Friday, September 18, 2009

Health and Politics

Sargent: Grassley: I Would Have Let Baucus Kick Football If He’d Tried One More Time
The perfect postscript to the Gang of Six fiasco! After months spent cannily stringing along Max Baucus, Senator Chuck Grassley is now insisting they would have worked things out if Baucus had just given it a bit more time:
Sen. Max Baucus would have been able to craft a health bill with broad bipartisan support had he been given more time, a key Senate colleague claimed Thursday…
“The sad commentary is that we were working to practically completion of a bill,” Grassley told CNBC during an interview this morning. “Another couple weeks would have given us an opportunity to have a bipartisan bill that I think would have gotten broad-based support.”
I’ve enlisted my seven-year-old son, a big Peanuts fan, to act as research assistant on this one. He unearthed this exchange:
Grassley/Lucy: Okay, Charlie Brown…I’ll hold the ball, and you come running up and kick it…
Baucus/Charlie Brown: I can’t believe it! I can’t believe that anyone would think I was so completely stupid!
Grassley/Lucy: I won’t pull it away like I usually do, Charlie Brown…I promise!
Baucus/Charlie Brown: Ha! I know your promises!
Grassley/Lucy: Look…we’ll shake on it, okay? Let’s shake on it…this proves my sincerity…
Baucus/Charlie Brown: What could I do? If someone is willing to shake on something, you have to trust her…[he runs...Lucy yanks away ball...] AAUGH! [he lands flat on back.]
Grassley/Lucy: A woman’s handshake is not legally binding!
Update: Commenter Liam sends in the illustration….

Health care lacks a southern strategy  

Sept. 17: Rachel Maddow points out that red states like Mississippi and South Carolina, whose representatives oppose improving health care, rank the worst in a variety of national health metrics.

It seems unlikely that Sen. Olympia Snowe of Maine, Congress' least-conservative Republican, would leave the GOP altogether. She's been with the party this long, and unlike Arlen Specter, Snowe has no reason to worry about the security of her seat.

Yesterday, however, she made some comments that are sure to raise eyebrows on the Hill. Snowe sat down with the New York Times' John Harwood, who asked a simple but provocative question: why are you a Republican?
Here's her answer, in its entirety: "Well, you know, it's -- I've always been a Republican for the traditional principles that have been associated with the Republican Party since I, you know, became a Republican when I registered to vote. And that is limited, you know, limited government, individual opportunities, fiscal responsibility, and a strong national defense. So I think that those principles have always been a part of the Republican Party heritage, and I believe that I, you know, reflect those views. And I haven't changed as a Republican, I think more that my party has changed."
I'm reluctant to read too much into this, and if I had to guess, Snowe will probably, at some point today, reiterate her commitment to her party. Dems have talked with Snowe in the past about taking that short walk across the aisle, and she's always politely declined.
That said, whenever lawmakers start talking publicly about how they haven't changed, but their party has changed, it tends to reflect some deep, fundamental misgivings. Snowe has consistently rebuffed Democratic overtures, but that was before the Republican Party became the right-wing, moderates-free party it is today.
And at the risk of over-interpreting her comments, I also noted that Snowe said "you know" four times in 40 seconds. Was that the result of nervousness?
Let's also not forget the larger context here. As we talked about yesterday, Snowe is the only Senate Republican willing to negotiate in good faith with Democrats on health care reform -- a move that has drawn considerable ire from the Senate Republican caucus.
Snowe didn't initiate yesterday's discussion about her party affiliation; Harwood did. But Snowe's answer sent a not-so-subtle signal about her dissatisfaction with the state of the GOP.
Benen: BACK TO 60 BY NEXT WEEK?... 
Ted Kennedy's death brought the Senate Democratic caucus down to 59 seats. Massachusetts Gov. Deval Patrick (D) would love to fill the vacancy, but can't, at least not yet.
To briefly recap, in 2004, state lawmakers, worried about Mitt Romney choosing John Kerry's replacement, passed a measure to leave Senate vacancies empty until a special election is held within five months. In August, Kennedy, aware of his limited time remaining, asked that the law be changed -- empowering Patrick to fill a vacancy immediately with an interim senator, with a special election to follow soon after.
State policymakers were reluctant to act, until Kennedy's passing made the matter extremely relevant, not only to the state, but to national affairs. Yesterday, the Massachusetts state House took a step towards remedying the problem.
House lawmakers approved legislation last night that gives Governor Deval Patrick the power to appoint a temporary successor to the late Edward M. Kennedy in the US Senate, putting Massachusetts on track to have a new senator in place by next week.
The passage of the bill, by a 95-to-58 vote, was a crucial step toward filling the seat left vacant by Kennedy's death last month and could carry major implications as Congress debates an overhaul of the nation's health care system.
Attention now shifts to the Massachusetts state Senate, where there is a strong Democratic majority, but where Republicans hope to use parliamentary maneuvers to delay the process. The Boston Globe reported that the GOP minority "would probably exhaust their options for stalling by the middle of next week," at which point the chamber could approve the bill.
If all goes according to plan, a bill may be on Deval Patrick's desk as early as Wednesday, and an interim senator could be named almost immediately.
The scuttlebutt in Boston seems to be over who Patrick will pick, not over whether the legislation will become law, but of even greater importance to officials in Washington is how the U.S. Senate landscape changes if/when the Democratic caucus goes from 59 to 60 again.
How would this affect health care reform negotiations? Would Olympia Snowe still be the Senate's most important member? Would center-right Dems consider joining with the GOP on a filibuster, even if Dems have a 60-vote majority?
Next week will be awfully interesting.
Sargent: New Ad Showcases Ted Kennedy’s True “Progressive” Legacy
The first ad in the race among Dems to succeed Ted Kennedy is now out, and it’s really worth watching, because it shines a bright light on the true nature of Kennedy’s liberal legacy.
The ad, from Massachusetts Rep. Michael Capuano, who’s expected to declare his candidacy today, explicitly ties him to the man he’s hoping to replace:

