With all the hullabaloo and disagreement even amongst your faithful editors about whether the current, everyone-agrees-crappy-in-some-respects, Senate health care bill is worth passing, one does occasionally have to sit back and wonder what is driving President Obama’s curious approach to getting health care passed.
I do wonder how much of this situation is due to the current president thinking to himself, “I’ll be goddamned if I’ll be number eight.”
UPDATE: (By Bob) Poll added in honor of a similar poll on DailyKos on the “Franken to Lieberman: Shutup” thread. You can go there to vote after you have voted here.
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… and he’s also realizing that he’s not all-powerful, that he’s not 60 Senators all at once. Therefore, he’s giving them a lot of space to hash it out: No bright lines, no absolutes.
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p>As a side note … if you want to understand how Obama operates, I recommend the Tao Te Ching, eg.:
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A less erudite way of making a similar point about Obama was when Jon Stewart wondered aloud whether Obama was a Jedi who was ten steps ahead of everyone else, or a rookie who had lost control of the debate. He knew it was one of the two, but he wasn’t sure which. I’m not either.
one day, people are saying he’s the master of 11th dimensional chess and all the other fools questioning his logic are just too dumb to understand. The next day, those very same people are complaining that he just didn’t have the power and didn’t have the control.
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p>The truth of the matter is a president has tremendous weight in DC, more than most would even think (and most would think a lot). He could have threatened the Landreua’s of the world by saying the DNC and DSCC would not give one drop of support to her in her reelection effort if she didn’t vote for cloture on the bill. They could have threatened Ben Nelson with major speeches in Nebraska on the importance of the public option. They could have threatened Joe Lieberman with his committee chairmanship. These were all options open to Obama and Reid that they refused to take, and Reid would have followed Obama’s lead on these issues. The truth of the matter is this is what Obama supported in the end — he didn’t give a crap about the public option and other important aspects of health care reform, which is precisely why he not only didn’t lift a finger to help it, but went out of his way to thank the likes of Lieberman and Snowe, while putting immense pressure on Dean and others to stfu.
Could have threatened Landrieu with withholding $$$ … who then goes down to defeat to a R who votes against everything, PO or no. Goes against Nelson in a cherry-red state … who then loses to a cherry-red R.
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p>Lieberman I don’t know about. I don’t know what his pressure points are. It’s a decent question.
she refuses to consent to supporting cloture.
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p>And you ignore the possibility that Landrieu is just as likely to lose the primary as she is the general. What is it with you and straw men today?
Evidence that’s possible or likely in LA?
the fact that she’s wildly unpopular within the democratic party and democratic voters
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p>B) the fact that it’s probably the best shot the Democratic Party has in keeping the seat
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p>C) the fact that primary opponents are already being recruited and will get national support, especially after the stunts she’s pulled on health care.
Well, no, actually — the point is to get them to modify their behavior so that they can keep their jobs with support from the party. That has worked pretty well when the WH has pressured lefties to toe the line. No reason it wouldn’t work in this case as well. There does seem to be a double-standard at play, where lefties have to play ball and conservaDems have to be appeased.
From the Greenwald article:
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p>Seems like a fair question to me.
Obama wants any bill passed.
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p>He’s negotiated from a stance of weakness all along, and has done very little with his much ballyhooed rhetorical skills to publicly shame the insurance companies and lobbyists who have spent hundreds of millions on campaign donations instead of on health care for the people who need it.
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p>The people wanted a public option. The people wanted Medicare to be available for buy-in.
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p>Obama did not trust the people.
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p>He may have grown up without much money, but I’m beginning to think he has forgotten how tough it is for most people, now that he’s selling millions of books.
what might have happened if he did insist on a PO, if he did more to shame the insurance cos (I seem to remember that he did, and has).
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p>Lieberman says “no” … and then we’re … where exactly? Ah yes, the same place?
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p>The dude is not God, people. He can’t do it by himself. The last Prez to do that was Clinton (with a big assist from Hillary) … and again … what happened?
If you want to make this argument.
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p>My position is that (a) much, if not all, of desirable health care reform can be passed with 50 votes in the Senate, and
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p>(b) that a Republican filibuster against health care reform would be a disaster for them and could not be sustained. Can you imagine the Congress not being able to vote funds for our troops in the field, for example, because the Republicans were filibustering health care reform that a big majority of the population wants? They’d be routed.
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p>Conclusion: Obama and the Democrats could do much more if they wanted to.
On (a), reconciliation:
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p>(1) It is likely that at least some pieces of a “dream” health care bill would not be eligible for reconciliation according to the Senate parliamentarian’s reading of the Byrd rule (particularly the new insurance regulations).
