About a month ago, I recommended breaking up opponents of health care reform into several groups, because they're not all driven by the same motivations. We have The Greedy (who profit for the status quo's failings), The Partisans (who want to deny Democrats a historic policy victory); The Tin-Foil Hats (who are paranoid, delusional conspiracy theorists), and The Dupes (well-intention folks who've been misled by the professional liars from the other groups).There is, however, a tiny fifth category: The Wonks. These are conservatives who actually care about substantive policy details, have read the proposals, and believe there are better ways to improve the system. I think they're mistaken, but The Wonks are at least worth engaging in debate.
The New York Times reports today on their existence.
Far from embracing the attacks, many leading conservative health care policy experts said in recent interviews that the dynamic was precluding a more robust real-world debate while making it nearly impossible for them to inject their studied, free-market solutions into the discussions.
And they said the focus on what they consider misleading or secondary issues was getting in the way of real questions about the plan they believed worthy of consideration.
"There are serious questions that are associated with policy aspects of the health care reform bills that we're seeing," said Gail Wilensky, a veteran health care expert who oversaw the federal Medicare and Medicaid programs for the first President George Bush and advised Senator John McCain in his presidential campaign last year.
Their conservative allies, however, don't want to hear "serious questions." They want to spout nonsense, conspiracy theories, bogus scare tactics, and obvious lies -- because they're convinced that's what wins.
And for all I know, they're probably right. If the political world had an honest, serious debate, in which credible experts explored real-world solutions, chances are very good progressive reform advocate would win. When it comes to health care and the broken system, the facts just aren't on conservatives' side. Indeed, the NYT piece noted some of the conflicts among conservative wonks who realize that a) they want to cut costs from the health care system; b) the most effective ways to save money in the system come from centralized, government decision-making; and c) they're against centralized, government decision-making.
So, The Wonks don't get invited to Tea Parties or onto Fox News. They don't write nutty pieces for the Wall Street Journal editorial page. Their opinions are not sought out by Republican policymakers.
Instead, we're left with liars and fools, spreading propaganda and nonsense, leaving us with a discourse unbefitting our democracy. It's a shame the voice of the opposition is stark raving mad, and the idea of an enlightened debate is a naive daydream.
Yglesias: Fear of Foreigners
Maddow provides a great history lesson here ...Kevin Drum returns us to this classic of the health care debate:
I don’t think anyone has ever tried to suggest that American health care is somehow “twice as good” as European health care. Better at some things, maybe, sure. But the evidence is that our results are actually worse than what the French get at half price. The evidence is that the Swiss do about the same as we do at a fraction of the cost, except in Switzerland there are no medical bankruptcies and nobody can’t get treatment because they’re too poor. And so on and so forth.
But these facts about foreign models are staples of random blog posts, but they’re almost never mentioned in the official political debate. And I wonder why. The conventional wisdom, as expressed in this Third Way strategy memo, is that talking about foreigners is for losers: “Don’t compare the U.S. to other countries, or assert that America does not provide quality health care. (i.e. Do not cite statistics that say the U.S. is 37th in the world in health outcomes).”
They don’t, however, share with us the research on which this is based. Is there really research showing that Americans are such knee-jerk nationalists that they’ll just tune out evidence from abroad that it’s possible to do things differently and better? I suppose that’s possible. But it’s hardly going to be possible to hide from voters the fact that other countries have national health care systems. So naturally voters will wonder if such systems produce better or worse results than ours. And naturally opponents of creating a national health care system will claim that things are worse abroad. So I don’t see how failing to mention that results are actually better in other countries actually lets you avoid the argument. It seems to me to just avoid having a chance at winning it.
Rep. Weiner on health care fight Sept. 3: Rep. Anthony Weiner, D-NY, joins Rachel Maddow to talk about the health care reform battle ahead of President Obama's address to a joint session of Congress.
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Ezra Klein: The Bush Record of Tax Cuts, Failure and Betrayal
I'm not sure what good it does for progressives to delude themselves about Bush's success in passing pure domestic policy initiatives that easily overcame the opposition of Republican moderates, but the reality is that he saw his initiatives watered down at every turn.
