Pressure: The Senators Who Killed Health Care? Or the President?

Paul Krugman writes:

[N]obody can now say with a straight face that the U.S. health care system is O.K. And if surveys like the New York Times/CBS News poll released last weekend are any indication, voters are ready for major change. The question now is whether we will nonetheless fail to get that change, because a handful of Democratic senators are still determined to party like it’s 1993.

. . . Yet it remains all too possible that health care reform will fail, as it has so many times before. . . . The real risk is that health care reform will be undermined by “centrist” Democratic senators . . . Senator Ben Nelson of Nebraska initially declared that the public option — which, remember, has overwhelming popular support — was a “deal-breaker.” . . . Mr. Nelson softened his stand after reform advocates began a public campaign targeting him for his position on the public option.

(Emphasis supplied.) It's great that Ben Nelson "softened." But there is only one way for the public option to survive -- reform groups need to tell the President that he will be remembered as the guy who killed health care - not Ben Nelson or Kent Conrad. He needs to call them out when the time comes. Believe me, nobody remembers that Moynihan killed health care reform in 1994. Hell, Hillary announced her first Senate campaign at his farm in New York.

Speaking for me only

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    It's so completely pathetic that (5.00 / 5) (#1)
    by masslib on Mon Jun 22, 2009 at 07:05:52 AM EST
    the best we can hope for is a friggen public option.  I'd like all the details on that option before I sign on.  Like who will be able to enroll?  Because in MA, you have to be low income to take the public option.  That keep us in silos.  Therefore, private insurance doesn't "compete" with public insurance.  It's a scam that has no political legs.  How long will residents of MA subsidize the poor and lower middle class in great public health care while they toil away in the private system?  This would be akin to allowing only some people to take advantage of Medicare or social security.  This is not a new new deal, and LBJ most be spinning in his grave.

    I'm sure with public support where it is for the public option it will pass, in some form, but the devil is in the details.

    The Administration (5.00 / 1) (#2)
    by jbindc on Mon Jun 22, 2009 at 07:09:58 AM EST
    HHS Secretary Kathleen Sebelius said last week:  "This is not a trick. This is not single-payer...That's not what anyone is talking about -- mostly because the president feels strongly, as I do, that dismantling private health coverage for the 180 million Americans that have it, discouraging more employers from coming into the marketplace, is really the bad, you know, is a bad direction to go."

    Asked if the administration's program will be drafted specifically to prevent it from evolving into a single-payer plan, Sebelius says: "I think that's very much the case, and again, if you want anybody to convince people of that, talk to the single-payer proponents who are furious that the single-payer idea is not part of the discussion."

    Sebelius says such concerns are unfounded because a single-payer plan is not under consideration, and these "draconian" scenarios have muddled the conversation over the president's proposal for a public option.

    "The whole idea of the public option has been difficult, in part, because some of the opposition has described it as a potential for a, you know, draconian scenario that was never part of the discussion in the first place," Sebelius says. "So, disabusing people of what is not going to happen is often difficult, because there's no tangible way to do that."

    I think the thing that (5.00 / 0) (#3)
    by Militarytracy on Mon Jun 22, 2009 at 07:22:57 AM EST
    the insurance companies fear about a public option is that the poor will be able to afford it.  Their service becomes worth less if it isn't scarce.

    I think it is a little more than that (5.00 / 8) (#6)
    by MO Blue on Mon Jun 22, 2009 at 07:28:41 AM EST
    A well run public option would be much less expensive. They fear that it would be so effective that a large group of people, not just the poor, would sign up for the public option making them irrelevant or seriously cutting into their profit model.

    I wonder if those who continue (5.00 / 1) (#14)
    by Militarytracy on Mon Jun 22, 2009 at 09:18:28 AM EST
    to defend Obama on this issue realize that the gist of it is corporations must make a nice robust tidy profit to the tune of human suffering and death.  All the while the corporations have applied not one single bandage or stitched one suture.

    Actually, I don't think it is (5.00 / 1) (#11)
    by dk on Mon Jun 22, 2009 at 08:59:37 AM EST
    that at all.  What the insurance companies fear is a public option that the non-poor would buy into.  But, because Obama has said over and over and over again, both during the campaign and since he has been President, that such a program would be as extreme as the most right wing republican ideas for health care, it will not happen.

    And of course the non-poor (none / 0) (#12)
    by Militarytracy on Mon Jun 22, 2009 at 09:12:02 AM EST
    will buy a better plan.  I certainly will.  So the insurance companies fear competition that is service based?

    Oh the irony (5.00 / 3) (#16)
    by cawaltz on Mon Jun 22, 2009 at 09:21:16 AM EST
    The right is opposed to a "free market" system where the private players have to compete and if they don't have a better business model they go extinct.

    Well, assuming you are (none / 0) (#18)
    by dk on Mon Jun 22, 2009 at 09:36:59 AM EST
    including Obama and the rest of the Democratic leadership as "the right," then you are correct.

    I'm assuming it would be like Medicare, (5.00 / 7) (#25)
    by sallywally on Mon Jun 22, 2009 at 10:14:45 AM EST
    and living with my sister who has Medicare vs my state university employee or my state employee retirement program, Medicare wins hands down. I mean REALLY hands down.

    What they're afraid of is the the public option would be much better than what the private corporations offer, and that it would drive the private insurance companies out of business. They have openly said this in recent weeks, although I think they are realizing that is a point in favor of a public plan and are trying different (and equally lame) objections.

    With the NYT poll showing 72% want the public option, I don't understand wh Obama is so clueless and so without backbone on this issue. He should go ahead and pass the real thing and screw the Blue Dogs and Repubs.