The spot from Capuano, who’s entering a crowded primary, strongly emphasizes that he’s a “progressive,” using the word twice.
“Only one candidate stood with Ted Kennedy against Bush’s Iraq war and mirrors his progressive record,” the ad says, emphasizing his support for a “strong public option” and his opposition to the death penalty.
Whatever you think of Capuano, what’s interesting here is that the race could force a conversation about Kennedy’s real legacy — his strong, unabashed commitment to real liberal principles in the face of tremendous derision and hostility — rather than the mushy paeans to Kennedy’s supposed love of “compromise” we keep hearing from pundits.
C&L: Kent Conrad proudly tells us why the Senate Finance Committee Bill is a Republican Bill
By John Amato Thursday Sep 17, 2009 2:00pm

Watching Kent Conrad proudly read off the list of items that the Senate Finance Committee included or should I say turned over to the conservatives in their bill just to kowtow to the obstructionist minority party is just mind numbing. Why didn't Baucus just let Renzi and Grassley write the bill for the democrats? Didn't John McCain win the election? He's actually proud of what they've done. Republicans should just love this bill. It cuts out all the things that would have an impact on health care reform. Here's Kent Conrad's ode to da republicants.
Mitchell: How did you do? Are you guys going to get any Republicans to join you in this?
Conrad: Well, we certainly hope so. Look, they asked a series of things be excluded.
*They didn't want a public option, it's not in this package. They didn't want an employer mandate, it's not in this package.
*They wanted tax reforms so that the high end Cadillac plans would have a levy on them to discourage over utilization, that's part of the package.
*They didn't want illegals to benefit, many Democrats agreed, that's not in the package. Those here illegally will not benefit.
*They wanted to make certain that federal dollars not be used to support abortion and so they're not.
*There's the beginning of medical malpractice which many wanted to see be included. There's a clear statement on that.
So I hope that they'll see as we go through the process that there's much here that's worthy of their support....
If Mitch McConnell had told the Baucus Dogs that Americans should be required to produce at least three forms of ID to enter hospital emergency rooms, Conrad probably would have included that, too. In that respect I think the Republicans blew it. Luckily for us, Americans, Senators, Republicans and a lot of members of his own committee do not feel the same way.
Republicans don't like it because... it's a health care bill. Democrats don't like it because... it's a bad health care bill designed to kowtow to Republicans who won't even vote for it. Health care advocacy groups don't like it because it "would give a government-subsidized monopoly to the private insurance industry to sell their most profitable plans - high-deductible insurance - without having to face competition from a public health insurer." A good reason not to like it! And unions don't like it because there's no employer mandate and it would "tax health plans."
Even President Obama's response to the bill was terrible:
Despite months of anticipation, the White House on Wednesday stopped well short of endorsing Sen. Max Baucus's (D-Mont.) healthcare bill.
White House press secretary Robert Gibbs said the release of Baucus's Senate Finance Committee healthcare legislation — the last of five committees to unveil a proposal — moved the legislative process along, but President Barack Obama still thinks the bill will change.
Oh, there is one group of people that love the Bacus bill:Insurance companies.
Following Baucus’ announcement, HealthNet shares increased by 3%, United Health Group Inc shares rose by 2.7%, Humana Inc. grew by 2.6%, Wellpoint stock gained 1.7% and Aetna Inc rose 1.6%...
I go back and forth on whether such senators are truly this stupid or if it's all just their way of pretending to be kinda for something they're really against. I don't know what they're trying to achieve.
Krugman: Baucus and the Threshold
So Senator Max Baucus, the chairman of the Senate Finance Committee, has released his “mark” on proposed legislation — which would normally be the basis for the bill that eventually emerges from his committee. And serious supporters of health care reform will soon face their long-dreaded moment of truth.
