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July 28, 2009

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Obviously the individual mandate stays, though. Can't take back the cookie that got the ins. cos. on board.

Sixty isn't a relevant number (or shouldn't be). They should pass this on reconciliation, in which case Baucus's whole play group is simply in the minority.

Baucus, Bingaman and Conrad, or course, don't personally support the public option, employer mandates, or a surtax (indeed, they're being paid good money to oppose these things). So its not quite fair to say that they're bargaining these things away. The more accurate way to put this is that they are forging the kind of "reform" that they'd support.

It we end up with a bill that looks anything like this, it will be the majority of the Democratic leadership (and indeed, a majority of the Senate itself) who will have bargained away these things in dealing with Baucus, Bingaman, Conrad and the Republicans.

Of course, that's assuming that the Democratic Senate leadership actually wants employer mandates, a public option, or a surtax, and I'm not entirely unconvinced of that.

I hope that Obama stands firm on his promise that he will veto any (health care reform) bill that does not contain a public option.
But I could imagine the perfidy that the GOP senators will lend their votes to a horrible bill to overcome that veto (after of course voting against the same bill before it).
GOP before the veto: This is a horrible bill that Osama (eh, Obama) wants to ram down our throat.
GOP after the veto: Obama tries to kill bipartisan reform. We can't allow that to happen.

I support "ramming down the throat" when it comes to the Republican Party and their fellow travelers in the Democratic Party, as long as throat damage is considered a prexisting condition and is NOT covered in the public option.

Say "AHHH".

Seeing as the anti-"Obamacare" crowd will never be satisfied as long as they have to accept the idea of a democrat doing anything, and seeing as the current "compromises" are now firmly to the right of the street level, it's time to really start tuning out the squealing for "bipartisanship" or "moderation", seeing as those two causes have been taken hostage by ideologues and partisans.

This should be about results, sustainability and fairness towards all parties. If some congressmen want to stall things in order to appease their lobbyists or ideological obsessions, then they are no longer of value to the process or the people they were elected to represent.

Look how failure sets in the minute those poor oppressed bipartisans and blue dogs get their way: http://www.fivethirtyeight.com/2009/07/baucus-bills-bad-math.html

If a public plan gets worse results, then there will be no public plan. If a public plan gets better results, then it should be in the bill and screw every other concern. Bang for the buck is the only thing that matters, and since the blue dogs and the republicans don't seem ready to forego their lobbyists or partisan indignation, screw them all and do reconciliation if they aren't interested in doing the hard math and creating a bill based on results.

Yes, FYI, No Exit isn't three people in a room with annoying chatty Cathys -- the three people are the only ones in the room and *they're* the annoying one (to each other).

Bang for the buck is the only thing that matters

In the long run, yes. In the short run, no. The only thing that matters is getting a public option. Absent that, reform gets quotation marks.

On a brighter, OT note: the long-running controversy about who is the Stupidest Senator will get a little calmer - the shockingly dumb Jim Bunning, from publius' home state of KY, is not going to run for re-election! The king is dead - long live King Inhofe.

We need to do three things:

1) Get Reid out of office. Majority Leader means squat when you can't get people in your own party to stay on board.
2) Get Max Baucus out of office, and anyone else with all that goddamn lobbyist money in their pockets. They ARE NOT serving the true needs of the American people.

3) Get people elected to office who will for the LOVE OF GOD FIX OUR HEALTHCARE SYSTEM.

Dear people of Montana: now is a very good time to head to Baucus' state office(s) and stage sit-ins until he does what he's supposed to do - which is, return all that healthcare lobby money and give us a health care system that works!!!

I believe The Onion best summed up "No Exit" - "hell is other Frenchmen."

Senators from Montana, North Dakota, New Mexico, Maine, Iowa and Wyoming.

Yeah, that's America all right. I think these states have more Senators than Representatives.

Z. Mulls is right: In "No Exit", each of the trio helps make the experience hell for the others. And it's not so simplistic as the famous summary "hell is other people" might make it seem. It's not so much that the people are annoying as it is that the people start to reveal the truths about each other. The hidden wretchedness and cruelty of each person is slowly and inevitably exposed as they chip away at each other's facades.

It's a frightening premise: that life outside of hell is only bearable because it involves a kind of constant flight from the inevitable truths that would come from being stuck in a room with nothing to do but talk. Only with constant escape can we keep hold of the illusions that sustain us.

As such, your comparison of "No Exit" to politics is fair: there's something terrifying about realizing, with inevitable finality, that THIS IS WHO AMERICA IS.

