Let's recap: the United States spends about twice as much on healthcare as any other developed nation in the world and in return receives just about the worst care. Can someone remind me again why there's even a debate about whether we should put up with this?Benen: TIME FOR THE NARRATIVE TO SWITCH BACK....
In June, health care reform was very likely to happen. It was one of those observations "everyone" knew to be true. In July, however, reform was in trouble, and "everyone" knew that, too. It's August, and now reform is practically dead. "Everyone" says so.Of course, August is almost over, and those observations about the reform effort failing have become stale and uninteresting. September starts tomorrow and it's time for a new narrative. Maybe now would be a good time for "everyone" to start talking about reform is going to pass after all.
The NYT's John Harwood has a piece today on the "stronger prospects" for a health care reform bill this year.
If sentiment ever ruled the United States Senate, it does not now. Advocates of health care overhaul should not expect a big boost in memory of Senator Edward M. Kennedy.
Yet other factors suggest that President Obama still has stronger prospects for achieving his health policy goals than surface impressions of the Congressional recess indicate. He lags behind his own timetable for action, but remains ahead of presidential predecessors who pursued the same objective.
As Harwood sees it, there's already widespread agreement on several key elements of reform; reconciliation is still very much an option; the Gang of Six nonsense is nearly complete; and "Democratic leaders believe" they might be able to break a filibuster with Sen. Olympia Snowe's (R-Maine) support.
Former Sen. John Breaux (D) of Louisiana told Harwood, "They'll get something done. It'll be a major step."
E.J. Dionne Jr. touched on a similar point in his column today: "Despite health care's summer of discontent, supporters of change are in better shape than the accounts of recent weeks would suggest."
And Kevin Drum emphasized the fact that as August comes to a close, the Tea Baggers and their tantrums haven't fundamentally changed much of anything: "[T]he Fox/FreedomWorks crowd has created some great political theater, but underneath it all not a lot has changed. If Democrats can just take a deep breath after the trauma of being yelled at all summer, they'll realize that the loons at their townhalls represented about one percent of their constituency; that the public still wants reform and will reward success; that the plans currently on the table are already pretty modest affairs; and then they'll stick together as a caucus and vote for them. And that will be that."
Health care reform could be the phoenix, rising from the ashes, if Democrats show some spine and roll up their sleeves. The elements are already in place, and the media narrative is ready to shift. It's not rocket science.
Ezra Klein: Why Seniors Oppose Government-Run Health Care (Except for Their Own)
Benen: MOTIVATED REASONING....This appeared in Sunday's Outlook section. I'm posting it here so folks can comment.
"We need to protect Medicare," Republican National Committee Chairman Michael Steele exhorted last week, "and not cut it in the name of 'health-insurance reform.' " It was a rousing defense of government-run health care from the . . . conservative chairman of the GOP. But incoherence doesn't necessarily make for bad politics. In this case, Steele was aiming his message directly at America's seniors. Lucky for him, they share his incoherence in full.
In late July, President Obama recounted a letter from a woman who told him, "I don't want government-run health care, I don't want socialized medicine, and don't touch my Medicare." The president chuckled. "That's what Medicare is," he protested at an AARP town hall. "A government-run health-care plan that people are very happy with."
Jokes aside, the White House is struggling to attract seniors to health-care reform. No age group is as solidly opposed to the project as the over-65 set. But that's the same set that relies on government-run health care and loves it.
That's not how it's supposed to work; successful government programs are supposed to create constituencies for their expansion. But the happy experience of Medicare has made seniors less, not more, open to a generous welfare state. It hasn't created advocates for more single-payer health care; it has created advocates just for Medicare. And they fear that health-care reform will endanger Medicare.
Resolving this tension could decide the future of Obama's make-or-break domestic policy push. The opposition of seniors matters. Older people vote in bigger numbers than younger people do; they're more likely to call their representatives or attend a town hall meeting. Most important, says Robert Blendon, a Harvard scholar who studies public opinion on health care, "they make off-year elections. The secret about Congress and health policy is that in 2010, there will be a lot more seniors at the polls than there were in 2008."