    I'm 64.5 years old and can't wait to get on Medicare in 6 months. I will have more freedom in choosing where I get my care, and more procedures, drugs, etc., will be covered more thoroughly.

    Obama should stop his adulation of Reagan and place it where it really belongs - with LBJ!


    I wonder is single payer (5.00 / 1) (#15)
    by oculus on Mon Jun 22, 2009 at 09:18:30 AM EST
    Will solve all ills. AP report of a VA hospital which malpracticed a large no. Of prostrate cancer patients.

    No coincidence that story caome out now (5.00 / 3) (#21)
    by ruffian on Mon Jun 22, 2009 at 09:57:02 AM EST
    I'm sure there will be a rash of such scare stories in the next 60 days. Of course it is horrible, and malpractice should be punished wherever it occurs. But there are certainly such cases in private health care as well.

    I think you have to ask yourself why (5.00 / 7) (#23)
    by Anne on Mon Jun 22, 2009 at 10:01:31 AM EST
    you are beginning to see stories about the problems in the VA hopsitals - why now?  Could it be planting the seeds of doubt in the minds of Americans about the government being involved in a single-payer system?

    I am not suggesting that there are not problems in the VA system - but there are problems in private hospitals, too - but I don't think you are likely to see any reporting or exposes or other horror stories on the private side because it gets in the way of the message that government-run is bad, and the private sector is always better.


    Yes, because these problems have (none / 0) (#30)
    by Militarytracy on Mon Jun 22, 2009 at 10:30:06 AM EST
    existed within the VA system for a very very long time and are nothing new. There for awhile though such incidents were swept under media rugs and I read many puff pieces about how wonderful the VA system was. Why now are media stories suddenly surfacing as if there are problems with and in the VA system?

    As above... (5.00 / 2) (#38)
    by Romberry on Mon Jun 22, 2009 at 11:37:55 AM EST
    ...the quality of care in the VA from, at least until the end of the Clinton admin, had improved by leaps and bounds. My 70+ year old father relies primarily on the VA and they have done a very good job at the Montgomery and B'ham VA hospitals with his heart and with an injury to his knee that required surgery. Staffs are pleasant, physicians are skilled and wait times are quite within the norm for civilian hospitals.

    If the VA is having issues now, I think it might be traceable to both the influx of new patients (thanks to the wars in Iraq and Afghanistan) as well as the attitude of the previous admin. After all, look what they did to FEMA.

    (It's probably not a good idea to put people who hate government in charge of running it.)


    I don't think much if any of this has to do (none / 0) (#60)
    by Militarytracy on Mon Jun 22, 2009 at 01:21:44 PM EST
    with "new" problems.  No healthcare delivery system is perfect and the VA never has been either.  Somehow though we have traveled very swiftly mediawise from glowing reports of the VA to suddenly having these VA "horror" stories.  There will always be someone in our midst who is a bad apple, but strangely we have gone from noticing the 99% healthcare success reports to the 1% healthcare horror story report.  And it happened very quickly.

    That was a private physician... (5.00 / 1) (#36)
    by Romberry on Mon Jun 22, 2009 at 11:32:52 AM EST
    ...working under contract to the VA. He wasn't a government employee as such and he had a sterling resume to be such a sh*tty physician/surgeon.

    The VA, at least before the last eight years of Bush, had come a long, long way. The quality of care at the VA is actually quite good, those just as in private hospitals, the quality of care varies from location to location and from doctor to doctor.


    Remember that Single-Payer (5.00 / 1) (#41)
    by cal1942 on Mon Jun 22, 2009 at 11:49:13 AM EST
    DOES NOT deliver health care.  Health care providers remain intact.

    Care providers can still be either cometent or incompetent.

    It would take a tightly run 'socialized' system to root out incompetence.


    Would single payer (none / 0) (#17)
    by Militarytracy on Mon Jun 22, 2009 at 09:28:40 AM EST
    make all of our nurses and doctors government employees?  I think that's one of the primary problems with the VA system, and if I had my say I wouldn't use the VA system as the model or a goal of what we would create using single payer.

    Has Medicare made all of our (5.00 / 4) (#26)
    by Anne on Mon Jun 22, 2009 at 10:15:07 AM EST
    doctors and nurses and other providers government employees?  No, and neither would a single-payer system.

    As an aside, my husband gets his care through the VA, and has been nothing but impressed by the quality of the care he has received - the VA seems quite interested in preventive care and keeping people as healthy as possible - the efficiency of the system, the coordination of care and the facility itself.  Is the quality standardized throughout the entire system?  I wouldn't think so.  But it's not the same in the private system, either.  We live in an area where you cannot swing a dead cat without hitting a doctor - we have two excellent medical schools here and loads of teaching hospitals, and I think that makes a difference.


    I wish that all areas of the VA system (none / 0) (#31)
    by Militarytracy on Mon Jun 22, 2009 at 10:35:21 AM EST
    were functioning at such a high standard, and it has improved greatly but there are still pockets of very poor performance.  It depends on where you are receiving care and who is running the show in that area and what care you need to receive.  Of course, now that there is a spotlight on the VA system will they use this opportunity to standardize the quality of care throughout the system?