Bush initially sought a $1.6 trillion tax cut. The votes didn't exist. So the price tag was reduced to $1.35 trillion, and since a filibuster looked unbreakable, the bill went through the budget reconciliation process, which meant that its deficit-increasing provisions — that is to say, most all of it — would sunset in 2010. For that reason, much of that bill evaporates this year. Interestingly, Olympia Snowe advocated a "trigger" option that year, too, which would have revoked the tax cuts if the budget surpluses were beneath expectations.
The 2003 tax cuts were trimmed from more than $700 billion to about $300 billion by a coalition of Senate moderates. Social Security privatization was, of course, quickly abandoned. Medicare Part D was loathed by many House conservatives. Tellingly, Dick Armey wrote an op-ed opposing it, and Tom DeLay had such trouble passing it over conservative objections that the Department of Justice opened an investigation into the tactics he used to pass it.
There's a sort of comfort in believing that George W. Bush got everything he wanted, because it suggests that if liberals could only emulate his tactics, they too could get everything they want. But Bush's domestic policy was appalling to most conservatives. His tax cuts were a victory, but he never matched them with spending cuts. No Child Left Behind, Medicare Part D, and McCain-Feingold looked a lot more like liberal efforts to increase the welfare state than anything the Heritage Foundation would produce. Ted Kennedy, in fact, was a key mover in each of those bills, though he voted against the final version of the Medicare expansion. Social Security Privatization was a bust.
The Bush White House was very good at leveraging 9/11 to ensure congressional support for Middle East adventurism, but they didn't crack the code unlocking a compliant Congress for a hard-line conservative agenda. That's why most conservatives think their domestic policy was a mixture of tax cuts, failures and betrayals, and they're right about that. The problems posed by the Senate are part of the system, not specific to a particular party.
Benen: PUTTING ON A RECEPTIVE APPEARANCE...
Throughout the debate over health care reform, congressional Republicans haven't exactly played a constructive role. In addition to lying shamelessly and constantly about the provisions in the proposals, the GOP's response to every possible idea has been the same: "No." Even one of the Gang of Six members has publicly conceded that he's only at the table to reject Democratic ideas.
Now, it's worth noting that this isn't necessarily offensive. Republicans are the opposition party. They're supposed to oppose. They tried governing, failed, and were rejected by voters. Now their principal task is rejecting what the new majority wants to do.
But there are several factors that continue to make Republican satisfaction relevant. Senate Democrats, for example, don't have a filibuster-proof majority, and the reconciliation process comes with its own set of problems. For that matter, "centrist" Dems, especially those in "red" states, are looking for some partisan cover on health care. And the media still places enormous value in "bipartisan" solutions, and necessarily casts doubts on major initiatives passed solely with Democratic support.
And what do Republicans want? Other than to say "no," mislead the nation, and kill Democratic legislation? Apparently, they now want to appear constructive. Sen. Bob Corker (R) of Tennessee suddenly thinks a compromise is at least possible, just as soon as the majority scuttles that pesky public option.
"There is a common ground," Corker said Wednesday in an interview before his final town hall meeting. "It's half a loaf, possibly, from the administration's viewpoint. But what it does is take us way down the field."
Sen. Charles Grassley (R) of Iowa, after spending the past month trashing the White House and reform proposals, is suddenly taking a slightly more optimistic tone.
Arguing that the town hall forums of August have "changed the direction" of the health care reform debate, Sen. Charles Grassley (R-Iowa), said Thursday that he nonetheless expects a bill to pass before Christmas -- though it "may be kind of miniature to what we're talking about."
"...I believe [the bill] will be a little more scaled down than what we were originally thinking when we left for August summer break."
Even House Minority Whip Eric Cantor (R) of Virginia, who hasn't tried to be constructive all year, suggested Republicans are just waiting at the negotiating table, ready to be helpful.
Cantor said that Republicans need to hear from Obama that there will be "no government decision making" in rationing care or restricting Americans to get medical treatment.
"That's the signal for us that we could produce some reform," Cantor told The Hill Thursday.
