Issues Raised By The Health Care Fight

I started typing a comment to last Monday's post, but it was getting a bit long. And heck, I think the issues here are front-page worthy. So here it is:

Piecemeal Reform vs. Comprehensive Reform

I think Caterpillar, and the few companies who've made similar statements (about how the health care bill will cause them to lay off lots of workers) are playing a little fast and loose in order to make a point. Here's a story today about Congress kind of calling their bluff by asking them to come defend their claims before the House Energy and Commerce Committee. But even if the claims were perfectly true, it is a conversation worth having. Is guaranteeing health care for every American worth the price Caterpillar is claiming? I think it is.

But if the health care bill did in fact cause large companies to lay off workers, it would highlight a bigger issue: It's hard to win social justice one step at a time through piecemeal reforms. As Elizabeth pointed out in comments, Caterpillar would be laying off workers while it's executives continue to make millions. Or, what if instead of laying off workers they decided to cut costs by ignoring environmental laws? Or moving to Burma? It turns into a game of whack-a-mole, with democracy and social justice trying to bop capitalist excess every new place it pops up.

What we need instead is comprehensive economic reform. Instead of a system where we try to milk universal health care, living wages, and environmental standards from entities that have no interest in such things, what if we started with universal health care and a decent life for everybody as the first priority. Then we could allow corporations to rise up, and we could treat them as luxuries that only add to the basic foundation of dignity and security for every person. And if they ceased to do that, we could dissolve them. That way, we could make corporate capitalism serve us instead of the other way around.

Name Calling vs. Truth Telling

I think almost all who followed the long health care battle closely would say it was a draining experience. Such intensity from both sides. And often our politics feels pretty removed from our basic humanity, with the harsh rhetoric from every direction. But this nasty fight over the last year just won quality medical care for tens of millions of people who didn't have it. We should be reminded that some things are worth fighting for. And health care is one of them. And I agree with new commenter, What Blue Dot?, that name calling is a waste. But I hope you'll agree that we ought to have the guts to speak the names of our oppressors. If someone is standing on my neck or my neighbor's neck, I'm going to call him out. If someone is standing on my neck or my neighbor's neck by virtue of a social or economic system, I'm going to call out the system. The question is, can we call out the oppressor or the system without turning off the people we need to stand with us? Often, no.

For Those Of You Who Are Really Hardcore...

C-SPAN is showing tonight's marathon debate in the Senate. They are going through the dozens of amendments the Republicans are offering to the reconciliation bill. The Dems are trying to get through this so they can vote on final passage sometime tomorrow.

So if you're up late tonight, so is the Senate. Looks like they're at it till at least 1:00 am.

Calling All Principled Conservatives

It's time for some soul searching on the right. It's time for honest and benevolent people to control the Republican Party.

America has just reached the end of a 14-month debate over whether or not and, if so, how to reform our health care system. The legislation with which we've emerged is a big tapestry of ideas, many of which are historically Republican ideas and many of which are Democratic ideas. The president said, "This isn't radical reform, but it is major reform." He's right. It's not radical because we will still have a predominantly employer-based insurance system. It's not radical because for-profit insurance companies will continue to be the major players on the scene. But it's major reform because through a series of tweaks to the system (subsidizing insurance purchases for the poor, expanding Medicaid, creating a national insurance exchange, reining in the worst industry practices, etc) we will end up insuring virtually every American. And according to the most objective referee we have for stuff like this, the CBO, we will make these "tweaks" while also reducing the budget deficit and reducing the tax and premium burden on working families. In other words, having everyone insured is going to be cheaper for America than having millions uninsured.

Sounds great. So why did this debate feel like nuclear war? Why did every single Republican member of Congress vote against this bill? What were conservatives standing up for by opposing the bill?

The Usual Suspects Of Anti-Progress

We would expect the small class of people who own and manage big health care companies--and big companies in general--to oppose the bill. They're looking out for their own personal interests and defending their positions of power. If anything is consistent throughout our political history, it is that this class exists and it intelligently defends its interests.

We would also expect racists and social conservative extremists to oppose the bill. They would view the legislation as too big of an equalizing force in society. They would not want to see people of other colors, religions, or sexual orientation gain any more solid footing and security in America.

