People don’t have to use it and will only use it if it can actually provide cheaper service. Otherwise both bills call for an individual mandate, which is what I think the comment is talking about. So under both bills people will purchase insurance from the private companies. According to the CBO, even with the public option, the majority of people will still buy from the private sector.
But while the companies will still be private, the service they provide will be very different. New regulation in the Senate Bill provides for stronger medical loss ratios, excludes insurers who jack up premiums from the exchanges; prohibits excluding people based on pre-existing conditions and will immediately prohibit excluding children with preexisting conditions; ensures access to care by banning the use of annual limits; and it adds new patient protections and a guaranteed independent appeals process. It will add transparency by forcing insurers and providers to report on their performance.
But while the companies will still be private, the service they provide will be very different. New regulation in the Senate Bill provides for stronger medical loss ratios, excludes insurers who jack up premiums from the exchanges; prohibits excluding people based on pre-existing conditions and will immediately prohibit excluding children with preexisting conditions; ensures access to care by banning the use of annual limits; and it adds new patient protections and a guaranteed independent appeals process. It will add transparency by forcing insurers and providers to report on their performance.
The Senate bill does a lot to reform our system, to add morality and justice back into the picture, and it will force insurers to comply.
I don't really follow the comment about transferring insurance companies a trillion dollars. The bill actually gives people, that is America workers, mothers, fathers, and children, subsidies to help them buy insurance over the next decade. It’s true that money will end up with insurers, but at the end of the day those millions of people will also be happier and healthier. It’s kind of like saying food stamps are awful because they subsidize big Agri-business or saying we shouldn't subsidize the costs of medicine for seniors because we’re only subsidizing big Pharma. It’s true, I guess. But it neglects the fact that tens of millions will now have coverage and hundreds of thousands of lives will be saved over the course of a decade.
Krugman is right, believing that killing the Senate Bill will somehow move us closer to universal coverage is the underpants gnome theory of business.
However, I do agree that Dems should change the cloture rules. The filibuster has been too used and abused over the last year.
I don't really follow the comment about transferring insurance companies a trillion dollars. The bill actually gives people, that is America workers, mothers, fathers, and children, subsidies to help them buy insurance over the next decade. It’s true that money will end up with insurers, but at the end of the day those millions of people will also be happier and healthier. It’s kind of like saying food stamps are awful because they subsidize big Agri-business or saying we shouldn't subsidize the costs of medicine for seniors because we’re only subsidizing big Pharma. It’s true, I guess. But it neglects the fact that tens of millions will now have coverage and hundreds of thousands of lives will be saved over the course of a decade.
Krugman is right, believing that killing the Senate Bill will somehow move us closer to universal coverage is the underpants gnome theory of business.
However, I do agree that Dems should change the cloture rules. The filibuster has been too used and abused over the last year.
Thursday, January 21, 2010
Underpants Gnome's Health Care Plan
By Dave
Krugman explains the House Democrats plan:
For those not in the know:
Krugman explains the House Democrats plan:
It’s the Underpants Gnomes business plan. In its original form this was:
1. Collect underpants.
2. ?????
3. Profit!
The current version is:
1. Reject the only bill that can be enacted any time soon.
2. ?????
3. Universal coverage!
Sigh.Saddly, this looks like it might really be the case...
For those not in the know:
Don't Give Up, Call Your Representative!
By Dave
I've said time and time again that the Senate Bill is much better than the status quo. Those who support reform need to give Democrats more political coverage and remind them of the stakes. This is a come to Jesus moment for progressives. The Senate Bill is not getting any more progressive. We either take what we have (which is not a bad deal), or we accept nothing. If we accept nothing, we admit defeat. We admit Democrats are unfit to govern, that Democrats are weak, that the tea-partiers know what's best for America, that Republicans were more in touch all along, and we walk into a political bloodbath this November.
These are the political stakes. The moral stakes are higher. Insurance companies will continue to deny people based on pre-existing conditions, costs will continue to spiral out of control, more and more will continue to file for bankruptcy, the deficit will continue unabated until we are faced with the collapse of major entitlement programs, and more and more Americans will go without coverage. This is unacceptable.
I'm asking everyone to call your elected representatives and urge them to pass the Senate Bill. Go to this link for contact info.
Kevin Drum provides a helpful list of other Reps who could use a phone call:
I've said time and time again that the Senate Bill is much better than the status quo. Those who support reform need to give Democrats more political coverage and remind them of the stakes. This is a come to Jesus moment for progressives. The Senate Bill is not getting any more progressive. We either take what we have (which is not a bad deal), or we accept nothing. If we accept nothing, we admit defeat. We admit Democrats are unfit to govern, that Democrats are weak, that the tea-partiers know what's best for America, that Republicans were more in touch all along, and we walk into a political bloodbath this November.
These are the political stakes. The moral stakes are higher. Insurance companies will continue to deny people based on pre-existing conditions, costs will continue to spiral out of control, more and more will continue to file for bankruptcy, the deficit will continue unabated until we are faced with the collapse of major entitlement programs, and more and more Americans will go without coverage. This is unacceptable.
I'm asking everyone to call your elected representatives and urge them to pass the Senate Bill. Go to this link for contact info.
