Editore"s Note
Tilting at Windmills

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January 20, 2010

NARROWING THE OPTIONS.... The need for health care reform hasn't changed, the political calculus obvious has. With a Coakley victory in Massachusetts, the landmark legislation was a near-certainty. In the wake of Brown's victory, the once-in-a-generation opportunity is hanging by a thread.

As policymakers began to realize over the last week or so that Massachusetts was moving in the wrong direction, a variety of backup plans were considered. One possibility was wrapping up the negotiations on combining the House and Senate bills, and approving the bill before Brown takes office.

That option, which was a long shot anyway, was quickly taken off the table last night.

Less than 15 minutes after the race was called for Republican Scott Brown, the first of what could be many conservative Democrats asks for leadership to put the brakes on health care reform.

Sen. Jim Webb (D-VA) congratulated Brown on his win and delivered a zinger: "...I believe it would only be fair and prudent that we suspend further votes on health care legislation until Senator-elect Brown is seated."

Indeed, the very idea of the Senate approving any health care bill anytime soon seems largely impossible. Proponents would still need 60 votes in the face of Republican obstructionism. The Democratic caucus is down to 59, and there's evidence that several of those 59 aren't prepared to support a reform bill if it comes back to the chamber. Joe Lieberman, for example, is already distancing himself from the bill he helped make worse. Somehow convincing Olympia Snowe, in other words, is no longer good enough.

Another option, preferred by some progressive activists, is to literally start over in both chambers, pursuing a more ambitious reform through reconciliation. This seemed exceedingly unlikely before the special election in Massachusetts, and the odds are far worse now. Lawmakers are ready to move on to other issues, not spend the next few months on a new bill.

Which brings us back to the most obvious, most direct, and most promising avenue: the House approves the Senate bill, and sends it to the president for his signature. Democratic leaders in the House still hold out hope that this is a viable alternative -- especially when additional improvements to the bill can be made through the upcoming budget reconciliation process.

The question is whether rank-and-file House Dems have the stomach for it. As of right now, they appear ready to throw in the towel and accept defeat. "If it comes down to that Senate bill or nothing, I think we're going to end up with nothing, because I don't hear a lot of support on our side for that bill," Rep. Stephen Lynch (D-Mass.) said.

The NYT added a similar assessment, reporting that "the prospect of passing the health care overhaul by pushing the Senate plan through the House appeared to significantly diminish."

To be sure, it's early. The results in Massachusetts were called 12 hours ago, and the dust has not yet settled. The political world will catch its breath, take a closer look at its options, and decide how (and whether) to proceed.

But if the House rejects the most promising path -- pass the Senate bill, make improvements through reconciliation -- they're making a devastating mistake and risking electoral suicide. More on this later.

Steve Benen 9:30 AM Permalink | Trackbacks | Comments (57)

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Comments

Jim Webb, self-appointed Democratic leadership. Thanks so much.

Posted by: Alex on January 20, 2010 at 9:36 AM | PERMALINK

Is Democrat Latin for "coward" or "pussy"? I don't remember. Why aren't they just jamming their agenda down the Republicans' throats?

Posted by: angry young man on January 20, 2010 at 9:38 AM | PERMALINK

"the most promising path -- pass the Senate bill"

I can think of almost nothing that would be, in my view, less appropriate. My reasons are not entirely to do with the differing versions of the bill, although I do consider the House version to be considerably less pernicious than the Senate one.

This is a spending bill, and by the terms of the constitution all such bills must originate in the House of Representatives. This would stand that procedure on its head.

More important, such a move would establish the Senate as the “senior” of what are supposed to be two equal houses of the Legislature, allowing the elitist Senate to run roughshod over the “people’s house” which is the House of Representatives. Such a move would take our government one more step toward oligarchy by rendering irrelevant that legislative body which is, by its elective nature, most required to be responsive to the will of the people.

Posted by: Bill H on January 20, 2010 at 9:40 AM | PERMALINK

"appropriate"? "procedure"? those quaint days disappeared the instant gingrinch shouted down tip o'neill from the back of the house. it's time the democrats stood up for america. they only need 51 votes. that's how the game is played.