OK, so that explains the CEO and KKK vote. But even I don't think the Republican coalition is just the corporate class and the hateful class.

The "Silent Majority" Of The GOP

How do we explain the raging opposition to health care reform from good-hearted, principled conservatives--conservatives like many of my friends and extended family? Sometimes in the heat of battle I have to remind myself that these conservatives exist. Decent and wise people have good reasons to argue for less government intervention in our lives, more local control, more emphasis on markets for distributing resources and making decisions. There is a principled conservatism out there, and there is an important place for it in our political dialogue.

But how does that principled conservatism translate into opposing health reform that saves lives and saves money--especially when there isn't a conservative path to universal health care on offer? What, other than abstract principles, are these conservatives losing with this reform? It's as though you told them, "I'll give you each $500 if you will let me save that person's life over there," and they chanted back in unison, "KILL THE BILL! KILL THE BILL!" (Actually, that seems like a pretty accurate summary of the whole health care saga of the last year.)

I understand conservative principles. I understand how comprehensive health care reform violates a number of conservative principles. But I cannot understand why so many good people would stick to conservative principles even when the demonstrable consequences are poverty and death for so many.

Is A Different GOP Possible?

In the wake of their biggest legislative defeat since the 1960s, it's time for principled conservatives to capture the Republican Party from the corporate class and the hateful class. I think it would be good for America. But it's going to take some political soul searching for them to get there.

Principled conservatives should ask themselves:

What positive agenda are we advocating?

Are there any compromises we are willing to make--any at all?

In what ways should modern conservatism differ from what we say "the Founding Fathers intended?"

Is it perhaps more than an embarrassing coincidence that we are so often on the same side of the issues as CEOs and the KKK?

It's my sincere hope that once the provisions of the health care bill come into effect, large numbers of principled conservatives will also ask themselves, "What the hell were we doing at those Tea Party protests?" But I'm not holding my breath. What's more likely is that the provisions will slowly and quietly become more and more popular, until one day even mainstream Republicans will defend them, like they're now doing with Medicare.

Watching the Health Care Vote

Consider this a health care vote discussion thread. I'm watching the speeches in the House on C-SPAN right now. Latest I've heard is that they'll vote on the Senate's bill after 10pm and vote on the reconciliation bill after 11pm. Both are on track to pass with votes to spare.

Listening to these floor speeches is entertaining. A little while ago I heard a Republican member say something about "the socialist ghosts" of the Eastern Bloc creeping into the House chamber. The Repubs are laying on thick the language about government micromanaging Americans' lives for "things Americans don't want or need." (Mike Pence said that. BTW, who doesn't want or need health insurance?) Their rhetoric gets crazier the closer we get to reform.

Here's what I've been saying all day:

This is what winning looks like. Slow, grinding progress. The right wing is going to shriek loudly that the sky is falling. They're going to rile up and draw confused, misinformed, and racist people to their side. And there will be an attempted counterrevolution of sorts. But like I've said before, big social gains like this bill are hard to reverse. This is a Social Security-Civil Rights-Medicare kind of thing. America is marching on to a more perfect Union, and corporate power, the right wing, and the Republican Party are kicking and screaming. This is what winning looks like.

Check the comments section for updates.

The Odds on Health Care Reform

I've been keeping an eye on the political prediction markets at Intrade. The odds of the health care bill passing, according to Intrade, have climbed dramatically over the last couple of weeks. March 4th was the first day the odds were above 50%, and since then the trend line has been up, up, up to where we are as of this writing: 82%.

It's interesting that Intrade was predicting the bill's passage as a sure bet before political pundits were. In my unscientific sampling, it seemed like yesterday was the first day that the media was really treating passage as more likely than not. For instance, the New York Times ran an article looking at which conservative-district Democrats will be "allowed" to vote "no" once the House leadership gets its magic number of 216 votes. Today, a Reuters article quotes an anonymous business lobbyist working against the bill who now believes it will pass.

All this is not to say that the votes are there yet. The best whip count I've seen suggests we need two more representatives who voted "no" on the first House bill to flip to "yes" on this vote.

