Closing Arguments-The Day of Reckoning
President Obama making the final arguments for Health Reform
My Saturday began on the West lawn of Capitol Hill, where conservative activists were mounting one final, desperate effort to block health care reform. They came by the thousands, carrying flags and pushing strollers, in a demonstration of genuine grassroots fervor. They chanted “Kill the Bill,” over and over again, in a vaguely menacing tone that, perhaps, foretold a bit of ugliness to come.
But the most remarkable thing about the demonstration was how little it had to do with health care. The signs said “Stop socialism,” “A government of laws, not men,” “Respect our constitution–preserve our republic.” Nobody talked about death panels. Instead, one speaker–a Chicago radio host, I believe–attacked the First Lady’s obesity initiative. “Michelle, keep your hands off my kids’ lunchbox!” Yet another protest sign seemed to capture the mood perfectly: “This isn’t about health care. This is about control.”
A few hours later, inside the Capitol complex, President Obama urged House Democrats to do precisely what the protesters feared: Pass health care reform. It was not the first time he’d given such a speech. Just before the House voted on its initial reform bill in November, he’d come to Capitol Hill. And, broadly speaking, his intent had been the same: To embolden the Democrats by making them enthusiastic about the cause, demonstrating his own commitment to it, and making clear the political virtues of success.
But, like the protesters, this time Obama seemed to dwell less on health care and more on the significance of the moment. He invoked Lincoln, and the importance of fighting for principle. And then he invoked the legacy of the New Deal and Great Society, reminding members that their purpose in office was not to win elections–it was to make life better for their constituents. His closing argument was not about policy or politics. It was about posterity. And it was good.
For the last week or so, ever since it’s become apparent a climactic vote on health care was approaching, I’ve also been thinking about closing arguments. For most of the past year–and, really, it’s been far more than a year–the argument has been most practical. What would the bill do? What wouldn’t it do? And it’s easy enough to make the case for reform on those grounds.
As readers of this space know, I like to think of reform as achieving three broad goals: Making sure anybody can get an affordable insurance policy, shoring up everybody’s coverage so that it provides real economic security, and transforming medical care in order to make it both more effective and less expensive. Those arguments got a lot stronger this week, when the Congressional Budget Office determined that the final reform package–including both the Senate’s health care bill and the proposed amendments to it–would provide coverage to 32 million additional people, strengthen the baseline for coverage, and reduce the federal deficit over time.
But there’s another argument for health care reform, one that is at once more subtle and more sweeping. The disturbing part of our health care system is the financial and physical suffering it causes. But the unjust part of our health care system is the way it distributes that suffering. There are things all of us can do to stay healthy–we can eat right, we can exercise, we can avoid excessive risks. But even when we do the right things, we remain vulnerable.
You can have the perfect diet, jog three miles every day, and wake up one morning to discover you have cancer. So now you face mortal peril. And if, on top of everything else, you can’t pay your medical bills, you face financial ruin, as well.
Chance, of course, is part of life. Americans, in particular, seem to accept that. But every now and then, we have decided that need for such expansion–that there was, even now, the kind of common vulnerability to chance that required the sorts of initiatives we had enacted in the past. It happened with the New Deal, when we created the modern welfare state, and then again with the Great Society, when we expanded it.
The signature programs of these eras, Social Security and Medicare, work because they address a vulnerability we all share. Everybody is at risk of getting old; and everybody is at risk of misfortune, physical and financial, when that happens. To protect against that misfortune–to insure against that misfortune–all of us contribute. We all give, in the form of financial contributions; and we all get, in the form of financial security. Together, quite literally, we are stronger than when we are apart.
The conservatives protesting on the Capitol lawn Saturday see things differently. Health care reform isn’t about contributing money for the sake of their own security; it’s about having their money taken for the sake of somebody else’s security. When they hear stories of people left bankrupt or sick because of uninsurance, they are more likely to see a lack of personal responsibility and virtue than a lack of good fortune. As my colleague Jonathan Chait has observed, theirs is an extreme version of a view common (although surely not universal) on the right: That individuals can fend for themselves, as long as they are responsible and as long as the government gets out of the way.
There’s obviously a balance to be struck between these two world views. But, broadly speaking, conservative ideas about responsibility and vulnerability have dominated political discussion for most of the last four decades. That will change on Sunday, if health care reform passes. The bill before Congress may be flawed. And the process that produced it may be severely flawed. But it is, nevertheless, an expression of the idea that we–as as society–are not prepared to let people continue to suffer such dire consequences just because they’re unlucky.
