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“How A President Negotiates With Congress”: Cross-Party Negotiations In Congress Are More About Leverage

The Democratic presidential primary has sparked a discussion on the left about the value of bold proposals vs incrementalism. In arguing for the latter, Scott Lemieux takes on the ridiculous notion that the history of Social Security and Medicare/Medicaid are examples of bold change proposals.

The idea that the Social Security — which not only offered modest benefits but intentionally excluded large numbers of African-Americans — was not an example of incremental reform is quite remarkable. Even more revealing is the Medicaid example. Nothing makes it clearer that this fake-nostalgia for the REAL LIBERAL Democratic Party of yore is just a rhetorical cudgel with which to beat Democrats and not any kind of serious historical analysis than this. Apparently, a public health insurance program that required states to cover only a subset of people well below the poverty line was REAL, UNCOMPROMISING LIBERALISM while a public health insurance program that required states to cover everyone up to 138% of the poverty line is the hopelessly compromised neoliberal work of useless corporate sellouts. Right.

But then Lemieux takes on an argument we’ve heard often during the Obama presidency about how he has too often pre-compromised by negotiating with himself. This is the case Brian Beutler made not too long ago when arguing in favor of Bernie Sanders’ approach.

But if we’re imagining both of their agendas as opening bids in negotiations with Congress, why fault Sanders for not negotiating with himself? Ask a future Democratic Congress for single payer and a $15 minimum wage and you might get laughed at… but you also might get the public option and a bump to $12. Ask it for the public option and a $12 minimum wage, as Clinton might, and you’ll get a fair hearing from the outset, but you might end up with advancements barely worth fighting for. President Obama, as Sanders is fond of noting, negotiated with himself, and progressives paid an unknowable price as a result.

Here’s what Lemieux says about that:

People who think that important legislation gets passed by presidents making opening bids far outside the expected negotiating space have no idea how presidential power works. (And, for that matter, have no idea how negotiating works. If the Mariners phone up the Angels and offer Mike Zunino for Mike Trout, that doesn’t mean that the Angels will then offer to accept Leonys Martin for Mike Trout; it means the Angels GM will stop taking your phone calls.) To say that a president “pre-comprimised” is often used as an insult, but it is in fact a sign that he knows what he’s doing. The lessons of FDR and LBJ — and now Obama — are the opposite of what this faction of the left thinks they are.

Frankly, the argument Beutler makes is something that has never made sense to me – no matter how many times I’ve heard it over the last 7 years. For example, if President Obama had made single payer his opening bid in health care reform, I fail to see how that would have triggered a more progressive negotiation process. First of all, it would have negated what he ran on as a candidate and more likely would have been ignored – even by Democrats – as a serious proposal. Similarly, the President proposed raising the minimum wage to a meager $10/hour a couple of years ago. Did that spark a negotiating process with Republicans? No, they’ve simply ignored it – just as they did his “bold” proposals for things like the American Jobs Act, universal pre-K and free community college.

The truth is that cross-party negotiations in Congress are more about leverage than they are about bold opening bids. In order to get the other party to the table, you have to be willing to give them something they want. That is why – since 2010 when Republicans took control of the House – pretty much the only thing that has been negotiated is the budget and raising the debt ceiling. Initially Republicans used those “fiscal cliffs” as leverage (or hostages) to get what they wanted. For the last couple of years, both parties have eventually come to the table on budgets in order to avoid another government shut-down (which is the leverage).

Beyond what Lemieux wrote, it is important to remember that when FDR was negotiating for Social Security and LBJ for health care, they were engaged in intra-party negotiations – much as Obama did during those few months that Democrats controlled the House and had a 60-vote majority in the Senate. That is not a likely scenario for a Democratic president any time in the near future. Any “bold” proposal will therefore require having leverage that brings Republicans to the table. In other words, it will require pre-compromise.

 

By: Nancy LeTourneau, Political Animal Blog, The Washington Monthly, May 13, 2016

May 16, 2016 Posted by | Congress, Democratic Presidential Primaries, Liberals | , , , , , , , | Leave a comment

“Makes More Sense Than Critics Admit”: The Brave Politics Of Clinton’s Medicare Buy-In Proposal

Predictably, much of the commentary about Hillary Clinton’s newly expressed interest in making a Medicare buy-in option available to people near retirement age is treating it as another calibrated “move to the left” to head off Bernie Sanders or placate his supporters. The unstated assumption is that anything other than a full-on single-payer system (the only creditable progressive proposal, you see) is a half measure reflecting either political cowardice or corrupt kowtowing to private insurance interests.