But when the vote comes Sunday afternoon, I predict that the bill will pass with at least a few votes to spare. I think Pelosi will get a few more "no to yes" votes in the next day-and-a-half and some representatives in the anti-abortion "Stupak block" will end up voting yes too. Then its over to the Senate, where passing the sidecar fix bill should be easy. Then finally to the president's desk for what no one saw coming: Obama vetoes the bill! Just kidding. He'll sign it into law, and everyone and their brother will try to crowd into the picture behind him.

This has been a long and plodding march. But this is what progress looks like. It's never as swift and decisive as you hope. But gains like this health care bill, once they're won, are very hard for the right-wing to reverse. See Social Security, Civil Rights, the direct election of Senators, women's suffrage, labor law, and Medicare for examples. If history is any indication, this bill will permanently shift the country in a more progressive direction and move "the center" to the left. If Obama were defeated in 2012 (though I doubt he will be), and this health care bill ended up being the only major, lasting accomplishment of his administration, in my grade book Obama would still get a B. Health care itself--specifically, extending coverage to 32 million people--is that big.

One Battle In The War

BREAKING: AHIP, the health insurance industry trade group, announces that it opposes the final health care bill! Shocked? I guess the announcement was just in case you thought that insurance companies had magically transformed into insurance charities. Nope. Still bloodsuckers.

Seriously, it makes sense that the industry the American people are trying to regulate opposes the regulation. Of course they'd rather keep their prerogatives than not.

But here's something that ought to get more attention:

The U.S. Chamber of Commerce, the nation's largest business association, has been pouring gobs of money into anti-health care ads. This isn’t just a health insurance industry front group. The Chamber is the political arm of Big Business itself. So why is the broader Big Business community dead set against a bill that would extend health insurance to 32 million people, strengthen Medicare, and reduce the deficit?

Maybe they realize that if the American people can successfully wield government power to serve the people’s interests in the face of corporate opposition on health care, then we can do the same in other areas too. String a number of these victories (or losses, from the Chamber’s point of view) together, and the balance of the country begins to shift. It starts to become a nation where the basic security and well being of everyone comes before the privilege and perks of the lucky or successful or conniving few. Think of it as a great realignment of values. Everybody gets a helping before anyone gets seconds, thirds, and dessert. People before profit. Granted, they would be values that we, as a nation, probably already claim to have. The difference would be that we finally act on them. Because from Corporate Power's point of view, we can claim whatever we like as long as we never act on it. With their last-ditch effort to derail health care reform, they hope we never do.

Words Bret Baier Did Not Utter: Insurance, Company, Premiums, Uninsured, etc.

I just took a deep breath and plunged into the president's interview on Fox News. The White House has previously called Fox "the communications arm of the Republican Party," which I think is a good description. So over the past day or so the White House has taken flak from the Left for legitimizing Fox by giving them a presidential interview and treating them like a real news organization. That's a fair criticism. But if the president meets with Republican politicians, from whom there is zero chance of good faith bargaining, what's the difference between that and giving an interview to Fox? Obama is dancing with the Devil not because he thinks he can persuade the Devil but because he thinks he might persuade other people (junior demons?). That's what the health care summit last month was about. There was no chance Republicans were going to be persuaded, even though Democrats have steadily thrown them concessions by weakening the bill at every turn.

Likewise, there was no chance Fox was going to give a fair interview. But after watching it, I think Obama did exactly what he intended to do. Bret Baier faithfully delivered the right wing's most recent talking points, and the president patiently responded with confident, sensible answers.

If you look at the questions Baier asked--and consider the ones he didn't--it's really telling about how narrowly the Right has framed this debate as we enter the home stretch. He began with a loaded question on parliamentary procedure, specifically the "slaughter rule," a scary term for an up or down vote. He moved on to loaded questions about "seedy deals" and arm twisting to ram the bill through. Then on to something like, "So, does your wife know you want to destroy Medicare? Yes or no?" Finally, there was an intentionally confusing question about the deficit. And that was pretty much it.

So in the world Fox is trying to create, the health care debate in America is really all about an out of touch Democratic majority and the trickery it works in back rooms to illegally foist an unwanted bill on America and sink us all in debt. Forget expanding coverage, forget affordability. (What are you, some kind of communist?) In other words, Fox is behaving true to form, because this is exactly the message we are hearing from corporate interests and the Republican Party right now.