A few hours after Obama was speaking, the Capitol had nearly cleared out. Leadership staff were meeting in House Speaker Pelosi’s office while a few stray congressmen were giving floor speeches to a nearly empty chamber. By and large, though, members had scattered–a tell-tale sign that Pelosi was confident. If she’d still needed to do serious arm-twisting, she’d have held a series of votes to keep members on the Hill.
I walked the length of the building and then out to the east lawn where the conservative protesters, who spent the day visiting (and, on a few occasions, haranguing) House Democrats, had reconvened. The crowd was more subdued now. It was smaller, too–hundreds instead of thousands. The setting sun behind the capitol dome cast a long shadow over them, as night approached. But a new dawn would come soon enough. And with it, perhaps, a new era.
By: Jonathan Cohn-Senior Editor-The New Republic-March 21, 2010
Vital Center: Why are Democrats Fighting for a Republican Health Plan?
Here is the ultimate paradox of the Great Health Care Showdown: Congress will divide along partisan lines to pass a Republican version of health-care reform, and Republicans will vote against it. Yes, Democrats have rallied behind a bill that large numbers of Republicans should love. It is built on a series of principles that Republicans espoused for years.
Republicans have said that they do not want to destroy the private insurance market. This bill not only preserves that market but strengthens it by bringing millions of new customers. The plan before Congress does not call for a government “takeover” of health care. It provides subsidies so more people can buy private insurance.
Republicans always say that they are against “socialized medicine.” Not only is this bill nothing like a “single-payer” health system along Canadian or British lines, but it doesn’t even include the “public option” that would have allowed people voluntarily to buy their insurance from the government. The single-payer idea fell by the wayside long ago, and supporters of the public option—sadly, from my point of view—lost out in December.
They’ll be back, of course. The newly pragmatic Rep. Dennis Kucinich (D-Ohio) was right to say that this is just the first step in a long process. We will see if this market-based system works. If it doesn’t, single-payer plans and public options will look more attractive.
Republican reform advocates have long called for a better insurance market. Our current system provides individuals with little market power in the purchase of health insurance. As a result, they typically pay exorbitant premiums. The new insurance exchanges will pool individuals together and give them a fighting chance at a fair shake.
Republicans now say that they hate the mandate that requires everyone to buy insurance. But an individual mandate was hailed as a form of “personal responsibility” by no less a conservative Republican than Mitt Romney. He was proud of the mandate and proud of the insurance exchange idea, known in Massachusetts as “The Health Connector” (the idea itself came from the conservative Heritage Foundation).
What does it tell us that Republicans are now opposing a bill rooted in so many of their own principles? Why has it fallen to Democrats to push the thing through? The obvious lesson is that the balance of opinion in the Republican Party has swung far to the right of where it used to be. Republicans once believed in market-based government solutions. Now they are suspicious of government solutions altogether. That’s true even in an area such as health care, where government, through Medicare and Medicaid, already plays a necessarily large role.
As for the Democrats, they have been both pragmatic and moderate, despite all the claims that this plan is “left wing” or “socialist.” It is neither. You could argue that Democrats have learned from Republicans. Some might say that Democrats have been less than true to their principles.
But there is a simpler conclusion: Democrats, including President Obama, are so anxious to get everyone health insurance that they are more than willing to try a market-based system and hope it works. It’s a shame the Republicans can no longer take “yes” for an answer.
By: E.J. Dionne, Jr. -author of the recently published Souled Out: Reclaiming Faith and Politics After the Religious Right. He is a Washington Post columnist, a senior fellow at the Brookings Institution, and a professor at Georgetown University. March 20, 2010, The New Republic
Top 10 Reasons Why Voting Yes on Health Care Reform is Good Politics for Democrats
Reason # 10 — Consider the source. Who are the major advocates of the theory that it is bad politics for Democrats to vote for health care reform? None other than Republican leader Mitch McConnell and House Minority Leader John Boehner. If they recommend that Democrats vote no, then any Democrat with half his wits should fall all over himself to vote yes.