Posted by: angry young man on January 20, 2010 at 9:49 AM | PERMALINK

The American people will always, always go for "strong and wrong" over "weak and right." This is why the Democratic Party is continually losing ground. We never really had 60 votes, and now we can't even pretend. Nuke the filibuster and pass the best legislation possible with a simple majority. Then move on to jobs and Wall Street regulation. Obama needs to give a speech where he makes it clear he has heard the public's anger and is going to change the way he runs things. Fire Emanuel, fire Geithner, tell Biden (President of the Senate) to nuke the filibuster. That is the only way to avoid a 2010 bloodbath.

Posted by: Josh G. on January 20, 2010 at 9:53 AM | PERMALINK

All the Dems DO is "accept defeat." I am sick and tired of this.

Posted by: J on January 20, 2010 at 9:53 AM | PERMALINK

I can't believe they're not calling that vote right now. The single worst mistake the Democrats can make on this is to follow the idiot Beltway common wisdom and take yesterday's vote as some kind of referendum on either Obama or health care overhaul. Everyone who actually has been in Massachusetts and listening to voters knows otherwise.

Of course there were some Brown voters who were voting against Obama and all his policies. They're the same small but dedicated percentage of the electorate they've always been. The rest of his vote, though, came from a combination of (a) low-information voters who didn't realize that his moderate image doesn't reflect his actual record or policies; and (b) voters who couldn't bring themselves to vote for Coakley, whether for populist-type reasons (out of touch, couldn't be bothered to campaign, was the candidate of some distant insider elite) or for the more strategic reason that if she had won, the incumbency advantage would have given her that senate seat forever.

People shouldn't discount that final group. There's a tendency to dismiss old-time-Democratic, blue-collar and union voters as people who vote on party line, on tradition, and on their sense of who'd be fun to have a beer with. It's not nearly as true as the Village likes to think, though. I spoke to two of these folks yesterday, in unrelated conversations, who told me spontaneously that they were voting for Brown because they figured we could vote him out in '12 and elect a Democrat we actually liked.

Posted by: fiorinda on January 20, 2010 at 9:56 AM | PERMALINK

Does Obama have balls? That is the question that will be decided in the next couple of days: if he does, he has a good chance of getting his bill through Option 3 described above; if not, then the bill is toast and so is he.

Oh, and the country, too.

Posted by: sjw on January 20, 2010 at 9:57 AM | PERMALINK

Somehow convincing Olympia Snowe, in other words, is no longer good enough.

Aw, c'mon, Steve -- Brown gave away the game long ago by his boast of being the 41st vote to defeat health care (thanks, of course, to the Democrats' tolerance of Republican obstructionism).

He wouldn't be the 41st vote if the Republicans weren't certain to vote in lockstep. Courting Snowe or Collins is a fool's errand -- there's no reason at all to believe at this point that they're acting in good faith any more than Mitch McConnell is.

Posted by: Gregory on January 20, 2010 at 9:58 AM | PERMALINK

"I spoke to two of these folks yesterday, in unrelated conversations, who told me spontaneously that they were voting for Brown because they figured we could vote him out in '12 and elect a Democrat we actually liked."

And you don't consider these people to be low-information voters? It's hard to think of anything more stupid and ill-informed.

Posted by: Virginia on January 20, 2010 at 10:00 AM | PERMALINK

I hate to say I told you so -- the Dems would embrace the "we're losers" storyline and kill HCR -- but I told you so.

Posted by: Dems lose huge in 2010 on January 20, 2010 at 10:00 AM | PERMALINK

So the chance of a lifetime: Accepting the dog shit Senate Clown Car health care 'reform' bill of enriching the insurance companies beyond their wildest dreams by mandating more customers by law, and subsidizing those who caint afford it -- while doing little if anything to actually regulate the complete breakdown of actual health care offered through these same happy, shit-eating grinning insurance companies?

Fuck! i caint understand why Coakley or any other Dim couldn't run -- and win -- on that...even on vacation and not knowing shit about baseball...

and despite, you know, the misogyny also built into it...

Nor can I understand why there is some kinda Jimmy Carter Jimmy Carter type malaise among the "base" after this triumphal first year of Obama and them...

Come on you guys, quit yer complainin'. Here's a quarter, go play a song on the juke box...
"celebrate good times, come on!!11!"