But consider what Bret Baier did not ask President Obama:

• There was not a single question about insurance companies. Check the transcript. Bret Baier did not say the word "company" during the entire interview. Shoot, he didn't even say the word "insurance." (How is that even possible?)
• There was not a single question about about the uninsured. The word "uninsured" was never uttered.
• There was not a single question about premiums.
• There was not a single question about deductibles.
• There was not a single question about co-pays.
• There was not a single question about doctors.
• There was not a single question about hospitals.
• There was not a single question about prescription drugs.

It makes you wonder if Bret Baier even knew that he was doing an interview on health care reform. Maybe his ear piece malfunctioned, and he couldn't hear his instructions from Cheney. In reality, it's just a good illustration of how narrowly the right wing is framing the entire issue. It's like we got a glimpse of a Republican strategy memo for the final days of the HCR debate: "Focus on confusing process. Ignore substance and human life."

Taking It To The Streets To Finish Health Reform

As promised here are some pictures from the health care rally that Kate and I attended on Tuesday.

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Assembling in Dupont Circle for the march to the Ritz-Carlton.

CREDO Action had tons of signs that said "Another ____ for the PUBLIC OPTION." I saw blanks filled in with "Republican," "Voter," "Socialist," "Doctor," "Clergy Person," "Young Person," and "Pinko Commie," to name a few.

Mock counter-protesters were on hand from "Billionaires for Wealthcare." These folks were dressed in Gilded Age ruling class attire and were reminding us all that the status quo for-profit health insurance system was working quite fine for them.

Here's reason enough to be a Lefty: progressive marches and rallies feel like street celebrations. This group called themselves the "Rhythm Workers Union." That wheeled cart carried drums that a couple people played while they walked. You can also see the tuba player in the background. There was a trumpet and a sax too.

The lovely Kate, marching to the Ritz.

Around the Ritz-Carlton Hotel, where health insurance executives and lobbyists are meeting, protesters unfurl yellow "crime scene" tape.

Yours Truly, sign in hand, at the entrance of the Ritz.

As the rally winds down, the band plays on. Also, a couple people in cow suits. Not sure what that was about.

One of the more creative protesters.

All in all, a good time and a good event. I think it's important that the Left recapture street politics from the Tea Party types. Everyone understands what's going on when they see right-wingers in the streets today: They're protesting "big government" and the Democratic Party. But seeing lefties in the streets would remind the public that just because Democrats control Congress and the White House, it does not mean that a progressive coalition rules. There is always that higher power, which is neither Democratic nor Republican and is stronger than both--corporate power. Corporate power means that even when the Democratic Party is riding high, legislation that would extend health coverage to more than 31 million uninsured Americans and lower the deficit--a win-win for virtually everyone--takes a tooth-and-nail fight to pass.

This Week In Things I Don't Care About

1. Eric Massa's tickle fights and "nonsexual groping." Was this really one of the top news stories this week?

2. Who's cool, who's mean, who's up, or who's down among White House advisers. There's too much real drama going on for the Washington Post and New York Times to be reporting on White House palace intrigue. OMG! Is Rahm gonna invite Axelrod to his b-day party or not?!

Inching Closer to Health Insurance Reform

54 Senate Democrats now say they support using reconciliation to finish health insurance reform. That means the Senate is no longer really a problem as far as getting at least something passed.

41 Senate Democrats now support passing a public option through reconciliation. Nine more and there will be absolutely no reason for a public health insurance option not to be part of the final bill. It's worth noting that these 41 Senators have gone on the record without any urging from the White House on the issue. It's the blogosphere and progressive health reform groups that have kept the public option alive. The president is not talking about the public option anymore. Congressional leaders aren't really talking about the public option anymore. It's a rank and file movement at this point. The White House has said the votes aren't there in the Senate, but each day, we see another vote or two show up. If Obama (not to mention House and Senate leaders) started actually pushing for a public option in the final bill, I think we would certainly see at least 9 more senators step up.