Reason # 9 — A receding tide leaves those in the shallowest political waters aground. We all saw what happened in 1994 when President Clinton’s health care reform went down in flames: so did a substantial number of the most vulnerable Democrats. Like it or not, Democrats in swing districts are tied at the hip to the political fortunes of their own President. And fundamentally, Senator Jim DeMint (R-SC) was right last year when he argued that if Republicans can stop the President on health care reform, they will cripple him politically. Like President Clinton, President Obama could fight back from such a setback. But there is no doubt it would massively injure his political stature and that of the Democratic Party going into the fall elections. Let’s face it, people don’t like to vote for losers — or for people who they put in charge who then can’t deliver. Since leaving office, former President Clinton has argued persuasively that the party that nationalizes the mid-term elections always wins. There will be no running away from the national Democratic Party for members in swing districts – no immersing yourself in “local issues.” If health care fails, it will lower the ambient level of support for Democrats across the country among swing voters, and it will depress turnout in the Democratic base. Let’s recall that the biggest reasons the Republicans took power in 1994 was that the depressed and dispirited Democratic base failed to appear at the polls. The defeat of health care reform would hurt every Democrat. And it will mortally wound those in the toughest districts – whether or not they vote for the bill.
Reason # 8 – The Republicans will say you did anyway. When I was 16 years old, it snowed in my hometown of Shreveport, Louisiana. When it snows in Shreveport, everything stops and the schools let out. This snowstorm happened right in the middle of Mardi Gras, so a friend and I set off on the train to stay with his brother in New Orleans and partake in the Mardi Gras fun. In the course of that trip, we were naive — and with wide eyes — walking down Bourbon Street, when a big hawker at a strip joint said something that taught me an important lesson in life and politics. He said: “Come on in, sonny, they’re going to say you did anyway.” Most Democrats have already voted in favor of health care reform. The Republicans will attack them for that vote regardless. So much better to be able to point to the upsides of passing the legislation. So much better to overcome the negatives created by kilotons of negative advertising, by demonstrating that the sky did not fall when health care reform was passed – and that many positive benefits immediately accrued to everyday Americans.
Reason # 7 – Even voters who say they oppose “health care reform” tell pollsters they support the major elements of the reform. That’s because “Obamacare” as a concept has been vilified by incessant negative advertising and the right wing noise machine. But it wasn’t so easy to convince people not to like concrete policies that were good for them, such as banning insurance companies from denying care because of pre-existing conditions, or preventing them to continue massive rate increases. Once the bill passes, the Republicans will be confronted with having to rail against popular policies – not rant about vague concepts like “Obamacare.”
Reason #6 – Nobody ever votes based on “legislative process.” Democrats who worry that voters will retaliate against them for “jamming through” health care need to take a deep breath. First, of course, no one ever “jams through” a piece of legislation if it passes by a majority vote. Majority rule is the central premise of democratic governance. But that aside, no one ever remembers — or cares — how a law is passed. They care about its effect on everyday people. What normal person remembers how Medicare or Social Security, or the minimum wage, or the State Children’s Health Insurance Program (SCHIP), or any other bill is passed? It doesn’t happen — ever.
Reason #5 – The bill is a great “starter house.’ Some progressive Members of Congress are concerned that the final health care bill will not include a public option, as it should. It won’t be perfect in other respects either. But as Senator Tom Harkin says, it is a great “starter house” to build on and add to. The other side knows that. And that’s one of the reasons they want to kill it dead in its tracks. People ask, why isn’t the insurance industry wild about having more customers? The answer is that they don’t care about customers, they care about the freedom to make big profits and provide huge paydays to top executives. In fact, in the last few months, profits have shot up at the same time that the number of people covered has actually dropped. That’s possible because in most states these companies — fundamentally bereft of competitive pressure — can raise premiums until they are blue in the face. The insurance industry knows that this is the beginning of the end of their ability to stalk the countryside unchallenged — to do whatever it is they want to do to make money – and they will do everything they can to stop it cold.
Reason #4 – A victory on health care reform will completely change the political narrative. Instead of “Obama fails to deliver on promises” or “Democrats confront gridlock” the new narrative will be “Obama and Democrats raise health care — like a Phoenix — from the dead.” That new narrative is heroic. It is about people who stay tough when things get hard and triumph in the end — who overcome massive odds to succeed. It is about taking on the massive insurance industry — with its infinitely deep pockets — and winning. Voters like winners. And voters love heroes. That narrative is part of a winning political narrative for the fall elections.
Reason #3 – The boost from passing health care reform will massively increase the odds that Democrats can pass other critical, politically popular measures in Congress this year. Success on health care will enormously increase our ability to pass tough legislation to hold the big Wall Street banks accountable, to create more jobs,and to forge a path to energy independence. For Hispanic voters it will greatly increase the odds that Obama can lead the way to pass bi-partisan immigration reform. All of these measures, and many others, will boost his ability to show swing voters that Democrats deliver — and inspire support and enthusiasm among base voters. But the opposite is also true. If we lose the health care battle, our ability to win other legislative fights will be greatly reduced — and with it the political benefit as well.