This is what is generally referred to as a "sucker's bet." Congressional Republicans have spent every waking moment for the last nine months trying to destroy the Obama presidency, and kill reform. Now, perhaps worried about being blamed by the public for obstructionism, we suddenly see Republican lawmakers sound receptive notes.
To believe this is to believe Lucy really will let Charlie Brown kick the football this time. The White House and Democratic leaders could agree to drop a public option and the GOP would simply move on to the next set of demands. Eventually, Dems would say they can't give up any more, and Republicans would immediately respond that the majority isn't open to good-faith negotiations.
Senate Minority Whip Jon Kyl (R) of Arizona, just a couple of weeks ago, said Republicans would oppose reform measures no matter how many concessions Democrats made. He wasn't kidding.
Benen: WHAT HAPPENED TO BAUCUS?...
Marcy Wheeler had a terrific item yesterday, summarizing a point that's been circulating a bit: Senate Finance Committee Chairman Max Baucus (D) of Montana used to have a great health care plan.
On November 12, 2008, about a week after voters handed Barack Obama a sweeping national victory and congressional Democrats large majorities in both chambers, Baucus put together a White Paper on his vision of reform. The plan included a national health care exchange, a public option, new consumer protections, universal coverage, an individual mandate, a Medicare buy-in at 55, and subsidies up to 400% of the poverty line, among other progressive measures.
Marcy noted, "It's like a journey through the looking glass, to a time when even a conservative Democrat would openly espouse doing what's right to truly improve health care."
That was Baucus in November, but let's also not forget where Baucus was in April. At that point, he and Ted Kennedy co-signed a letter to the president, explaining that they've been "working together toward the shared goal of significant reforms to our health care system" for nearly a year, and they planned to "swift" action. Indeed, they saw smooth sailing ahead: "Our intention is for that legislation to be very similar, and to reflect a shared approach to reform, so that the measures that our two committees report can be quickly merged into a single bill for consideration on the Senate floor."
So, what happened? Where'd this Max Baucus go? How did the Baucus of November and April (champion of a progressive, ambitious plan) become the Baucus of June and August (leader of the Gang of Six, opponent of the public option)? Ezra Klein explains the circumstances behind the switch.
Baucus pulled a bit of a bait-and-switch. That paper proved less his plan than his effort to articulate the Democratic consensus in such a way that Democrats were comfortable with him leading the debate. In particular, Kennedy had to be happy with that paper, because Kennedy was the threat to Baucus's leadership.
But Kennedy's illness took him out of the game. Baucus no longer needed to worry about Kennedy stealing the leadership of health-care reform away from him, which meant he stopped looking over his left shoulder. The effect was a bit like shutting down a primary challenge against Baucus: His surprising leftward lurch stopped entirely, and he drifted back to the more centrist approaches that had defined his career. It's hard to say how the process would have differed if Baucus had spent his days worrying about keeping Kennedy onboard, but it seems possible that the practical impact would have been to keep Baucus closer to the paper he'd written to attract Kennedy's support.
For all the recent talk from Republicans about Kennedy's absence undermining bipartisanship -- a cheap talking point, to be sure -- the real consequence of Kennedy not being able to serve is the effect it had on Baucus, who quickly embraced "bipartisanship," delayed the process, and continues to prefer to water down what was a strong proposal.
Yglesias: Ben Nelson Threatens to Blow Up Health Reform
I know a lot of the readers of this blog think that Barack Obama could cause any bill to pass the Senate that he wants if only he were sufficiently spiney, and that any effort to point out the existence of objective impediments to passing legislation is just “shilling” for the White House, but it’s still the case that objective impediments exist. To pass a bill through a non-reconciliation process, you not only need the support of guys like Max Baucus and Kent Conrad, you also need the support of even-less-progressive Democrats like Mary Landrieu and Mark Pryor and Blanche Lincoln. And then there’s Ben Nelson, the most conservative Democrat of all:
“I see two endings,” Nelson said when asked by the paper what’s next for reform. “One is we find areas we can agree upon and we begin to do things incrementally, taking more of an insurance approach, not a government approach. Or it implodes.”