Kevin Drum provides a helpful list of other Reps who could use a phone call:
| Public Option | Blue Dogs |
| Earl Blumenauer (OR-03) Corrine Brown (FL-03) Andre Carson (IN-07) Judy Chu (CA-32) Emanuel Cleaver (MO-05) Mike Capuano (MA-08) John Conyers (MI-14) Elijah Cummings (MD-07) Bill Delahunt (MA-10) Lloyd Doggett (TX-25) Donna Edwards (MD-04) Keith Ellison (MN-05) Chaka Fattah (PA-02) Bob Filner (CA-51) Barney Frank (MA-14) Marcia Fudge (OH-11) Luis Gutierrez (IL-04) Alcee Hastings (FL-23) Maurice Hinchey (NY-22) Mazie Hirono (HI-02) Michael Honda (CA-15) Jesse Jackson, Jr. (IL-02) Eddie Bernice Johnson (TX-30) Hank Johnson (GA-04) Marcy Kaptur (OH-09) Carolyn Kilpatrick (MI-13) Dennis Kucinich (OH-10) Barbara Lee (CA-09) Carolyn Maloney (NY-14) Eric Massa (NY-29) Jim McDermott (WA-07) Jim McGovern (MA-03) Gwen Moore (WI-04) Jerry Nadler (NY-08) Grace Napolitano (CA-38) John Olver (MA-01) Bill Pascrell (NJ-08) Donald Payne (NJ-10) Chellie Pingree (MN-01) Laura Richardson (CA-37) Lucille Roybal-Alard (CA-34) Linda Sanchez (CA-39) Jose Serrano (NY-16) Albio Sires (NJ-13) Jackie Spier (CA-12) Pete Stark (CA-13) Bennie Thompson (MS-02) John Tierney (MA-06) Ed Towns (NY-10) Nydia Valezquez (NY-12) Maxine Waters (CA-35) Diane Watson (CA-33) Mel Watts (NC-12) Lynn Woolsey (CA-06) John Yarmuth (KY-03) | Jason Altmire (PA-4) Mike Arcuri (NY-24) Joe Baca (CA-43) John Barrow (GA-12) Robert Marion Berry (AR-1) Sanford Bishop (GA-2) Dan Boren (OK-2) Leonard Boswell (IA-3) Allen Boyd (FL-2) Bobby Bright (AL-2) Dennis Cardoza (CA-18) Christopher Carney (PA-10) Ben Chandler (KY-6) Travis Childers (MS-1) Jim Cooper (TN-5) Jim Costa (CA-20) Henry Cuellar (TX-28) Kathy Dahlkemper (PA-3) Lincoln Davis (TN-4) Joe Donnelly (IN-2) Brad Ellsworth (IN-8) Bill Foster (IL-14) Gabrielle Giffords (AZ-8) Bart Gordon (TN-6) Jane Harman (CA-36) Stephanie Herseth Sandlin (SD-AL) Baron Hill (IN-9) Tim Holden (PA-17) Frank Kratovil (MD-1) Betsy Markey (CO-4) Jim Marshall (GA-8) Jim Matheson (UT-2) Mike McIntyre (NC-7) Charlie Melancon (LA-3) Mike Michaud (ME-2) Walt Minnick (ID-1) Dennis Moore (KS-3) Patrick Murphy (PA-8) Scott Murphy (NY-20) Glenn Nye (VA-2) Collin Peterson (MN-7) Earl Pomeroy (ND-AL) Mike Ross (AR-4) John Salazar (CO-3) Loretta Sanchez (CA-47) Adam Schiff (CA-29) Kurt Schrader (OR-5) David Scott (GA-13) Heath Shuler (NC-11) |
Snatching Defeat from the Jaws of Victory
By Dave
A TPM Reader recounts their conversation with Barney Frank (D-MA):
I whole heartedly agree that if Democrats let HCR die, there will be disaster in November.
But Franks comments are illuminating. What is the problem here? Why won't House Dems pass the Senate bill? The answer: Democratic rank-and-file won't let them. It's our fault. We haven't given them the political cover.
Some Democrats, let's call them Hamsher Democrats, appear to be totally delusional. They talk as though they are oblivious to Senate politics. And so they lobby the House to hold a position that will ultimately yeild nothing for Americans. They say public option, or nothing.
Let's be clear, the Senate Bill will cover an additional 30 million Americans, begin to control costs, reduce the deficit, create stability for the unemployed, give access to those with pre-existing conditions, and add other regulations that will make our system more moral and just. But the Hamsher Dems say this just simply is not enough and when given the choice, they prefer nothing at all. They are out of their minds. If this sounds like your friend, coworker, spouse, or colleague, please, tell them to take a deep breath, look clearly at the political landscape, and stop hurting reform.
Tell them to, at least, recognize self-interest. If Democrats pass reform soon, they will face a difficult but manageable mid-term election. If they fold, or fail because of trivia, they might as well give the Republicans the keys back now, because it is all over.
A TPM Reader recounts their conversation with Barney Frank (D-MA):
I live in Barney Frank's district, and I called his office this morning. To my surprise, he took my call and I asked him why on earth couldn't the House simply pass the Senate version of the health care bill. He told me straight up that the votes weren't there to pass the Senate bill. He said that labor is totally against it, the abortion caucus is against it, and more than a few progressives were against it.
I asked him about Democrats' prospects in the 2010 election if they don't get something done on health care. He told me it would be worse electorally for Democrats if they passed the bill versus dropping it and facing voters having done nothing. I told him I disagreed with him on that point, but I suppose he knows more about this stuff than I do. I hope.
I whole heartedly agree that if Democrats let HCR die, there will be disaster in November.
But Franks comments are illuminating. What is the problem here? Why won't House Dems pass the Senate bill? The answer: Democratic rank-and-file won't let them. It's our fault. We haven't given them the political cover.
Some Democrats, let's call them Hamsher Democrats, appear to be totally delusional. They talk as though they are oblivious to Senate politics. And so they lobby the House to hold a position that will ultimately yeild nothing for Americans. They say public option, or nothing.
Let's be clear, the Senate Bill will cover an additional 30 million Americans, begin to control costs, reduce the deficit, create stability for the unemployed, give access to those with pre-existing conditions, and add other regulations that will make our system more moral and just. But the Hamsher Dems say this just simply is not enough and when given the choice, they prefer nothing at all. They are out of their minds. If this sounds like your friend, coworker, spouse, or colleague, please, tell them to take a deep breath, look clearly at the political landscape, and stop hurting reform.
Tell them to, at least, recognize self-interest. If Democrats pass reform soon, they will face a difficult but manageable mid-term election. If they fold, or fail because of trivia, they might as well give the Republicans the keys back now, because it is all over.
Tuesday, January 19, 2010
Democrat's Implode, Blame Each Other and Decide They Aren't Fit to Govern
By Dave
Well, as predicted, Brown won tonight in MA and the Democrats will lose their 60th vote in the Senate. This isn't the worst news in the world. The Democrats still have a sizable majority and they still have time to make the HCR reform a reality.
The worst news in the world is that congressional and senate Democrats have decided now is the time to admit defeat and lie over on their backs.
See if Dems had any backbone or spine, they could use the next fifteen days until Brown is seated to quickly hash out their differences and pass a conference bill.
But instead we get Democrats like Jim Webb (D-VA) who say stuff like this:
51% of Massachusetts voters does not equal a national referendum on health care. You've been working on this for over 9 months, get it done already. Now! The bill you are now abandoning will improve the deficit. It will begin to control health care costs. It will expand coverage to an additional 30 million Americans and it will give new access to people with pre-existing conditions. The American people will respect you when you pass reform and explain to them in clear language what it will do for them.
Fourteen months ago, the American people entrusted Democrats with control of both houses of Congress and the White House. Sen. Webb has all but said that they don't deserve any of it. According to Sen. Webb, we can restore "the respect of the American people in our system of government and in our leaders" by killing the centerpiece of the Democratic legislative agenda. Way to go, Webb!
This is what my head feels like:
Since Sen. Webb has decided to cripple reform in the Senate until the Republican, who opposes reform, can be seated, the only option still available is for the House to pass the Senate Bill, as is, and then try to hash out their differences at a later date, maybe with a reconciliation bill. But it's hard to read how open this path is.
