How Obama Punted Away Real Health Reform


ObamaHealthCareUpdate: Today’s Calbuzzer comments reflect a contentious debate raging in the blogosphere about the virtues, or lack thereof, of the Senate bill. While Calbuzz is triangulating like crazy – it’s a lousy bill but pass it anyway ‘cuz somethin’s better than nothin’ – others are whacking deep into the weeds on this.

If you care to join them, here’s a guide to the best arguments string: Jane Hamsher, founder of Fire Dog Lake, posted 10 reasons why the Senate bill should be killed, and was promptly attacked by the Washpost’s Ezra Klein,world’s leading authority on practically everything. Then Jon Walker of FDL attacked Klein’s attack, and we give the final world to Nate Silver,the smartest person in the world, who attacked Walker’s attack of Klein’s attack of Hamsher.


In a case of life imitating art, comic blogger Andy Borowitz provided the most accurate and trenchant commentary about the Democrat’s misadventure on health care reform, as he offered a look at  details of his own, newly unveiled,  “CompromiseCare™” program“:

— Under CompromiseCare™, people with no coverage will be allowed to keep their current plan.
— Medicare will be extended to 55-year-olds as soon as they turn 65…
— A patient will be considered “pre-existing” if he or she already exists…
— You’ll be free to choose between medications and heating fuel…
— You will be entitled to natural remedies, such as death

And so on. The Borowitz Plan would be a riot if it didn’t come to so close to the truth.

The sad fact is that Barack Obama’s wimp-out on his signature issue has resulted in a legislative end game defined by a default bill in the Senate that’s godawful. Riddled with half-measures, the bill is framed and defined by the institutionalized transfer of hundreds of billions of public dollars to the same, rapacious private insurance industry that shaped the dysfunctional system supposedly being transformed.

Even its worthwhile nods to reform – efforts to end the industry’s disgraceful practices on pre-existing conditions, rescissions and lifetime benefit caps – are largely dependent upon regulatory enforcement by the states, woefully over-matched by the legal firepower of insurance companies, as David Dayen  argues most persuasively at Fire Dog Lake.

So now, Obama will be left holding the bag on weak, compromise legislation repellent to Democratic advocates on the left and Republican opponents on the right.

Worse, a new NBC/Wall Street Journal poll shows that less than one-third of Americans say that the stinky cheese that Obama now supports as “reform” is a good idea – a number that has steadily eroded since he jettisoned his support for the public option. Worse, more people, by 44-41%, say it would be better to do nothing than to pass the measures before Congress.

Yes we can!bidensmirk

The strongest argument for nose-holding passage of the health bill in its current form is made in a NYT op-ed by Vice President Joe Biden. But Biden’s take-whatever-we-can-get-and-declare-victory stance avoids the hard fact that the White House made one fundamental strategic error, followed by a series of tactical blunders.

Strategically, Mr. Smartypants Rahm Emanuel and the geniuses in the White House political shop should have counted noses at the start to determine if there was a threshold of support for a public option – which also should have called something more politically palatable, like “health insurance competition” or “consumer choice” – or an expansion of Medicare. If they couldn’t see a way to put the votes together, they should have taken on some other signature issue — jobs would have been a good one.


–Obama frittered away his mandate. After stomping John McCain and leading the way to Democratic domination of both houses of congress, he retreated to a passive posture in which he uttered Yoda-like platitudes about reform while letting the food fight in congress shape the legislation.

–Obama quickly signaled the special interests were still in charge. About the only substantive moves by the White House were a) to dump, before they even got started, the progressive’s goal of a single payer system and b) to break his campaign promise of transparency by cutting an early, backroom deal to minimize the impact of any bill on the pharmaceutical industry.

–Obama shined on his political base in the name of pursuing “bipartisan” harmony with people whose only interest was sticking it to him. Back in August, when Obama began backing away from support for a public option, we warned that he was setting himself up for failure with his fetish Fairy_largefor fairy tale bipartisanship.