Just ask Bill Clinton. In September 1993, the strongest supporters of his plan to reform the health-care system were seniors. A solid 62 percent approved of his efforts. By April 1994, the president had lost 25 points among seniors, and they were his weakest backers. "In the Clinton plan, it didn't come out till later that the financing came substantially from Medicare," Blendon says. But once it did, seniors revolted. In that fall's midterm elections, Democrats lost more than 50 seats in the House. Seniors were a big part of the reason -- giving Republicans 51 percent of their votes.
Seniors are moving in a similar direction this year. A Washington Post-ABC News poll this month found that only 35 percent of people 65 and older approved of Obama's handling of health care. Compare that with 44 percent of respondents between the ages of 30 and 64, and 57 percent of 18- to 29-year-olds. More telling, only 8 percent of seniors thought reform would improve their health care, while 42 percent thought their care would get worse. All this despite the fact that a staggering 94 percent of seniors are satisfied with the quality of care they receive, and Medicare polls much better than the private health insurance market.
What are seniors so afraid of?
From the beginning, Medicare has been named as one of the potential sources of savings that would fund subsidies for the uninsured. That sounds like service cuts, even if the specific changes don't involve anything of the kind (most of the savings would come from reducing overpayments to the private insurers that participate in the Medicare Advantage program).
So the fear is not of a welfare state but of changes in their welfare state. The result is that the coalition against reform is an odd union between people opposing government-run health care and people defending government-run health care. It's a potent combination.
Seniors are also the most conservative segment of the population and are getting more so. They constitute not only the sole age group that Obama lost in last year's election, but also the sole age group in which his results were worse than those of John Kerry in 2004. And both Obama and Kerry underperformed Al Gore's 2000 results.
"The Roosevelt seniors are being replaced by the Reagan seniors," says Paul Begala, who helped run Clinton's 1992 campaign. A May poll by the Pew Research Center found that for the first time in 20 years, the GOP is now an older party than the Democrats.
The June Post-ABC poll asked whether respondents would prefer a smaller government with fewer services or a larger government with more services. Seventy percent of seniors -- the segment of the population with government-run health care and a government pension, also known as Social Security -- preferred a smaller government, compared with 37 percent of people 18 to 29. Seniors are the age group most solidly opposed to the public option. In fact, in the August Post-ABC poll, they were the only age group in which a majority opposed it. "Seniors are like the American West," says Julian Zelizer, a Princeton historian. "They depend on government and then say they hate it."
But taken as a whole, the attitudes seniors express on health care are arguably the greatest vote of confidence anyone has offered reform. Seniors live in America's version of Canada. They have single-payer health care. And they love it. They love it so much that they've got the chairman of the RNC swearing to protect it.
To paraphrase Twain, right-wing health care talking points can travel the nation, while the truth is still getting its pants on. If the most frustrating aspect of the policy debate is the willingness of reform opponents to make stuff up, the most dejecting is the willingness of gullible people to believe nonsense.And believe it they do. Just a couple of weeks ago, an NBC News poll found that most Americans have already come to believe a wide variety of transparently false claims, all of which have been pushed aggressively by the right.
Of particular interest, though, are those who are confronted with reality, but prefer to believe lies anyway. There's widespread confusion, to be sure, but there's also a large group who deliberately embrace the lies they've been told. Newsweek's Sharon Begley, for example, recently wrote a piece scrutinizing reform myths. She found, not surprisingly, that a wide variety of right-wing allegations are without foundation in fact.
For her trouble, Begley was blasted by conservatives for, ironically enough, having "lost touch with reality." Some far-right Newsweek readers even wished her dead for daring to write a piece that debunked claims they preferred to believe were true.
In a follow-up piece, Begley considers the thinking behind this bizarre trend. She spoke to sociologist Steven Hoffman who explained, "Rather than search rationally for information that either confirms or disconfirms a particular belief, people actually seek out information that confirms what they already believe." For the most part, he added, "people completely ignore contrary information" and are able to "develop elaborate rationalizations based on faulty information."