I see a real danger in fetishizing "public option". An underfunded option available to a few million people at the bottom of the heap could be the enabler for a bunch of really awful stuff. (I want someone to tell me with a straight face that they are sure any individual mandate comes with the most ruthless provisions for scrutiny of fees charged and coverage provided. I'm not seeing it, and that means it's a license to give money hand over fist to insurers. Just for a start.) I can think of lots of "public options" that would contribute to making the overall picture substantially worse than it already is.

But then I believe that what people need and (when they get a chance to think it over) want isn't insurance at all. They want access to reliable, good health care. Insurance is supposed to be a means to that end, but in the US it stopped being so quite a while back. Access to health care is in fact not compatible with insurance as we do it in the US, and I'd rather have the access than the insurance, thanks.

Nate, I'd say that the horror here is more that these decisions reflect who America isn't and that there seems to be no good way to change it. Whether it's the war in/on Iraq, investigation and punishment of war crimes, access to health care, or countless other issues, the public clearly wants things there seems to be no way to get out of our government.

My parents have thought for a long time now that this is a crueler political culture than the one they grew up with in the Depression. There's less fundamental ignorance on the part of leaders, more conscious awareness of what people are suffering and more calculated responses to keep the masses from mucking it up for the elite subcultures whose rivalries are the real substance of routine politics.

Perhaps you were alluding to it, but "No Exit" was the title of the notorious New Republic article by Betsy McCaughey in 1994. It falsely alleged that the Clinton health care proposal would prohibit fee-for-service treatment outside the system, and gave crucial "even the liberal TNR" cover to the effort to block it.

Hmm, that Nate is a different Nate than I. Hope we haven't cross-posted too often.

The king is dead - long live King Inhofe.

The sad thing is, it's not entirely clear that Inhofe is even the dumbest Senator from Oklahoma.

I'd say that the horror here is more that these decisions reflect who America isn't and that there seems to be no good way to change it. Whether it's the war in/on Iraq, investigation and punishment of war crimes, access to health care, or countless other issues, the public clearly wants things there seems to be no way to get out of our government.

FTPyrrhicW!

I hope that Obama stands firm on his promise that he will veto any (health care reform) bill that does not contain a public option.

I really don't remember Obama making any such promise. Cite?

Ceri B: Yeah. If you can get some solid regulations (community rating, no recissions, and so on), have a decent health care exchange with subsidies for low-to-medium workers, implement some sort of halfway decent cost controls, and improve Medicare and Medicaid, that's a pretty decent bill, and on the flip side a public plan if done poorly can end up being a rather expensive dumping ground for sick people.

It's worthwhile as a tactical move to just draw some sort of line so that we don't just concede everything to death, but it's more complicated than just "public plan good."

I really don't remember Obama making any such promise. Cite?

That's because he hasn't promised anything of the sort.

I see a real danger in fetishizing "public option". An underfunded option available to a few million people at the bottom of the heap could be the enabler for a bunch of really awful stuff. (I want someone to tell me with a straight face that they are sure any individual mandate...) I can think of lots of "public options" that would contribute to making the overall picture substantially worse than it already is.

Of course there are ways a 'public option' could be bad - as you mention, if it's something just for the very poor, it's a bad idea. I'm not fetishizing the phrase, and don't worry about the danger of doing so. I worry about the enormous danger of getting some piece of s--t bill which doesn't change anything, fundamentally. Such a bill could have all kinds of semi-meaningless or incoherent phrases in it. Does that mean we shouldn't try for the things those phrases are supposed to mean? ???

It makes no sense to think of health care without risk-pooling, which is what 'insurance' is.

Much of your comment baffles me, Ceri.

The sad thing is, it's not entirely clear that Inhofe is even the dumbest Senator from Oklahoma.

I think it is. Coburn doesn't lack native (raw) intelligence. He's weird. Inhofe is just dim.

"Hmm, that Nate is a different Nate than I."

This sort of thing is why I've pointed out for -- well, a decade and a half ago it wasn't necessary to point out, but for the past decade -- that people should choose unique handles, not handles absolutely guaranteed to be used by thousands of other people, such as unadorned common names. It simply guarantees you'll be confused with another "Nate" or "John" or "Shirly," or whatever.

Inhofe: bachelor's from Tulsa University, completed surreptitiously at age 38 on the eve of run for governor (claimed to have graduated in 1959, but the TU registrar responded to a journalist's query that he had actually graduated in 1973).

Coburn: M.D.

Not that Coburn isn't crazy. But in terms of basic intelligence, he has it all over Inhofe.

"I really don't remember Obama making any such promise. Cite?"

On the contrary:

President Barack Obama said Tuesday his healthcare overhaul needed a public insurance option to enforce market "discipline," but stopped short of saying he would veto legislation without one.

