Beyond Reason on the Budget: House Republicans Have Finally Revealed There Real Vision
After two years of raging at President Obama’s spending plans, House Republican leaders have finally revealed their real vision of small government: tens of billions in ideologically driven cuts to job training, environmental protection, disease control, crime protection and dozens of other critical functions that only the government can perform.
In all, they want more than $32 billion in cuts below current spending packed into the next seven months. They would be terribly damaging to a frail recovery and, while spending reductions must be part of long-term deficit control, these are the wrong cuts, to the wrong programs, at the wrong time.
But they are not deep enough for many Tea Party members, freshmen and other extremists in the House Republican caucus. In a closed-door meeting on Wednesday, they forced the leadership to abandon its cuts and prepare to double them. The new list is expected on Friday and promises to be one of the most irresponsible budget documents ever issued by a House majority.
The Senate should make it clear that it is not worthy of consideration, and President Obama should back them up with a veto threat.
If House Republicans don’t come to their senses, they could shut down the government on March 4 when the stopgap measure that is now financing it runs out. If that does take place, it will at least be clear to voters that their essential government services were turned off in the service of two single-minded and destructive goals: giving the appearance of cutting a deficit that was deliberately inflated by years of tax cuts for the rich, and going after programs that the Republicans never liked in good times or bad.
Many of the Republican freshmen want to stick to the “Pledge to America” that they would cut $100 billion from the president’s 2011 budget, a nice round number apparently plucked from thin air. More experienced Republican leaders knew it would be impossible to cut that much in the remaining few months of the fiscal year and said they would trim the equivalent percentage. Harold Rogers, the Republican chairman of the House Appropriations Committee, warned that the full cut would require laying off F.B.I. agents and air traffic controllers.
If he was trying to make his $32 billion in cutbacks seem modest by comparison, he failed. The list would cut $2 billion from job training programs — precisely what is needed to help employ workers mismatched with the job market. It would cut $1.6 billion from the Environmental Protection Agency, which is struggling to keep up with the growth of greenhouse gases. There would be significant cuts to legal assistance for the poor and renewable energy programs and an end to all spending for AmeriCorps, public broadcasting and high-speed rail.
The battle over the rest of the 2011 budget is only a prelude, of course, to the bigger fight about to begin over the 2012 budget. President Obama is scheduled to unveil his budget on Monday, and already he seems willing to feed the bottomless Republican hunger for cuts rather than fight them. An ominous early sign is his proposal to cut the low-income heating assistance program nearly in half to $2.57 billion. Administration officials say that energy prices have fallen, but, as Democratic lawmakers from the frostbitten Northeast have pointed out to him, there are many more unemployed people now.
Some cuts will have to be made, but strategically it seems to make little sense to start giving away important ones before reaching the negotiating table. Republican lawmakers in the House have already made it clear that they are indifferent to the suffering and increased joblessness their cuts will cause. As the extreme reductions are heaped up in the next few days, Democrats in Congress and in the White House need to make a clear case to the public that quality of the nation’s civic life is at stake.
By: Editorial-Opinion Pages, The New York Times, February 10, 2011
Be Careful What You Wish For: Repeal of the Affordable Care Act Would Be Harmful to Society and Costly for Our Country
The new Republican leadership of the House of Representatives says repeal of the recently enacted Patient Protection and Affordable Care Act is their top priority. The Republicans pushing for repeal, however, conveniently ignore the enormous step backward that repeal would represent for health care in our country, for the income security of our citizens, and for the fiscal health of our government.
The Affordable Care Act is not just a law designed to cover the majority of our nation’s uninsured, moving us into the league of industrialized nations which guarantee universal health coverage for its citizens. The law also takes the crucial first steps toward reining in our runaway health care costs. It ends discriminatory insurance practices that leave many of our citizens one bad gene, or badly timed accident, away from personal bankruptcy. It does so while introducing insurance market competition that will lead to lower health insurance premiums for some, and better coverage for others, in the so-called nongroup insurance market where workers without employer-provided health insurance turn for coverage. The Affordable Care Act does all this while significantly reducing our enormous federal budget deficit over the next 10 years.