Posted by: neill on January 20, 2010 at 10:01 AM | PERMALINK

I think part of what you're seeing in the House is the aftereffects of one side being bashed and battered and forced to make concession after concession after concession -- and then watching as some of their voices (John Conyers, I would argue Howard Dean) are viciously attacked by the White House while simultaneously having Rahm Emanuel demand that Joe Lieberman be given everything he wants. As a result, I suspect most House Progressives flat-out don't trust whatever promises could be being made that the shitty Senate bill will be improved. (Not to mention the clear fact that Harry Reid is one of the worst Majority Leaders in history).

About the only way I can see something happening that will get Progressives behind the Senate bill is if the White House follows it up with a change in personnel that would basically tell Progressives that they won't be crapped on anymore. Something like bringing Howard Dean on staff in a major role.

Short of that, I don't know why Progressives would cut a deal with a White House that abuses them the way they have.

Posted by: EdgewaterJoe on January 20, 2010 at 10:03 AM | PERMALINK

You know, the one thing I can say about Teddy Kennedy was his willingness to take what he could achieve and keep pushing. The response to Coakley losing is to pass the bill as Benen says, and keep pushing to make it better. One real benefit to having the mandates/exchanges begin later is the chance to change them. Why members of the House can't seem to wrap their pea brains around this kind of astonishes me. If you change the filibuster rules, or by some miracle given the pathetic mewing we are hearing, retain the majority, you will have that opportunity, and it will be a bigger and better opportunity because you will be amending something rather than starting from scratch.

Posted by: Barbara on January 20, 2010 at 10:07 AM | PERMALINK

About the only way I can see something happening that will get Progressives behind the Senate bill is if the White House follows it up with a change in personnel that would basically tell Progressives that they won't be crapped on anymore. Something like bringing Howard Dean on staff in a major role.

Howard Dean got the Democrats a majority in Congress. Rahm Emanuel has devoted the past year to pissing it away.

Replacing Emanuel with Dean is the obvious choice. Firing Geithner and withdrawing Bernanke's reappointment are also no-brainers.

Posted by: Josh G. on January 20, 2010 at 10:10 AM | PERMALINK

...they're making a devastating mistake and risking electoral suicide...

Standard operating procedure for Democrats.

One defeat -- ANY defeat -- and they turn tail and run. And then they're slaughtered, and they bemoan their cruel fate, and the inexplicable whims of the public, and the boo hoo hoo hoo.

Idiots and cowards. They deserve to lose. Pity that 40 million people in America lose with them.

Posted by: bleh on January 20, 2010 at 10:12 AM | PERMALINK

One additional comment is that the Dems did not start this term with 60 senators, and in many ways getting Specter to change lulled them into thinking they could keep conducting business usual without confronting what are clearly unsustainable Senate procedures. Obama and Biden need to address this. Even if they could have gotten a reformed HCR bill throught the Senate, they won't get anything else if the filibuster stays in place. Evan Bayh is Exhibit A of the willingness of a few (maybe more than a few) Dems to convince themselves that, really, a vote for insurers and Wall Street IS REALLY a vote for the common man. He's an idiot, but so is Obama if he doesn't try to change that dynamic.

Posted by: Barbara on January 20, 2010 at 10:16 AM | PERMALINK

I'm disappointed in Jim Webb. I thought he had more backbone than the Process Wing of the Democratic party. And Barney Frank, too. Sigh.

Posted by: JUnruh on January 20, 2010 at 10:19 AM | PERMALINK

Pity that 40 million people in America lose with them.

300 million.

Posted by: Alex on January 20, 2010 at 10:20 AM | PERMALINK

As hypothetical, Steve, how bad would this bill have to be in its final form or implementation for you to admit that you were wrong?

BLEH "One defeat"?? Its been one defeat after another since before Obama took office. Oh right; the base should only be concerned that their beloved leaders are in office.

Posted by: Michael7843853 on January 20, 2010 at 10:22 AM | PERMALINK

I agree with Barbara above--letting the bill die would be the worst option of a group of bad ones. If the house doesn't pass the bill, they'll still get crushed in november, and a major accomplishment can't be sold to the people. If you do pass it--keep working to improve it, and run on what Kevin Drum calls the most significant progressive legislation of our generation. I understand covering your bases (or other things) when reelection is at stake--but if you're going to get hammered either way, do the right thing. Cowardice to protect nothing is ridiculous.