    No. (5.00 / 2) (#39)
    by Romberry on Mon Jun 22, 2009 at 11:39:05 AM EST
    Single payer is a program like Medicare/Medicaid. Physicans and health care providers remain private. The thing that changes under single payer is...the payer. :)

    Imagine the benefit to your bottom line (5.00 / 6) (#20)
    by Anne on Mon Jun 22, 2009 at 09:46:23 AM EST
    if you were one of - what, 1,000+? - insurance companies which would be signing up the bulk of the 47 million who don't currently have insurance.  And then imagine that potential bonanza being severely limited by giving those 47 million people - plus those who already have insurance - the option to enroll in a public plan.  You'd probably be wondering why you were shelling out all those millions of dollars to lobby Congress if you couldn't be guaranteed a monopoly on the entire pie.  And you'd be gnashing your teeth over the possibility that a public plan was going to open the eyes of the American people to the reality that the system does not have to be what the private insurance companies have made it into - and then the you-know-what would really hit the fan.

    A public option, done the right way - and I'm not convinced Congress would do it the right way, but that's another subject - would do more to change the status quo and more to break the stranglehold the private insurance companies have on the entire system.  Just as politicians are not going change their positions unless they are in fear for their jobs, insurance companies are not going to change the way they do things if there is no incentive to change.

    I'd prefer single-payer, but it's harder to rustle up enough Congress-people with the courage to fight for it than it is to herd cats.  

    If nothing else, Americans are learning just how uninterested their representatives are in helping them - and that, I hope, will have consequences.


    Exactly right (5.00 / 6) (#22)
    by ruffian on Mon Jun 22, 2009 at 10:01:10 AM EST
    Out of one side of their mouths they argue that publicly run health care is so terrible that we should not want it, and out of the other side they argue that so many people will choose it that it will put private insurance out of business.

    They are scared to death people will find it a good thing.


    Our reps are more concerned with (none / 0) (#24)
    by Militarytracy on Mon Jun 22, 2009 at 10:09:39 AM EST
    propping up the failing than encouraging healthy new economic growth.  The failing gave them money once.  The failing will rob you and I in order to have a surplus of money to give to our reps.  Healthcare is just one more area where we get to witness the entrenched filthy rich pleading their case that if they "evolved" it would kill them.  As if corporations feel anything or need to eat or breathe.  A healthy growing corporation though could employ more people, perhaps even start a healthy pension for its workers using some ummmmmm finance and investment regulations?

    What's all this crazy talk about (5.00 / 2) (#28)
    by cawaltz on Mon Jun 22, 2009 at 10:20:46 AM EST
    regulation......Don't you know the market should be free and unfettered. Unless of course it means that you might be forced to compete with an entity with the potential of being a better business model and cutting into your profit. Or if your name happens to be Goldman Sachs.

    Perhaps we should incorporate. Then we might have a snowballs chance in Hades of getting Congress's attention.


    Or unless you might fall on your face (none / 0) (#29)
    by Militarytracy on Mon Jun 22, 2009 at 10:25:57 AM EST
    and fail :)

    No wonder (none / 0) (#45)
    by cal1942 on Mon Jun 22, 2009 at 12:11:32 PM EST
    she got elected in Kansas.

    Further, we don't even need Ben Nelson's vote. (5.00 / 5) (#4)
    by masslib on Mon Jun 22, 2009 at 07:24:29 AM EST
    51 Democrats could pass Medicare for All through reconciliation, if they wanted to, if the President pushed them to.  Gee, what an opportunity lost.  And why?  For whom?  I've heard Obama is still pinning his hopes on 60-70 votes.  Bipartisan health reform is meaningless.

    Bipartisan legislation equals (5.00 / 5) (#7)
    by MO Blue on Mon Jun 22, 2009 at 07:30:49 AM EST
    Republican legislation and is to be avoided at all cost.

    Worse Still (5.00 / 1) (#33)
    by cal1942 on Mon Jun 22, 2009 at 11:04:49 AM EST
    is the danger that Obama might compromise to get those 60-70 votes.

    That would mean that his view of the purpose of government is childish, seriously flawed.


    Good idea to remind Obama (5.00 / 7) (#5)
    by MO Blue on Mon Jun 22, 2009 at 07:24:57 AM EST
    that he will be the one who will get the credit for failure. Maybe, that is as it should be. No matter how bad Bush was at policy (extremely bad IMO) he was extremely effective at getting most of his horrible legislation through Congress pretty much intact.

    I've gone from being afraid that no health care will be passed to being afraid that what will be passed will be so bad that failure would have been better.

    Part of the problem is (5.00 / 9) (#10)
    by Anne on Mon Jun 22, 2009 at 08:19:25 AM EST
    that Obama thinks success will be passing anything that has the phrase "health care reform" in the title; if he knew more about the mechanics of the system, he might actually be steering a plan in the direction it needs to go, and would understand why what is being concoted in Congress is not going to actually re-form the system in a way that benefits the people it will purport to serve - us.

    My impression is of a president who wants to stay above the fray, delivering broad outlines, while the Dems in Congress seem to be floundering among themselves and not listening to the people.

    What this looks like to me is failure of leadership, all the way around, and that failure started with not making a commitment to having ALL the stakeholders at the table to discuss how to fix the syatem, and allowing the loudest voices to be those who most want to protect the current arrangement.  

    You just can't fix the system if you aren't willing to actually change it; if all it ends up being is a huge payday for the insurance industry, it fails.

    I am convinced that Obama will blame us if it passes and then does not solve the problem.  He will say that if we wanted something else, we should have fought for it.  Mr. Community Organizer will blame the community, not the organizers.


    Well Obama would be wrong if (5.00 / 1) (#40)
    by inclusiveheart on Mon Jun 22, 2009 at 11:42:21 AM EST
    he thought that preserving the status quo - or making matters worse - would be well received if he slaps the stamp "Healthcare Reform" on it.  It is that simple.  People will figure it out well before his next term is contested.  Unless, of course, they do something like they did with the stimulus and delay enactment until after the first term is nearly over - before it could affect the campaign in 2012 - then he'll just go down in history as a cynical - perhaps even corrupt - (insert swear word here).