Opponents of the new health reform law claim we can have many of the beneficial features documented above while repealing the parts they don’t like. This is a misleading and dangerous assertion. In fact, virtually none of the accomplishments of the new law are possible without the entire law’s infrastructure coming into place. That’s why all of the harms of repeal documented in this issue brief below will take place if the new law were to be scuttled.
To understand the consequences of repealing the Affordable Care Act, we can turn to two sources of objective information. The first is the careful and comprehensive effort put in by the Congressional Budget Office to evaluate the law’s impacts, including their recent report summarizing the effects of repealing the new law. The second is the closest case study we have where major elements of the new federal law are already in place—the state of Massachusetts, which passed a similar reform in early 2006. So let’s now turn to the different harms repeal of the health reform would deliver up to the American people.
Repeal means more uninsured, and worse public health
The first noticeable feature of a world without the new health reform law would be the much higher share of Americans without health insurance coverage. Absent the Affordable Care Act, CBO projects that 54 million people in our country, or almost 20 percent of our nonelderly population, will be uninsured by 2019. The new law will cover 32 million of those uninsured, according to CBO, or about 60 percent, with much of the remainder undocumented immigrants who are ineligible for coverage. This is more than a projection: It is also the same percentage share of the uninsured in Massachusetts who have been covered by that state’s health reform effort.
Clearly, repeal of the new law would have enormous negative consequences for our nation’s public health. Numerous studies document the dire health implications of uninsurance. An earlier study by the Institute of Medicine estimated that, in the year 2000 (when 38 million persons were uninsured), there were 18,000 deaths per year due to uninsurance. This suggests that repealing the Affordable Care Act could lead to 15,000 more deaths per year due to higher lack of insurance.
Repeal means increased financial risk for U.S. households alongside distorted labor markets
The impact of repeal extends well beyond those households who are uninsured. Indeed, repealing the new law would reach any household who faces the risk of losing their employer-sponsored health insurance. This is because the Affordable Care Act will fix the fundamental broken system of nongroup insurance in the United States.
Currently, individuals who do not have access to employer-provided group insurance coverage face a nongroup insurance market that is discriminatory and expensive. In most states individuals can be denied insurance coverage because they are ill or have their pre-existing illnesses excluded from coverage. Individuals who become ill can face personal bankruptcy as a result. Even when nongroup insurance is available, in most states insurance is priced according to individual health, with the oldest and sickest enrollees paying many multiples of younger and healthier enrollees.
There is a fundamental unfairness to a system under which individuals can face financial ruin because they have the wrong genes, or cross the street at the wrong time, but don’t happen to have access to insurance through their employer. Moreover, such a system significantly distorts our labor markets by forcing individuals to stay in jobs that offer health insurance rather than to move to newer and more productive positions where coverage is not available. Millions of U.S. workers are not moving to better jobs for them or starting new businesses because there is nowhere to turn for insurance coverage should they leave their jobs.
The Affordable Care Act would fix this flaw in our system. Insurance companies would no longer be allowed to price discriminate or deny coverage based on health or pre-existing conditions, and price differentials by age would be lowered. Individuals would be free to move to the job of their choice or to become entrepreneurs without fear of facing uninsurance.
Repealing the new health reform law would leave us in a world of broken nongroup insurance markets, with the attendant financial risk for individuals and the continued distortion to our labor markets. Why? Because without the comprehensive framework of the new law, it is incredibly costly to make insurance fairer in nongroup markets.
If insurance companies must charge the same price to people whether they’re sick or healthy, for example, then many healthy people will view this as a “bad deal” and not buy insurance. This results in higher prices because only the sick would buy insurance, chasing even more people out of the market. The result is a “death spiral” that leads only the sick to purchase insurance at very high prices. Several states tried such community rating reforms in their non-group markets over the past two decades, and the results were sharp rises in insurance prices and rapidly shrinking market size. The only way to make insurance market reform feasible is to pair it with large subsidies to purchase insurance and an individual requirement for coverage, as is the case with the Affordable Care Act.