In the political fight of his life, Obama has been putting his energy and emphasis almost exclusively on the can’t-we-all-just-get along aspect of his message, in a desperate bid to pass a bill – any bill – that he can spin as an alleged victory, even if represents right-center policies and politics.

With Democrats in the rare position of controlling the White House and both houses of Congress, however, he needs to stop singing kumbaya and start busting some heads by fighting fiercely for the populist – and, yes, partisan – principles that led millions to support the progressive promises of his campaign. And that means taking on, not just the other party, but some of the obstructionist Senators in his own party…

Obama’s we’re-all-in-it-together action, in place of a principled fight, has simultaneously succeeded in emboldening his Republican enemies and alienating his progressive base, in the name of imaginary bipartisanship and placating the self-absorbed Lieberman-Nelson-Snowe “centrist” axis, whose members keep dumping on him from a great height for his trouble.

What’s even more troubling is the suspicion that Obama’s kumbaya strategy was timid by design, aimed at avoiding any effort to make real change in the status quo, viewing process as more important than  policy. As Rep. Anthony Wiener, the most articulate  champion of substantive health reform, told Politico:

This has been a fairly transactional presidency, and the president did nothing to insulate himself from the compromises — which were inevitable — by making it clear at the outset what his values were on some of these important issues. While being transactional may help you get through the days in Washington and get things on the scoreboard, it creates a weird disconnect that most people in the country don’t know what you want and don’t feel they should rally to your side.

In a pair of must-read pieces, here and here, Salon’s Glenn Greenwald makes the case that, after the massive Wall Street bail-outs, abdicating to Goldman Sachs and wimping out on credit card reform, Obama with health care has now fully revealed hiobamapostermself as a triangulating advocate of corporate power,  his soaring populist rhetoric be damned.

As was painfully predictable all along, the final bill will not have any form of public option, nor will it include the wildly popular expansion of Medicare coverage. Obama supporters are eager to depict the White House as nothing more than a helpless victim in all of this — the President so deeply wanted a more progressive bill but was sadly thwarted in his noble efforts by those inhumane, corrupt Congressional “centrists.”

Right. The evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives. The administration is getting the bill which they, more or less, wanted from the start — the one that is a huge boon to the health insurance and pharmaceutical industry.

So whether by incompetence or design, the White House has left health reform advocates (boy is Ted Kennedy missed) with little choice but to support badly flawed legislation, an argument summed up in Biden’s op-ed: “I share the frustration of other progressives that the Senate bill does not include a public option. But I’ve been around a long time, and I know that in Washington big changes never emerge in perfect form.”

Not exactly change we can believe in.

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There are 15 comments for this post

  1. avatar cbarney says:

    this sentence-by-sentence dissection of obama’s record is so precise it is painful to read. now we are being soothed by the “don’t worry, it’s a start, we’ll make it better later” threnody, which is persuasive because giving up on obama is so dismal; he’s what we’ve got.

    guess that’s politics. and the democrats have to come back to us next year; got to be an opportunity there.

  2. avatar Cicero says:

    Rather than reading the same platitudes about how President Obama should have “butted heads” and how he was “disengaged” and how this is all Rahm Emanuel’s fault, I’d love to read someone explain, specifically and in detail, what President Obama could have and should have done to change Joe Lieberman or Ben Nelson’s minds about the expansion of Medicare, the public option or (you’re kidding, right?) single payer. Give another speech? I don’t think so. Threaten Lieberman that he’ll be challenged in the Democratic primary in . . . 2014? Been there, done that. Take away his committee chairmanship? He becomes a Republican and the game is over.
    Do you think Ben Nelson cares about the national polls on health care reform? I assure you he does not. I’m sure that he does care that according to a poll reported in the Weekly Standard http://www.weeklystandard.com/weblogs/TWSFP/2009/12/more_trouble_for_nelson.asp, 61% said it would make them less likely to vote for Sen. Nelson for reelection (in 2012), only 26% said it would make it more likely. This may be a somewhat sketchy poll, if anyone has another one showing this is a popular vote in Nebraska I’d love to see it. You do know, I’m sure, that all three Representatives in Congress from Nebraska are Republican (NO! on health care reform), as is the other Senator (NO!). Governor Heineman, who was elected with only 73% of the vote in 2006, has publicly called on Sen Nelson to use his power as the 60th vote to kill health care reform. Please tell me what power President Obama has over Sen Nelson (or the people of Nebraska, who voted for McCain with 57% of the vote).
    What depresses me is how naive the left in this country is. Go to Nebraska and mobilize. Go to Connecticut, and Louisiana, and Maine. Stop whining about how disappointed you are in the President.