Posted by: WYUva on January 20, 2010 at 10:23 AM | PERMALINK

Is it not true, changing the rules of the Senate requires only majority vote? If they have the guts, curtail filibuster and make "50" (with Biden, and of whom the COTUS clearly says to be a tie-breaker) rather than "60" the relevant number.

Posted by: neil b on January 20, 2010 at 10:24 AM | PERMALINK

Man Steve, how can you be so blind on this HCR issue? The Senate bill sucks. It doesn't lower the cost of health care for anyone, it makes it a crime not to buy insurance from the corporations and yet for some INSANE reason you think that is what will get Democrats votes in '10.

You either have to stop smokin' what yer smokin' or share it with the rest of us.....

Posted by: kindness on January 20, 2010 at 10:25 AM | PERMALINK

Why can we not make each major component of true health care reform into its own bill? Make the Republicans vote against insuring all kids. Make them vote against ending recisions. Make them vote against Medicare for everyone. Make them show their true colors in an unmistakable way-- right as we're coming up to fall elections.

Would someone explain to me why we aren't doing this?

Posted by: Missouri Mule on January 20, 2010 at 10:27 AM | PERMALINK

Hey Jimbo, STFU! Seriously.

The message Obama, his idiots, and the idiots in the house and senate need to understand is that Democrats will no longer support their GOP-lite agenda. Democrats will no longer GOTV for blue dogs and crappy candidates. We want progressive candidates and progressive policy. Get with it or we will sit on our hands and wallets again. If you think you can convince Republicans and independents to elect you, good luck!

We now know it is not raining, you are just pissing on us.

Posted by: gttim on January 20, 2010 at 10:28 AM | PERMALINK

Sorry Steve, the House is NOT going to blank-check the horrific senate insurance company giveaway bill. Ain't happening.

Your dream of forcing me and other Americans to support insurance company CEO bonuses is dead. Take your mandate for corporate profits over healthcare and cram it so far up your ass that when you talk it comes out as a mumble.

Posted by: Praedor Atrebates on January 20, 2010 at 10:32 AM | PERMALINK

The day after the resounding unpopularity of the Senate bill has caused an electoral disaster, we should just ram it through anyway. You're just full of great advice, Steve.

In reality, comprehensive health care reform has been dead since the moment when Obama put Baucus in charge of it. Time to pass a small package of modest, broadly popular insurance reforms and move on quickly to the issue that will really get the Dems killed in November if it's not seriously addressed- JOBS JOBS JOBS.

Posted by: Steve LaBonne on January 20, 2010 at 10:33 AM | PERMALINK

Neil B: Is it not true, changing the rules of the Senate requires only majority vote?

How many times are you going to ask this and get your answer of exactly when and how this can be done? Quit calling it your "Socratic method." You just sound stupid.

Missouri Mule: Would someone explain to me why we aren't doing this?

Because many of the pieces are interdependent -- you don't drive costs down, for just one example, without a mandate because otherwise the pool is too small and only includes high-risk people. When you break the legislation apart, you lose unpopular pieces that are required to make the whole thing work, and you open every piece of it to even more intense anti-reform lobbying.

Posted by: Romeoville on January 20, 2010 at 10:34 AM | PERMALINK

they're making a devastating mistake and risking electoral suicide.

It's not risking electoral suicide; it's guaranteeing it. I, for one, won't bother getting out of bed to go vote for such a bunch of feckless fucks, and they can forget all the sweet, sweet cash I tossed their way in 2008. They seem to believe that just because having their asses warming the seats in Congress is a good enough outcome for them, the rest of us expect them to, you know, deliver on the improvements they promised when they ran. If their commitment to health care is so shallow that they'll dump it after a full year of rancorous fighting to finally, after 50 years, get it done, then they're of the stripe that they don't stand for anything. So why should I stand for them?

I won't, and hardly anyone else will, either.

Posted by: Jennifer on January 20, 2010 at 10:37 AM | PERMALINK

Wrong romeoville:

To drive costs down, you needed a PUBLIC OPTION that didn't give a flying fuck for corporate profits and shareholder value. To pass a bill that people actually liked and supported, you go with 65% of the populace and keep the public option.

Hell, as soon as the public option went out the window (as a favor for congressional paymaster insurance company lobbyists) the public support for the bill crashed.

The senate bill is DOA. Suck it!

