Political Realities

Claiming the mantle of "political realist" has been the mantra of people supporting the Stand Alone Senate bill. In fact, political realists should have seen the fundamental political flaw of the Senate bill. John Judis describes it:

Where Obama invited a voter backlash was by letting the burden of reducing health care costs appear to fall on senior citizens and those middle-class workers who had acquired good health insurance through decades of union battles with management, and not on the insurance and drug companies. Obama ceded too much to the policy wonks who were devising intricate schemes to show they could cut the deficit. He took his eye of off the political imperative of keeping middle America in his corner.

(Emphasis supplied.) The Village Dems spent yesterday screaming "it's simple" - pass the Senate bill. This meltdown was revealing, the Village Dems have no connection to political reality. There simply is no doubt that, speaking politically, there is no worse feature in the health bill than the excise tax. It was an unproven policy that was sure to cause a political debacle. Indeed, it is the principal impediment to the House passing the Senate bill stand alone.

Speaking for me only

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    I certainly agree that (5.00 / 1) (#21)
    by dk on Thu Jan 21, 2010 at 08:46:23 AM EST
    the passing the Senate bill is bad policy and bad politics (I think passing the House bill in its current form is that as well, though I understand there are differences), but I don't think the excise tax alone is why the bill is so awful.  

    I think the reason is that the senate bill has mandates + excise tax + potential medicare cuts - virtually anything that helps the vast majority of the working/middle class.  Getting rid of the excise tax is a help, but not enough, IMO, to make the bill good politics or good policy.

    Mccain Proposed Medicare Cuts in 2008 campaign (5.00 / 3) (#25)
    by Dan the Man on Thu Jan 21, 2010 at 08:59:01 AM EST
    and progressive bloggers were saying how awful it was.  Obama proposes Medicare cuts and progressive bloggers are saying how awesome it was.  Pretty funny watching the difference in reaction.

    Obama People (none / 0) (#48)
    by cal1942 on Thu Jan 21, 2010 at 10:00:30 PM EST
    still have gallons of Kool Aid on hand.

    Excise tax and no employer mandate (5.00 / 2) (#22)
    by Coral on Thu Jan 21, 2010 at 08:48:27 AM EST
    while imposing mandates and fines on the uninsured. To be honest, as a MA resident my anger at the bad policy in the Senate bill tempted me to vote against Coakley in protest.

    Reason won over emotion, and of course I voted Coakley. But if a dyed-in-the-wool Dem/Progressive like me can have these emotions, I do understand how Brown won on Tuesday. Especially once people began to realize that Coakley was not the slam-dunk we all assumed she was.

    The reality, political or otherwise, (5.00 / 4) (#27)
    by Anne on Thu Jan 21, 2010 at 09:11:37 AM EST
    is that Obama's take from the Democrats' defeat on Tuesday is that Dems should be moving more to the right, working harder to find mutual agreement with Republicans so they can all do what's right for the American people...

    I don't think there's any help - or hope - for this legislation to improve, nor do I see any hope that Congress can or will ignore these calls for more bipartisanship and start acting like Democrats; the bright spot for Obama may be that the bloodbath that is coming in November will finally give him the Republicans he needs to enact the Republican policies he's always been so fond of.

    As for voter backlash, it might also have something to do with these two headlines, that dropped into my I Box this morning:

    Goldman Sachs posts nearly $5 billion profit as CEO highlights tighter compensation ratio


    Last week's initial jobless claims up the most in eight months, hitting 482,000

    The rich are getting richer, the poor are getting poorer, and Barack Obama's not doing one damn thing to slow or change that dynamic.

    Never fear (5.00 / 2) (#30)
    by jbindc on Thu Jan 21, 2010 at 09:16:56 AM EST
    House Liberals say "No way". So sayeth Greg Sargent...

    In a private meeting in the Capitol just now, a dozen or more House liberals bluntly told Nancy Pelosi that there was no chance that they would vote to pass the Senate bill in its current form -- making it all but certain that House Dems won't opt for this approach, a top House liberal tells me.