    • avatar pjhackenflack says:

      Perhaps he could have started by actually mentioning the public option to Lieberman, who says he had “no input” on the issue from the White House: http://www.huffingtonpost.com/2009/12/21/lieberman-obama-never-pre_n_399355.html

    • avatar Cicero says:

      So you’re saying that (i) you believe anything that Joe Lieberman has to say; and (ii) all Obama had to do was “mention” the public option and Lieberman would have said, “Gee, Mr. President, I hadn’t hear about that! I’m all for it! Please…..

    • avatar pjhackenflack says:

      Chris Matthews tried to make the same disingenuous argument on Hardball last night: the point is not Lieberman’s integrity, but that Obama’s failure to even bring up the public option is symptomatic of his passive stance on the issue all along. Yet he dispatches David Axelrod to all the Sunday shows to (disingenuously) claim that the president “repeatedly made the case” for the public option, in an effort to have it both ways. Jonah Goldberg has an excellent column that goes to this point in today’s LAT op-ed at http://tinyurl.com/y8vrrjp.

  3. avatar Mark Paul says:

    With all due respect, the Calbuzz alter kockers don’t know what they are talking about. The health care bill to be voted on by the Senate and the one passed earlier by the House are the most progressive pieces of legislation enacted since the 1960s.

    They provide affordable health insurance coverage for 25-30 million people who currently lack such coverage–and more important, put in place a new system that will assure continued coverage for tens of millions of people who currently have coverage but would certainly lose it in the years ahead as the flaws in the current system cause employers to drop their plans.

    They provide what true progressives have long sought: protection against families’ losing health coverage and their economic security because of job loss, illnesses, pre-existing conditions. For a middle-income family earning $60K a year, they cut the cost of insurance and out-of-pocket payments by half (see http://bit.ly/5pLiCV).

    They expand Medicaid and improve Medicare.

    They reduce the federal deficit over the next ten years.

    The Senate bill contains an impressive array of measures to bring health costs under control and begin shifting the country away from low-cost, low-quality fee-for-service medicine and toward a system that encourages hospitals and doctors to deliver care that benefits patients, not just the providers’ profit statements.

    There’s no accounting for the loony left’s mania for the public option. It’s the hula hoop of 2009. The public option would be available only to persons buying insurance through the exchanges in the non-group market; that is, less than 10 percent of the population. Even if one assumes that the public option could and would, through competition restrain premiums in that market (and that is open to debate), the benefit to households is microscopic compared to the thousands of dollars of savings they will receive from the other reforms in the bill. As Jonathan Gruber, the MIT health economist, has said and demonstrated in his respected anaylses, the premium savings and wage increases that the reform produces is “10 times as important as the public option and has received one one-hundredth of the coverage.”

    The lefty bloggers who are railing against this bill have as little contact with political and policy reality as Glenn Beck. The Senate bill puts the nation far down the road toward the health changes it needs. Once passed, universal coverage, like Social Security and Medicare, will be impossible to roll back. With a sound basic structure in place, we will be able to think about how to make it better.

    There is now only one thing that could keep Americans from finally winning this battle for universal health care coverage: the kind of political idiocy that doesn’t understand that every great legislative achievement is a compromise and every great president is a compromiser.