Reason #2 – Voters hate the insurance industry. They will be thrilled that Obama and the Democrats have vanquished them on the field of battle. They will love that we have begun to hold them accountable, and rein in their power. It will enable us to frame the legislative battles of the last year and a half — and the electoral battle this fall — as a contest between everyday Americans and the insurance industry, Wall Street and the oil companies. Of course the most important thing about this narrative is that it rings true, because it is true. Victory will allow us to escape the quicksand of “policy speak” and legislative procedure, to the pure essence of who is on whose side.
Reason #1 – Finally, victory will allow Members of Congress to be on the right side of history. Social Security, Medicare, Civil Rights, a woman’s right to vote, ending slavery…. every one of the major steps on America’s road to become a more democratic society has been marked by controversy and conflict. But how many people today would want to brag that their grandfather voted against Social Security or Medicare? There is a reason why progressive leaders are the heroes and heroines of American history. They embody the values and aspirations that are at the core of American values — and human values. When the House of Representatives finally votes this week to make health care a right in America it will be making history that will be remembered for generations. And in the final analysis, there can be no better politics than that.
By: Robert Creamer, political organizer and strategist, and author of the recent book: “Stand Up Straight: How Progressives Can Win” -March 16, 2010, The Huffington Post.
What Failure Would Cost the Democrats-A Cold Analysis of This Weeks Vote
Disgruntled (if not former) Democrats Pat Caddell and Doug Schoen are the latest to join in offering advice to President Obama and Congressional Democrats to abandon their health reform quest before it causes catastrophic damage to the party. Caddell and Schoen close their Washington Post article with the following warning: “Unless the Democrats fundamentally change their approach, they will produce not just a march of folly but also run the risk of unmitigated disaster in November.”
The case Caddell and Schoen make parallels the one made the previous day by Karl Rove in the Wall Street Journal, and that is made daily by a parade of Republican pollsters and lawmakers: The Democrats’ health reform plan is wildly and deeply unpopular, mirroring the unpopularity of Washington and big government. If it passes, it will result in a huge political backlash, especially if Democrats use reconciliation, which Caddell and Schoen call manipulation and liken to the “nuclear option” that Senate Republicans threatened during the Bush administration. For Rove, the use of reconciliation will open the way for Republicans to use the same technique to repeal health plan when they recapture the majority.
We fundamentally disagree; the surest path to political debacle for Democrats is to fail to enact health reform, and the best way to avoid a rout in November is to show that the party in charge can actually govern. The reconciliation process is entirely appropriate for amending the Senate-passed bill; in any case, the public will judge the Democrats on the basis of the results, not the inside-baseball process. In fact, the Democrats most reluctant to support health reform–those from more conservative, Republican-leaning districts and states–are the ones most likely to lose in November if health reform is defeated.
The obvious first antecedent to examine is 1994. Democrats went into the midterm elections after a presidential contest in which they grasped the full reins of power in Washington for the first time in a dozen years. Early momentum disappeared when first President Bill Clinton’s modest stimulus proposal went down in the Senate and then his deficit-reduction package staggered to the finish line after eight long months and without a single Republican vote in either house. It looked more like a setback than a victory. This was followed the next year by a lengthy struggle to enact sweeping health care reform that ended in a complete collapse, without even a vote on the Clinton plan. A shocking loss in the House on a crime bill, though ultimately reversed, reinforced the image of a president and party that could not govern competently.
What followed was a disastrous midterm for Democrats—losses of 54 seats in the House and eight in the Senate. Heading into that election season, House Minority Whip Newt Gingrich, described the Democrats’ condition bluntly: “Imagine it’s October, and the Democrats are going to get up and make the following case: ‘We’ve run the House for 40 years, we’ve run the Senate for eight years, we have the White House, and the Republicans are so much more clever than we are that they’ve obstructed us. We need you to elect more dumb Democrats so we can overcome those clever Republicans.’” Conservative Democratic Senator John Breaux, of Louisiana, echoed that point on health policy, saying, “We can blame the Republicans for filibustering, but we have the responsibility to govern.”