    "We cannot support the Senate bill -- period," is the message that liberals delivered to the Speaker, Dem Rep Raul Grijalva told me in an interview just now.

    Those House Dems (none / 0) (#49)
    by cal1942 on Thu Jan 21, 2010 at 10:08:39 PM EST
    may save the Democratic Party from TOTAL self destruction.

    And you know what Goldman Sachs... (5.00 / 2) (#36)
    by Dadler on Thu Jan 21, 2010 at 09:46:38 AM EST
    ...paid in corporate taxes on its profits in 2008?

    Get ready to vomit.

    0.6 percent.

    Not even one percent. That is criminal.


    Political Reality (5.00 / 1) (#38)
    by grouse on Thu Jan 21, 2010 at 10:12:09 AM EST
    Is there not one single person in this administration reminding the President "who brung him to the dance?"  I don't believe I've ever seen an administration walze away from his base as thoroughly and completely as Obama has.  How can Obama not see this even if his advisors can't?  It's beyond me!  I wish he had Howard Dean as chief of staff then at least one person would speak up for the base.

    Really (none / 0) (#43)
    by Socraticsilence on Thu Jan 21, 2010 at 11:04:11 AM EST
    were you not around in the 90s for Clinton or the 60s when JFK repaid African-American voters by wiretapping MLK?

    Two big mistakes with one message (5.00 / 3) (#39)
    by MO Blue on Thu Jan 21, 2010 at 10:36:41 AM EST
    1.  Back door deals with pharma and insurance industry.

    2.  Choice of funding legislation on the backs of senior citizens and those middle-class workers who had acquired good health insurance instead of taxing individuals making $500,000 and families making $1,000,000 a year.

    The perceived message: Obama and Congress was focused on protecting the profits of corporations and the wealthy at the expense of ordinary people.

    Well, we could have had Hillary....someone with (4.57 / 7) (#4)
    by Angel on Thu Jan 21, 2010 at 08:01:55 AM EST
    some experience and better qualifications.

    sher (3.43 / 7) (#6)
    by kmblue on Thu Jan 21, 2010 at 08:12:57 AM EST
    try justifying your ratings, instead of just using them to defend your boyfriend.

    What on earth can this mean? (5.00 / 1) (#31)
    by lambert on Thu Jan 21, 2010 at 09:19:15 AM EST
    What "boyfriend"? What are you talking about?

    Stop this (1.00 / 1) (#17)
    by Big Tent Democrat on Thu Jan 21, 2010 at 08:42:15 AM EST
    Ratings do not matter here and comments on ratings are off topic.

    Spoken like a true proponent of a BCS playoff (5.00 / 1) (#20)
    by steviez314 on Thu Jan 21, 2010 at 08:45:45 AM EST

    We also could (none / 0) (#41)
    by Socraticsilence on Thu Jan 21, 2010 at 10:59:39 AM EST
    have Unicorn's to ride to work, world peace, and immortality, man it'd be sweet to live in the land of hypothetical scenario's that are impossible to verify.  

    I read the linked article (4.50 / 8) (#1)
    by kmblue on Thu Jan 21, 2010 at 07:36:50 AM EST
    I'm afraid the thought of Obama and his administration trying to relate to the middle and lower classes seems impossible.  But he's certainly welcome to try.  Obama might try lowering his chin when he speaks, just for starters. ;)

    I know you think that the excise tax is an (2.00 / 0) (#3)
    by steviez314 on Thu Jan 21, 2010 at 08:00:54 AM EST
    experiment, while I think it is good economic policy.

    Assuming I am correct, then what is the point of "political reality"?  If the goal of politicians should be to just win the next election, then who needs them?

    At some point, someone needs to enact good policy DESPITE any political repercussions, if we have any hope to survive as a country.

    My goal is to leave to my children a better health care system, not a Democratic majority.

    If? (5.00 / 2) (#5)
    by Big Tent Democrat on Thu Jan 21, 2010 at 08:06:07 AM EST
    It does not matter what it should be, it IS. That is the political reality. But let's be clear, you can't do anything if you are not elected.