    Obama has to (none / 0) (#34)
    by cal1942 on Mon Jun 22, 2009 at 11:14:16 AM EST
    be clear, specific and tough, a regular bullying, threatening SOB willing to exhume the bodies.

    Congress will take leadership and direction if it's provided.  

    The outlook isn't brilliant.


    Which is why (none / 0) (#8)
    by jbindc on Mon Jun 22, 2009 at 07:31:29 AM EST
    Nothing will really get done.  The Dems don't want to lose those campaign contributions from the insurance companies.....

    To favor Obama, they (5.00 / 2) (#35)
    by oldpro on Mon Jun 22, 2009 at 11:17:04 AM EST
    weren't afraid to lose mine.  And they did.

    Anyone who 'believed' that Obama would deliver on healthcare reform should look under their pillow to see what the tooth fairy left.


    Very ironic that one of the attacks on (5.00 / 7) (#42)
    by inclusiveheart on Mon Jun 22, 2009 at 11:53:33 AM EST
    SoS - then Senator Clinton - during the election was that she would never be able to pass real healthcare reform and that Obama absolutely would and could.

    I could have told you back in February that he was missing his window.  That's when I wondered if his committment to healthcare reform was shaky at best.  This White House seems to have no legislative strategy what so ever.  Maybe it is his time in legislative bodies that cripples his ability to develop a big picture legislative plan.  Were I advising him during the transition, I would have told him to put together a triumverate of bills - one stimulus - one green jobs initiative - and one Medicare for all single payer health insurance expansion - tie them together as economic recovery drivers and sold them and gotten them passed under the umbrella of economic recovery.  But they missed that window by a mile.

    Now based on what I know about both the House and the Senate bills, this reform could well turn out to be an even uglier mess than we currently have AND it is likely going to be more expensive for individuals as well as for government - way more expensive than single payer Medicare for all would be.  It is pretty outrageous really.


    I think that (5.00 / 6) (#44)
    by cal1942 on Mon Jun 22, 2009 at 12:05:25 PM EST
    Obama's background in the legislative branch has nothing to do with his tepid "leadership."

    LBJ had an exhaustive legislative background and as President was able to pass an enormous amount of beneficial domestic legislation.

    I believe it's just plain Obama.  I don't think his ideas of government and governance promote real policy reform.

    Hopefully I'm wrong, hopefully he'll take an interest in effective policy.


    Well, I think I was thinking about (5.00 / 1) (#56)
    by inclusiveheart on Mon Jun 22, 2009 at 12:58:52 PM EST
    legislators in the modern day sense - the LBJ era crowd was in my opinion a far gutsier group on the whole.  It is like that comment from Auntie Mame about "braces on their brains" in this era.  They seem to lack vision and while Obama made a lot of high flying speeches, they mostly lacked detail and objectives that I think people like LBJ had a much firmer grasp of than Obama or Rahm seem to have.  Both are so easily distracted by minutuae imo.

    The easiest, most efficient and cost effective healthcare reform bill would have started with the sentence, "Medicare expanded to all regardless of age," and would be followed by a progressive pay scale for the basic premium.  It would not be that complicated.  What they are writing is fully of malarkey like tax credits and tax breaks and taxes.  Most having little to do with the basic goal of achieving universal heathcare access in this country.


    Also, just a note on the legislative (5.00 / 1) (#61)
    by inclusiveheart on Mon Jun 22, 2009 at 01:26:02 PM EST
    experience question - Obama is apples to oranges where it comes to breadth and depth of experience that LBJ came to the White House with.  

    Well, let's not forget (5.00 / 1) (#69)
    by brodie on Mon Jun 22, 2009 at 02:14:21 PM EST
    that after the 64 election, Lyndon and the Dems had a slight liberal working majority (in real #s, a more than 2 to 1 Dem majority overall in both chambers), and, operating still in a New Deal Era, they had been able to move the political center leftward following Johnson's and the Dems' overwhelming electoral victories over Barry and the anti-SS, anti-Medicare Repubs.  Obama, at best, moved the center leftward only half as far, imo.

    Lyndon also had the very underrated Leader Mike Mansfield to work with, the fellow whose strategy in the 64 CR bill had been the deciding factor; Harry Reid, another soft-spoken type, is only a cheap imitation of MM.

    Also, the most pro-AMA and anti-Medicare obstructionist of the time, Dem senator Rbt Kerr from OK, a huge player blocking the bill, had died.  Previously stubborn anti-Medicare House W&M Chairman Wilbur Mills also had earlier been convinced by Kennedy and his legis liaison that the Medicare proposal could be adequately and reasonably funded, his major hangup, so by the time Lyndon had to deal with him, it was not a question of aye/nay but only when (and Mills won that battle, delaying until after the 64 election against Lyndon's furious attempts to have it done by November).


    Also, LBJ dealt (5.00 / 1) (#77)
    by NYShooter on Tue Jun 23, 2009 at 01:26:40 AM EST
    belly to belly with the key players from both sides. He was armed with longstanding personal relationships, and the experience of knowing when, and how, to compromise, and when to stand firm.

    Since the electorate in 2008 decided experience was an unnecessary relic, we settled for a frenetic, BlackBerry addict instead.

    Today's voter, unfortunately, is finding out that to solve difficult problems, you can't always Google it.