Direct evidence for this point comes from Massachusetts. In the late 1990s the state moved to a nondiscriminatory nongroup market, but without the subsidies and the individual requirement that are central to the Affordable Care Act. The result was a collapse of the state’s nongroup market, so that by 2006 the state had by far the highest nongroup premiums in the nation. In 2006, the state implemented their comprehensive reform, which added to the insurance market reforms extensive low-income subsidies to purchase insurance and an individual requirement for coverage. This resulted in a 40 percent reduction in nongroup premiums in Massachusetts over a period where such premiums were rising by 14 percent nationally. That’s just one reason why the new law is called the Affordable Care Act.
Repeal means a noncompetitive and expensive nongroup insurance market
Another reason the Affordable Care Act works to bring down costs is because without it, a typical health insurance policy is much more expensive in the nongroup market than in the group market, partly because nongroup insurance markets are less competitive than group insurance markets in many states. There is no common marketplace where individuals can compare the prices of all the options that are available to them in the nongroup market. As a result, existing market participants keep prices high and new firms are unable to promote lower costs as a tool of market entry.
The Affordable Care Act addresses this problem in two important ways. The first is by introducing competitive insurance exchanges in every state. Individuals would be able to shop more effectively, comparing their nongroup options in a competitive and transparent environment. This approach has already had a notable success in Massachusetts, where the introduction of the state’s Connector health insurance exchange expanded the use of nongroup insurance and promoted the entry of a major new low-cost insurer into the state’s nongroup insurance market.
Without the Affordable Care Act states are unlikely to be able to establish transformative and competitive exchanges for the purchase of nongroup insurance. Many states have tried over the past 20 years to establish insurance exchanges and they have virtually all either failed or had little impact. This is typically because insurers were afraid that individuals would choose to buy from the exchanges only if they were sick, which meant prices in the exchange were high and demand for exchange products was low. With low demand, exchanges could not establish the economies of scale necessary for success.
The success of exchanges under the new health reform law will be due to the fact that individuals will be both required to purchase insurance and that insurance purchase will be subsidized only through the exchange. This will promote exchanges on a scale necessary to succeed in promoting competition in state insurance markets.
The second way that the Affordable Care Act addresses the high costs of nongroup insurance is through the introduction of new tax credits to make health insurance affordable through the exchange. The typical middle-class family in the United States would now be provided financial support to ensure that they would not have to spend an unfair amount for the insurance they need to protect their family.
The upshot: Repealing the new law would mean returning to an era where individuals can’t effectively compare their insurance options, guaranteeing continued noncompetitive and expensive insurance in this market. And it would mean that individuals would face the full prices in these noncompetitive markets without the necessary tax credits to make insurance affordable. Repeal, in short, would be unfair, ineffective, inefficient, and costly.
Repeal means free riders would continue to exploit the health care system
Another fundamental flaw in our current health care system before passage of the Affordable Care Act was that individuals could “free ride,” remaining uninsured until they need care and then turning to emergency rooms. Emergency rooms are required by law to provide care to all regardless of insurance coverage. The associated uncompensated care costs of treating these individuals amount to a more than $40 billion a year tax on the insured in the United States
The Affordable Care Act ends this free riding by requiring that individuals purchase insurance if it is affordable for them (which it will be for most due to the subsidies described earlier). This personal responsibility requirement, originally the brainchild of Republican experts, would end the unfairness of a system where emergency room health care providers are required to treat everyone but individuals are not in turn required to pay their fair share of the costs of treatment. Repealing the new law would mean returning to a world where individuals can simply wait until they are sick to get treated, passing the costs on to the rest of society that is paying their share.
Repeal means the continued decline of private insurance
There was an enormous erosion of private insurance coverage in the United States over the past decade. Employer-sponsored insurance fell by 15 percent and nongroup insurance has not grown to keep pace. The result today is an increase in both the ranks of the uninsured and the publicly insured.