Here’s the thing, though. People who love to cite polls showing the popularity of “Medicare for all” (the favored buzz-phrase for single-payer) should be aware that the popularity of the venerable retirement program is based on its current characteristics as an “earned entitlement” program for which working Americans pay payroll taxes and then, after becoming beneficiaries, premiums. The “buy-in” proposal, by targeting people who have (a) presumably been paying those same payroll taxes and will continue to do so until retirement if they are employed, and (b) will immediately pay relatively steep premiums (though not as steep, in most cases, as private insurance premiums), does minimal violence to the structure, financing and original purpose of Medicare. “Medicare for all,” once it is a tangible proposal rather than a bumper-sticker slogan, changes Medicare in all these respects, and might make it unrecognizable. The financing challenge alone for a single-payer system — which never much gets mentioned in the polling — makes the incremental approach, via a combination of Medicare, “Obamacare”-subsidized private insurance, and Medicaid, a much easier reach financially and politically.

Perhaps I’m wrong and perhaps Hillary Clinton is wrong in feeling this way. But one thing’s for sure: Expanding Medicare and providing a “public option” under Obamacare are not popular ideas in the private insurance industry. That’s certainly not the constituency Clinton is representing here. And anyone who doubts the political courage it takes to achieve universal health coverage incrementally, instead of just intoning “Medicare for all” until the walls fall down like Jericho’s, hasn’t been paying much attention the last quarter-century.

 

By: Ed Kilgore, Daily Intelligencer, New York Magazine, May 11, 2016

May 14, 2016 Posted by | Bernie Sanders, Hillary Clinton, Universal Health Care | , , , , , , , , | Leave a comment

“Sanders’ ‘Medicare For All'”: The Devil Is In The Details

Bernie Sanders is a proud and self-described socialist, a veteran Vermont senator who wants to bring some European ideas to the United States. One of those ideas is a single-payer health care system: a government-funded program in which the patient bears little to no cost. Sanders describes it as “Medicare for all.”

It’s an excellent idea. The United States is the richest country in the world, and it ought to grant every citizen guaranteed access to doctors and hospitals. That’s what Canada, Japan and the countries of Western Europe have all done.

But Sanders is vague — and his supporters quite naive — about the prospects of bringing a single-payer system to the United States. He insists that he could accomplish that in a prospective first term “if many millions of people demand it.”

Here’s the rub: They won’t — at least not in the systematic and sustained manner that would be required to bring about that sort of, well, revolutionary change to the American medical-industrial complex.

There’s a reason that the U.S. doesn’t have “Medicare for all”: politics. Do Sanders and his supporters remember the epic battle to pass the Affordable Care Act?

Democrats have been trying to pass a version of universal health care since the days of Franklin Delano Roosevelt. But conservatives have fought every proposal that would increase access for ordinary Americans, including Medicare; Ronald Reagan, then a neophyte political activist, toured the country campaigning against it.

Bill Clinton made universal health care a cornerstone of his presidential campaign in 1992, and he appointed his wife, Hillary, to head a task force to propose legislation after he won. They tried mightily to pass it, but conservatives denounced it, and the insurance industry spent millions to defeat it.

That’s why President Barack Obama brought the insurance industry on board when he started toward the Affordable Care Act. He knew he needed their support to have a prayer of passage. So the ACA preserves the business of selling health insurance through private companies.

Still, it has helped millions of families; nearly 9 million more Americans had health insurance in 2014 than the year before, according to government data. Moreover, the ACA prevents insurance companies from banning patients because they are sick and prohibits insurers from placing “lifetime caps” on the amount of money any person can collect for health care.

Would a single-payer plan have been even better? You bet. But listen to Obama’s former aide, David Axelrod, describe the difficulties of trying to pass such a proposal.

“I support single-payer health care, but having gone through health reform, we couldn’t even get a national consensus around the public option! It was Democratic votes that were ultimately missing on that issue,” Axelrod remembered. (The public option was a proposal for a government-run health insurance plan to compete with private health insurers.)

History shows that Obama and his allies spent months trying to make the ACA more palatable to conservatives to entice a few GOP votes. Actually, the mandate requiring that all adults have health insurance was originally a conservative idea. While the federal government provides subsidies to help families with modest incomes buy insurance, it doesn’t pay the full cost. (Obamacare also sets aside billions for states to expand Medicaid, but the Supreme Court made that optional, and many states have refused to expand.)

Still, the ACA did not get a single Republican vote in the end — not one. Republicans are still trying to repeal the law, taking more than 60 votes in Congress and going to the Supreme Court with challenges. Most of those Republicans will be easily re-elected to Congress.

Given recent history, it’s clear that Sanders’ plan would face very long odds — and that’s before details become clear. The Vermont senator proposes an extraordinary range of patient care — dental and vision coverage, mental health care, long-term care — while, he says, saving trillions of dollars. Many health care experts say that can’t be done, so health care spending would likely increase. You don’t have to be a conservative voter to fear where that would lead us.