We have optimistic statements from Speaker Pelosi:
I don't get it. Don't Democrats understand that this is the choice between necessary and important reform or total, complete, abject failure?
Failure on HCR means more people will continue to suffer in our broken health care system. No cost control, no reduction of the deficit. It means that even with the greatest majority since the time of LBJ, Democrats can't accomplish their most important legislative agenda. With failure, you tell the world you are unfit to govern. If you fail, you will lose the base and you will lose the center. It means an stronger, more energized opposition. Failure now means failure next November.
For God's sake, pass the Senate Bill in the House. Claim victory and move on. Stop asphyxiating your party with inaction, cowardice, and incompetence.
Well, as predicted, Brown won tonight in MA and the Democrats will lose their 60th vote in the Senate. This isn't the worst news in the world. The Democrats still have a sizable majority and they still have time to make the HCR reform a reality.
The worst news in the world is that congressional and senate Democrats have decided now is the time to admit defeat and lie over on their backs.
See if Dems had any backbone or spine, they could use the next fifteen days until Brown is seated to quickly hash out their differences and pass a conference bill.
But instead we get Democrats like Jim Webb (D-VA) who say stuff like this:
"In many ways the campaign in Massachusetts became a referendum not only on health care reform but also on the openness and integrity of our government process. It is vital that we restore the respect of the American people in our system of government and in our leaders. To that end, I believe it would only be fair and prudent that we suspend further votes on health care legislation until Senator-elect Brown is seated."Are you fu*&^ing kidding me!? What bullshit! How dare you abandon the American people!? How cowardly. How disgusting.
51% of Massachusetts voters does not equal a national referendum on health care. You've been working on this for over 9 months, get it done already. Now! The bill you are now abandoning will improve the deficit. It will begin to control health care costs. It will expand coverage to an additional 30 million Americans and it will give new access to people with pre-existing conditions. The American people will respect you when you pass reform and explain to them in clear language what it will do for them.
Fourteen months ago, the American people entrusted Democrats with control of both houses of Congress and the White House. Sen. Webb has all but said that they don't deserve any of it. According to Sen. Webb, we can restore "the respect of the American people in our system of government and in our leaders" by killing the centerpiece of the Democratic legislative agenda. Way to go, Webb!
This is what my head feels like:
Since Sen. Webb has decided to cripple reform in the Senate until the Republican, who opposes reform, can be seated, the only option still available is for the House to pass the Senate Bill, as is, and then try to hash out their differences at a later date, maybe with a reconciliation bill. But it's hard to read how open this path is.
We have optimistic statements from Speaker Pelosi:
"Whatever happens in Massachusetts, we have to do that," she said. "And whatever happens in Massachusetts we will have quality affordable health care for all Americans, and it will be soon."And not so optimistic statements from Rep. Barney Frank:
I have two reactions to the election in Massachusetts. One, I am disappointed. Two, I feel strongly that the Democratic majority in congress must respect the process and make no effort to bypass the electoral results. If Martha Coakley had won, I believe we could have worked out a reasonable compromise between the House and Senate health care bills. But since Scott Brown has won and the Republicans now have 41 votes in the senate, that approach is no longer appropriate. I am hopeful that some Republican senators will be willing to discuss a revised version of health care reform. Because I do not think that the country would be well served by the health care status quo. But our respect for democratic procedures must rule out any effort to pass a health care bill as if the Massachusetts election had not happened. Going forward, I hope there will be a serious effort to change the senate rule which means that 59 are not enough to pass major legislation, but those are the rules by which the health care bill was considered, and it would be wrong to change them in the middle of this process.
I don't get it. Don't Democrats understand that this is the choice between necessary and important reform or total, complete, abject failure?
Failure on HCR means more people will continue to suffer in our broken health care system. No cost control, no reduction of the deficit. It means that even with the greatest majority since the time of LBJ, Democrats can't accomplish their most important legislative agenda. With failure, you tell the world you are unfit to govern. If you fail, you will lose the base and you will lose the center. It means an stronger, more energized opposition. Failure now means failure next November.
For God's sake, pass the Senate Bill in the House. Claim victory and move on. Stop asphyxiating your party with inaction, cowardice, and incompetence.
Monday, January 18, 2010
Pointing Fingers
By Dave
Bernard Avishai at Talking Points Memo vents:
The real villain has been the Republican Party of No. They made this awful mess we're in. They spent like no tomorrow and caused massive deficits. They illegally wiretapped US citizens. They instigated, not one, but two failed wars. They created secret, illegal torture programs and even now they call for even more torture and more war. They scoffed at global warming and fought against science. They gave the rich tax breaks while cutting programs for the poor, and then had the audacity to sit lazily back when New Orleans drowned. For eight years, they wasted our time and money with their corruption, lies, and downright incompetence. Americans should hate their guts. But they don't. Conservatives have one advantage. To them politics is war. They admit nothing and give no ground. They know what flag they fight under. Most importantly, they will do anything to resume power.
If we hope to defeat this, Democrats need to rally. They need to find a home under the 'big tent' and they need to find room for others. Stop fighting. Stop pointing fingers at conservative, or liberal, or progressive Dems. If they are willing to work towards the same common goals then we are going to need all of them.
Most of all we need to stop moping because things didn't turn out as idyllically as we had dreamed. Yes, it's true. Health care reform will not usher in a utopian age of health and wellness but it will make things a hell of a lot better than they are today. We've already made huge strides in putting America back on track. Feel good about it. Spread the word. Get back in the game because losing is not an option. Not if you care about the future of our country.
Bernard Avishai at Talking Points Memo vents:
I wish I had a bluefish dinner for every time Coakley referred to the health package as "not perfect." It all came out so forced and fake.
The real question Democrats have to ask themselves is: how come the greatest piece of social legislation since Medicare is something a progressive Democratic candidate for Ted Kennedy's seat has to speak so defensively about?
And we can look no further than Howard Dean, and MSNBC, and Arianna Huffington, and, yes, some columnists at the Times and bloggers here at TPM--you know, real progressives--who have lambasted Obama again and again since last March over arguable need-to-haves like the "public option," as if nobody else was listening. They've been thinking: "Oh, if only we ran things, how much more subtle would the legislation be," as if 41 senators add up to subtle. Meanwhile the undecideds are thinking: "Hell, if his own people think he's a sell-out and jerk, why should we support this?"Avishai's frustration is understandable. It seems the Democratic 'big tent' coalition cracked against the unity of the GOP opposition. Unfortunately, and somewhat predictably, Dems began to turn on each other. Unfortunate, because it took conservatives years to eventually turn against Bush. It only took liberals ten months. It's predictable because divide and conquer was their strategy. We've been demoralized because every issue, even the simplest, has required a supermajority to pass. We've been disheartened because logic and reason have been thrown out the window and craziness wins in the 24-hour news cycle. This was their plan all along, and somehow we didn't see it coming.