Posted by: Praedor Atrebates on January 20, 2010 at 10:40 AM | PERMALINK

Romeoville,
Thank you for your answer, and for not being the condescending asshat many here are being.

In passing smaller, specific pieces of legislation I would not be seeking to enact all of the goals currently stated. It would be positive change, change that people could see and feel immediately. The other portions could be given the deliberation they need-- voters would already have seen real change. And, furthermore, Medicare for All was enacted, it would affect costs.

I still don't see a downside. Pass some things that make an immediate difference or force the Republicans to show their true agenda (and that is not concern for the average American).

Posted by: Missouri Mule on January 20, 2010 at 10:40 AM | PERMALINK

To drive costs down, you needed a PUBLIC OPTION that didn't give a flying fuck for corporate profits and shareholder value.

Yep, the PO would have been by far the best way to control costs and certainly the only way to create real competition.

However, I'm explaining to MM why the risk pool has to be spread across the entire population. Given your humiliating performance in the "Backup Plan continued" thread yesterday (they're still waiting for you to back your insane rants up with something a little more policy-oriented than "burn the rich," but looks like you skedaddled when challenged), I'm not surprised that you're not getting it.

Enjoy your Tricare. I think you're a mentally ill jackass, but I'm glad you have health insurance. Really.

Posted by: Romeoville on January 20, 2010 at 10:46 AM | PERMALINK

Smaller fixes can simply include:

Requiring that insurance companies spend 90% of their income on providing actual healthcare.

Banning rescission and discrimination for pre-existing conditions - and requiring that ALL people be in the same pool (no "high risk" pool at high cost).

Generous subsidies for healthcare coverage for lower middle class (at least what's left of it).

Medicare for 55 and older AND for the poor/unemployed.

Higher taxes for bazillionaires to cover costs.

No more health insurance for congress criminals at all until there is universal healthcare.

Posted by: Praedor Atrebates on January 20, 2010 at 10:50 AM | PERMALINK

What a bunch of freaking wimps.

Posted by: kc on January 20, 2010 at 10:52 AM | PERMALINK

Sorry Romeoville, I got VA benefits.

Your desire to force me and everyone else to subsidize CEO bonuses by force of law is dead. Deal with it. The mandate is over and done.

Seriously, you have to accept the reality.

Posted by: Praedor Atrebates on January 20, 2010 at 10:52 AM | PERMALINK

I still don't see a downside. Pass some things that make an immediate difference or force the Republicans to show their true agenda (and that is not concern for the average American).

The problem is that you don't get majority votes on separate bills for the things that will make the difference, because legislation like this relies heavily on dealmaking and tit-for-tat. Let's say we want to end rescission in a standalone bill, or end denial for preexisting condtitions in a standalone bill. Insurers strongly resist this because it costs them obscene profits, but they agree to go along with it if those losses can be offset by, say, expanding the pool of insured. Now, I don't give a shit about insurers' big party at the expense of human life and happiness being slightly curtailed -- boo fucking hoo -- but large portions of Congress, including too much of the Democratic caucus, are pretty much owned by insurance, so you don't get the bill passed if you don't deal.

Standalone bills are not really effective ways of handling reform legislation that involves many moving pieces and lots of stakeholders and potential profit-losers. It sucks, but it is what it is as long as campaign financing is what it is. It may be possible to pass some smaller pieces as standalones, but at this point I'm not sure they'd be anything meaningful to consumers.

Posted by: Romeoville on January 20, 2010 at 10:54 AM | PERMALINK

Now, I don't give a shit about insurers' big party at the expense of human life and happiness being slightly curtailed -- boo fucking hoo -- but large portions of Congress, including too much of the Democratic caucus, are pretty much owned by insurance, so you don't get the bill passed if you don't deal.

So YOUR answer is to accept insurance company rule and fuck the people for the sake of a deal, ANY deal. Doesn't matter that the deal is odious and WIDELY unpopular. Doesn't matter that health insurance is NOT the same thing as healthCARE. Just pass A bill, even though it is hopelessly and toxically polluted.

Bullcrap.

Posted by: Praedor Atrebates on January 20, 2010 at 10:57 AM | PERMALINK

Dear Jim Web and others:

1) My friend's husband divorced her after 20 years. He worked for Time Warner but was laid off. She receives works part time, moved to a small apartment, and has no health insurance. What do you suggest?

