Friday, November 20, 2009

It's Too Early to Celebrate the Senate Health Care Vote

[This article also appears on You can access it from my author page here.]

I swear, I find no no joy in being Debbie Downer. I really wish I could celebrate the Senate's 60-39 vote to begin the debate on health care legislation, narrowly holding off the blocking tactic of the Republicans. I am 100 percent in favor of health care reform (I'm a fan of Rep. Anthony Weiner's proposal to extend Medicare to everyone). But a realistic view of what happened (and what has happened leading up to the vote) reveals far more things to be concerned about than to cheer for.

For starters, to get to an up-or-down vote on the final bill in the Senate, this 60-vote procedural hurdle will have to be jumped over again to close debate, and Sen. Joe Lieberman has already promised to join the Republicans in filibustering any bill that contains a public option. There are also several other centrist Democrats in the Senate who may not vote for cloture if there is a public option in the bill. Since the Democrats were only able to secure the minimum 60 votes to get past the Republicans this time, without Lieberman's vote (and all of the centrists'), if no Republican jumps ship, a bill containing a public option cannot get to the floor.

Also, it is easy to forget that a health care bill only barely made it through the House (220-215), and did so only after Democrats agreed to pass the bill despite the inclusion of the anti-abortion Stupak Amendment, which wouldn't just prevent the government from funding abortions, but would actually have the effect of making it harder for many women to exercise their constitutional right to choose under health care reform than it is today. True, the Senate's version has a less onerous anti-abortion provision, but if the House anti-choice Democrats stand firm again, even if a bill gets through the Senate, when it comes out of conference, the House will have two options, neither of which is good: pass the bill with the odious Stupak Amendment intact, or watch the bill go down to defeat at the hands of the anti-choice Democrats.

So what am I supposed to celebrate, exactly? That a health care bill will be debated? Even though, to get past a 60-vote cloture motion, it will have to be gutted even beyond the shadow of a bill it is now (the current bill has a weak public option, no other mechanism to really cut costs, and hands billions of dollars to the insurance companies who are a big part of the original problem)? I'm not saying I don't support this weak bill (it's better than nothing), but if it gets any weaker and cuts into the constitutional right of women to choose, really, does the good still outweigh the bad?

And the whole notion that there will be a debate is really hard to take seriously. There has been no honest health care debate up to this point. There has be a flood of outright lies from the right (two words for you: "death panels"), and if you think it's getting any better, as the vote neared, Sen. Kit Bond compared health care reform to one of the biggest Ponzi schemes ever: "Move over, Bernie Madoff. Tip your hat to a trillion-dollar scheme." This is the level of debate. Paranoid ramblings about government takeovers and hidden agendas of doing the bidding for insurance companies, hospitals and pharmaceutical companies that line the pockets of those opposing reform. The nonpartisan Congressional Budget Office can report that the Senate health care bill will cut the deficit by $130 billion over the next ten years without raising taxes on the middle class, but Republicans will still scream about expanding deficits and massive tax increases. Some debate.

You know, there is one thing I really like about the health care legislation that will now be debated in the Senate, and, oddly enough, it's something that most of my fellow progressives oppose: the ability of states to opt out of the public option. Honestly, I think this part of the bill is spectacularly brilliant. Why? It's simple, actually. It's democracy at work.

Consider that in the last months since the health care debate took off, we have been treated to the following:

- Rep. Joe Wilson of South Carolina screamed "You lie!" during President Obama's health care address to a joint session of Congress.

- Sen. Mitch McConnell of Kentucky said that passing health care reform with a public option could "cost you your life."

- Rep. Paul Broun of Georgia, who, by the way, is a physician, said that health care reform with a public option "is gonna kill people."

- Sen. James Inhofe of Oklahoma said, regarding the health care bill: "I don't have to read it or know what's in it. I'm going to oppose it anyways."

- Sen. Richard Shelby wrote to one of his constituents that health care legislation would "directly subsidize abortion-on-demand," "rations health care so that our citizens are withheld important and potentially life-saving treatments," and "requires taxpayer dollars to fund health benefits for illegal immigrants," all scare tactics that he knew (or, as a U.S. senator, should have known) is patently false.

Unfortunately, I could go on a lot longer, but you get the point. All of these politicians have many things in common, but there are two I would like to point out here: 1) They represent states that would likely opt out of a public option, and 2) they were duly elected by their constituents to serve in Congress.

Item 2 is really something important to remember. These men did not stage coups d'etat. No, they were elected by the majority of the voters of their states or districts. They were chosen by their constituents in democratic elections. And now it's time for democracy to do its job, so that the citizens of these states get exactly what they voted for. Why should we, as a country, spend taxpayer money to improve the health care of citizens who would send to Congress men capable of uttering baldfaced lies, all in the name of politics (trying to prevent the president from getting a "win") or protecting the special interests that fill their campaign accounts? And if they are telling their lies in defense of some kind of pure ideology that abhors the government's involvement in anything (except the bedrooms of its citizens, of course, but that's another issue for another day ...), well, then, let's give their constituents what they want. Hell, Shelby went after Medicare in his constituent letter, so I would be happy to let the states opt out of Medicare and Medicaid, too

In Shelby's state, Blue Cross Blue Shield controls 83 percent of the health insurance market, with more than 600,000 people living without health insurance and another more than 175,000 who cannot obtain group coverage and are forced to buy insurance on their own. Under health care reform, most would have access to health care, more than 400,000 Alabama residents would be eligible for government subsidies to help pay for health insurance, and the 175,000 plus not on group plans could get more affordable insurance. But these people also voted for Shelby. I respect the democratic process, and the people of the good state of Alabama should be free to get exactly what they voted for. I wouldn't dream of standing in their way. And the same can be said for the folks in South Carolina, Kentucky, Georgia, Oklahoma and all the other states who have sent representatives to Washington to obstruct health care reform.