The real villain has been the Republican Party of No. They made this awful mess we're in. They spent like no tomorrow and caused massive deficits. They illegally wiretapped US citizens. They instigated, not one, but two failed wars. They created secret, illegal torture programs and even now they call for even more torture and more war. They scoffed at global warming and fought against science. They gave the rich tax breaks while cutting programs for the poor, and then had the audacity to sit lazily back when New Orleans drowned. For eight years, they wasted our time and money with their corruption, lies, and downright incompetence. Americans should hate their guts. But they don't. Conservatives have one advantage. To them politics is war. They admit nothing and give no ground. They know what flag they fight under. Most importantly, they will do anything to resume power.
If we hope to defeat this, Democrats need to rally. They need to find a home under the 'big tent' and they need to find room for others. Stop fighting. Stop pointing fingers at conservative, or liberal, or progressive Dems. If they are willing to work towards the same common goals then we are going to need all of them.
Most of all we need to stop moping because things didn't turn out as idyllically as we had dreamed. Yes, it's true. Health care reform will not usher in a utopian age of health and wellness but it will make things a hell of a lot better than they are today. We've already made huge strides in putting America back on track. Feel good about it. Spread the word. Get back in the game because losing is not an option. Not if you care about the future of our country.
Krugman Sez: Obama Shoulda Blamed Bush More
By Wade
If you've overheard Fox News at all in the past year, it's likely that you've been treated to kvetching about Obama putting too much blame on Bush, and that he ought to live in the present, etc. etc. (a rhetoric notoriously absent when Bush said similar things about Clinton). However, Krugman disagrees(emphasis mine):
And because it tickles me in relation to my previous post about the WSJ, here's another good Krugman quote:
I simultaneously agree and disagree with the rest of Krugman's sentiments. On the one hand, he talks about how Obama hasn't really accomplished that much, and how he needs to focus on two remaining options: pushing financial and health care reform. He's right; these are things that must happen. Krugman says that "not passing a bill would surely be [Democrats'] political doom." And he's right.
On the other hand, Dave's had two different posts detailing Obama's accomplishments and effectiveness. Let's not be giving aid and comfort to the enemy now. Make sure the Republicans know that we still want the same things we wanted when we overwhelmingly elected President Obama, and that we're still willing to back him and fight for what Krugman himself calls "the right thing to do."
One of the key strengths of the Party of No is their ability to remain unified while preying on the fractiousness of the left. It's like the Democrats are constantly trying to prevent a big game of rock paper scissors Hippies who hate pollution protest the Union workers who are against Immigrants taking their jobs who are against the Supporters of Gay Marriage and so on down the line (this is obviously not an accurate representation, but you get the point).
What we have to realize is what the right realized long ago: we are stronger than the sum of our parts. Every election they win is a representation of this. Most polls in the past few years put the amount of left-leaning Americans anywhere from five to twenty-five percent above the amount of right-leaning Americans. We have the power, and we need to remember that. It was proven a year ago when we chose Hope and Change over those who sought to continue the downward spiral of the Bush years. Compromising and taking the good with the bad is always better than refusing to accept anything but 100% goodness. Obama knows this well.
If you've overheard Fox News at all in the past year, it's likely that you've been treated to kvetching about Obama putting too much blame on Bush, and that he ought to live in the present, etc. etc. (a rhetoric notoriously absent when Bush said similar things about Clinton). However, Krugman disagrees(emphasis mine):
The Obama administration’s troubles are the result not of excessive ambition, but of policy and political misjudgments. The stimulus was too small; policy toward the banks wasn’t tough enough; and Mr. Obama didn’t do what Ronald Reagan, who also faced a poor economy early in his administration, did — namely, shelter himself from criticism with a narrative that placed the blame on previous administrations.
And because it tickles me in relation to my previous post about the WSJ, here's another good Krugman quote:
It’s often forgotten now, but unemployment actually soared after Reagan’s 1981 tax cut. Reagan, however, had a ready answer for critics: everything going wrong was the result of the failed policies of the past. In effect, Reagan spent his first few years in office continuing to run against Jimmy Carter.
I simultaneously agree and disagree with the rest of Krugman's sentiments. On the one hand, he talks about how Obama hasn't really accomplished that much, and how he needs to focus on two remaining options: pushing financial and health care reform. He's right; these are things that must happen. Krugman says that "not passing a bill would surely be [Democrats'] political doom." And he's right.
On the other hand, Dave's had two different posts detailing Obama's accomplishments and effectiveness. Let's not be giving aid and comfort to the enemy now. Make sure the Republicans know that we still want the same things we wanted when we overwhelmingly elected President Obama, and that we're still willing to back him and fight for what Krugman himself calls "the right thing to do."
One of the key strengths of the Party of No is their ability to remain unified while preying on the fractiousness of the left. It's like the Democrats are constantly trying to prevent a big game of rock paper scissors Hippies who hate pollution protest the Union workers who are against Immigrants taking their jobs who are against the Supporters of Gay Marriage and so on down the line (this is obviously not an accurate representation, but you get the point).
What we have to realize is what the right realized long ago: we are stronger than the sum of our parts. Every election they win is a representation of this. Most polls in the past few years put the amount of left-leaning Americans anywhere from five to twenty-five percent above the amount of right-leaning Americans. We have the power, and we need to remember that. It was proven a year ago when we chose Hope and Change over those who sought to continue the downward spiral of the Bush years. Compromising and taking the good with the bad is always better than refusing to accept anything but 100% goodness. Obama knows this well.
Andrew Sullivan: Insightful and Right
By Wade
I'm not even surprised that things look so grim for Coakley. Sad, not surprised.
The first full paragraph sums up the major BS of the last year so succinctly it's beautiful:
Congratulations, Republicans. Your quagmire in this country is nearly as ugly as the quagmires you've created across the Atlantic.
Massachusetts, I'm talking to you now. I know we've had at least a couple readers from your neck of the woods (and anyone who knows any swing voters there, pass this on).
Don't think of Coakley as a replacement for a beloved figure from a political dynasty. Don't think of her even as the sub-par candidate she is. Think of her as the least objectionable alternative. Think of her as the stop-gap measure to keep Republicans from succeeding in their goal as the "Party of No." Think of her, as we so often must in politics, as a means to an end. Think of her as the instrument that will help enact the health care policies we need in this country, that Ted Kennedy fought for the majority of his political career. Think of her as, at the very least, better than the guy who seems pleased by the idea of violating her back door with a hot metal rod.
I know she's not who we want. All she can be now is who we've got.
I'm not even surprised that things look so grim for Coakley. Sad, not surprised.