I thought Obama did threaten the veto in public but I have so many downloaded Obama events that it will be difficult to check all of them. It 's of course possible that he did and later stepped back (as on several other topics).

I thought Obama did threaten the veto in public but I have so many downloaded Obama events that it will be difficult to check all of them.

No Hartmut. I really don't think so. Obama making such a promise would be a very big deal. In fact, this entire debate would be quite significantly different if he had. I am not sure it would be better or worse for such a promise but I do know for sure that it would be one of the single most discussed parameters of the entire negotiation, both on Capitol Hill and in the press. If he had mad such a promise, we would have all been hearing it repeatedly on a continuous loop for weeks. Guaranteed.

the range of the "possible" in America apparently runs from Max Baucus to Olympia Snowe. That's the left and right-most edges of the spectrum.

What's really sad is how much of an improvement this represents over the way it was three years ago when Snowe was at the left-most edge of the spectrum, and there was no right-most edge.

Johnnybutter: Sorry, I'm not trying to be cryptic, and I was really free-associating from comments here to discussion elsewhere. What I mean is simple enough. If we place too much value on a particular phrase or some specific feature, then we can get a thing that meets the criterion we said we wanted but is still awful. I'm discouraged by what seems to me a common thread in center-left punditry of being more interested in narrow, often de-contextualized checklists than overall actual outcomes. We've already got the Republican Party and its running-dog lackey pundits for that kind of idiot savant approach to legislation.

(I used to call that a chosen autistic style. Getting to know more real autistic people has convinced me that it's a dreadful slur on them, and that the moral blindness of always haggling nits and never looking overall has nothing to do with the real autistic spectrum.)

I want a good law, not something that can in some tortured sense be called a public option and therefore be assumed to be okay.

It appears that Max Baucus just got reelected. Did he have a primary challenger at the time?

He's either expecting people to forget that he sold US out in 2014 or he's currying favor now for a corporate job later (ala Billy Tauzin style).

Just for the record, I'm not at all for passing one of the most significant substantive reforms in my lifetime through the budget 'reconciliation' process. Health care reform isn't a budget reconciliation process. Remember that rule of law thing about means and ends? If you can pass this kind of reform as a buget reconciliation, the term means nothing.

Furthermore, if Reid doesn't think health care is an important enough issue to force the real filibuster, can some one tell me exactly which issue he thinks might be important enough?

Though on a political tactics sidenote--wouldn't it have been better to break the back of the filibuster on an issue that Democrats could have easily made the Repbulicans look stupid on? Something like the stimulus? Waiting until a super contested issue with a not-really-great bill risks letting the filibustering Republicans look like they are standing on defensible priniciples.

Sorry, I'm not trying to be cryptic, ...What I mean is simple enough. If we place too much value on a particular phrase or some specific feature, then we can get a thing that meets the criterion we said we wanted but is still awful.

And I certainly wasn't meaning to be a jerk. Just trying to clarify. I think there is a huge difference between demanding a particular feature, and fetishing a phrase - the former could still be part of an overall bad result, but a perversion of the meaning of words is much more likely. Please correct me if I'm wrong, but what I sense from you is a general fear to break inertia, which is itself probably the biggest thing of all to fear. An imperfect bill can be changed. Inertia, OTOH, is the 'pre-existing condition' of entropy.

As von says in his article, HR 3200 is a terrible bill. Virtually everything about it is wrong. Having the republic senators remove bits of its terribleness, while it may annoy me from a partisan point of view, is nonetheless unlike to make it any worse. Well actually it might - they might take out all the financial provisions and fail to replace them with something that worked, but they're the part of fiscal rectitude. Oh ... umm. Oh dear.

Johnnybutter: Actually I'm a single-payer advocate, since it demonstrably works. Medicaid has saved my life in the last two months - finding a great doctor who takes Medicaid let me discover unsuspected critically high hypertension and rapidly advancing diabetes - and I'd be delighted to see everyone in need in the US have access to it, or better.

I think Obama gave away far too much right at the outset, and I worry because some compromises get devilishly well entrenched once they're in place, and programs that start off with too small and too marginalized a constituency tend not to ever flourish.

I hate to keep saying this, but we -- meaning Democrats -- don't HAVE 60 votes -- even counting Sanders, Lieberman and the Blue Dogs, we have 58 in most cases. There is no proxy voting in the Senate, no clerk, chief of staff, or colleague is allowed to cast a vote for an absent Senator. Which means, unless Kennedy and Byrd are physically able to get to the floor, their seats are, effectively vacant -- and their resignation wouldn't help. In Massachussetts there are no 'interim appointments' which means the seat would STAY vacant for at least three months before a new Senator could be elected. The WV Governor is, technically, a Democrat, but very much the bluest of blue dogs -- anti-choice and NRA Member -- so he's unlikely to appoint someone we'd like.