To be sure, there were many reasons for Democrats’ massive losses in 1994, including scandals and angry gun owners. But the failure to fulfill their responsibility for governing contributed mightily to the debacle. That was the conclusion of pollsters from both parties in the aftermath of the November contests. Two weeks after the election, Republican pollster Bill McInturff found that “one of the most important predicates for Republican success was not having health care pass.” He noted that the collapse of the plan reinforced voters’ belief that Washington was in a dysfunctional state of gridlock. At the same time, Democratic pollster Mike Donilon, who worked on the losing campaign of Pennsylvania Senator Harris Wofford, said he believed that Wofford would have won had health reform passed.
It is undeniably true that a Washington plan to reform health care is not overwhelmingly popular. But that’s mostly because Washington is unpopular these days. When the component parts of the Democrats’ plan are parsed out, surveys show high approval for nearly all of them, including removing preexisting conditions, ending lifetime benefit caps, providing tax credits to small business to get them to cover employees, subsidizing low- and middle-income families to enable them to buy insurance, and creating a health-insurance exchange to shop for policies.
We also know that voters are warming somewhat to the idea of a reform plan, in part because the president has ramped up his efforts on its behalf beginning with the State of the Union and the health-reform summit—letting voters know what is actually in the bills. The actions of insurance companies like Anthem and Wellpoint, raising premiums sharply before enactment of reform, has also contributed to a public receptiveness to change. And we know that there was a noticeable bump in public approval when bills passed the House and the Senate—voters like action, and like success. Even where we are skeptical about the benefits of government programs, we want government to work.
It is also true that the health-reform plan, contrary to conventional wisdom, will not simply frontload the costs and backload the benefits. The plan will move quickly to erase the unpopular “doughnut hole” that results in a costly jolt for many seniors buying prescription drugs, to end discrimination based on preexisting conditions for children, to ease the insurance burden on those losing or leaving their jobs, and to enable parents to carry children up to the age of 26 on their family policies. Many House and Senate Democrats are understandably nervous about voting to enact health reform. We are convinced that the political damage will be far, far worse if they fail to do so.
By: Norman J. Ornstein and Thomas E. Mann. They are co-authors of The Broken Branch: How Congress is Failing America and How to Get It Back On Track. March 15, 2010-The New Republic
How to Make Something Controversial
People say the media is more viscerally sympathetic to Democrats than Republicans. But working in the other direction is the fact that Republicans understand the media much better than Democrats do. Take the reconciliation process. The media is giving blanket coverage to this “controversial” procedure being used by the Democrats. But using reconciliation for a few fixes and tweaks isn’t controversial historically, and it’s not controversial procedurally. It’s only controversial because Republicans are saying it is. Which is good enough, as it turns out. In our political system, if Democrats and Republicans are yelling at each other over something, then for the media, that is, by definition, controversy. This is something Democrats did not understand when George W. Bush was in power.
The Senate reconciliation vote occurred on May 23, 2003. In the month of May, only one New York Times article so much as mentioned the use of reconciliation for the tax cuts — a May 13, 2003, article that devoted a few paragraphs to wrangling over whether Senate Republicans could assign the bill number they wanted (S.2) to a bill approved via reconciliation. The Times also used the word “reconciliation” in a May 9, 2003, editorial, but gave no indication whatsoever of what it meant.
And that’s more attention than most news outlets gave to the use of reconciliation that month. The Washington Post didn’t run a single article, column, editorial, or letter to the editor that used the words “reconciliation” and “senate.” Not one. USA Today, the Los Angeles Times, and the Associated Press were similarly silent.
Cable news didn’t care, either. CNN ran a quote by Republican Sen. Chuck Grassley about the substance of the tax cuts in which he used the word “reconciliation” in passing — but that was it. Fox News aired two interviews in which Republican members of Congress referred to the reconciliation process in order to explain why the tax cuts would be temporary, but neither they nor the reporters interviewing them treated reconciliation as a controversial tactic.
And ABC, CBS, NBC? Nothing, nothing, nothing.
And why was there nothing? Because Democrats weren’t complaining. The tax cuts might have been controversial, but they weren’t creative enough to polarize the procedure the Bush administration was using to pass them.
But some of the credit for that has to go to the Bush administration, which took seriously the need to institutionalize reconciliation when they were strong and popular rather than weakened. When Bush came into office, he used reconciliation for his first tax cuts. That was a sharp break with precedent: Reconciliation had never been used to increase the deficit, and the process was so poorly suited to the purpose that the Bush administration had to let all of them sunset after 10 years. It was a bizarre, bizarre bill. But by using it for his popular first round of tax cuts, Bush normalized it such that Democrats couldn’t really complain when he used it for his much more controversial second round of tax cuts.
By Ezra Klein | March 5, 2010; 9:53 AM ET
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