    Not so fast (none / 0) (#78)
    by cal1942 on Tue Jun 23, 2009 at 10:23:44 AM EST
    Remember that the public accomodations Civil Rights act was passed before the election.  In those days it took two thirds of those present for cloture.

    As far as the Democratic majorities are concerned it should be remembered that a good portion of those majorities consisted of Dixiecrats.  Many of those Dixiecrats were fairly conservative even on non-Civil rights measures.

    While the center had remained intact since FDR no other President of that era, with the exception of FDR, had such a prodigious record, a record that included the passage of controversial legislation that had eluded others.

    Denigrate LBJ's role in domestic accomplishments all you like but the record is clear.

    So far as Obama is concerned, to date, he's not shown the willingness to tackle really meaningful problems.  We'll see how he does regarding health care reform but given his lame actions regarding the finance industry and the recovery act, which he compromised without cause, I won't hold my breath.

    We haven't had a leader in the White House since LBJ. But, that's been the trend for all too long.  We just don't produce leaders anymore, probably yet another symptom of our decline.


    Public option + a mandate is "effective" (none / 0) (#52)
    by lambert on Mon Jun 22, 2009 at 12:41:58 PM EST
    After all, it props up the insurance companies by guaranteeing them a market, and you can't get more effective than that!

    How does it guarantee (5.00 / 1) (#55)
    by Steve M on Mon Jun 22, 2009 at 12:52:30 PM EST
    that the entire market won't flock to the public option, if the insurance companies can't or won't offer a competitive product?

    The legislation will be crafted... (5.00 / 1) (#59)
    by lambert on Mon Jun 22, 2009 at 01:15:18 PM EST
    ... to prevent exactly that, according to Katherine Sibelius:

    Asked if the administration's program will be drafted specifically to prevent it from evolving into a single-payer plan, Sebelius says: "I think that's very much the case, "

    She's a real peach. (5.00 / 2) (#62)
    by inclusiveheart on Mon Jun 22, 2009 at 01:28:04 PM EST
    Shaking head.

    It looks more and more like (5.00 / 3) (#63)
    by inclusiveheart on Mon Jun 22, 2009 at 01:32:04 PM EST
    the public option is being set up to fail.  To have enough holes and problems - including cost to consumer - to make it undesireable.  That's a winger trick - if they can't make something go away - they make it deeply flawed and frustrating so that eventually the public calls for its end.

    Well, it's all in who can access the public option (5.00 / 2) (#67)
    by masslib on Mon Jun 22, 2009 at 02:09:21 PM EST
    It's my greatest fear about the increasing push among the Left for the public option, rather than Medicare for All.  I will never forget when MA health reform passed and I went to the connector website to apply for the wonderful public insurance program here.  Imagine my devastation when I found I made slightly too much to qualify.  That's my worry.  Public option for whom?  It's a very important piece of the puzzle.

    Krugman is wrong (5.00 / 5) (#9)
    by BernieO on Mon Jun 22, 2009 at 08:15:55 AM EST
    He must have missed this past weekend's McLaughlin Group.  McLaughlin strongly asserted we have the best health care system in the world and asked why we should change it. He even went so far as to assert, a la George Bush, that no one lacks coverage because the uninsured can just go to the emergency room.

    Worse, neither Eleanor Clift nor Lawrence O'Donnell bothered to counter these arguments. Clift did get in a brief mention during the shouting about how the rest of us subsidize the uninsured who go to emergency rooms, but neither Clift nor O'Donnell pointed out that by the time they seek help they are a lot sicker and more expensive to treat than if they had been able to get treatment earlier.

    Both let the claim about our fabulous system go unchallenged and Clift even said that reform will be gradual not comprehensive. She didn't seemed bothered by this at all. It was appalling.

    As I have done before, I urge everyone to take the time to read James Fallows' article in the Jan '95 Atlantic Monthly "A Triumph of Misinformation" about what really happened when the Clintons tried to reform our nightmare of a system. Clift and O'Donnells performance was a repeat of the behavior of our spineless liberals descibed in that article.

    Also I urge you to take the time to watch Frontline's excellent show "Sick Around the World", or at least read the info on their website. It explains thoroughly what models other countries use to get universal, affordable, effective care. (Germany and Switzerland are not single payer, btw.)

    Krugman mentions that reform advocates managed to get Ben Nelson to soften his position. Does anyone know what groups he is referring to? I would like to get in touch with them to send them money. They are at least having some effect and would be even more successful if they had support from the rest of us who want true "change we can believe in". The only group I know of is Blue America which Digby supports. Does anyone know if that is who Krugman is referring to? I would like to know where to donate money before it is too late.

    Democracy for America with (5.00 / 1) (#46)
    by inclusiveheart on Mon Jun 22, 2009 at 12:12:13 PM EST
    Howard Dean leading the charge is probably the most high profile group doing the tough advocacy work on the healthcare front.  At the very least, you should be checking in at their website to see their activities and participate.

    Also you should call the White House comment line and share your thoughts with them.

    Some of the rightwing groups are doing a slightly better job of getting people to call Members of Congress than the left is - in part because there is a split between lefties on the public option v. single payer.  I thought I could live with the public option for now, but having seen both the Senate and House bill highlights, I am probably going to end up being a single payer or nothing person again pretty soon.  The Senate bill has 300 amendments - thanks Chairman Dodd for keeping that under control! - and the House bill is 800+ pages of god only know what that mandates insurance purchase with a public option that is not in my opinion strong enough to create the market shift it was originally intended to - both versions seem to take stands against undocumented workers which actually takes us backwards not forwards particularly in states like CA.