The context leaves no doubt that by “government approach” he means the public option, and this statement would seem to be pretty definitive. How can Nelson support the public plan if it will destroy reform?
As Greg Sargent notes later in that item, it’s extremely annoying to see Nelson’s use of the passive voice here to avoid responsibility. What Nelson is saying is that he, personally, will cause health reform to implode unless reform is incremental and lacks a public option. But instead of fessing up, he’s using a lot of weasel words. Maybe you can get a public option put in place via reconciliation, in which case you don’t need Nelson, but absent reconciliation you do need Nelson and he’s intransigent.
Now of course Nelson represents Nebraska which is a pretty conservative state. It’s worth noting, however, that it’s pretty hard to think of pieces of major beneficial legislation becoming law in the United States purely out of people behaving in a craven and self-interested manner. The Civil Rights Act of 1964, for example, secured the support of Senator Mike Monroney of Oklahoma, not exactly the most black-friendly state in the Union. But Monroney seems to have been a man of conscience and thus he “voted for the Civil Rights Acts of 1957, 1960, and 1964. He also refused to sign the ‘Southern Manifesto,’ a call by a group of Southern senators in 1956 urging resistance to school desegregation.” These were real acts of political courage. Oklahoma was once upon a time a safe Democratic state, but it went for Eisenhower in 1952 and 1956 and Nixon in 1960. The state elected its first Republican governor in 1962, and he was re-elected in 1966. And Monroney’s political courage met with exactly the fate that cowardly politicians fear—he got beaten in 1968. But he still did the right thing.
No compassion at town halls Sept. 3: Msnbc analyst Lawrence O'Donnell discusses the ugly behavior at some of the health care town halls. What has turned some protestors into defenders of insurance companies?
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Think Progress: McCain Endorses Claim That Obama Finds Seniors ‘Expendable’: ‘I’ve Never Heard It More Eloquently Put’
EDITOR’S NOTE: Over the past month, ThinkProgress has traveled to town hall events across the country to report what we’re seeing on the ground. This is our fifth eyewitness report.
This past Tuesday, Sens. Mitch McConnell (R-KY) and John McCain (R-AZ) took their nationwide health care road show to Florida, where they teamed up with Sen. Mel Martinez (R-FL) to participate in a closed-door town hall event at the Palmetto General Hospital in Hialeah. ThinkProgress attended the forum.
During the question-and-answer session, Jim Dolan, president of the Florida Medical Association, expressed his anger with the American Medical Association for supporting President Obama’s health care plan. We “repudiate that action on their part,” Dolan said, speaking for his Florida chapter.
Dolan went on to propagate a version of the false “death panels” myth, claiming that the Obama administration is promoting “dranconian rationing that Rahm Emanuel’s brother, Ezekiel, talks about as though it’s going down to pick up a loaf of bread.” Dolan wondered when are people going to realize that “the people advising this president” feel that the seniors “are expendable.”
Rather than distance himself from Dolan’s false assertion, McCain wholeheartedly embraced it:
McCAIN: Doctor, I know you have a day job, but I’d like to take you with me wherever I go. [Laughter] I’ve never heard it more eloquently put than you just stated the situation.
Watch it:
When his former running mate Sarah Palin first offered the false “death panel” claim last month, McCain defended her. He said that end-of-life counseling “at least opens the door to a possibility of rationing.”
Think Progress: Pence embraces town hall questioner who compares Obama to Hilter.
Yesterday, Rep. Mike Pence (R-IN), who serves as chairman of the House Republican Conference, held a town hall-style meeting at Madison Park Church of God in Anderson, IN. During the event, an elderly woman stood to ask Pence a question, and in the midst of doing so, told the congressman that President Obama wants members of Congress to be treated as “a superior race.” “And we know who came up with the terminology of a superior race,” she continued, “it sounds a lot like Hilter.” Many in the crowd applauded. Rather than reject the questioner’s false assertion, Pence simply said, “Thank you.” Watch it (beginning at 1:50):
(Video courtesy of the Pendleton-Gazette)
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