This is the country in which we live now. This is what passes for debate. So you will forgive me if I am not optimistic that a worthwhile health care reform bill will make its way past another cloture vote in the Senate, past an up-down vote in Senate, through a post-conference vote in the House, through yet another cloture vote in the Senate, and finally through a final up-down vote in the Senate, all while the Stupaks, Liebermans, and Lincolns of the world are standing in the way, not to mention the stop-at-nothing lies and scare tactics employed by the right. I am sorry, but I am firmly in I'll-believe-it-when-I-see-it mode.

The bottom line is that I don't want to be the messenger of doom. I would love to celebrate a health care reform victory. And when a real one arrives, I will.

Tuesday, November 3, 2009

Candidate Obama Might Have Some Questions for President Obama

[I was invited by the editors of to write a reaction to Arianna Huffington's article comparing President Obama to Candidate Obama, after she read David Plouffe's new book. This is what I came up with. You can access it from my author page here.]

As Barack Obama stood in Grant Park a year ago tonight and gave his victory speech, it was a galvanizing moment, one I (and millions of others) will never forget. A year later, many of the president's supporters are expressing concern as to whether he has kept faithful to the vision he laid out in his campaign.

Today, Arianna argued that candidate Obama might not be so thrilled with the job President Obama is doing. She wrote: "Would he look at what the White House is doing and say, 'that's what I and my supporters worked so hard for?'"

I understand the dismay some, like Arianna, are expressing. It's hard to read headlines on HuffPo like "Obama Administration Helps House Gut Post-Enron Reforms" and not wonder where the "change" we were promised is hiding.

I find myself torn between two points of view I find compelling. On the one hand, it would have been virtually impossible for a president to come in and undo decades of corruption and inertia in Washington politics in one year. The mountain the president had to climb in this regard was immense. To me, though, the biggest problem has been that Obama lacks a necessary partner in this epic struggle: Congress. As I wrote in September in the context of the health care debate, it seems to me that the Democrats in Congress have forgotten that the president won 365 electoral votes last November, and that the American people handed 59 seats in the Senate (before Arlen Specter's defection made it 60) and 256 seats in the House to the Democrats. From the fight over the stimulus legislation, through the battle over the budget, and careening right into the war over health care reform, Congressional Democrats seem to have forgotten that the American people bestowed a mandate on them to enact the president's agenda. For some inexplicable reason, they've been scared of the Republicans, who retain the ability to be obstructionist, but don't have any power to actually do anything. (Making the Republicans filibuster something is not a bad thing.)

If Obama has been timid, the Democrats in Congress have been straight-out terrified.

And despite the Democrats on Capitol Hill not pulling their share of the "change" weight, Obama did manage to get through stimulus legislation and important programs in the budget, and health care reform has gotten further along in the process than it ever has before. Not to mention the general competency and positive world view that Obama has brought to the White House, a huge change from his bumbling, toxic and disastrous predecessor.

At the same time, I would be lying if said I wasn't disappointed with Obama's leadership. I applauded his early efforts at bipartisanship, but once the Republicans revealed themselves to be completely uninterested in any kind of cooperation, only focused on blocking the president at every turn, his attempts to come up with bipartisan solutions morphed from being admirable to being naive and counterproductive. (I agree with Arianna that I couldn't care less what Olympia Snowe does or does not want in health care reform legislation.) I appreciated Obama's desire to learn from past mistakes and allow Congress to generate legislation, rather than imposing solutions on the legislators (after the Clinton administration's failed attempt at health care reform). But coming off the election, the president had enormous political capital (really a blank check to move forward with anything he campaigned for), and I can't help thinking that he didn't make enough use of it. Some more outspoken leadership was necessary (and missed).

And most of all, the president hasn't done enough to foster the idea that his is an administration of change, just like he promised. Arianna is unhappy that Larry Summers has an influential position in the Obama White House, and such an objection is understandable, given his close ties to the kind of deregulation, anything-goes attitude that contributed to creating the economic mess the administration now has to try and clean up. But to me, the problem isn't who the president does and doesn't hire. It all comes down to him. When he spoke to a joint session of Congress about health care, it re-ignited action on reform and turned the mood around. It was an important speech and an important show of leadership from the president. I'd like to see more moments like that one.

During the campaign, every time writers (and I was one of them, on occasion) groused that Obama wasn't hitting back hard enough when his opponents attacked, his strategy always seemed to pay off in the end, making the pundits look bad. So I can't help feeling like he must know what he is doing now, that there is a strategy behind his less-than-assertive public approach to his presidency. But as each day goes by, it becomes harder to have faith. As Arianna noted, the ability to make pitch-perfect course corrections during the campaign was a key to Obama's success. Hopefully, he will continue that trend in the second year of his presidency.

Just over 10 months ago Obama took the oath of office with unfair expectations hovering ominously over his head, so I am inclined to give him the benefit of the doubt. But, as Arianna's article shows, that benefit is not extended by all, and it is not available indefinitely. One thing I think we can all agree on is that President Obama would benefit from a little infusion of Candidate Obama. The future of his presidency may depend on it.