2) Another friend has AIDS and the meds make him nauseus to the point where he cannot move. The anti-nausea pills are $13.50 each. His Dr. prescribes 60 pills a month. The insurance company used to pay to for 45. Two months ago it started only paying for 15 nausea pills a month. It turns out smoking dope is cheaper than buying the nausea medicine. What do you suggest?

3) Last year, HMO insurance through my work price of premiums went to $1700 a year from $300. PPOs went to about $600 from about $100 and deductables increased and the types of meds covered changed. Often I have had to ask my doctor to change my prescriptions because many of the meds he had prescribed are not covered or the deductable had gone up to $50 or $75. He says the old meds are not as good as the new ones. What do you suggest?

Now to you, the amounts of money involved may be trivial. But I assure you, they are not to the people who are involved.

So what do you suggest?

Posted by: Kurt on January 20, 2010 at 11:03 AM | PERMALINK

umm, steve.

lynch was opposed to the health care reform bill. it was the reason why he bounced out of the MA senate race so early.

to quote him as saying "there is no stomach for this bill in the house" is like asking bernie madoff to weigh in on financial regulatory reform.

Posted by: bruce on January 20, 2010 at 11:04 AM | PERMALINK

Praedor - bullcrap on you.

You suggest that "do nothing" is the winning path? Democrats will be fucked for the next decade if they go into the next election having passed NOTHING on health care, even if it only really addresses the issues of recission and pre-existing conditions. And there won't BE another next time, because the smoking crater that health care will create in our economy long before the Democrats ever again have a majority with which to accomplish NOTHING is right around the corner.

Posted by: Jennifer on January 20, 2010 at 11:05 AM | PERMALINK

Virginia -

No, I don't. Nor do I see why it's hard to think of anything more stupid or ill-informed.

Risky? Sure. But given the power of incumbency, if you really don't like your party's candidate, electing her means you're going to have a lifetime of banging your head against a wall. (See, ie, Lieberman, Joe.) It's much, much easier to unseat a senator from the opposing party than it is to primary a senator from your own. Plus, we in Massachusetts make something of a habit of electing Republicans who turn out to be wingnuttier than they said they'd be while campaigning, and tossing them out when the awful truth becomes clear.

The real risk, obviously, is that the whole DC establishment will decide the sky is falling. Which appears to be happening, yes. But when you and everyone you talk to know that you're not voting against HCR, it's as difficult to believe that the DC establishment can't be prevented from thinking that you are as it apparently is for DC to believe the opposite. Community is powerful that way.

But otherwise -- for God's sake, we never had a strong 60 votes. The odds of negotiating a better bill through the ordinary procedure were never particularly good. We still have 58 votes, or 59 if you count Holy Joe. Passing the Senate bill now and fixing it via reconciliation should not be materially harder than fixing it via the process already underway.

As it happens, I voted for Coakley, because I didn't trust DC not to panic. But I'm not sure now that I was right and the strategic voters who didn't want to give her a longterm senate seat were wrong, and I'm certainly not prepared to say they were stupid. And not without a damned good explanation, certainly.

Posted by: fiorinda on January 20, 2010 at 11:05 AM | PERMALINK

Coakley, the Carly Fiorina of Massachusetttttttes. Der-p! I'm tired of voting for Der-pocrats and I wont vote for the insane asylum. Time to move to France I think. It's a shame that everyday Americans don't wake up and really realize that our corporate controllers can individually be brought to their knees with a simple targetted boycott. Americans aren't bright enough to live in America. This book appears to be finished.

Posted by: Trollopo's Pizza on January 20, 2010 at 11:06 AM | PERMALINK

The Democrats deserve what they got. They sqaundered the majority they had. There is still a majority. Extend m'care for all with up or down vote with a change in fine print. It does not have to go into discussion or debate. Bring the legislation to the floor and vote for it for God;s sake. The Democrats would prefer to give into corporations than provide what every American deserves.Reconciliations can occur after thelegislationis passe. thsi will cost a lot less than the Senate bill that brings it all to corporations and not to Americans. Howard Dean wa right B. Sanders was right. LISTEN

Posted by: MLJohnston on January 20, 2010 at 11:09 AM | PERMALINK

"I'm explaining to MM why the risk pool has to be spread across the entire population."