The first full paragraph sums up the major BS of the last year so succinctly it's beautiful:
I can see no alternative scenario but a huge - staggeringly huge - victory for the FNC/RNC machine tomorrow. They crafted a strategy of total oppositionism to anything Obama proposed a year ago. Remember they gave him zero votes on even the stimulus in his first weeks. They saw health insurance reform as Obama's Waterloo, and, thanks in part to the dithering Democrats, they beat him on that hill. They have successfully channeled all the rage at the massive debt and recession the president inherited on Obama after just one year.
Congratulations, Republicans. Your quagmire in this country is nearly as ugly as the quagmires you've created across the Atlantic.
Massachusetts, I'm talking to you now. I know we've had at least a couple readers from your neck of the woods (and anyone who knows any swing voters there, pass this on).
Don't think of Coakley as a replacement for a beloved figure from a political dynasty. Don't think of her even as the sub-par candidate she is. Think of her as the least objectionable alternative. Think of her as the stop-gap measure to keep Republicans from succeeding in their goal as the "Party of No." Think of her, as we so often must in politics, as a means to an end. Think of her as the instrument that will help enact the health care policies we need in this country, that Ted Kennedy fought for the majority of his political career. Think of her as, at the very least, better than the guy who seems pleased by the idea of violating her back door with a hot metal rod.
I know she's not who we want. All she can be now is who we've got.
Friday, January 15, 2010
What has Obama Done For Me Lately?
By Dave
I wanted to spend some time on this because a lot of people mistakenly believe that little has been accomplished in the last year.
Remember how bad things were this time last year? It was awful! The economy was in a tailspin. The banking sector was on the verge of collapse. Massive job loss and foreclosure. Health care costs were strangling our nation. The deficit was growing unchecked. The government didn't care or didn't believe in climate change. World opinion of America was abysmal. We were engaged in two failed wars. We were torturing people for bogus information. Remember all this? Then Obama became president.
What has he done? Well, he:
Updated: The Guardian has a pretty good timeline of Obama's first year in office. It's worth checking out.
I wanted to spend some time on this because a lot of people mistakenly believe that little has been accomplished in the last year.
Remember how bad things were this time last year? It was awful! The economy was in a tailspin. The banking sector was on the verge of collapse. Massive job loss and foreclosure. Health care costs were strangling our nation. The deficit was growing unchecked. The government didn't care or didn't believe in climate change. World opinion of America was abysmal. We were engaged in two failed wars. We were torturing people for bogus information. Remember all this? Then Obama became president.
What has he done? Well, he:
- Passed a $800b Stimulus Bill that:
- Invested in infrastructure like roads and bridges
- Invested in green, renewable technology
- Invested in new High Speed Rail corridors
- Invested in an electric smart grid, weatherizing homes, and alternative energy
- Computerized medical records
- Helped cities and states to close gaps in their budgets to maintain services
- Gave $237 Billion in tax cuts for small businesses, college students, and 95% of working families
- Billions for Pell Grants, Headstart, increased teacher salaries and to prevent school layoffs
- Expanded Job training programs, unemployment insurance, and food stamp programs
- Put people to back work and helped pull our economy back from the brink
- Repaired America's damaged image in the world
- Engaged the Muslim world
- Banned the use of torture, including waterboarding, and restricted interrogation to the Army Field manual
- Expanded SCHIP to include an additional 4 million children
- Passed new regulation preventing credit card companies from ripping people off
- Proposed new laws in place to protect consumers from mortgage fraud and predatory lending.
- Passed national service legislation which boosted funding for volunteers and for AmeriCorp members
- Passed stronger hate crimes law
- Reformed defense spending to cut out waste like the F-22
- Had more spending cuts than Bush
- Changed strategy in Afghanistan and increased the number of troops fighting the war
- Withdrew some troops and set a timetable for further withdrawal in Iraq.
- Proposed financial regulatory reform.
- Is on the verge of real health care reform. This reform will:
- Prevent insurers from refusing coverage for preexisting conditions for children or from dropping coverage when people get sick and need it the most.
- No restrictive annual limits or lifetime limits
- Insurers will be required to offer free preventive care like checkups, routine tests and mammogram
- Lower costs for most people
- Insure an additional 30 Million people
- Bring down the deficit by $100 Billion in the first 10 years and by a trillion in the second ten years.
- That's not going to appeal to seniors who are now seeing the possibility of that doughnut hole finally closing and so they can finally get discounts on their prescriptions.
- Tax credits for employers who provide coverage to their employees
- Allow kids to stay on their parents plan until they are 26
Updated: The Guardian has a pretty good timeline of Obama's first year in office. It's worth checking out.
WSJ Lives in a Fantasy World
By Wade
This would be a much better article if it was actually founded in reality.
Most of these strategies are laughable at best.
Because they took the country for a joyride, crashed it, and then got upset when they were held accountable for their actions? I'd love to see any member of the GOP admit that.
Yes, please run on the platform of denying 30 million people health care coverage. I think some people might get angry about the government getting involved with their Medicare. Don't mind that steadily amplifying whistling sound. That's just the sound of your political career in a nose-dive toward self-destruction.
Exsqueeze me? Baking powder? Did I just hear you right? YOU MORONS ARE THE ONES THAT PUT US IN THE 1930S TO BEGIN WITH. Then we are led to believe that these three institutes have boldly put forth new solutions that will revolutionize America and save us from the gol'dern kommonists. Only, all three of those are well-known conservative, libertarian think tanks(read: policy shills). Need some research to back up your point that removing restrictions on logging will keep our forests healthier? Call up one of these guys. They make Aaron Eckhart's character in Thank You For Smoking look like a saint.
Oh really? Then why is there a sharp upswing in debt every single time a Republican takes office? I'll tell you why. Republicans aren't interested in doing the most good for the most people in our country. They're interested in doing the most good for their people in our country, namely, those poor beleaguered millionaires who unjustly have to pay taxes. Tax cuts are the Republicans theology, a term more appropriate to a party that wants to run America like a theocracy anyway.
I wholly recommend reading the rest of this vomit-inducing lie festival. The Wall Street Journal is always good entertainment.
This would be a much better article if it was actually founded in reality.
Despite tanking poll numbers both for themselves and their president, congressional Democrats have persisted for months in a stunning act of political self-destruction. The evaporation of home-state support for Nebraska Sen. Ben Nelson and the retirements of Christopher Dodd and Byron Dorgan should give the White House and the congressional majority pause...It's not surprising that a paper owned by Rupert Murdoch would repeat misinformation and misdirections.
Most of these strategies are laughable at best.
10) Face up to why the party lost in 2006 and 2008.
Because they took the country for a joyride, crashed it, and then got upset when they were held accountable for their actions? I'd love to see any member of the GOP admit that.