    As for enacting good policy, absolutely. This is the way to good politics.

    But to ignore the political cost of the policy, which even you HAVE to admit, is marginally good at best, is ridiculous.

    Hell, if no one thought about being reelected and only considered policy, we would have single payer today.

    I never argued for single payer not because I do not think it clearly the best policy - I do, I did not because it would not fly politically right now.  


    I guess I'm just tired of political reality (5.00 / 2) (#7)
    by steviez314 on Thu Jan 21, 2010 at 08:13:52 AM EST
    But let's be clear, you can't do anything if you are not elected.

    Guess what?  It seems you can't do anything even if you ARE elected, either.  Or, at least, they don't seem to want to.

    It seems like no one in Congress knows that good policy leads to good politics, or certainly not a critical mass of them.  I think too many have it backwards.

    And good politics just doesn't seem to be generating good policy, just more politics.


    "In a Democracy, (5.00 / 1) (#10)
    by Buckeye on Thu Jan 21, 2010 at 08:22:33 AM EST
    the people get the government they deserve."

    Alexis de Tocqueville/Hunter S. Thompson


    Not all of the people. (5.00 / 4) (#33)
    by Cream City on Thu Jan 21, 2010 at 09:24:54 AM EST
    Just the ones who treat elections as American Idol contests.

    My unemployed children do not deserve this.  My spouse working to support them when he ought to be retired does not deserve this.  

    So I am changing my voting patterns to no longer support the undeserving -- on the ballot or in the lines to cast their ballots so stupidly.


    We could have gotten better policy (none / 0) (#40)
    by Manuel on Thu Jan 21, 2010 at 10:42:23 AM EST
    with better politics.  The heath care politics have not been good, mostly on the part of the administration and the Democratic leadership. Furthermore, whether the end result is good progressive policy is debatable.  I happen to think it is but that does not matter.  It is undeniable that it is unpopular and has no chance of passage through congress as is.  The best possible result now is some populist legislation that helps people.

    It's not the only good policy; (5.00 / 4) (#8)
    by observed on Thu Jan 21, 2010 at 08:17:14 AM EST
    furthermore, it was patently NOT chosen because it was the best approach, but because the rich fat cats want to pile more taxes on the middle class, who don't pay enough already, in their opinion.
    The politics of the choice are transparent, and disgusting.

    Assuming you are correct... (5.00 / 1) (#13)
    by lilburro on Thu Jan 21, 2010 at 08:27:32 AM EST
    there were many other ways to control costs.  And I doubt the bastardized bill we have on the table is going to be the healthcare system we leave to our children (I hope it's not anyway).  

    The excise tax is doable in the Senate, sucks politically, may work policy wise.  The PO was doable in the House, was good politically, will work policy wise.

    This last part is not directed at you, but I am getting the impression from some who want the Senate bill passed (w/o fixes) that the excise tax was the only good idea in the bill ever.  And that just isn't true.  It's just more ridiculous boosterism.


    The P.O. was good policy AND good politics. (5.00 / 1) (#14)
    by steviez314 on Thu Jan 21, 2010 at 08:30:23 AM EST
    One of those rare things.

    I think insurance company regulations are also both, except there will be some negative effects from them that would have been mitigated by the PO.


    Was it the "good politics" part ... (5.00 / 1) (#32)
    by lambert on Thu Jan 21, 2010 at 09:24:27 AM EST
    ... that caused [a|the] [strong|robust|triggered] public [health insurance]? [option|plan] to fail?

    Or the lies from its "progressive" proponents, who started out by claiming it would be like single payer, with 130 million enrollees, and still kept pushing the same line as it dwindled to 10 million?


    My understanding of the excise tax (5.00 / 2) (#15)
    by itscookin on Thu Jan 21, 2010 at 08:34:19 AM EST
    is that it is really not intended to raise revenue. The idea is that employers will offer less expensive insurance plans to avoid the tax. Those less expensive plans will have higher deductibles and larger copays so people will find it more expensive to access health care, go to the doctor less, have fewer tests, etc. which will lower the cost of health care in this country. This is how the benefits guru at our company explained it to us. Is he wrong?

