Thursday, September 10, 2009

Health Care Thursday: Anything Happen Yesterday? Edition

Another day. Anything happen yesterday to change the game? Just wondering.

Greg Sargent:

9:33 PM: Very weird moment: On CNN, McCain denounced Obama for disputing Palin’s death panel falsehood, claiming it was “partisan in nature” and “did nothing to contribute to bipartisan dialog.” But when asked whether he believes the death panel claim, McCain said: “No.”

10:25 PM: Striking numbers from the CNN snap poll, just released: Seventy seven percent reacted positively to the speech; the number who think Obama’s policies will move us in the right direction jumped 10 points, to 70%; the number who back Obama’s health care plan has jumped 14 points, to 67%; and 72% say he clearly stated his goals.

Think Progress:
[Rep. Joe Wilson (R-SC) shouted out, “LIE!”]: The rudeness shocked even veteran political observers such as NBC’s Chuck Todd, who wrote on Twitter, “Wow. What’s next a duel?” MSNBC’s Joe Scarborough also wrote, “Whoever shouted out that the president was lying is a dumbass who should show the President respect.” On MSNBC after the speech, Newsweek reporter Howard Fineman said, “The Republicans were mostly stage props in this speech tonight and they behaved like it.” ... On Fox Business News, Karl Rove and host Neil Cavuto thought Wilson shouting at the President was hilarious. "Joe Wilson, good guy," said Rove. "Lovely," agreed Cavuto.
From the comments at Krugman's blog:
As soon as I saw the article about Joe Wilson shouting “You lie!” during Obama’s speech, I remembered how during Bush’s term you were considered “shrill” for refusing to euphemize Bush’s frequent lies. I wouldn’t have been in favor of a Democratic congressman heckling Bush during a speech, but I believe in a journalist in a newspaper identifying an indisputable lie as such.

Daily Kos: Ted Kennedy's Letter to the President

Below is the text of the letter from Senator Edward M. Kennedy referenced by the President in tonight’s address to a Joint Session of Congress.

May 12, 2009

Dear Mr. President,

I wanted to write a few final words to you to express my gratitude for your repeated personal kindnesses to me – and one last time, to salute your leadership in giving our country back its future and its truth.

On a personal level, you and Michelle reached out to Vicki, to our family and me in so many different ways. You helped to make these difficult months a happy time in my life.

You also made it a time of hope for me and for our country.

When I thought of all the years, all the battles, and all the memories of my long public life, I felt confident in these closing days that while I will not be there when it happens, you will be the President who at long last signs into law the health care reform that is the great unfinished business of our society. For me, this cause stretched across decades; it has been disappointed, but never finally defeated. It was the cause of my life. And in the past year, the prospect of victory sustained me-and the work of achieving it summoned my energy and determination.

There will be struggles – there always have been – and they are already underway again. But as we moved forward in these months, I learned that you will not yield to calls to retreat - that you will stay with the cause until it is won. I saw your conviction that the time is now and witnessed your unwavering commitment and understanding that health care is a decisive issue for our future prosperity. But you have also reminded all of us that it concerns more than material things; that what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.

And so because of your vision and resolve, I came to believe that soon, very soon, affordable health coverage will be available to all, in an America where the state of a family’s health will never again depend on the amount of a family’s wealth. And while I will not see the victory, I was able to look forward and know that we will – yes, we will – fulfill the promise of health care in America as a right and not a privilege.

In closing, let me say again how proud I was to be part of your campaign- and proud as well to play a part in the early months of a new era of high purpose and achievement. I entered public life with a young President who inspired a generation and the world. It gives me great hope that as I leave, another young President inspires another generation and once more on America’s behalf inspires the entire world.

So, I wrote this to thank you one last time as a friend- and to stand with you one last time for change and the America we can become.

At the Denver Convention where you were nominated, I said the dream lives on.

And I finished this letter with unshakable faith that the dream will be fulfilled for this generation, and preserved and enlarged for generations to come.

With deep respect and abiding affection,
[Ted]


Rachel asks the right questions in this piece . . .
Axelrod on Obama's speech Sept. 9: Rachel Maddow is joined by Obama senior advisor David Axelrod following President Obama's health care speech to the joint session of Congress to address the president's willingness to do the hard work required to get the health care reform bill passed.

Steve Benen: OBAMA DELIVERS...
It's impossible to say with certainty whether President Obama's speech on health care reform last night will have the intended impact. Will intra-party differences between Democrats be resolved? Will public attitudes shift back in the White House's direction? Did the speech help reframe the debate? We don't yet know.