6) For the midterm election, unite around a clear agenda of repeal. The party should give its candidates a list of programs and spending that will be up for cancellation the hour a Republican Congress is sworn in. At the top of the list should be the Troubled Asset Relief Program, unspent stimulus funds, and the health-care overhaul.
Yes, please run on the platform of denying 30 million people health care coverage. I think some people might get angry about the government getting involved with their Medicare. Don't mind that steadily amplifying whistling sound. That's just the sound of your political career in a nose-dive toward self-destruction.
5) Add in an agenda of market-freeing reforms in health care, energy, environmental and education policy. Scholarly centers such as the Hoover Institution, the Pacific Research Institute, and the Manhattan Institute have developed market-freeing solutions to health inflation, energy dependence, real and immediate environmental challenges, and education quality. Reform for congressional Democrats means more spending and more mandates. After the health-care debate the nation has rejected that 1930s-style model. The new model's time has come.
Exsqueeze me? Baking powder? Did I just hear you right? YOU MORONS ARE THE ONES THAT PUT US IN THE 1930S TO BEGIN WITH. Then we are led to believe that these three institutes have boldly put forth new solutions that will revolutionize America and save us from the gol'dern kommonists. Only, all three of those are well-known conservative, libertarian think tanks(read: policy shills). Need some research to back up your point that removing restrictions on logging will keep our forests healthier? Call up one of these guys. They make Aaron Eckhart's character in Thank You For Smoking look like a saint.
2) Tax cuts must be part of the answer. The surpluses of the late '90s were to a significant extent a product of the growth in revenues that came after the capital gains tax was cut. The Democrats' theology—actually economic superstition—prohibits them from renewing the 2003 tax cuts, the looming expiration of which has been a drag on the economy ever since they recaptured Congress.
Oh really? Then why is there a sharp upswing in debt every single time a Republican takes office? I'll tell you why. Republicans aren't interested in doing the most good for the most people in our country. They're interested in doing the most good for their people in our country, namely, those poor beleaguered millionaires who unjustly have to pay taxes. Tax cuts are the Republicans theology, a term more appropriate to a party that wants to run America like a theocracy anyway.
I wholly recommend reading the rest of this vomit-inducing lie festival. The Wall Street Journal is always good entertainment.
Sunday, January 10, 2010
All Eyes on Massachusetts
By Dave
It's looking like the senate race to fill Ted Kennedy's seat in Massachusetts has gotten a little close for comfort, and it has huge implications for health care reform. If Democrat Martha Coakley loses to Republican Scott Brown, Democrats will lose their 60th vote right at the 11th hour. To make matters more interesting, the polling is all over the map. The Boston Globe has a poll that shows Coakley up 15 points, PPP shows them nearly in a dead heat. Nate Silver gives an interpretation:
It's looking like the senate race to fill Ted Kennedy's seat in Massachusetts has gotten a little close for comfort, and it has huge implications for health care reform. If Democrat Martha Coakley loses to Republican Scott Brown, Democrats will lose their 60th vote right at the 11th hour. To make matters more interesting, the polling is all over the map. The Boston Globe has a poll that shows Coakley up 15 points, PPP shows them nearly in a dead heat. Nate Silver gives an interpretation:
All of the polls have positives and negatives. And any of them could be right.So, your guess is as good as mine. It sounds like Coakley has a reasonable chance of pulling this off, but it's not unthinkable that she won't. If she doesn't Democrats will either have to scramble to pass health care before Brown gets into office, which probably means the House will have to accept the Senate bill nearly as is. Or they will have to go back and see if they can pull in a Republican like Olympia Snowe (R-ME).
The average of the three polls shows Coakley up by 8 points. As I've written before, I would probably take "over" on that 8 percent number. Fundamentally, this is still Massachusetts, and unless the Democratic candidate has some sort of fatal flaw (Coakley is a bit boring, but that's hardly an unpardonable sin), it's just going to be a really heavy lift for the turnout to be lopsided enough to allow the Republican to prevail.
At the same time, while I'm taking the "over" on that 8 percent, I'm also taking the over on variance. Special elections are notoriously hard to predict. And we also seem to be at some weird sort of inflection point in the electoral cycle. You can point toward some evidence to make the case that the bottom is really falling out from Democrats, and you can point toward other evidence which suggests that the whole tea-party backlash, while not unimportant, is really just operating at the margins. So, I acknowledge that there is a fairly tangible shot of Brown winning -- higher than the 3-5 percent I assigned to him after seeing the Rasmussen poll, but lower than the 15-25 percent chance I gave him before seeing the Boston Globe result.
Wednesday, December 30, 2009
To Excise Tax or Not to Excise Tax
By Dave
Public policy is hard. There are very few opportunities left to make Pareto Improvements. I don’t believe in utopia. Everything involves a trade-off. To me, it's no surprise that all public policy creates winners and losers. The job of those crafting policy and those who are watching it be crafted is to evaluate the policy based on a range of criteria and then ask if it does more good than bad. If so, then it can be called, "good policy" and should probably be implemented.
That's how I approach Bob Herbert's piece in the NYT. I think the excise tax and other cost-controls will make the country better off as a whole, but some people will be made worse off than they are today. Herbert, on the other hand, calls the excise tax a “Less than Honest Policy”. Here are a few snippets:
So I'm sympathetic, but I think he's wrong in his analysis. Here’s what I know about the excise tax and here’s why I support it.
From the CBO report:
Herbert's right that the excise tax is a revenue generator and over the long term will help reduce the deficit. But it's also a cost control designed to reduce the costs of health insurance.
In fact, Christina Romer, the Chair of the Council of Economic Advisors, called it "probably the number one item that health economists across the ideological spectrum believe is likely to stem the explosion of health-care costs."
and MIT Economist Jonathan Gruber says:
The national average cost for a family is $13,000. The excise tax has been dubbed a “Cadillac tax” because it will tax high-deductible plans, ones that cost more than $23,000 a family. The intention of the tax is no dirty secret. In fact, it should be no secret at all. It's job is to create a powerful incentive for insurers to be very wary when they increase their premiums. If their plan gets too expensive, the price will snow ball and get very expensive, too expensive for most people. This will drive consumers into the lower priced plans of their competitors, which should be more available through the new insurance exchanges.
In Herbert’s mind, this is the same as ratcheting down the quality of a plan. But if there is anything we’ve learned in the last few months it’s that price and quality are not always correlated in health care. In fact, we spend huge amounts of money and get lower outcomes. Just look at this graph from National Geographic if you needed any more evidence.
Here's Ezra Klein:
The other part of health care reform means getting away from an employer-based model of health care. In the long-run this will be better for both workers and employers. But in the short run, there will be people who will lose. As Herbert notes, the Unions are not thrilled about this. In fact, they are openly opposing it. But of course they are! Unions currently receive a $250 Billion a year subsidy from the US taxpayer on health insurance plans. So of course they oppose it. Who wouldn’t grumble if a chunk was taken out of their giant subsidy?