Which brings us back to health-care reform -- in particular, the apoplexy at town-hall meetings and the effectiveness of the lies being spread about health-care reform proposals. First of all, let's remember that 59,934,814 voters cast their ballot for John McCain, so we can assume that tens of millions of Americans believe the wrong guy is in the White House. To justify that belief, they need to find evidence that he's leading the country astray. What better evidence of that than to seize on the misinformation about Obama's health-care reform ideas and believe that he wants to insure illegal aliens, for example, and give the Feds electronic access to doctors' bank accounts?
Obama's opponents also need to find evidence that their reading of him back in November was correct. They therefore seize on "confirmation" that he wants to, for instance, redistribute the wealth, as in his "spread the wealth around" remark to Joe the Plumber -- finding such confirmation in the claims that health-care reform will do just that, redistributing health care from those who have it now to the 46 million currently uninsured. Similarly, they seize on anything that confirms the "socialist" label that got pinned on Obama during the campaign, or the pro-abortion label -- anything to comfort themselves that they made the right choice last November.
There are legitimate, fact-based reasons to oppose health-care reform. But some of the loudest opposition is the result of confirmatory bias, cognitive dissonance, and other examples of mental processes that have gone off the rails.
Of course, it's difficult to explain this to the enraged conservatives who are convinced that health care reform would destroy civilization. They like their delusions, thank you very much, and prefer that reality be kept at arm's length.
As for what to do about it, I'm open to suggestion. Ignorance seems to be spreading like a virus, which makes the discourse stupid and constructive debate nearly impossible.
- Which leads me naturally to post this classic from Tim F. at Balloon Juice: Fear Is The Mind Killer
Fear can be useful with respect to decisions like, say, whether or not to chase a bear with a stick, but for higher-level thinking the frightened state of mind blows goats. People do irrational, stupid, senselessly violent things when motivated by fear.
Naturally fear has its political uses. Steering a frightened public towards a stupid policy is, so to speak, frighteningly easy. When terrorists attacked America a normal leadership would have gone out of its way to reassure people and calm nerves. The GOP went the other way, maybe disgracefully, but in naked terrorist fear Republicans found a winning meal ticket at a time when national polls put them on the wrong side of virtually every issue.
Anyhow, on the topic social science that we should probably leave alone but due to some personal flaw just can’t, here are two more editions of science revealing what we already know.
First, an unpleasant surprise frightens conservatives more than liberals.
[Subjects] were attached to equipment to measure skin conductivity, which rises with emotional stress as the moisture level in skin goes up. Each participant was shown threatening images, such as a bloody face interspersed with innocuous pictures of things such as bunnies, and rise in skin conductance in response to the shocking image was measured. The other measure was the involuntary eye blink that people have in response to something startling, such as a sudden loud noise. The scientists measured the amplitude of blinks via electrodes that detected muscle contractions under people’s eyes.
The researchers found that both of these responses correlated significantly with whether a person was liberal or conservative socially. Subjects who had expressed a high level of support for policies “protecting the social unit” showed a much larger change in skin conductance in response to alarming photos than those who didn’t support such policies. Similarly, the mean blink amplitude for the socially protective subjects was significantly higher, the team reports in tomorrow’s issue of Science. Co-author Kevin Smith says the results showed that automatic fear responses are better predictors of protective attitudes than sex or age (men and older people tend to be more conservative).
To be honest this result is so un-novel that it’s almost a tautology. One basic definition of conservatism is a negative reaction to whatever is new and shocking at a given point in time, whether the problem du jour is interreligious marriage, interracial marriage or gay marriage. Social progress generally involves accepting things that shock most people who see it for the first time relatively late in life. The liberal deals with his shock and gets over it where the conservative internalizes his discomfort and transforms it into a Kantian moral imperative. Finding out that unpleasant surprise impacts the conservative more strongly therefore beats reporting that the sun will come up in the east tomorrow, but not by much.