    • avatar pjhackenflack says:

      Yes, it “provides” health insurance to millions of people who can’t afford health insurance by forcing them to afford it, for what will most likely be junk coverage, or get fined by the government. There’s a reason insurance stocks went soaring when this emerged.

    • avatar david says:

      If they turn out to be junk policies, there will be enormous pressure to improve them — and the principle of extending insurance to all will already be in place. What is the alternative? How, exactly, would we better off to keep the existing system, where instead of having insufficient policies, millions have no policies at all? If you have one apple, and you want ten, but you wind up with two, is it better to throw the second apple away in a tantrum about wanting ten? Or keep the second apple, and in lieu of a tantrum, spend all that energy planning how to get a third and fourth?

    • avatar cbarney says:

      david wrote:

      If they turn out to be junk policies, there will be enormous pressure to improve them

      there was enormous pressure for a public option as well; it is now referred to as a fantasy of thge “loony left,” although 2009 polls showed more than 70 percent of the population favoring it.

      “pressure” in washington means money, and i would like to know exactly who it is who will be lavishing funds on senators the way the insurance companies did in order to have their own way with the health care bill.

      not the loony left, not even the non-loony left. and certainly not the insurance lobby.

  4. avatar sqrjn says:

    Great compromise? Only if you assume that this is a work in progress that eventually will get fixed. The truth is this new system is a regressive health care tax on the middle class for the benefit of the poor. Those who stand to benefit are the insurers who will have a wealth of new business.

    The dems who have attempted to justify this mess with any degree of intellectual honesty, all argue that its only a first step. But what they are really saying is that they are intentionally making things worse in the hopes it will allow them to make it better. This kind of revolutionary politics is harmful. Obama has screwed the pooch and this is gonna be a weakness for him all the way til 2012.

  5. avatar SezMe says:

    I am reminded of, for example, the cry of the true believers on the right who rail against a moderate Republican, saying they don’t want a RINO. Similarly, the true believers on the other end of the spectrum wail at moderate Democrats, saying they don’t want Republican-Lite.

    So it is with Obama. He is DLC-Lite. If the voters had really wanted a corporatist, DLC center-winger, Hillary would have been a better vote. Well, at least a more honest vote. As it is, we voted for “Change” and got a President who did, in fact, change on us. Sadly, not for the better.

    • avatar pjhackenflack says:

      Today’s Calbuzzer comments on health care reflect a contentious debate raging throughout the blogosphere about the virtues, or lack thereof, of the Senate bill. For a guide to the best of the argument, see our just-posted update.

    • avatar Cicero says:

      No, actually he didn’t change (at least on this issue). The President said all along that he wanted a health care reform bill and that he favored a public option, but he studiously avoided saying that if there were no public option he wouldn’t sign the bill. He’s been consistent. You may disagree with him, but he’s been consistent.

  6. avatar Jerry Schwarz says:

    I’m reminded of the old story about the dog who plays checkers. Someone tells the dog’s owner that it’s amazing and the owner replies that it’s not so amazing because the dog always looses. In this case the idea that seems to be missing from the debate is “universal health care”. Liberals/Progressives have been failing to achieve that for so long that we’ve almost forgotten that it has been the primary goal. The final bill won’t be perfect. Everyone will object to something in it, although no two people will have the same list. But it does move us very close to universal health care and for me that is amazing..

    I voted for Obama (in the primary) not because I was convinced by his “change” and “hope” rhetoric but because I saw him as a consummate politician who could actually deliver on universal health care where everyone else who had tried (including the Clintons) had failed. And he has done so. It confirms my conclusion that he is a pragmatist who can get things done and is willing to sacrifice positions that aren’t essential to his main objective.

  7. avatar chrisfinnie says:

    Unfortunately, we won’t get to see how badly this works until after the next elections. But we will get the bill before that. Because of that timing, it seems likely that Democrats will no longer have the majorities needed to fix the bill, and maybe not even the veto power. In that case, we will either be stuck with this deeply flawed bill, or with whatever the GOP does to it later. Neither prospect fills me with hope.

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