It's ironic that it's now the House that is the potential obstacle to passing any bill at all. If you count every Republican as a no vote on a final bill, add a possible no vote or two from the left, then include the handful of Stupak bloc Democrats, it's gonna be a squeaker. After all this time, all this debate, a handful of conservative Democrats trying to make a point about abortion may be the thing that sinks the entire bill and keeps 30 million Americans uninsured. Can they please make their point somewhere else? Like, in a bill that pertains to abortion? A deal will be struck between Stupak and the leadership. But the question is how long will it take and how will that delay harm the overall process.

However you look at it, we're nearing a conclusion.

BTW, Kate and I went to the health care rally in DC yesterday. I'll post pictures soon.

Approaching The Finale

I floated the idea from the previous post, about the House sending two "fix bills" (one with public option and one without) to the Senate for passage through reconciliation, around at DailyKos and at OpenLeft. There were lots of good comments but no one knew of any rule why the Congressional leadership couldn't do both: vote on an easy-to-pass reconciliation bill to merge the House and Senate health reform bills and vote on a more progressive reconciliation bill with a public option.

I think the takeaway point is that when you get down into the nitty gritty parliamentary rules, it's a bit murky. And in the end, interpretation of the rules is largely up to the President of the Senate, Biden, and the Senate Parliamentarian. So I think the focus should continue to be on pressuring Senate Democrats to support passage of a public health insurance option through reconciliation. Right now, 37 Senate Dems are on record supporting the public option through reconciliation. The closer that number gets to 50, the fewer excuses Democratic leadership have for telling us over and over again that the public option is dead.

All indications are that the current health care debate is going to reach its conclusion in the next couple of weeks, and we're going to find out if the Democrats can pass anything and, if so, what.

Tomorrow may provide the best visual of the where the situation stands: The health insurance industry's premier lobbying group, America's Health Insurance Plans (AHIP), will meet at the Ritz-Carlton hotel in downtown Washington, D.C. to plot its next steps to block reform. Outside in the streets, thousands of union workers and members of grassroots health care reform groups will rally to put people before health insurance profits. More than 100 progressive leaders will risk arrest in protest of AHIP and Big Insurance. On one side, the comfortable representatives of a parasitic industry in a plush hotel. On the other side, a large and diverse coalition of workers and activists who have less and less to lose. If you're in town, stop by and pick a side.

Update--11:22pm: About picking a side... Come to think of it, if you pick Big Insurance, you will probably get tazed trying to get into the hotel. That should make the choice easier.

Public Option Solution? House Passes TWO Reconciliation Bills

Someone tell me why this wouldn't work. Because it seems to me like a good way to assure that Democrats have the votes to "fix" the Senate bill and also that the public option gets an up or down vote.

Why not have the House pass two reconciliation bills to "fix" the Senate health reform bill?

1. The first fix (which is the one they're drafting now) does not include a public option.
2. The second fix does include a public option.

Let's imagine the House passes both of these fix bills, and both go to the Senate.

The first one ought to be a very safe pass through reconciliation in the Senate. At that point the original Senate reform bill and the first fix bill would be on the president's desk ready to be signed into law. We would have guaranteed that 31 million more Americans have health insurance. And though we would not have the public option on a national exchange, as many as 48% of the newly insured would be on a public health insurance option, thanks to the bill's expansion of Medicaid eligibility. (Thanks to Chris Bowers for this point.) Not bad, Democrats.

But we can do better.

So then the second fix, with the public option, comes up for a reconciliation vote in the Senate. Now we get an up or down vote on the public option--in isolation--in the Senate. This is what progressives have wanted all along. Many of us believe the 50 votes are there to pass it. Polls have always shown the public option in itself is very popular with the public. And there is a steadily growing number of Senators who say they would pass the public option through reconciliation: 35, as of this writing. So, if 50 votes are there, the public option also goes to the president's desk to sit right beside the original Senate bill and the first, "safe" reconciliation bill. The president then signs all three into law, and the celebration drinks are on me that night.

As far as I see it, the only argument against including the public option in a reconciliation bill is that it might "sink the whole bill" in the Senate. But that argument is meaningless if we can essentially isolate the public option from the rest of the reconciliation bill. The House can send one fix bill that is a safe pass. Then they can send another fix bill with a provision that is highly popular with the American people and hugely important to the progressive base and let the Senate Democrats prove which ones of them really are Democrats.