We do know, however, that the president did exactly what he needed to do, and delivered what was probably the best speech of his presidency.

Under the circumstances, it's safe to assume Obama didn't want to have to deliver this speech at all. Remember, the White House wanted the House and Senate to pass their respective bills in June. The president would have been just as happy if a national address before a joint session of Congress was entirely unnecessary.

But the summer was unkind to reform. As Obama explained last night, "Instead of honest debate, we have seen scare tactics.... Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned."

So, the president set the record straight, and delivered on some specific benchmarks.

* Centrist: In reality, Democratic reform proposals are poised to be the biggest progressive victory on domestic policy in four decades, but last night, Obama deftly positioned his vision of reform as a centrist, pragmatic, middle-of-the-road approach. The president specifically rejected a "radical shift" that would "disrupt the health care most people currently have... I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch."

* Defining reform: What's this initiative all about? Obama spelled it out in 39 words: "It will provide more security and stability to those who have health insurance. It will provide insurance to those who don't. And it will slow the growth of health care costs for our families, our businesses, and our government."

* Defending government: The right has spent most of the year convincing the nation that anything related to government is, by definition, evil. I was delighted to see the president make the opposite case: "Our ability to stand in other people's shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise."

* Explainer in Chief: I was glad to see Obama talk about mandates and the public option, but more important, I was thrilled to hear him explain them. These can be complicated concepts, and the president made the case clearly.

* Moral case: One area of criticism of late is that the White House hasn't made the moral case for reform. Last night, Obama did just that, quoting Ted Kennedy: "What we face is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country." It was the start of a stirring last act.

* Historical context: The president was very effective in explaining that right-wing hysterics were wrong on Social Security, and wrong again on Medicare. But in the process, he wasn't just dismissing the Tea Baggers, he was connecting his presidency to the progressive legacy.

Towards the very end of the speech, Obama struck a note of American optimism: "I still believe we can act even when it's hard. I still believe we can replace acrimony with civility, and gridlock with progress. I still believe we can do great things, and that here and now we will meet history's test."

The phrase wasn't just about reform; it was about encouraging Americans to have faith in what's possible, even in the face of trying circumstances. It was, in a way, a subtle request -- we elected him to lead, he sees a path ahead, and with patience, he'll try to take us where we need to go.

Americans, in other words, need to "still believe" in his presidency, too. After hearing his vision last night, I think he's earned it.


DemfromCT (Daily Kos): Your Abbreviated Pundit Round-up

Here we go:

Adam Nagourney:

For nearly an hour, Mr. Obama spoke strongly and passionately, pausing only to acknowledge the repeated cheers from his audience as he made what appeared to be his clearest and most concise case yet on a complicated issue that had repeatedly defied his communications skills.

He managed to invest his case with both economic and emotional urgency — particularly when he invoked the memory of Senator Edward M. Kennedy, whose widow, Victoria, was in the audience — without getting bogged down in too many details.

Kaiser health news:

Obama To Congress And The Nation: 'I Will Not Accept The Status Quo'

News round-up by AP and others.

The day after The Speech:

Obama's offer to back an effort to limit malpractice verdicts against physicians may have been devised as a carrot to attract Republicans to his side, and it could also attract support from another key constituency, says William O'Neill, dean of clinical affairs at the University of Miami's Miller School of Medicine. "It could make doctors stand up and take notice," he said. "If the administration could get physicians enthused, then they would enthuse their patients."

And a round-up by The Health Care Reform Debate Blog shows that the docs are there.

Today, the American Medical Association sent a letter to House leaders supporting H.R. 3200, "America's Affordable Health Choices Act of 2009." "This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform," said J. James Rohack, MD, AMA president. "We urge the House committees of jurisdiction to pass the bill for consideration by the full House."

Chris Cillizza:

• Republicans' Audio-Visual Problem: It's always a mistake to assume that the only thing viewers take from a nationally televised speech is the words the president is using. If so, the White House could simply release the remarks and be done with it. Visuals (and audio) matter. And, the two most compelling pieces of audio-visual that came out of tonight's speech -- House Minority Whip Eric Cantor (Va.) checking his blackberry and Rep. Joe Wilson (R-S.C.) shouting "you lie" at Obama -- don't work in Republicans' favor.

In fact, it makes them look like petulant adolescents compared to the grown-up in the room.