But this subsidy is a problem. It encourages waste because employers can offer bigger packages during labor negotiations and they’re worth more because unlike wages they’re tax-free. So companies keep dumping more money into exorbitant health insurance packages and workers think they’re better off, but for the money being dumped in, it’s more likely their getting a raw deal.
However, the excise tax probably makes workers better off in the long run. Gruber again:
So the excise tax will reduce the national deficit, bend the cost curve in health care, encourage insurers to provide more affordable plans, wean the country off employer-based health care, and maybe lead to better wages over the long-run for workers. I'd say this is good policy, not great policy. But on the whole, if we hope to control costs, these are the types of things we have to do.
Public policy is hard. There are very few opportunities left to make Pareto Improvements. I don’t believe in utopia. Everything involves a trade-off. To me, it's no surprise that all public policy creates winners and losers. The job of those crafting policy and those who are watching it be crafted is to evaluate the policy based on a range of criteria and then ask if it does more good than bad. If so, then it can be called, "good policy" and should probably be implemented.
That's how I approach Bob Herbert's piece in the NYT. I think the excise tax and other cost-controls will make the country better off as a whole, but some people will be made worse off than they are today. Herbert, on the other hand, calls the excise tax a “Less than Honest Policy”. Here are a few snippets:
Proponents say the tax will raise nearly $150 billion over 10 years, but there’s a catch. It’s not expected to raise this money directly. The dirty little secret behind this onerous tax is that no one expects very many people to pay it. The idea is that rather than fork over 40 percent in taxes on the amount by which policies exceed the threshold, employers (and individuals who purchase health insurance on their own) will have little choice but to ratchet down the quality of their health plans.
...
Proponents say this is a terrific way to hold down health care costs. If policyholders have to pay more out of their own pockets, they will be more careful — that is to say, more reluctant — to access health services. On the other hand, people with very serious illnesses will be saddled with much higher out-of-pocket costs. And a reluctance to seek treatment for something that might seem relatively minor at first could well have terrible (and terribly expensive) consequences in the long run.
...
Those who believe this is a good idea should at least have the courage to be straight about it with the American people.
So I'm sympathetic, but I think he's wrong in his analysis. Here’s what I know about the excise tax and here’s why I support it.
From the CBO report:
Beginning in 2013, insurance policies with relatively high total premiums would be subject to a 40 percent excise tax on the amount by which the premiums exceeded a specified threshold. That threshold would be set initially at $8,500 for single policies and $23,000 for family policies (with certain exceptions); after 2013, those amounts would be indexed to overall inflation plus 1 percentage point.
Herbert's right that the excise tax is a revenue generator and over the long term will help reduce the deficit. But it's also a cost control designed to reduce the costs of health insurance.
In fact, Christina Romer, the Chair of the Council of Economic Advisors, called it "probably the number one item that health economists across the ideological spectrum believe is likely to stem the explosion of health-care costs."
and MIT Economist Jonathan Gruber says:
It would reduce the incentives for employers to provide excessively generous insurance, leading to more cost-conscious use of health care and, ultimately, lower spending. In other words, it "bends the curve." It would also be progressive, in that it would take from those with the most generous insurance to finance the expansion of coverage to those without insurance.
The national average cost for a family is $13,000. The excise tax has been dubbed a “Cadillac tax” because it will tax high-deductible plans, ones that cost more than $23,000 a family. The intention of the tax is no dirty secret. In fact, it should be no secret at all. It's job is to create a powerful incentive for insurers to be very wary when they increase their premiums. If their plan gets too expensive, the price will snow ball and get very expensive, too expensive for most people. This will drive consumers into the lower priced plans of their competitors, which should be more available through the new insurance exchanges.
In Herbert’s mind, this is the same as ratcheting down the quality of a plan. But if there is anything we’ve learned in the last few months it’s that price and quality are not always correlated in health care. In fact, we spend huge amounts of money and get lower outcomes. Just look at this graph from National Geographic if you needed any more evidence.
Here's Ezra Klein:
First, more insurance is not always better. Health-care outcomes in Canada and England -- both of which have strong pressures against overuse -- are not worse than those in America. More to the point, health outcomes in Kaiser Permanente, which is a managed-care organization, are not worse than those in Aetna's more expensive PPO plans.
...
But loose rules also encourage a lot of waste -- estimates run at about 15 to 30 cents of every dollar we spend. That waste won't be painless to cut out of the system, but it'll be less painful -- and less harmful -- than anything else.So we have to get rid of the waste and the excess. No doubt the excise tax is a crude implement to accomplish this and there are ways that we could improve it, such as allowing the threshold to change based on demographics. But by penalizing insurers who charge too much we can stop the excessive creep of health care costs.
The other part of health care reform means getting away from an employer-based model of health care. In the long-run this will be better for both workers and employers. But in the short run, there will be people who will lose. As Herbert notes, the Unions are not thrilled about this. In fact, they are openly opposing it. But of course they are! Unions currently receive a $250 Billion a year subsidy from the US taxpayer on health insurance plans. So of course they oppose it. Who wouldn’t grumble if a chunk was taken out of their giant subsidy?
But this subsidy is a problem. It encourages waste because employers can offer bigger packages during labor negotiations and they’re worth more because unlike wages they’re tax-free. So companies keep dumping more money into exorbitant health insurance packages and workers think they’re better off, but for the money being dumped in, it’s more likely their getting a raw deal.
However, the excise tax probably makes workers better off in the long run. Gruber again:
Moreover, most experts and Congress's Joint Committee on Taxation assume that most companies would not end up paying this tax but would instead reduce their insurance spending to below the threshold for the tax. And when firms reduce their insurance generosity, they make it up in higher pay for their workers. We saw this in the late 1990s, when the rise of managed care temporarily lowered insurance costs, and wages rose in real terms for the first time in many years. But as soon as managed care was weakened and health costs rose again, we once again saw flat or declining real wages in the United States.
By my calculations the excise tax in the Senate legislation will raise U.S. worker wages by a total of $223 billion over the next decade, which would mean about $660 in extra annual earnings per employer-insured household by 2019. Moreover, the vast majority of those wage increases accrue to middle- and lower-income households; 90 percent would go to families with incomes below $200,000.
So the excise tax will reduce the national deficit, bend the cost curve in health care, encourage insurers to provide more affordable plans, wean the country off employer-based health care, and maybe lead to better wages over the long-run for workers. I'd say this is good policy, not great policy. But on the whole, if we hope to control costs, these are the types of things we have to do.