The Affordable Care Act arrests this decline and promotes private insurance coverage. According to the CBO, the new law will lead to a small erosion in employersponsored insurance coverage, offset by a rise in nongroup insurance coverage that is almost five times as large. Overall, private insurance coverage in the United States will rise by 15 million people due to the Affordable Care Act.
Repeal would provide no cushion for our citizens to offset this rapid decline in employer-sponsored insurance coverage. Fifteen million fewer U.S. residents would have private insurance than without the law. The Affordable Care Act is not a government takeover of the U.S. health system; it is a means of using reformed private nongroup insurance markets to more effectively fight the steady decline in employer-provided group insurance. Repeal means a fundamental retreat from the promise of private health insurance coverage for our citizens.
Repeal means higher and more rapidly growing budget deficits
The Affordable Care Act delivers a unique dose of fiscal responsibility in an era of rapidly growing federal budget deficits. The new law offsets its new spending with even larger reductions in other spending and revenue increases. As a result, CBO estimates that the legislation will reduce the deficit by more than $100 billion by 2019, and by more than $1 trillion in the decade after that.
What is not widely appreciated is that deficit reduction due to the new health law will rise over time. The cuts in excessive spending and increases in revenues are back-loaded, not front-loaded as with so many other recent pieces of legislation. This is illustrated by the fact that the most recent CBO estimate shows that repeal would raise the deficit by $230 billion over the next decade. And, because the net budget savings from the new health law will grow over time, repeal would raise the deficit by much larger and ever growing amounts into the future.
Repeal would therefore mean undoing the enormous fiscal benefits of this legislation. Offsetting a more than $100 billion hole in the budget deficit by 2019 would require significant cuts elsewhere in the budget or other increases in revenues. And it seems highly unlikely that Congress would enact spending or revenue changes that would increase so rapidly over time. That means even fixes that offset the short-term costs of repealing the new law would not address the enormous long-term hole it would leave in our budget.
Repeal means a critical step backward on cost control
Reforming insurance markets and covering the uninsured are actually the relatively easy lifts for the new health reform law when compared to the more daunting and fundamental challenge—reducing the rate of growth in health care costs, which threatens to bankrupt our government and our nation. U.S. spending on health care is very high and a source of great concern but it is the growth rate of medical spending, not its level, that ultimately determines our country’s financial well-being. Absent the Affordable Care Act, if current trends persist we will be spending an unsustainable 38 percent of our GDP on health care by 2075 because the growth of health care costs would continue to outstrip the growth rate of the overall economy.
Addressing the rapidly rising costs of medical care, however, faces two daunting barriers. The first is scientific: There is tremendous uncertainty about how to lower health care costs without sacrificing health care quality. There is a broad consensus that there is significant waste in our health care system. But there is little consensus about the best way to address that waste without risking the enormous gains in population health due to health care improvements in recent decades. The second barrier is political: There are major entrenched interests that are threatened by fundamental health care reform and who will strongly oppose any such efforts.
In the face of these barriers, our political process has found it difficult to make progress on significant cost-control efforts over the past several decades. The Affordable Care Act represents the most important step forward in cost control in at least 30 years. The new law pursues many different approaches toward cost control, studying them to see which ones work best. This is through provisions that:
- Reduce consumer demand for excessive medical care through the “Cadillac tax” on high-cost insurance plans.
- Reduce health care provider payments by appointing a depoliticized board to make up-or-down recommendations to Congress on changes to Medicare’s provider payments.
- Set up dozens of health care pilot programs to test various approaches to revamping provider-payment incentives and organizational structure.
- Invest hundreds of millions of dollars in new comparative-effectiveness research.
- Launch pilot programs to assess the impact of various reorganizations of the medical malpractice process.
None of these approaches is guaranteed to work but together they represent a significant step toward fundamental cost control.