    Honestly, the work product from the 111th Congress on this front is bad enough in my opion to merit foregoing any reform for the time being - because it is setting up to be quite possibly worse than doing nothing at all.  And it is obvious that a lot of the "worse" parts are being inserted by the Republican camp alone.  There are way too many "Democrats" playing games here - and that's a real problem.


    Thanks for the information (none / 0) (#49)
    by BernieO on Mon Jun 22, 2009 at 12:36:34 PM EST
    I am getting really frustrated by the wusses in the Democratic party and our ignorant and/or dishonest media. I will check out Dean's website ASAP.

    Not sure I understand this (none / 0) (#53)
    by lambert on Mon Jun 22, 2009 at 12:44:51 PM EST
    In what sense is DFA's public option "tough advovacy"?

    You want tough, try advocating single payer in Max Baucus's hearing room -- you'll get arrested. More toughness like that, and we might get somewhere.

    Holding down the left end of the Overton Window, with a public option plan that's a guaranteed FAIL from every aspect other than keeping the insurance companies in business, sounds like a pretty soft job to me; the reverse of tough.


    I should have said "toughest". (none / 0) (#57)
    by inclusiveheart on Mon Jun 22, 2009 at 01:05:12 PM EST
    And that was primarily meant in terms of confrontational advocacy targeting Senatos and Congresscritters who are throwing up road blocks.

    As a native Washingtonian, I don't really think screaming at a hearing from the peanut gallery is anywhere near as effective as voters in large numbers contacting congress and the white house to make their desires known.  But to each his own.

    As for PO v SP - at least DFA is trying to put these people on the spot who can't even abide a PO - it isn't like they think that single payer is better.


    Well, after asking politely over (5.00 / 4) (#65)
    by Anne on Mon Jun 22, 2009 at 01:45:01 PM EST
    and over again to be included in the discussions and meetings and hearings and been turned down and turned away and grudgingly allowed in on a you-can-listen-but-don't-talk basis, the "little single-payer advocates" reached the point where they felt the only way Americans might even know of their existence and efforts to advocate for a credible and cost-effective health plan was to make some noise.

    Some of us feel it marked a turning point of sorts.  That Max Baucus was essentially shamed into at least giving the appearance that he cared, and later admitted that he should have considered single-payer at the beginning, but that it was "probably too late now" shows that making noise worked - it opened the door, even if only a little.  It got enough attention that a hearing was held in the House.  More polling was done - the latest of which shows that over 70% of people want a public option, a number that is hard to ignore, despite the best efforts of the Insurance Company Protection Authority, otherwise known as Most of the Congress.

    There are times when etiquette must be cast aside because the principles at stake are too important to subordinate to the social imperatives of hands being folded in one's lap and legs being crossed demurely at the ankle.

    But that's just my opinion.


    It is not about being polite. (none / 0) (#71)
    by inclusiveheart on Mon Jun 22, 2009 at 02:44:38 PM EST
    Baucus had his head handed to him by angry constituents on a recent trip home.  Activist tend to sway the media narrative.  Constituents scare Congresscritters - and if they are screaming and yelling in large numbers - that's really helpful.

    Activists tend to sway the media narrative. (none / 0) (#72)
    by Anne on Mon Jun 22, 2009 at 03:15:50 PM EST
    Yes, they do.  And the single-payer advocates who interrupted the Baucus hearing helped get that started.  Do you think that maybe Baucus' constituents, having seen and heard how he treated those activists, might have been inspired to descend on him with their complaints and questions?  Or that Baucus' announcement that he was going to hold these town hall meetings around his state had anything to do with the arrest of those protestors and the reaction from constituents?  It sure seems it did, as it wasn't until after the brouhaha in the hearing room and Baucus' ham-handed reaction to it that he decided maybe he needed to get in touch with the voters.

    Honestly, you act as if people had not been writing and calling and faxing and visiting local offices all along - and just chose to show up and make trouble out of the blue.  

    Of course it's about being polite, and following protocol, or you wouldn't have referenced the "screaming" from the peanut gallery.  But, hey - sometimes it takes a little public yelling to break through the bubble when the faxes and phone calls and e-mails and letters aren't getting anywhere.

    Democracy: it isn't always pretty.


    You have chosen the tone (5.00 / 0) (#73)
    by inclusiveheart on Mon Jun 22, 2009 at 05:23:45 PM EST
    you seem to want to hear.

    I'll try to explain this again.

    Angry constituents tend to have a much greater impact on individual Members of Congress than those people who show up at hearings and sit in what the Congresscritters perceive to be "the peanut gallery."

    DFA has been mobilizing citizens from across the country to get calls in.  I never said that people have not been communicating all along - you created that out of thin air - not from anything I've said.

    In any case, you are free to create any narrative about the relative impact of any movement that you want.  I was just offering up some basic facts about how advocates and the public are viewed on the Hill - generally with some or much contempt - and what actually scares the Members more - lots of angry constituents.

    But don't mind me.  I've only worked very briefly on the Hill and both my Mother's and Father's government service on and off the Hill in this town over the course of 40 years probably doesn't give me any special insight into the culture or attitudes.  My Father's living with a Congressman as his personal assistant for five year or work on six consecutive Presidential elections including two with the now Speaker of the House probably counts for nothing.