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p>(2) If reconciliation is used, there is no guarantee that it will be permanent. Under reconciliation, the bill must be revenue-neutral, and if it is not in any year after a 5-year window, the whole thing will expire. This is major point about reconciliation that is oddly absent from the debate over this method.
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p>(3) There is hardly any guarantee that a reconciliation bill with a strong public option will get 50 or more votes, especially if some (overly?) sensitive Senators believe that this is “ramming it down their throats”. Plus, the use of this method for health care could endanger support for key initiatives in 2010 (climate change, financial regulatory reform, a jobs bill).
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p>On (b), the Republican filibuster:
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p>(1) It is unlikely that a Republican filibuster will prevent anything else from being passed, due to the double tracking procedure in the Senate. An “actual” filibuster does not have the effect that you imply here.
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p>(2) Even if it were the case that all Senate business slowed to a halt in the case of a filibuster, which it does not, then this would threaten other elements of the Democratic agenda noted briefly above. Further, history has shown that voters tend to attribute the lack of congressional production to the majority party, not “obstructionists” using obscure Senatorial rules.
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p>(3) Why would a Republican filibuster be a political “disaster” for them? Polling is pretty clear that the public has soured on the Democrats’ handling of health care. They would certainly not be “routed” for doing so.
re (a)(1), that’s true, but it’s my understanding that some of the insurance regs (e.g. banning pre-existing condition exclusions) have 60 votes. The idea is to split out the stuff that can be passed that way from the stuff that has to be done via reconciliation.
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p>(a)(2) – that’s an interesting wrinkle. Can you give us a link explaining how this 5-year rule actually works? Who decides?
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p>(a)(3) – presumably one would not begin the push for reconciliation without being certain of 50 votes + Biden in the bag. As far as endangering a climate bill goes, what’s the argument — that Joe Lieberman will be mad that he got marginalized via reconciliation, and therefore won’t back a climate change bill out of spite? Honestly, we can’t let the assholes control every debate to that extent. Sometimes, you just have to do something.
Yes, apologies for not including a link to back up my claim about the five-year sunset. It’s not the greatest summary, but this summary put together by Rep. Louis Slaughter (Chair of the House Rules Committee) is OK at getting to this point. If I can find a clearer summary, I’ll post it. The link to the CRS report below might also be helpful, but it is 48 or so pages.
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p>I’d direct your attention to one aspect of the definition of the test for “extraneous-ness” under the Byrd rule. One of the several tests is that the provision cannot “increase net outlays or decrease revenue during a fiscal year after the years covered by the reconciliation bill unless the provision’s title, as a whole, remains budget neutral.” The “years covered by the reconciliation bill” are the current budget years and (usually) the four out-years following this budget year, as noted in this excellent [PDF] (but lengthy) Congressional Research Service document detailing the process.
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p>To “get around” this aspect of the Byrd Rule requires the incorporation of sunset provisions into the bill going through reconciliation (for example, the Bush tax cuts had to do this). The period covered by reconciliation is 5 years, which is the maximum amount of time allowed before the sunset must trigger, absent additional action by Congress.
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p>That “additional action” is what concerns me — Republicans will have a hard time dismantling aspects of this health care bill if passed (e.g. subsidies) — even if they regain the majority — because the filibuster will require them to secure 60 votes to do so. But if the legislation automatically expires due to a sunset clause required under reconciliation rules, Republicans can simply allow it all to die, with no possibility of a Democratic filibuster.
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p>In the present case, all the presiding officer has to do is announce that the various provisions of the health reform measure are not extraneous matter and move on through reconciliation. Point of order challenges to such a determination, as I understand it, interesting report on filibusters prepared by Lieberman’s office are subject to a majority vote.
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p>The administration can pass all, or much of, the current health care reform legislation through reconciliation if it wants to do so.
why shouldn’t someone, Sanders maybe, declare that the bill is unacceptable unless they strip out (or gut) the individual mandate?
The public plan is for the most part pointless. It was slightly less pointless when medical reimbursements was tied to Medicare (which didn’t even last long in the House), but it’s still pointless. The public plan would just be another health insurer, with no structural advantages over any other insurer, in fact it might have disadvantages since the other insurers would be more inclined to play dirty (finding loopholes and whatnot) to keep its profit margins up, whereas the public option would (presumably) not do that, and thus would have to charge higher premiums to compensate, leading to risk selection pushing the sick to the public plan and the healthy to private plans.
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p>If everything went well, it might lower prices slightly, but it would still be a small segment of a small segment of the health insurance industry. The only difference between the public option and the other insurance companies would be that it would be led by government appointees. It would, of course, bring competition into an industry which is severely lacking in that, but it is merely one way to do that, and “one more” is a fairly limited kind of competition. The health insurance exchanges themselves do quite a lot, by making it easier for people to select between insurers.