That is entirely necessary to a good system, but that doesn't mean you can just make coverage mandatory. You have to combine that with a public option or single payer otherwise the mandate is nothing but forcing the populous to be a captive market for the insurance company bloodsuckers. This bill creates a mandate but does nothing to actually stop tyhe abse of that mandate because the regulations are tissue thin with no real enforcement and half the time (when the GOP holds the presidency) won't even be given lip service.

Posted by: Tlaloc on January 20, 2010 at 11:12 AM | PERMALINK

That is entirely necessary to a good system, but that doesn't mean you can just make coverage mandatory.

Of course it doesn't. My comments were about the legislative reality, not the value of the bill; I'm not cheerleading the bill in its entirety as written.

The original question from MM, you'll recall, was whether we could break up HC reform into separate chunks and pass it that way. The answer is no because of the interdependency of the pieces. As ineffective in cost control as a mandate without strong regulatory oversight would be (and there are different views of the regulatory strength of this one, but I tend to agree with you), you could not pass a standalone bill that, say, only ends rescission because the reality is that insurance companies will prevent its passage absent some concessions.

Posted by: Romeoville on January 20, 2010 at 11:25 AM | PERMALINK

For all you I'll-huff-and-I'll-puff-and-I'll-blow-my-house-down "progressives," I would suggest you go peruse the political history books:

The Social Security Act passed in 1935 did not cover any job category not "traditionally" held by white males, and didn't cover all of those. Over the 20 years following, that changed to where - whcn I got my Social Security Card in 1958 - everyone was covered as they are today.

The Medicare Act passed in 1966 did not cover most of the people who needed it, and was piss-poor as it was. In the years since, it has been modified and amended to where today, it gives far more adequate coverage to those in need.

What worked in both cases was that the progressive liberals at the time understood that getting the door jammed open by putting their foot - in the shape of the bill - in it, they would have the opportunity to change and modify what existed in the future as they build popular support for it by having it in existence.

In other words, they were willing to work for the goal.

So we got "kicked in the teeth"? So fucking what??!!!! If the progressive coalition actually is more than a bunch of latte-sipping, chardonnay-drinking Volvo owners, we take what we can, we work with what's there, we use reconciliation to get the financial changes necessary, to get the start date changed so people have the chance to see it in operation before 2012, etc.

And then we do to the Democratic Party what the Tea Baggers are doing to the Republican Party: get to work. Take it over from the roots on up, do the dirty work of becoming a precinct captain, walk the district, learn the voters, work for GOTV this fall and in 2012. It's hard, it's not glamorous, it doesn't provide the opportunity for jumping on a soap box and beating your chest like the wannabe-dominant chimp. It does create a situation where the party has to start taking us seriously.

And I will bet good money that there is no one here arguing that the bill should be killed who is in the situation of having no health insurance. Easy to argue how to be "clean and correct" when you don't have to pay the price. I have too many friends whose health situation is such that even the modest reforms in this bill are going to have major benefits in their lives.

So get off the holier-than-thou pre-adolescent soapbox most lefties find most comfortable, and put your actions where your loudmouths are, dickwads. And you know who you are, like it or not, and yes, you are indeed dickwads.

Posted by: TCinLA on January 20, 2010 at 11:40 AM | PERMALINK

And I will bet good money that there is no one here arguing that the bill should be killed who is in the situation of having no health insurance. Easy to argue how to be "clean and correct" when you don't have to pay the price.

You've got that fucking right.

Posted by: Tom T. on January 20, 2010 at 11:43 AM | PERMALINK

Hey, Praedor Atrebates:

Go stick your head further up your ass, and bray louder, you ignorant moron. I'm sure the health insurance you have will cover the chiropractic care you'll need after doing that. Permanent preadolescent Lefties like you are a damn embarrassment.

Posted by: TCinLA on January 20, 2010 at 11:44 AM | PERMALINK

Steve Benen wrote: "The question is whether rank-and-file House Dems have the stomach for it. As of right now, they appear ready to throw in the towel and accept defeat."

Those rank-and-file House Dems who oppose the Senate bill on substantive grounds would say that voting for the Senate bill would be throwing in the towel and accepting defeat.

If you disagree with them about the merits of the Senate bill, that's fine -- go ahead and argue about it.