    I think (5.00 / 2) (#16)
    by kmblue on Thu Jan 21, 2010 at 08:37:42 AM EST
    this will just cause people to postpone going to the doctor, which means when they finally do go, they will be REALLY sick, which means the cost of their care will be MORE expensive.  Lovely.

    But there is ridiculous waste in some Cadillac (none / 0) (#19)
    by steviez314 on Thu Jan 21, 2010 at 08:44:19 AM EST
    plans too...

    I look at my plan..accupucture is covered, as is 50 gym visits a year, and glasses once a year (at my age, my vision doesn;'t change that often)

    I am willing to give up things like that so that the uninsured can have basic health care.


    First question: are those a (5.00 / 1) (#23)
    by observed on Thu Jan 21, 2010 at 08:49:29 AM EST
    signficant part of the extra cost? They sound like small potatoes.
    Second, 50 gym visits are a small cost and perfectly appropriate for someone who needs to lose weight.
    The things that matter are the big heart procedures and the expensive tests. Also, the extra costs from unnecessary procedures which follow from overtesting.

    Wow (5.00 / 1) (#29)
    by gyrfalcon on Thu Jan 21, 2010 at 09:14:08 AM EST
    Stevie, not only are those, as the commenter points out, trivial in terms of health care costs, but gym sessions improve general health all around and therefore lower health care costs.  Acupuncture costs a lot less than traditional medicine for many, many sometimes intractable problems.  And your eyes may not change much, but many people's do as they age.

    Those things strike me actually as smart policy by your insurance company and your employer.  And I doubt very much they constitute more than a very small amount to the cost of the policy.


    Good vision is "ridiculous waste"? (5.00 / 2) (#35)
    by Cream City on Thu Jan 21, 2010 at 09:33:37 AM EST
    How nice that you are not of an age to need bifocals, trifocals, constant adjustments to cope with constantly changing eyesight.

    May you share the roads only with other drivers of your age.

    (But you must be old enough to figure out that tailoring plans separately for individuals would cost a lot more than blanket plans.  You want an individualized plan?  Then get out of group insurance . . . and see what individual plans cost.)


    That's good of you (no snark here) (none / 0) (#24)
    by kmblue on Thu Jan 21, 2010 at 08:51:16 AM EST
    I've never had a plan like that.  When I had a plan, it covered dental, vision check once a year, I had to pay for glasses out of pocket.  No acupuncture, no gym.  I'd love to have a plan like that again.

    But how will giving up those things (none / 0) (#26)
    by itscookin on Thu Jan 21, 2010 at 09:08:51 AM EST
    provide basic health care for poorer people? I'm not being argumentative. I really can't see how your employer cutting back on your health care plan so that they don't have to pay excise tax will provide funding for health care for poor people. You'll be paying more of your own personal dollars for health care, but it will be going to doctors and hospitals for your care not someone else's. It might make the lines shorter at the doctors' offices, but I don't see how it pumps money into the system. The only way for this to send money into the system is for the company to continue to offer the cadillac plan and pay the tax. That means less profit for the company or higher premiums passed on to you. The benefits guru at our company assures us that most companies will choose to scale back on benefits. Our plan isn't quite at cadillac prices, or cadillac coverage for that matter, but if the excise tax isn't indexed for inflation, by the time it kicks in, it will be. I would be willing to pay a higher copay if that meant a poorer person could go to the doctor, too, but I don't see how the money I'm paying the doctor ends up paying for someone else.

    "Waste" is subjective (none / 0) (#28)
    by jbindc on Thu Jan 21, 2010 at 09:11:56 AM EST
    Many people don't need maternity coverage in their plans.  Many don't need substance abuse coverage. Or mammograms.  In my plan, for example, I have all kinds of things that would cover kids' visits to the doctor, braces, etc.  I don't have children - Personally, I'd rather have "more" insurance go to my own coverage (to reduce deductibles) than an policy that offers "well baby visits".