On the other hand, it’s curious to find that disproving rightwing lies only makes them believe it more.
Political scientists Brendan Nyhan and Jason Reifler provided two groups of volunteers with the Bush administration’s prewar claims that Iraq had weapons of mass destruction. One group was given a refutation—the comprehensive 2004 Duelfer report that concluded that Iraq did not have weapons of mass destruction before the United States invaded in 2003. Thirty-four percent of conservatives told only about the Bush administration’s claims thought Iraq had hidden or destroyed its weapons before the U.S. invasion, but 64 percent of conservatives who heard both claim and refutation thought that Iraq really did have the weapons. The refutation, in other words, made the misinformation worse.
A similar “backfire effect” also influenced conservatives told about Bush administration assertions that tax cuts increase federal revenue. One group was offered a refutation by prominent economists that included current and former Bush administration officials. About 35 percent of conservatives told about the Bush claim believed it; 67 percent of those provided with both assertion and refutation believed that tax cuts increase revenue.
In a paper approaching publication, Nyhan, a PhD student at Duke University, and Reifler, at Georgia State University, suggest that Republicans might be especially prone to the backfire effect because conservatives may have more rigid views than liberals: Upon hearing a refutation, conservatives might “argue back” against the refutation in their minds, thereby strengthening their belief in the misinformation. Nyhan and Reifler did not see the same “backfire effect” when liberals were given misinformation and a refutation about the Bush administration’s stance on stem cell research.
Now you know why Atrios calls them “zombie lies.” But on reflection ‘zombie’ still doesn’t cover the perversity of this phenomenon. In most movies a zombie will go down if you hit it in the head hard enough. Rightwing lies aren’t just hard to kill, they get stronger the more thoroughly you kill them. Wingnut rumors function more like that mythical critter that grew two heads every time Hercules cut one off, except even the hydra eventually died. By comparison about 29% of America continue to think that Saddam had a WMD program and sat down with bin Laden to plan 9/11. In that sense the hydra is a piker next to rightwing stupidity. There’s nothing like it.
Many of the retrospectives on Ted Kennedy’s life mention his regret that he didn’t accept Richard Nixon’s offer of a bipartisan health care deal. The moral some commentators take from that regret is that today’s health care reformers should do what Mr. Kennedy balked at doing back then, and reach out to the other side.
But it’s a bad analogy, because today’s political scene is nothing like that of the early 1970s. In fact, surveying current politics, I find myself missing Richard Nixon.
No, I haven’t lost my mind. Nixon was surely the worst person other than Dick Cheney ever to control the executive branch.
But the Nixon era was a time in which leading figures in both parties were capable of speaking rationally about policy, and in which policy decisions weren’t as warped by corporate cash as they are now. America is a better country in many ways than it was 35 years ago, but our political system’s ability to deal with real problems has been degraded to such an extent that I sometimes wonder whether the country is still governable.
As many people have pointed out, Nixon’s proposal for health care reform looks a lot like Democratic proposals today. In fact, in some ways it was stronger. Right now, Republicans are balking at the idea of requiring that large employers offer health insurance to their workers; Nixon proposed requiring that all employers, not just large companies, offer insurance.
Nixon also embraced tighter regulation of insurers, calling on states to “approve specific plans, oversee rates, ensure adequate disclosure, require an annual audit and take other appropriate measures.” No illusions there about how the magic of the marketplace solves all problems.
So what happened to the days when a Republican president could sound so nonideological, and offer such a reasonable proposal?
Part of the answer is that the right-wing fringe, which has always been around — as an article by the historian Rick Perlstein puts it, “crazy is a pre-existing condition” — has now, in effect, taken over one of our two major parties. Moderate Republicans, the sort of people with whom one might have been able to negotiate a health care deal, have either been driven out of the party or intimidated into silence. Whom are Democrats supposed to reach out to, when Senator Chuck Grassley of Iowa, who was supposed to be the linchpin of any deal, helped feed the “death panel” lies?