Then you have Rolando the Silent (maybe i just haven't noticed, has he taken a position on anything?). And if the Hudson County scandals spread, Melendez might not be around longer. (Dear Bob, please resign NOW so you can be replaced by a Democrat. The scandals will ensure Christie's election -- regrettably.)

As for threatening primary fights against Blue Dogs, that only works if they are substantially more Conservative than their states. Want to challenge Baucus? Well, the respected Jon Tester ran against the massively corrupt Conrad Burns. He won, by 3500 votes.

I'm not giving up hope, I'm just saying that those who condemn Obama for his patience might learn to count. I think he'll get a good bill passed -- not good enough (I support a Canada-style system) but better than it looks now, but it will take all his skill to pull it off.

Actually I'm a single-payer advocate,

So am I. I also favor peace on earth!

programs that start off with too small and too marginalized a constituency tend not to ever flourish.

Yes, that worries me too. Doesn't make me not want a public option. Fine with me if it's called something else.

I hate to keep saying this, but we -- meaning Democrats -- don't HAVE 60 votes -- even counting Sanders, Lieberman and the Blue Dogs, we have 58 in most cases.

I don't really disagree with anything you say but what I would say is that, however many votes we can actually count on - lets say 52 - the Republicans have way fewer, and despite that it seems we have been approaching this debate from a position of weakness. Part of that is that the system is structured to favor the status quo but I would argue that another part of that is that the Democratic leadership on this have played this like we're the ones trying to catch up. The story is always about what they're willing to concede, not what concessions the minority party is able to pry out through threats of obstruction.

I realize that we may actually achieve something net positive for the progressive agenda in the end, but I feel like we could do much better than some incremental improvement which, honestly, seems like where this is going. I suspect that access may be significantly widened (not suggesting thats a small thing) and there will be some minor improvement in premium costs, but the woefully craptacular system we have now that threatens to bankrupt us in the event of any serious illness and closely ties our health considerations, both individually and collectively, to the obscene profitability of our carriers will remain substantially intact. With 60, 58, 53 votes or whatever, we should have been able to do better.

Ceri B: If Nell is mostly right, then you too are correct and I am wrong.

Maybe they should wheel Teddy K into the building, and let him go around stabbing Baucus and the rest of them with his chemo needle!
Poor Teddy. I've known him since he first ran in '62. What his own party is doing to this legislation has to be killing him faster than the cancer.

Also, if Nell is right, we are all utterly screwed. Call it the 'Alternative Public Option'.

" Remember that rule of law thing about means and ends? If you can pass this kind of reform as a buget reconciliation, the term means nothing."

Sebastian, could you remind me of the posts you wrote objecting to the Republicans passing, and George W. Bush signing the bill cutting Medicare and Medicaid by $6.4 billion from Medicare and about $4.8 billion from Medicaid over five years via reconciliation? Or any posts objecting to Republican use of reconciliation bills? Thanks, if so.

Jesurgislac, have I written posts objecting to the reconciliation useage in this case? Honestly, this "if you didn't write a post about it you clearly didn't think about it" thing is getting a little tired don't you think?

Belated answer to the Obama veto question:
Obama indeed threatened a veto explicitly in connection with health care but not on the topic of the public option but on a McCain proposal (or any bill that contained something similar). That means I confused two very close things. There are many sites where a veto threat on the public option is implied/expected/demanded/etc., so it was a mistake easy to make (but a mistake nonetheless).

I mean this kindly: you should take a break and go read No Exit.

Don't worry! We'll wait! It'll be worth your time!

Perhaps you were alluding to it, but "No Exit" was the title of the notorious New Republic article by Betsy McCaughey in 1994.
kth, thanks for pointing that article out. It's a small">http://en.wikipedia.org/wiki/No_Exit_%28disambiguation%29">small world of signifiers. I guess I have no idea if publius intended to allude to the dreadful TNR piece -- it would be weirdly fitting if he did -- but the Sartre play precedes it by about 50 years.

L'enfer, c'est David Broder.

I'm not happy about these senators holding the country hostage, either. Merely pandering to their constituents would make for much better policy here. I'm a little unclear on the rules of the game that give these six such power, but currently they're vetoing several crucial elements.

(No Exit is quite short, and very good. It's worth a read. It's better in the original French if you can read it (I did in a college class years back and appreciated it more), but the English translations aren't bad.)

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