Tuesday, December 29, 2009
Republicans Committed to Losing in 2010
By Dave
Tea party activists and GOP notables such as Newt Gingrich are pushing 2010 Republican candidates to run on a platform of repealing health care reform. This is a great strategy...for Democrats! Really, it sounds great! Seriously, please do this. LMAO!
Run on a platform that will actively deny 30 million people health care coverage, that will allow insurers to deny people based on pre-existing conditions, that will add billions to the federal deficit, that will make health care less affordable, and cause costs to spiral out of control. Please do this. I dare you, I double dog dare you.
Granted, the more savvy of the Republican contenders will probably pick and choose pieces out of the health care bill, like individual mandates, to attack. But who knows if this will be enough sate the teabaggers and party activists, I guess we'll see.
I think Republicans are looking at a bad year in 2010. They've decided to be 100% a Party of No. They've bet against the economy, against health care reform, against climate change, against the war, and against national security. They've doubled down on failure. But they've misread the tea leaves. Sure, people are mad right now, in part because the economy is so bad, and in part because the Obama administration has tackled big, controversial issues that have gotten people riled up and, frankly, scared and confused. But people aren't mad because they know what health care reform does, they're mad because they have no idea what it does. My guess is not many people off the street could explain health care reform. So people are rightfully anxious.
But there's a long time between now and Nov. 2010. There's a lot of pieces in play and it's too early to know where they'll land. The stimulus bill will begin to ramp up, the economy may begin to improve if only marginally, some health care reforms will kick in immediately, Guantanamo may finally be shut down, some troops may come out of Iraq, Afghanistan could be marginally better. There's enough to be anxious about but it's to uncertain to be excited about.
The Republican platform is just so tragically short-sighted. When the world doesn't crash around our ankles, when things do get better, then what? They have no answer. They're too blinded by rage and frustration, they can't ask the obvious questions about their own platform. But if Republican's want their platform to be the gallows of their own demise, so be it.
Tea party activists and GOP notables such as Newt Gingrich are pushing 2010 Republican candidates to run on a platform of repealing health care reform. This is a great strategy...for Democrats! Really, it sounds great! Seriously, please do this. LMAO!
Run on a platform that will actively deny 30 million people health care coverage, that will allow insurers to deny people based on pre-existing conditions, that will add billions to the federal deficit, that will make health care less affordable, and cause costs to spiral out of control. Please do this. I dare you, I double dog dare you.
Granted, the more savvy of the Republican contenders will probably pick and choose pieces out of the health care bill, like individual mandates, to attack. But who knows if this will be enough sate the teabaggers and party activists, I guess we'll see.
I think Republicans are looking at a bad year in 2010. They've decided to be 100% a Party of No. They've bet against the economy, against health care reform, against climate change, against the war, and against national security. They've doubled down on failure. But they've misread the tea leaves. Sure, people are mad right now, in part because the economy is so bad, and in part because the Obama administration has tackled big, controversial issues that have gotten people riled up and, frankly, scared and confused. But people aren't mad because they know what health care reform does, they're mad because they have no idea what it does. My guess is not many people off the street could explain health care reform. So people are rightfully anxious.
But there's a long time between now and Nov. 2010. There's a lot of pieces in play and it's too early to know where they'll land. The stimulus bill will begin to ramp up, the economy may begin to improve if only marginally, some health care reforms will kick in immediately, Guantanamo may finally be shut down, some troops may come out of Iraq, Afghanistan could be marginally better. There's enough to be anxious about but it's to uncertain to be excited about.
The Republican platform is just so tragically short-sighted. When the world doesn't crash around our ankles, when things do get better, then what? They have no answer. They're too blinded by rage and frustration, they can't ask the obvious questions about their own platform. But if Republican's want their platform to be the gallows of their own demise, so be it.
Sunday, December 27, 2009
Health Care Subsidies
By Dave
Paul Krugman gives us this graph from the Kaiser Health Reform Subsidy Calculator
It's pretty clear reform would make health care much more accessible to those at the lower end of the economic spectrum. In fact, for those at or below the poverty line, reform will practically pay for your health insurance. From a progressive standpoint, not bad at all. Now, of course tiered subsidy rates can cause perverse incentives, depending on what's lost between the move from say, 100% and 150% of the PL. But those potential problems aside, I'd say this is pretty cool.
Paul Krugman gives us this graph from the Kaiser Health Reform Subsidy Calculator
It's pretty clear reform would make health care much more accessible to those at the lower end of the economic spectrum. In fact, for those at or below the poverty line, reform will practically pay for your health insurance. From a progressive standpoint, not bad at all. Now, of course tiered subsidy rates can cause perverse incentives, depending on what's lost between the move from say, 100% and 150% of the PL. But those potential problems aside, I'd say this is pretty cool.
Saturday, December 26, 2009
Riddle Me This
By Dave
Riddle me this: If the health bill is nothing but big giveaways to the insurance companies, why are they still trying to kill the bill?
Riddle me this: If the health bill is nothing but big giveaways to the insurance companies, why are they still trying to kill the bill?
Big insurers are still hoping to influence some language in the legislation before Congress sends it to the president. But one thing is clear: The initiative is poised to change their industry more than any other sector of the U.S. health-care system, with huge potential to disrupt profitability.
Thursday, December 24, 2009
On the Precipice of Health Care Reform
By Dave
In a few hours, I am expecting to wake up to a nice cup of coffee and the news that the Senate finally, actually, for real passed a health care bill.
Of course, the next step will be a conference committee since it sounds like the House is not interested in ping-ponging it. Which is fine because it will probably create a better bill. However, look for the media to drum up ratings and suspense to suggest this process is fraught with peril and that the bill is still in constant danger of being destroyed. It's all true.
But in relative terms, the hard part is over. Everything else is window-dressing and, I don't care who you are, you don't burn down a house because you don't like the color of the window shades. You just keep nagging your spouse with snarky asides and one-liners until they get changed. Such is the nature of American politics.
So I say, it's time to prematurely celebrate! It could come back to bite me, but what the hell? I'm optimistic.
Oh andall you naysayers Mitch McConnell: suck it! Woo! Merry Christmas, Baby!
In a few hours, I am expecting to wake up to a nice cup of coffee and the news that the Senate finally, actually, for real passed a health care bill.
Of course, the next step will be a conference committee since it sounds like the House is not interested in ping-ponging it. Which is fine because it will probably create a better bill. However, look for the media to drum up ratings and suspense to suggest this process is fraught with peril and that the bill is still in constant danger of being destroyed. It's all true.
But in relative terms, the hard part is over. Everything else is window-dressing and, I don't care who you are, you don't burn down a house because you don't like the color of the window shades. You just keep nagging your spouse with snarky asides and one-liners until they get changed. Such is the nature of American politics.
So I say, it's time to prematurely celebrate! It could come back to bite me, but what the hell? I'm optimistic.
Oh and
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