But there’s another reason health care reform is much harder now than it would have been under Nixon: the vast expansion of corporate influence.
We tend to think of the way things are now, with a huge army of lobbyists permanently camped in the corridors of power, with corporations prepared to unleash misleading ads and organize fake grass-roots protests against any legislation that threatens their bottom line, as the way it always was. But our corporate-cash-dominated system is a relatively recent creation, dating mainly from the late 1970s.
And now that this system exists, reform of any kind has become extremely difficult. That’s especially true for health care, where growing spending has made the vested interests far more powerful than they were in Nixon’s day. The health insurance industry, in particular, saw its premiums go from 1.5 percent of G.D.P. in 1970 to 5.5 percent in 2007, so that a once minor player has become a political behemoth, one that is currently spending $1.4 million a day lobbying Congress.
That spending fuels debates that otherwise seem incomprehensible. Why are “centrist” Democrats like Senator Kent Conrad of North Dakota so opposed to letting a public plan, in which Americans can buy their insurance directly from the government, compete with private insurers? Never mind their often incoherent arguments; what it comes down to is the money.
Given the combination of G.O.P. extremism and corporate power, it’s now doubtful whether health reform, even if we get it — which is by no means certain — will be anywhere near as good as Nixon’s proposal, even though Democrats control the White House and have a large Congressional majority.
And what about other challenges? Every desperately needed reform I can think of, from controlling greenhouse gases to restoring fiscal balance, will have to run the same gantlet of lobbying and lies.
I’m not saying that reformers should give up. They do, however, have to realize what they’re up against. There was a lot of talk last year about how Barack Obama would be a “transformational” president — but true transformation, it turns out, requires a lot more than electing one telegenic leader. Actually turning this country around is going to take years of siege warfare against deeply entrenched interests, defending a deeply dysfunctional political system.
Benen: BEATS ME...
Kevin Drum recommends we take a moment to get "back to basics."Let's recap: the United States spends about twice as much on healthcare as any other developed nation in the world and in return receives just about the worst care. Can someone remind me again why there's even a debate about whether we should put up with this?
Reading this, it reminded me just how challenging the right's sales pitch was going into the debate over reform. In some ways, conservatives couldn't possibly win the argument -- the status quo is ridiculous. We spend too much and get too little. Tens of millions of Americans go without coverage, and thousands die as a result of not having insurance. The existing private system screws over consumers, is drag on the economy, and undercuts wage growth. The two groups of Americans best served by the status quo are seniors (in a Canadian-style, socialized system) and veterans (in a British-style, government-run system). Everyone else is in, at best, a precarious position.
Left unchecked, the dysfunctional, inefficient, patchwork health care system threatens to bankrupt the country. Reform was a no-brainer.
In this sense, Republicans, their allies, and their media partners had a seemingly impossible task. There are plenty of old sayings about the most effective sales professionals -- they can sell sand in the desert, they can sell ice to the Inuit, etc. The right's challenge was the opposite -- they had to tell a drowning country not to accept a life-preserver. That's an extremely difficult task.
They've pulled it off, so far, by telling almost comically-ridiculous lies, and managing to get scared, gullible people to believe them. It's no small feat. Indeed, it's almost impressive. Conservatives have managed to create a debate out of nothing but partisanship, paranoia, and greed.
If there's a Hall of Fame for political con jobs, this one's a first-ballot inductee.
- From the comments:
Hate and fear are the only effective political messages.
Posted by: JMG on August 30, 2009 at 9:03 AM
2. Getting Americans to admit that ANY aspect of our society isn't the best in the world is impossible.
Fact number one is an unhappy fact of human nature far older than this country, or any current country.
Fact number two is the uniquely American flaw that will be our doom.
Benen: AND THEN WHAT?...
On ABC's "This Week," it appears the question of the day is WWKD -- what would Kennedy do?