    Don't poo poo acupuncture - it helped me (none / 0) (#50)
    by suzieg on Fri Jan 22, 2010 at 02:08:06 AM EST
    tremendously in preventing nausea during my chemo treatment. Also during my perimenopause it stopped my hemorrages completely.

    Everyone agrees there are (5.00 / 1) (#18)
    by observed on Thu Jan 21, 2010 at 08:42:43 AM EST
    significant costs from extra procedures and tests.
    Going to the doctor more often is NOT  a big part of the cost problem.
    There are many causes for the extra tests and procedures. I have not seen anyone quantify how big a factor the patient's insurance type is, which is a large lacuna---at least in popular articles. I've skimmed some longer surveys, but they are daunting.

    Yes, the "Cadillac Tax" (none / 0) (#37)
    by KeysDan on Thu Jan 21, 2010 at 10:08:43 AM EST
    has several engineering tasks: as you note, the "sin tax" idea of more taxes, less use, it works for cigarettes and alcohol, and health care is no different), pass through of premium reductions as wages probably on a l:l, since that is the way employers do business,  taxes on the "new income" (a big revenue source since it is a flat tax of 40 percent on all income levels) and cost control since consumers who use less care owing to higher co-pays and deductibles do use less care, thereby promoting the desired skipping of care. Moreover, there are no ramifications to this bonanza, such as "savings" being offset by higher hospital admissions for those with chronic illnesses or older patients.  Health care is no different from any other "business", health care professionals are the same as any other worker, and efficiencies can be realized through these tried and true economic principles that "bend the curve", and save money for "people out there".

    yeah, (none / 0) (#2)
    by Ga6thDem on Thu Jan 21, 2010 at 07:50:15 AM EST
    well Judis is just one of many who are talking about the disaster that is Obama it seems. Zuckerman at the daily beast being one that comes to mind.

    Obama didn't do it alone. (5.00 / 2) (#12)
    by observed on Thu Jan 21, 2010 at 08:24:19 AM EST
    He has about 290 accomplices.

    No (5.00 / 1) (#34)
    by Ga6thDem on Thu Jan 21, 2010 at 09:26:09 AM EST
    I dont think they should be let off the hook either but the main blame falls on Obama since he is supposedly the leader.

    Disaster (none / 0) (#42)
    by Socraticsilence on Thu Jan 21, 2010 at 11:02:52 AM EST
    please the guys been a disappointment, he's far to Bill Clinton for my taste (at least he hasn't executed the mentally handicapped or signed of on Gay marriage bans yet), but he's done some good without a doubt, he had such a huge challenge when he took office I'd say he's in the B- to B level at the mnment.

    LOL (5.00 / 1) (#45)
    by Ga6thDem on Thu Jan 21, 2010 at 02:35:35 PM EST
    Yeah, losing a senate seat in deep blue MA really shows what a super duper fantastic job he's doing! We have double plus wonderful double digit unemployment and it's worth a B? Talk about grading on curve!

    Actually (none / 0) (#46)
    by Socraticsilence on Thu Jan 21, 2010 at 03:16:30 PM EST
    there's one more Dem Senator now than there was when Obama was sworn in- besides do you really want to use "control of congress as a metric" I mean given your views of Bill Clinton- 1994 would be a pretty massive indictment of his leadership wouldn't it?

    Well (none / 0) (#47)
    by Ga6thDem on Thu Jan 21, 2010 at 04:49:16 PM EST
    did Bill Clinton lose a seat in MA? I mean the whole MA senate seat was made into a referendum on a President by himself. He's the one that said that he needed that 60th seat for healthcare reform. Really, Obama could have 20% unemployment and you'd still give him a B wouldnt you? LOL. So far he hasn't produced any successes. Maybe he can change that but it doesnt look like it. His hubis will not let him.

    Well (none / 0) (#44)
    by jbindc on Thu Jan 21, 2010 at 01:31:30 PM EST
    At least you and Obama agree that he deserves a B.  

    Not so much for the rest of us living in reality.