You see, it has been clear for months that whatever health-care bill finally emerges will fall far short of reformers’ hopes. Yet even a bad bill could be much better than nothing. The question is where to draw the line. How bad does a bill have to be to make it too bad to vote for?
Now, the moment of truth isn’t here quite yet: There’s enough wrong with the Baucus proposal as it stands to make it unworkable and unacceptable. But that said, Senator Baucus’s mark is better than many of us expected. If it serves as a basis for negotiation, and the result of those negotiations is a plan that’s stronger, not weaker, reformers are going to have to make some hard choices about the degree of disappointment they’re willing to live with.
Of course, those who insist that we must have a single-payer system — Medicare for all — won’t accept any plan that tries, instead, to cajole and coerce private health insurers into covering everyone. But while many reformers, myself included, would prefer a single-payer system if we were starting from scratch, international experience shows that it’s not the only way to go. Several European countries, including Switzerland and the Netherlands, have managed to achieve universal coverage with a mainly private insurance system.
And right here in America, we have the example of the Massachusetts health reform, many of whose features are echoed in the Baucus plan. The Massachusetts system, introduced three years ago, has many problems. But as a new report from the Urban Institute puts it, it “has accomplished much of what it set out to do: Nearly all adults in the state have health insurance.” If we could accomplish the same thing for the nation as a whole, even with a less than ideal plan, it would be a vast improvement over what we have now.
So something along the general lines of the Baucus plan might be acceptable. But details matter. And the bad news is that the plan, as it stands, is inadequate or badly conceived in three major ways.
First, it bungles the so-called “employer mandate.” Most reform plans include a provision requiring that large employers either provide their workers with health coverage or pay into a fund that would help workers who don’t get insurance through their job buy coverage on their own. Mr. Baucus, however, gets too clever, trying to tie each employer’s fees to the subsidies its own employees end up getting.
That’s a terrible idea. As the Center on Budget and Policy Priorities points out, it would make companies reluctant to hire workers from lower-income families — and it would also create a bureaucratic nightmare. This provision has to go and be replaced with a simple pay-or-play rule.
Second, the plan is too stingy when it comes to financial aid. Lower-middle-class families, in particular, would end up paying much more in premiums than they do under the Massachusetts plan, suggesting that for many people insurance would not, in fact, be affordable. Fixing this means spending more than Mr. Baucus proposes.
Third, the plan doesn’t create real competition in the insurance market. The right way to create competition is to offer a public option, a government-run insurance plan individuals can buy into as an alternative to private insurance. The Baucus plan instead proposes a fake alternative, nonprofit insurance cooperatives — and it places so many restrictions on these cooperatives that, according to the Congressional Budget Office, they “seem unlikely to establish a significant market presence in many areas of the country.”
The insurance industry, of course, loves the Baucus plan. Need we say more?
So this plan has to change. What matters now is the direction in which it changes.
It would be disastrous if health care goes the way of the economic stimulus plan, earlier this year. As you may recall, that plan — which was clearly too weak even as originally proposed — was made even weaker to win the support of three Republican senators. If the same thing happens to health reform, progressives should and will walk away.
But maybe things will go the other way, and Mr. Baucus (and the White House) will, for once, actually listen to progressive concerns, making the bill stronger.
Even if the Baucus plan gets better, rather than worse, what emerges won’t be legislation reformers can love. Will it nonetheless be legislation that passes the threshold of acceptability, legislation they can vote for? We’ll see.

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