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."