But instead, you unfairly characterize the House Dems who are standing up for what they believe in as "defeatists".

That's nothing but name-calling, and you know better.

Posted by: SecularAnimist on January 20, 2010 at 11:56 AM | PERMALINK

Job one: Pelosi and Obama have to twist arms and get the Senate bill passed by the house. Pelosi can do it, she's demonstrated her ability before. Obama has shown that he's willing to go to the Capitol and confer with Democratic Congressmen to get the troops in line. Do it!

Job two: The filibuster has to go. The Republicans have abused it, and it's time for them to lose it. Why should the Democrats worry about not having it when they're in the minority? They never had the guts to use it anyway. The minute the Republicans threatened them with the "nuclear option" of abolishing it, they cringed and backed down. Now is a good time to start acting like the substantial majority that they still are, and use that "nuclear option" themselves. The filibuster isn't established by the Constitution or by any law, and there's a case to be made that it's unconstitutional. It's got to go.

Posted by: T-Rex on January 20, 2010 at 12:00 PM | PERMALINK

TCinLA wrote: "The Social Security Act passed in 1935 ... The Medicare Act passed in 1966 ..."

Both of which established government-run, nonprofit systems under open, accountable, efficient public administration.

Which makes them the diametric opposite of the Senate bill, which does no such thing, and instead requires each and every American to guarantee the profits of the insurance corporations in perpetuity, under penalty of law.

Social Security and Medicare established public programs that could be incrementally improved as you describe.

On the other hand, the fundamental premise of the Senate bill -- requiring all Americans to buy insurance from the for-profit insurance corporations, using public tax dollars to subsidize the profits of those corporations, and putting any sort of public option, expanded Medicare, or single-payer system "off the table" permanently -- is WRONG, and therefore cannot be incrementally improved.

Posted by: SecularAnimist on January 20, 2010 at 12:08 PM | PERMALINK

"And I will bet good money that there is no one here arguing that the bill should be killed who is in the situation of having no health insurance."

You are a pompous blowhard liar. I bet now its just a figure of speech.

Posted by: Michael7843853 on January 20, 2010 at 12:08 PM | PERMALINK

"Another option, preferred by some progressive activists, is to literally start over in both chambers, pursuing a more ambitious reform through reconciliation. This seemed exceedingly unlikely before the special election in Massachusetts, and the odds are far worse now. Lawmakers are ready to move on to other issues, not spend the next few months on a new bill."

Nonsense.

It could be done very quickly, as each vote would only require 50 votes and with no delaying debates. It is the failed option of trying to get 60 votes that dragged on for months and months.

Posted by: Joe Friday on January 20, 2010 at 12:20 PM | PERMALINK

The Progressives of the Dem Party are to blame. They believe that all they had to do was get Obama elected and everything would fall into place. They sat on their asses yesterday and look what happended. When, and only when, they begin to realize that whining and sitting an election out has consequences, will they mature enough to get fully involved. If not, they will continue to be the pox on the Party.

Posted by: fillphil on January 20, 2010 at 12:45 PM | PERMALINK

O.K. NOW is there any reason to keep Lieberman around as Chairman of anything except changing the toilet paper roll ? The Legislative branch is completely ineffective and until there are systemic changes that reflect a majority rule rather than the made up super majority, progress won't occur. One side, is galvanized, albeit mindlessly against against forward movement and the other side is paralyzed by fear of upsetting the yelling masses of tantruming Americans further. The media continues to throw gasoline on everything, stands back and giggles.

Posted by: DTR on January 20, 2010 at 1:28 PM | PERMALINK

What brain-dead House Democrats have to realize is that the quickest way to enable the party to quickly "pivot" and change the subject to jobs is to pass the damn bill now.

Progressive voices aren't about to let them off the hook anytime soon if they do not pass the Senate bill, so they can't change the subject unless they pass it.

Posted by: Jasper on January 20, 2010 at 1:31 PM | PERMALINK

...using public tax dollars to subsidize the profits..." SecularAnimist @ 12:08 PM regarding how the lack of a public option invalidates the Senate bill as compared to SS and Medicare.

Medicare is a use of public taxes to recompense private businesses (doctors, clinics, hospitals and laboratories).
Pass the bill.

Posted by: Doug on January 20, 2010 at 8:46 PM | PERMALINK
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