Sens. John Kerry (D-Mass.) and Orrin Hatch (R-Utah) told ABC's This Week that the late-Sen. Edward Kennedy (D-Mass.) -- who long supported the public option -- would compromise on health care before altogether abandoning the possibility for reform this year.
"Teddy would put the facts on the table, and the reality of life for many Americans on the table," Kerry told host George Stephanopoulos. "What Teddy would do is fight for the public option. He believed that the public option, like I do, would be the best option available ... But if he didn't see the ability to get it done ... he would not throw the baby out with the bathwater, he would not say no to anything."
"In every case he fought as hard as he could," Hatch added. "But when he recognized that he couldn't get everything he wanted, but could get a good bill, he [would compromise]."
I have no idea if this is true. I do know that "public, government-run health care was key to not one, but both of Kennedy's final health care initiatives." He helped shape the HELP Committee bill, which included a public option as its centerpiece. Kennedy also championed a Medicare for All bill, which never gained traction.
Given this, whether Kennedy would have been willing to scuttle a public option -- despite majority support among Americans, majority support in the House, and majority support in the Senate -- is open to some debate.
But I still think this is the wrong question, and it ignores the larger dynamic entirely.
I can imagine a set of circumstances in which Senate Republicans said, "Look, reform is important, but the public option is a bridge too far. If Dems were willing to drop that provision, we could have a broad, bipartisan consensus on a health care bill." But, newsflash, this isn't what's happening. Indeed, when the White House signaled a willingness to scuttle the public option, congressional Republicans insisted they'd still oppose health care reform.
Kerry and Hatch think Kennedy would have dropped the public plan to strike a deal. Maybe, maybe not. But the question badly misses the point -- what deal? Which Republicans are ready to support an ambitious reform package if Democrats agree to drop the public option?
The GOP expects Dems to get rid of one of the key provisions in the entire reform campaign. In exchange for what? Why is there even a discussion underway in which Dems negotiate with no one, giving up long-sought policies and get literally nothing in return?
We're hearing an awful lot about the "quid," with no talk about the "quo."
Really, how can you negotiate with this . . .?
Think Progress: Pawlenty Smears Stimulus While His Top Economic Adviser Tours Minnesota Touting Its Success
In an interview yesterday with Bloomberg, Gov. Tim Pawlenty (R-MN) gave a blistering speech attacking President Obama, slamming the the stimulus and efforts to reform health care. Pawlenty declared it would be “ludicrous” to think that the Recovery Act is “what pivoted” the economy back to stability. He also said any “fair critique” of Democratic health care legislation includes the argument that “death panels” would make life-or-death treatment decisions.
But as Bloomberg later reported, Pawlenty’s criticisms of the stimulus are at odds with both economists and the statements of Pawlenty’s own economic development director, Dan McElroy. McElroy, Pawlenty’s “point man on jobs and economic development,” leads the Department of Employment and Economic Development. He recently went on a 10 city road show titled “Advancing Economic Prosperity” touting the benefits of the stimulus. Speaking about the positive effects of the stimulus, McElroy said:
“Our goal was to put this money to work as quickly as possible. Communities and job-seekers throughout Minnesota are seeing tangible results from this funding.“
A longtime adviser to the governor, Pawlenty has praised McElroy as, “one of the smartest, most hard-working change-oriented leaders that has come to state government in modern history.” And McElroy isn’t the only Pawlenty official heaping praise upon the stimulus. Pawlenty’s top financial advisor, Tom Hanson, told Minnesota legislators that stimulus funds used to plug the state’s massive budget shortfall have made “all of our lives just a little bit easier.” He added, “The federal money will give us the opportunity to accept federal assistance and push it out into our state, to help as many people as possible.”
Not only is Pawlenty hitching his wagon to the outrageous “death panel” lie being propagated by Newt Gingrich and Sarah Palin, but he’s also joining the long line of hypocritical Republicans who try to score political points by knocking the stimulus while claiming credit for its success at home.
Update Watch the Pawlenty interview:
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