Ezra:

In this speech, in fact, Obama needed to do the precise opposite of what he's best at. He needed to bring health-care reform down to earth rather than launch it into orbit. He needed to make it seem less dramatic and unknown. He needed to cast it not as change, but as improvement.

All of which he did.

Nate Silver:

I called the speech a triple, because I think it was about 10 minutes too long. Andrew Sullivan's readers call it a home run. FOX News, I'm sure, will call it a long fly-out to the warning track. The bottom line: it was a well-delivered speech, and a very, very smart speech. It will remind people of what they liked about Obama. It won't do miracles. But it will increase, perhaps substantially, the odds of meaningful health care reform passing.

Tom Schaller:

That said, Obama is trying to win an argument on its merits, on logic, and statistics and projections. In an ideal world, that sort of pragmatic rationality would be enough. But we don’t live in such a world.

Errington Thompson, MD:

As I see it, Republicans are playing some type of child’s game where they claim to support healthcare reform. I don’t see any real effort to support healthcare reform. Senator Mike Enzi is probably the best example of this. He is supposedly negotiating for a bipartisan reform bill. Just last week he told a group of supporters at a rally that he was sure that healthcare reform was going to fail. Unfortunately, Mike Enzi is a very important senator, on the Finance Committee and the Health, Education, Labor and Pensions Committee. Some Republican senators have said they won’t even read the final bill. Democrats, liberals and progressives need to read the writing on the wall. If we truly want change, we’re going to have to push for it. We are going have to march for it. We are going to have to pull the rest of the country kicking and screaming to get it. This is the only way that we are going to prevent the USS Healthcare from sinking.

Dealing with the opposition on health care Sept. 9: Congressman Barney Frank, D-MA, joins Rachel Maddow to share his (low) expectations of being able to work with Republicans on health care reform.

Tim F. (Balloon Juice): Thursday Morning Graph Wonkery

Normally I don’t bother checking Kevin Drum’s graph work because he has done it professionally for longer than I have, and he seems quite good at it. The rare exception is a post last night that I think gets a pretty important point wrong.

Recently a British firm tracked the most influential voices in the health care debate. Here is the graph, with influence on the vertical axis (higher is better) and positive/negative opinion of the British NHS on the horizontal. Kevin added the ‘liberal blogosphere’ venn circle in post.

blog_market_sentinel_healthcare

Kevin makes two conclusions concerning netizens like us. He finds the influence of Twitter depressingly high, and and he finds the liberal blogosphere’s influence depressingly low. Here is why I think that neither conclusion holds water.

About Twitter, it is slightly unfair to compare an individual news outlet such as the Guardian to Twitter, which is basically a communication medium. Since the British firm almost certainly used online linkage and quoting to estimate influence* and Twitter is used by practically everyone who has both a pulse and an internet connection, graphing the influence of Twitter strikes me as about as valid as graphing the influence of email.

About the liberal blogosphere, that dot cluster leads me to the exact opposite conclusion from what Kevin reached. The higher dots, presumably Kos, TPM and HuffPo, sit uncomfortably close to the nearest major news outlet. If I were a WaPo writer trying to pretend (like they always do) that online liberals don’t matter I would not like that graph at all. More fundamentally, Kevin commits the multiplication fallacy by comparing the average influence score of a liberal blog (the center of Kevin’s oval) with the influence of any individual news outlet. Kos may not have the influence of the Washington Post (yet), but established liberal blogs outnumber commercial news outlets by more than one factor of ten. If you want to treat the liberal blogosphere as an aggregate entity, then on aggregate the liberal blogs have a hell of a lot of influeence. If you multiply the number of dots down there by their average influence (assuming the Y axis values are scalar, which is probably wrong), the ‘liberal blogosphere’ data point looks like it could give Twitter a run for its money. Given how those dots can coordinate on an important issue, this graph tells me that liberal blogs have come awfully close to being a new wing of the fourth estate.

BTW, where is the conservative blogosphere? Maybe the analysts did not feel like using a log scale.

(*) Full disclosure – I did not dive into the internals because, unfortunately, I am not paid to blog and what I am paid to do is kicking my ass right now.

***Update***

Also, did you notice Stephen Hawking made it halfway up the Y axis? He is one guy who made something like two public comments on the matter. That suggests that there is a ton of untapped potential for celebrities (other than Jon Voigt) who want to spread the word.

***Update 2***

Another thing. Is it true that the New York Times presents a dramatically more positive picture of the NHS than the liberal blogosphere does? Paging Brent Bozell…

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