If Vermont’s audacious senator has a plan for overcoming an ultraconservative GOP caucus in Congress, a right-leaning U.S. Supreme Court, and millions of voters who still flinch from the word “socialist,” he ought to lay it out. It would be quite a revolutionary plan, indeed.

 

By: Cynthia Tucker Haynes, Pulitzer Prize Winner for commentary in 2007: The National Memo, February 13, 2016

February 14, 2016 Posted by | Bernie Sanders, Medicare for All, Single Payer | , , , , , , , , | 1 Comment

“The Problem Is The Politics”: Sanders’ Single-Payer Plan Is A Distraction

If you’ve successfully landed on the beaches, but your forces are still taking heavy fire, what do you do? Do you concentrate on trying to hold the line and make further advances or do you sit in a circle and design a better landing craft?

The problem with Bernie Sanders’ health care vision isn’t the vision. His raw outline for a greatly simplified and less expensive health-care system is excellent in theory. The problem is the politics — the reality of which battle-scarred Hillary Clinton clearly has the better grasp.

This was the message Clinton tried to convey in the Sunday Democratic debate. Her most potent point on health-care reform centered on recalling the “public option” fiasco during the fight for the Affordable Care Act.

The public option was to be a government-run health plan competing with the private offerings in the health-care exchanges. It was a no-brainer to keep the insurance companies on a shorter leash. But, as Clinton noted, “even when the Democrats were in charge of the Congress, we couldn’t get the votes for that.”

John E. McDonough, a health policy expert at Harvard, has also been through the health-care wars. As a Massachusetts state legislator, McDonough led an unsuccessful campaign to bring single-payer to his liberal state. In a recent New England Journal of Medicine article, he explained why a similar effort in Sanders’ own state of Vermont failed.

Vermont was the great hope for we fans of single-payer. (I was waving pompoms.) The state is progressive and one footstep from Canada. Gov. Peter Shumlin was totally onboard. He spent four years trying to make a single-payer plan happen. Three major-league studies showed that it was economically feasible.

But even in Vermont, a clear public mandate for single payer never materialized. A rebellion against it almost cost Shumlin the governor’s job.

Asked about this on Sunday, Sanders took a swipe at Shumlin (who has endorsed Clinton).

“Let me just say that you might want to ask the governor of the state of Vermont why he could not do it,” Sanders responded. “I’m not the governor. I’m the senator from the state of Vermont.”
Yes, and as senator from Vermont, Sanders introduced several single-payer bills that went nowhere. The most recent one, the 2013 American Health Security Act, attracted not a single co-sponsor.

The plan Sanders released two hours before the debate remains too sketchy for a reliable independent analysis, according to McDonough. But lack of detail isn’t his biggest concern. It’s opening a new front in the battle to defend Obamacare.

“Republicans sent a bill to the President’s desk last week that would eliminate health insurance for 22 million Americans by 2018,” McDonough wrote me. “This is not beanbag. It’s the real deal, and we have to focus where it matters the most.”

“Bernie wants to lead us on a distraction tour while Republicans want to kill the progress we have made.”

How far have we come? Thanks to Obamacare, almost 18 million formerly uninsured Americans now have health coverage. A report just out of Georgetown University has the rate of uninsured Hispanic children falling to a historic low.

Insurers can no longer turn down people with pre-existing conditions. And important politically, Obamacare has demonstrated that universal coverage is doable without creating mass unemployment or “exploding” deficits. On the contrary.

Making Obamacare more Medicare-like through incremental steps may not feed the romantic urge to reinvent health-care reform from scratch, but there’s no other road, not in the America of 2016. Finally, let’s not forget that vanguard of reform is still on the beaches and taking fire.

Correction: The health policy expert at Harvard is John E. McDonough, not Thomas. We regret the error. This article has been updated to reflect that change.

 

By: Froma Harrop, Featured Post, The National Memo, January 19, 2016

January 20, 2016 Posted by | Bernie Sanders, Health Reform, Hillary Clinton, Single Payer | , , , , , , , | 2 Comments

“Propelling His Long-Shot Bid”: The Real Reasons Bernie Sanders Is Transforming The Election; Here’s Why He Galvanizes The Left

CNN dubbed this “the summer of Sanders” as media outlets finally picked up on the large crowds Independent Vermont Senator Bernie Sanders has attracted during campaign stops. His rocketing poll numbers in early primary states like Iowa and New Hampshire led to countless stories heralding a Sanders surge — but the story is as much about the issues as it is about the man.