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p>Most people (by which I mean the average voter, not people here) do not actually understand what the public option is. But in so far as people do, it’s more about the symbolism than anything else. They like the idea of being able to choose “something” other than the current health insurers, and those more to the left really like the idea of the government getting some sort of symbolic foothold into the industry. But does it actually mean anything?
That why they hates it, precioussss, hates it.
I think there are various explanations for that without it being all that important. First, there’s a difference between helping people and hurting insurance companies. For instance, if the public option transfers patients away from the for-profits while providing basically the same level of quality, “the people” don’t benefit all that much, but the insurance companies lose revenue. Secondly, even though the public option is broadly popular, it’s really easy to demagogue with the conservative base, since it’s much easier to attack as being “socialist” than other aspects of the health insurance exchange. So it’s easier to kill than trying to keep recissions and being able to reject people for pre-existing conditions, or whatever, which are technical issues which are hard for even the stauchest conservatives to get behind. Third, the industry hates the public option for the opposite reason that progressives love it: they’re afraid that it would lead to single-payer, which would be basically game over for the health insurance industry. But that doesn’t mean they’re right; big business is perfectly capable of doing very stupid things.
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p>I mean, I really am willing to be convinced that the public option really is the best thing ever, and I do think that it is ultimately on balance something that would be nice to pass if we can, but the argument that we should support something just because industry opposes it seems way too simplistic. Especially since it would be so easy for industry to game that sentiment by purposefully using the public option as a diversion: get everyone debating over the public option, while you get your lobbyists to work at the gritty level trying to work on weakening the bill in other areas.
“the argument that we should support something just because industry opposes it seems way too simplistic.”
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p>I completely agree. My only point was that opposition by the industry is an indicator that it might be detrimental to their interests.
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p>In general, the most obvious interpretation is probably the right one. One can go on forever spinning double-cross theories.
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p>”they’re afraid that it would lead to single-payer, which would be basically game over for the health insurance industry.”
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p>Personally, I think this interpretation is more right than wrong, and is one reason among many why a public option can, in fact, be considered quite important.
It is a foot in the door, for a public plan. Even if it only applies to a few people at first, it can be expanded.
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p>People are being gouged right and left by insurance companies. You make everyone in America buy insurance and the people who are already under stress will feel even more stress, and blame it on Democrats.
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p>We need some good politics in this bill.
If he gets some bill, any bill, he can claim victory as a political matter. If the current bill is passed he also in all likelihood will be able to collect big checks from the Powers that Be in the health care industry. Win-win.
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p>I think he is miscalculating. Forcing millions of Americans to buy insurance plays right into Republican assertions about his ambitions and will hugely energize them — the Great Republican Line of No is an indicator. “I can’t buy milk for my children because of those bill bills Aetna keeps sending me that the President says I have to pay.”
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p>Stripping the progressive heart out of the health care reform project (as I suspect even my esteemed co-editor Charley would agree is the sorry present state of things) will further dismay a good chunk of his base.
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p>But Obama is a political genius and I am not. No doubt he knows exactly what he is doing. There are some good things in the bill. I’ll give him the benefit of the doubt and vote Jedi.
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p>Uh, no. A genius would not have allowed this effort to become an obscene parody of what he claimed he was going to secure for the people. The problems are he doesn’t know what he is doing, he listens to people steeped in the bullshit days of the Bush administration, he is cowed by Republican discipline and “vision,” and he is too cowardly to stand up and lead.
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p>I said it before the presidential primary season was over and I’ll say it again now: Barack Obama is too conciliatory. And that will be his Achilles heel.
I’d say that if this bill goes down in flames, rather from the right or the left, Obama’s main legacy in 2010 will be the continuation of George W Bush’s policies on Iraq and Afghanistan…not the “change” people voted for. Without a health care bill, people will wonder what he has accomplished since his inauguration.
for Obama are: the ECONOMY – which has “stabilized” with Wall Street feeling better but you, me and Main Street still reeling; the WARS, with full occupation and more still going on in Iraq and Afghanistan (for all the talk of success in Iraq, let’s see what happens if we dare leave); and HEALTH CARE REFORM. Show me how he has carried the progressive flag into battle on any of the above. Lots of talk but disappointing results on all three.
this is the bill obama wanted all along.
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p>http://www.salon.com/news/opin…
Ryan, I’ve posted this Glenn Greenwald column and you’ve posted it but I haven’t seen anyone wanting to comment on it. How about it, Charley? It’s quite inflammatory. If Obama & Braintrust have been toying with us, never wanting serious reform, it’s awful. Or do people believe Greenwald is wrong?