    For my part, during my interniship in the Senate, I was tasked in part with sorting the mail.  All communications were given a value in that pre-internet era - and pre-fax I guess - based on for lack of a better term "level of difficulty".  Handwritten hand stamped letters were given the highest weight.  Pre-printed postcards with pre-paid postage were counted at like one tenth the value that handwritten letters were - and were at the time considered to be of the lowest importance.  It was explained to me that the person who might sign a pre-printed postcard on a street corner may or may not have a real stake in or even understanding of the issue.  Whether or not that is true is not relevant in the sense that that was what the rationale was on the Hill.  In addition, if you were not a voter from the Senator's state, you'd end up in a pile that was ignored.  There are and were and are formulas for "listening".  They are pretty much universal.  There are exceptions, but not many.  And activists are not high on anyone's list - UNLESS they are backed by passionate constituents - then they get an audience with the Congresscritter.  That's the way it works.  And as they shut down Washington access more and more with passes, badges, metal detectors, it only gets harder for everyone to just drop in on their Congressman to say "hi".  A practice that I actually remember being pretty common place when I was very, very young.  I spent most school holidays at my Dad's office in the Rayburn Building and I remember average people just stopping into say hi to his boss at that time.  A lot of times the Congressman would see them.  That just doesn't happen too much anymore.  These days they see special friends and lobbyists on a schedule - not Mr. and Mrs. No-Money Smith on a sight seeing trip to DC.

    All of these sad changes aside, if you aren't realistic about what really scares these Congresscritters into action, then you won't be very effective in advocacy with them.  DFA is doing a pretty good job, imo, at pushing their buttons - which is where this whole conversation started.


    With all due respect to your (none / 0) (#76)
    by Anne on Mon Jun 22, 2009 at 08:55:50 PM EST
    experience, and all these so-called "rules" that determine when, where and why the members of Congress will deign to listen to the people, we need to break through this ever-hardening bubble that keeps duly elected members of Congress from HEARING what is on the minds of the people, not perpetuate it; there comes a time when one has to chuck the misplaced reverence for institutional buffer zones and make noise.

    As long as I am getting e-mails and snail mails and phone calls from members of Congress who are not in my state or my district, I do not need lectures about not expecting those members of Congress to listen to me, or to the other citizens of this country who give money and vote and who have a right to be heard;they can just damn well stop putting up barriers and making up rules about who they will and will not pay attention to.

    Finally, can we please stop using a moniker for the members of Congress that connotes that they are cute and cuddly and life-size versions of something made by Beanie Babies?  Ugh.


    Hey, nice framing (none / 0) (#58)
    by lambert on Mon Jun 22, 2009 at 01:11:37 PM EST
    Equating civil disobedience and getting arrested with "screaming from the peanut gallery." The mind reels...

    Sorry - it is just one part (none / 0) (#70)
    by inclusiveheart on Mon Jun 22, 2009 at 02:27:12 PM EST
    of the equation and not nearly as impressive to the political elite as having a deluge of constituents calling them and writing them yelling and screaming actually.  The "peanut gallery" is how they view it - not me.  I am just disgusted that the Congress - a Democratically controlled Congress no less - wouldn't have the single payer proponents in the discussions from the outset.  I am not blaming the activists for the fact that the Congresscritters are playing the games that they are playing - and forcing them to challenge them in the ways that they have had to.

    I look on the bright side (5.00 / 1) (#74)
    by lambert on Mon Jun 22, 2009 at 08:21:05 PM EST
    They got a lot of coverage, they made Baucus look really, really bad, and they are also now in demand at rallies all over the country. I don't care what my betters think.

    I disagree (5.00 / 1) (#13)
    by cawaltz on Mon Jun 22, 2009 at 09:18:24 AM EST
    I believe the people who need to be leaned on are Reid and Pelosi. Both are up for re election in 2010. Both need to be reminded that if they can't get health care reform through then they will be fired. They need to understand their are consequences for their actions or lack thereof.

    The Correllation Is Exactly "One" (5.00 / 1) (#19)
    by tokin librul on Mon Jun 22, 2009 at 09:42:39 AM EST
    between the degree of satisfaction the CorpoRat interests betray with ANY "plan" offered by the Regime, and the extent to which such a 'satisfactory' program will screw the "People."
    Any outcome that is satisfactory to the CorpoRat will betray the needs of the people in direct proportion to the CorpoRats' comfort.

    No nation may regard itself 'civilized' in which the health of its people is subordinated to the wealth of its elites.

    Leaning on Critters is not going to count anywhere near as much as the $60 Million the Health Insurance Parasites have spent already since January to affect the Congress' decisions on what bills to support and which to defeat...

    The deal is done, the fix is in. All the rest is kabuki, including these feverish discussions.

    The game is rigged, and we, the suckers, are all DEAD MONEY...

    Couldn't agree more (5.00 / 2) (#27)
    by ruffian on Mon Jun 22, 2009 at 10:16:18 AM EST
    The deal is done, the fix is in. All the rest is kabuki, including these feverish discussions.

    I think both Obama and Congress are just too scared to do anything bold enough to be really effective. They do not care enough about health care to have the conviction it takes to face down the firestorm of fear and self-interested criticism that a strong public option, or, god forbid, single payer, would evoke.

    They say they don't have the votes, so they don't even try to convince the public to GET the votes. Kabuki is all we get.


    They aren't scared at all (5.00 / 1) (#75)
    by lambert on Mon Jun 22, 2009 at 08:22:01 PM EST
    They believe in what they are doing. This is their preferred policy.

    The point we're at (5.00 / 1) (#47)
    by cal1942 on Mon Jun 22, 2009 at 12:24:05 PM EST
    as a nation is telling.

    There was no necessity for the Bush tax cuts but they were passed.  There was no necessity to invade Iraq but it was authorized.  There is a need for real health care insurance reform and real reform of the financial system.