Even Republican candidates have taken notice of Sanders’ rise. Ahead of a recent stop in Madison, Wisconsin, likely 2016 contender and Wisconsin Governor Scott Walker welcomed Sanders to the state with a series of tweets attacking the democratic socialist once dismissed as too fringe. Walker may not have taken too fondly to Sanders attracting a record 10,000 people in his home state.

But Sanders’ campaign, surely more so than that of any of the Republican candidates, seems to be gaining traction more for the ideas he espouses than because of a cult of personality.

Granted, many supporters have pointed to Sanders’ straightforward manner and willingness to call out bad actors as refreshingly appealing, but unlike with Republican presidential candidates Donald Trump and Chris Christie, it isn’t just a brash style that’s being sold. Sanders makes a direct effort to address many of the issues that have arisen since the Hope & Change campaign of 2008 and it appears as though he is tapping into very real and long-simmering sentiments in the Democratic base.

More than a protest vote against Hillary Clinton, as some have suggested, Sanders’ support appears to be support for issues Clinton’s yet to fully address. Here are some of the ways that Sanders is gaining support by leading on issues or movements that other candidates ignore:

VA Scandal

Sanders was chairman of the Senate Veterans’ Affairs Committee when Democrats last controlled the chamber, and following the VA scandal, Sanders worked with Republicans in the House to pass legislation that expands health care access for veterans and makes it easier to fire underperforming officials.

His record and work on veterans’ affairs issues has earned Sanders top awards from the Veterans of Foreign Wars, the American Legion and the Military Officers Association of America, and now it appears as though that recognition is translating to support for his campaign.

The Boston Globe writes that Sanders’ “surge is partly fueled by veterans,” citing “entire Reddit threads [that] are dedicated to how veterans can best pitch Sanders to other veterans” and “a Facebook page promoting Sanders to veterans.” As the Globe notes, in the early voting state of South Carolina veterans make up about 11 percent of the electorate.

Occupy Wall Street

The short-lived global protest movement suddenly shifted the national debate in the aftermath of the recession from talk of austerity to a focus on growing income inequality by introducing terms like the 1 Percent to national prominence in time for the 2012 campaign. But the Occupy Wall Street movement achieved no great legislative win, and after the encampments were broken down many of the grievances remained unacknowledged, let alone addressed.

Sanders’ 2016 campaign embodies much of the demands of the OWS movement. Speaking to the largest campaign crowd of this cycle in Wisconsin this week, Sanders said, “The big money interests — Wall Street, corporate America, all of these guys — have so much power that no president can defeat them unless there is an organized grassroots movement making them an offer they can’t refuse.” For activists who organized, protested and camped out in Zuccotti Park and squares across America, this message of unfinished business is powerful. The acknowledgement of a continued struggle and willingness to put up a fight is what was galvanized the Draft Warren movement and it has now seemingly shifted to Sanders.

Student Debt Movement

Some Occupy Wall Street activists joined a movement against student debt, which has now surpassed $1 trillion in the U.S. The activists, some of whom had refused to make any more payments on their federal student loans, achieved a major victory this year when Corinthian colleges (you know them by their annoying commercials hawking their schools like Everest, Heald and WyoTech) shuttered the last of their remaining U.S. campuses, and the erasure of $13 million in debt. The movement has successfully overseen the closure of campuses in Canada the year before.

Sanders has proposed the College for All Act, a plan to provide tuition-free education at public colleges funded by a small tax on Wall Street transactions.

Citizens United

Since the 2010 Supreme Court ruling allowing unlimited political contributions by corporations and unions saw the rise of the Super PAC in electoral campaigns, Americans are shockingly united in their opposition to such obscene levels of money in politics. The overwhelming majority of Americans, including Republicans, support limits on campaign contributions.

Sanders is the only candidate to have completely sworn off all Super PAC funds, although a couple of independent political action committees have formed in support of his candidacy.

But Sanders has objected to their existence, saying, “A major problem of our campaign finance system is that anybody can start a super PAC on behalf of anybody and can say anything. And this is what makes our current campaign finance situation totally absurd.”

Obamacare

The Supreme Court may have upheld the Affordable Care Act twice, but the political battle over the health care law promises to rage on five years after its passage. With health care costs rising only marginally more slowly than they did before the law’s passage and a continuation of premium increases, even Democrats who support the law have called for marked improvements as millions of Americans are left uninsured because Republican lawmakers refuse to expand Medicaid.

Sanders has promised to return the debate to early 2007, when during the Democratic presidential primary the public option was on the table. Sanders has long called for a “Medicare-for-all” single-payer health care plan similar to what was tossed aside as too radical shortly after the talks began on health care reform once Obama took office.

 

By: Sophia Tesfaye, Salon, July 3, 2015

July 6, 2015 Posted by | Bernie Sanders, Democratic Presidential Primaries, Populism | , , , , , , , , , | 6 Comments

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