Importantly, they represent steps that are unlikely to happen if the Affordable Care Act is repealed. None of these ideas are new; most have been around for decades. But it was through the overall push for health reform that Congress was able to finally put them in place. Absent such a unifying framework, the barriers which have blocked cost-control efforts in the past will continue to stand in the way of moving forward on cost-control efforts.
Bottom line: Repeal is a dramatic step backward
The debate over repeal of the Affordable Care Act is characterized by enormous misinformation and confusion. Opponents of the legislation exploit this for political gains. A legitimate debate over the Affordable Care Act and the future of health care in America must recognize the fundamental improvements to our health care system put in place by this new law. Repealing would lead to:
- A society with poorer health and ultimately more deaths from lack of medical care
- A continued unfair and expensive nongroup insurance market that leads to economic instability, medical bankruptcy, and a less efficient job market where individuals are afraid to move to more productive job opportunities
- Continued free riding by those who pass billions of dollars in care costs onto the insured
- A massive decline in private insurance coverage
- Huge and unsustainable increases in budget deficits reaching trillions of dollars over coming decades
- A fundamental step backward in our efforts to control the health care costs which threaten to bankrupt our society
The Patient Protection and Affordable Care Act is aptly named. Repeal would mean less health care protection for more and more Americans at higher and higher costs to themselves, their families, and our nation. We simply cannot afford to repeal the new law.
By: Jonathan Gruber, Professor of Health Economics at the Massachusetts Institute of Technology and a member of the Massachusetts Health Connector Authority: January 19, 2011
The Conservative Constitution of the United States
TeaParty Sacred Text?
Article I
Congress shall have only the powers literally, specifically and expressly granted herein, and no others. That means definitely, without question, absolutely, no regulation of the Health Insurance or Financial Services industries. The Senate of the United States shall be composed of two Senators from each State, elected not directly by the People, but by other people whom the People have elected to better represent the People.
Any law enacted by Congress and signed by the President may be overturned by the vote of three or more States if they find it burdensome, offensive, annoying or in any way touching on Health Insurance, Property Rights or Guns.
Congress shall have no power to raise Taxes except on February 29, and then only if all the People of the United States approve such a measure unanimously, in writing and in English.
Congress shall balance the Federal Budget, preferably by eliminating the Departments of Labor, Energy, Education and State.
The preceding provision shall not apply to spending for the Department of Defense, appropriations for which shall increase three times as quickly as the growth in gross domestic product and upon the approval of House leadership in conference with Boeing, Halliburton, the Ashcroft Group and Kissinger Associates.
Arizona shall have the power to regulate Immigration.
Article II
No person except a natural-born Citizen who can produce video, photographic or eyewitness evidence of birth in a non-island American State shall be eligible to the Office of President.
The President shall faithfully execute the laws, except when, as Commander in Chief, he decides he’d really rather not.
The President shall not negotiate any Treaty without first receiving a signed and notarized note granting him permission, personally executed by every member of the Senate and the House, all 50 Governors and the editorial board of the Weekly Standard. Suspected Terrorists shall be taken to Guantanamo and drawn and quartered in a public ceremony. Trials are optional, but if they occur, must be conducted in a Military Tribunal in which coerced statements are admissible so long as they support a Guilty verdict.
1. Congress shall make no law abridging the Freedom of Speech, except where citizens desecrate the Flag of the United States; respecting an establishment of Religion, except to support Christian schools, religious apparitions in food products and the display of crosses and creches in public places; or abridging the free exercise of Religion, except to block the construction of mosques in sensitive areas as determined by Florida Pastors or the Fox News Channel.
2. The right to bear Semi-Automatic Weapons, AK-47s or Bazookas shall not be infringed by background checks, safety locks, age limits or common sense.
3. The right of Corporations, Hedge Funds, Business Leaders and Lobbyists to spend endless cash on campaigns and influence-purchasing shall not be infringed. The so-called right of Unions to associate shall be denied as fundamentally un-American and contrary to the agenda of the Chamber of Commerce.
4. Marriage and the benefits thereof shall be restricted to the Union of a Man and a Woman, consecrated in a Christian house of worship, with vows to expose any and all progeny to daily viewings of Bill O’Reilly.