    Failure to do both further weakens the nation.

    Neither of the necessary reforms will be implemented.

    When the frivolous is made policy and the necessary rejected no matter who is elected it means that our nation is unwilling to solve its own problems.

    Loss of faith in the democratic process and allowing continued decline are a dangerous combination.

    As a nation we really are in very big trouble.

    Good thing "progressives" have been... (5.00 / 1) (#51)
    by lambert on Mon Jun 22, 2009 at 12:39:22 PM EST
    dragging the Overton Window left by pounding on single payer, otherwise we might not end up with even a band-aid-on-a-cancer pissant solution like the public option.

    Oh, wait...

    NOTE Nothing to do with you, BTD. You've said health care isn't your beat.

    Health care better not suck. (5.00 / 1) (#64)
    by lilburro on Mon Jun 22, 2009 at 01:44:08 PM EST
    In part because we've all been told by Obama(bots) a hundred times over to put everything else off so something really, REALLY good can pass.  

    A crappy healthcare bill, at the expense of Truth Commission/torture prosecutions and swift action on gay issues does NOT cut it for me.

    National Healthcare System (5.00 / 3) (#66)
    by allpeopleunite on Mon Jun 22, 2009 at 02:08:10 PM EST
    I know it doens't seem pragmatic to many, but honestly the only way forward is a national insurance program that covers anyone. If people want to top that up with private coverage, then so be it, but there must be a real, comprehensive program for the nearly 50 million americans without healthcare.

    As in most cases of US politics, capitalism and its forces in White House and Congress are absolutely not interested in doing the sane thing and provding national healthcare, they want band-aids. There is a Democratic majority in both Houses and a Democrat in the White House, am I not correct? If there was the political will it could be done, without a doubt.

    Exactly. And, we already have such a program. (5.00 / 1) (#68)
    by masslib on Mon Jun 22, 2009 at 02:11:12 PM EST

    Do some thing about it. (none / 0) (#32)
    by mapleh23 on Mon Jun 22, 2009 at 10:58:50 AM EST
    It is interesting to see people complaining about the deal is done instead of organizing and pressuring congress and Obama to get a suitable health care bill. You can complain all you want, but if you don't get in the fight, things will remain the same. Don't sit there, do something!

    Some of us are multitaskers (5.00 / 1) (#37)
    by cawaltz on Mon Jun 22, 2009 at 11:34:35 AM EST
    Most of us(if not all) have contacted our Congresscritters. I'd suspect more than a few have cajoled our neighbors into doing so as well. We've signed petitions ad nauseaum.

    Folks, it's not going to happen (none / 0) (#43)
    by jbindc on Mon Jun 22, 2009 at 12:05:01 PM EST
    Like any good pol, he's talking out of both sides of his mouth.

    Obama said this on Monday while addressing the American Medical Association:

    "No matter how we reform health care, we will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."

    He didn't let up.

    "If you like what you're getting, keep it," Obama said. "Nobody is forcing you to shift."

    Problem is...the White House then backed off this statement when officials suggest the president's rhetoric shouldn't be taken literally: What Obama really means is that government isn't about to barge in and force people to change insurance.

    Sheesh. More change you can believe in.

    Well (none / 0) (#48)
    by Steve M on Mon Jun 22, 2009 at 12:30:16 PM EST
    I am honestly surprised that people took that statement to mean that the government, somehow, would prevent employers from changing or getting rid of employees' health coverage.  I mean, what stops your employer from taking away your health insurance if a reform bill passes? The same thing that stops them right now!

    Remember (none / 0) (#50)
    by jbindc on Mon Jun 22, 2009 at 12:38:47 PM EST
    There were people who went on TV and stated that their mortgages and bills were going to get paid since Obama was elected. I don't think it's a far leap for some of those same people and millions of others like that to be seduced by the rhetoric and personality once again.

    Not the whites in their eyes (none / 0) (#54)
    by joze46 on Mon Jun 22, 2009 at 12:47:25 PM EST
    They know it is, we know it is, everybody knows, health care is easy to do, only hard because the powers that be will loose trillions in profits due to corruption and mismanagement done casually for decades.

    The Mainstream Media ignoring the issue for years, now Americans are looking seriously why... all these agencies including the spectrum from investigative reporting by all the cable channels news show they are bias corrupt and misleading. Especially  the IRS transparency in minimal to so opaque no can understand where the  corruption is likely festering.  

    That would be Congress Senate and the Stock Market all tied to the Federal Reserve. It is all a dam lie and all those characters on the television assume casually America is in great condition but actually imploding at the tune of billions a day.  The public option ladies and gentlemen is built in the first amendment with the ability to present our grievances. Ladies and Gentlemen please look into the eyes of those who are creating such fuse about the change. It is not the whites in their eyes it's the white around their eyes. All that make up and made up reasons why we can't do this thing now...  

    The health care industry has been a huge trillion dollar slush fund for the rich and publically tied for decades. Its sort like turning the health care industry on its head and find out that the "fall out of money" will save the whole concept. Likely not only pay for itself it will likely give better service and eliminate mediocrity that is wide spread in the industry reason for the need of malpractice insurance.

    It all makes one wonder why we should not have malpractice business insurance. Or is not what this "derivative" stuff is. Sure it is...Or, isn't it an oxy moron situation where business can have risk insurance, go broke to the tune of trillions of dollars , and get bailed out by our tax dollars, then turns around and says hey health insurance is impossible to do. Wouldn't you at least think these business and political idiots would like to keep this cash cow of tax doughnut legal loop holes shut and keep Americans healthy. Or are they a bunch of Nazi's.