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If someone knows of a parliamentary rule that makes this impossible, please let me know.

Otherwise, let's spread this idea around and make some noise. It makes no sense to skip the public option, when everywhere we look--the House, the Senate, the White House, the American public--a majority supports it.

How We Enable Jim Bunning

Right now Senator Jim Bunning is on the floor of the Senate, filibustering a one-month extension of unemployment benefits, including health insurance, for laid off Americans. He's hurting millions of people to make a small point about budget deficits. The fact that Republicans are trying to make budget deficits of all things seem like the major issue facing the country is a conversation for another post. But seeing this guy's face all over the news has got me thinking about some of the other issues that put this crazy conservative from Kentucky where he is right now--in the national spotlight.

1. America continues to tolerate high levels of unemployment. We could expand the public sector with WPA-style job creation. We could make truly huge infrastructure investments for a green economy and create private sector jobs in the process. (While we're at it, we could make the minimum wage a living wage.) We could pick our favorite combination of ideas. The point is, we are not facing a mystery of how to create jobs. We know how to create jobs. We just decide not to do it. We decide that it's basically OK that 15 million Americans need a job and another 10 million people need more hours in the job they have. The country lacks the political will to solve the problem. Or at least the political will to solve the problem is diluted and misdirected through our politics and our government. But we should not forget that the big, green FULL EMPLOYMENT button is right in front of us if we ever decide to push it. Until we do, there will always be a Jim Bunning standing between millions of Americans and economic security.

2. The Senate is specifically designed to grind democratic momentum to a halt. It's specifically designed to throw a spotlight on Jim Bunnings. Current filibuster rules mean anyone elected to the Senate--in an election system that is already tilted heavily in favor of moneyed interests--can singlehandedly block the work of both houses of Congress. Only a supermajority--an arbitrarily selected number of 60 Senators--can stop him. And good luck finding 60 Senators who will do anything that might inconvenience the money kings. As if democratic rule and political equality weren't hard enough already in a society of such extreme economic inequality, it turns out majority rule isn't even good enough. You need supermajority rule. Oh wait, did we say supermajority? No, we meant you need a super-duper!-majority to do anything important.

It's encouraging that a growing number of Democrats in the Senate are calling for reform of filibuster rules. I don't know if they'll be able to do it soon. But progressives should continue calling for filibuster reform even when Republicans eventually take back the Senate. It's not simply an issue of how powerful the party in power is going to be. It's an issue of whether the Legislative Branch of government will be able to do anything important. In the long-run, a Senate subject to majority rule is a good thing for progressives and democracy, even if it will sometimes be a reactionary Republican Senate. (This question is definitely worthy of a lot more attention.)

3. The Senate overrepresents rural white people, which generally means conservative Republicans. We're looking at you Jim Bunning. Thanks to the political realities of 1787--big states vs. small states, slave states vs. free states--every state today, regardless of population, still gets equal power in the Senate. This means that a very small state like Wyoming, which is very rural, very white, and very conservative, has the same sway in the Senate as giant California, which is more urban, more diverse, and more liberal. Here's another way to put it, based on the populations of those two states: Wyomingites have 74 times the representation in the US Senate that Californians have. So until the makeup of the Senate is changed, the Senate will always be whiter, more rural, and therefore more conservative than the country. We ought to be able to talk about this without being accused of "reverse racism" against white Americans. The Great Compromise of 1787 and our geography dictate that a rural, white political worldview will have more influence in our government than it should for the foreseeable future. The Jim Bunnings of America are going to be with us for a long, long time.

Update: I just read that Jim Bunning gave up his filibuster. Gosh, thanks Jim Bunning for letting my Uncle Bobby's family continue to receive their health insurance! I'm glad you had a change of heart! And it's really, really cool that the fate of so many people hinges on the wild whims of some guy who has no connection to them whatsoever. What will he decide next month?! Yay! It's exciting!

Update 2: I just heard a knock at your door. It's Jim Bunning. He's turning your electricity off because you don't look very cold.