5. All persons born or naturalized in the United States are Citizens of the United States of Real America only if their parents, grandparents and great-grandparents were Citizens, and only if they pledge opposition to Health Insurance Reform or New Taxation. Any Citizen convicted of providing material support to Terrorist organizations, wearing clothing bearing images created by Shepard Fairey, or displaying Nancy Pelosi bumper stickers shall be stripped of Citizenship.
6. Aliens, of this world or another, shall have none of the rights guaranteed herein to Citizens.
7. Corporations shall have all of the rights guaranteed herein to Citizens, and then some.
8. No White Male shall be denied equal protection of the law through Affirmative Action or otherwise. In keeping with the intent of the Framers, as discerned by the Honorable Justice Antonin Scalia, distinctions on the basis of sex shall not be deemed to deny equal protection.
9. The right to be uninsured and make other people pay the costs of one’s Health Care shall not be infringed under any circumstances.
10. Congress shall make no law limiting Americans’ right to warm the Planet by using all the energy they darn well please.
11. The Unborn shall have the rights to life, to vote, to bear arms, to practice Religion except in a mosque in Lower Manhattan (see First Amendment) and to make campaign contributions, but once the child is born, it shall have no rights if it is an Alien (see Sixth Amendment).
12. No one may be required to do anything He or She does not want to do. Ever.
Done in Convention by the Unanimous Consent of the Members present the Sixth Day of January in the Year of our Lord Two Thousand and Eleven. In witness whereof We have hereunto subscribed our names, [REDACTED]
By: David Cole who teaches Constitutional Law at Georgetown University and is the legal affairs correspondent for the Nation : Published, Washington Post-January 6, 2011
The Forgotten Accomplishments of The 111th Congress
It’s already been pointed out endlessly that the 111th Congress has been one of the most productive in decades. But here’s another way to look at it: Consider all the things this Congress has accomplished that we aren’t talking about.
Health care reform, the overhaul of Wall Street regulations, the ratification of New START and the repeal of don’t ask don’t tell are, of course, the accomplishments that will define this Congress in the history books. But there are a whole host of other relatively under-the-radar achievements that in and of themselves would normally be considered major achievements, had they not been completely overshadowed by the big ticket items.
Before we all depart for the holidays, let’s pause for a moment of reflection on these also-ran accomplishments, some of which passed with broad bipartisan support. There’s the Lily Ledbetter fair pay act, which reversed a Supreme Court decision limiting the ability of women to sue over salary discrimination. There’s the sweeping credit card reform measure putting a halt to unfair and deceptive industry practices. There’s the landmark legislation that greatly expanded the FDA’s authority to regulate the manufacturing and marketing of tobacco products.
There’s the largely forgotten measure that vastly expanded Federal aid to college kids that ultimately passed as part of health reform. More visibly, there is the food safety bill and the measure granting health benefits to 9/11 responders, both of which passed this month. And two women were confirmed to the Supreme Court, one of them a Latina — a historic accomplishment.
This is only a partial list.
Under normal circumstances, these alone would have constituted significant achievements. “When you look beneath the surface just a little bit there’s an enormous amount that under normal circumstances would have been heralded but got very little attention,” Congressional scholar Norm Ornstein tells me.
The larger story here, though, is that if you add in these accomplishments with the more visible ones, it becomes clear that Congress has expanded government’s reach even more than commonly thought. For all the justifiable criticism of health and Wall Street reform for not going far enough — and for all the talk about the coming battle to repeal them — the bigger story is that the sum total of this Congress’s major and minor achievements have produced an expansion of government’s role in society that will be very hard to undo.
“Taken together, the smaller accomplishments may have an impact on society that rivals the main accomplishments, and they have all bolstered government’s role as a protector of the public interest,” Ornstein says.
And so, one more tip of the hat to the 111th Congress and its leadership.
By Greg Sargent -The Plum Line, Washington Post- December 23, 2010
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.
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