… it proves nothing other than that they want something that will pass, and that means co-opting the insurance and PhRMA industries. To say this is secret is mystifying. That’s been the obvious model, even from the MA plan. When the WH and PhRMA came out to announce $80 bill in savings, of course that was the result of negotiation. Where else would it come from?
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p>It’s realpolitik, it’s sausagemaking, it’s unsavory, and it may not even be good politics — QED. I’m hoping that it’s policy that will be an improvement in a lot of ways, and I have good reasons to think so.
Well, yeah. That’s kind of the point of my post: that Obama’s principal goal here is starting to look more and more like being able to say he was the first president since FDR who was able to sign something plausibly styled “health care reform,” and less and less like signing a good bill.
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p>In other words, it’s starting to look like a PR stunt, and a plank for his 2012 campaign. Rather than good health care policy.
…FDR gave us the famous 100 days. He had huge majorities too, I believe, and said we have to get a bunch of things done NOW. He wouldn’t put up with a lot of this nonsense. FDR said he welcomed the hatred of the naysayers whereas Obama doesn’t want to upset anybody. Bringing people together is a nice idea, but clearly some people want no part of it.
And thus, I think, some very justified criticism of the president here and elsewhere and a health reform bill that, as David writes, looks increasingly shallow.
…Democrats gained seats in FDR’s midterm, rare for the incumbent party AND he won by one of the most lopsided margins of either the electoral or popular vote in history. This should calm any fears about pushing too hard.
.. that all the ‘good’ healthcare policies didn’t start out all that ‘good’. They got modified once they were in place over time.
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p>I’m in Charley’s camp. I agree a lot with Greenwald on a lot of stuff (especially when he’s in is area of expertise – the law), but I disagree with him about Obama’s intent here. I wouldn’t purport to ‘know’ if this is the bill he wants, but this is the bill he thinks he can pass (and if the left lets him – he’d be correct). If he telegraphed what the bill would look like early, I take that as an indication of early recognition of what would pass, not necessarily what he ‘wants’. This shouldn’t be surprising… he knew before his oath that the challenge would be congress and the senate. You can see it in his staff picks. The whole WH team seems engineered to help them maneuver through the body to passage. The staff picks were and are an acknowledgment that to get legislation done, all the major plays are in the other court. If this armed him with pretty good strategic knowledge of ‘what will pass’, then that’s a feature, not a bug.
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p>Sure I think he just want’s to get it passed,… but I don’t think that’s a bad thing. The problems with the particulars can and no doubt would be handled in future fights. We’re in a much better position going forward with the ground that is gained here than without it.
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p>I think my strongest misgiving was echoed by Stomv in that this would mandate a legal contract with a private entity. I can see the practical and structural reasons why a mandate is a ‘feature not a bug’, but the private nature of the mandate is very regrettable. That being said,… I don’t see the order of operations in what we can accomplish on this front as – public option then mandate. If that won’t pass then it wont. I do see, however, that from a no-public -option with a mandate we could ‘get to’ a public option more easily. Once the cost and competition controls happen through the exchange along with the information and transparency features are implemented, it will be much much harder for anyone to make the case that a public option wouldn’t help control costs.
History.
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p>He and Rahm are so comfortable ramping up privatized forms of government, such as military contractors in Afghanistan, it never occurred to them the American people might have a problem turning over 20% of their income to private corporations for crappy poorly-regulated insurance products, by law.
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p>Requiring insurance, by law, is a big step. You’d think they do more to make sure what they’re making people buy, by law, is something they want to buy.
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p>MORE
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p>read the whole post
This is the bill President Obama “wants?
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p>So, as with Afghanistan, people are angry because he’s doing what he said he’d do, rather than what they WISH he’d do?
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he campaigned on the public option and no mandate.
is because ire should be placed at Obama if we want this thing to be fixed soon. If he exerted any of the pressure Neil quoted above, a public option could still likely be had.
given that Obama and Reid aren’t willing to fight for what’s right with even one iota, this bill won’t even stop at Stupitts… now there will even be a state opt-out for the small increase in medicaid. http://www.americablog.com/200…
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p>Given that no one will say no to LieberCare and NelsonCare, when will this all stop? I’ll tell you when: when we stop compromising with these devils, tell them to all stfu and take it to them hard if they keep trying to torpedo this.
We both worked for John Edwards in NH. I think we were both moved by Edwards’ condemning the destructive influence of corporations and lobbyists on democratic government and believed his stated commitment to fighting it if elected. So I copy two passages from Glenn Greenwald’s latest post – The underlying divisions in the health care debate – for your reaction. Thanks.