The New Republic

For heaven's sake, why do you hate the poor and uninsured so? "But leadership is the art of expanding the possible." Oh for Christ's sake, how banal. OK, just how do you suppose they do this? Make ANOTHER speech? Do you honestly think another Goddamned speech will sway Holy Joe Lieberman, or any of the blue dog Democrats in the Senate, the ones who have to go home to states where the majority of the people are suspicious as hell of people like you? Do you really want to see the whole thing go down in flames so you can feel superior in your wisdom that it wasn't worth it anyhow? As to those people who lose insurance due to pre-existing conditions, or recission, or subsidies for the poor and uninsured, well screw them, right unless your vision is followed through. How about if we worry about saving lives first, and then, in time we can address cost containment issues. It is these f-ing wooly headed liberals who will doom us all.

- blackton

November 11, 2009 at 10:46am

OK, I just realized I missed this last line, being that I was so annoyed I never got to it. "The infamous den of useless utopian thinking known as the Brookings Institution." I don't know if you are being wry, sarcastic, ironic, cute, or what have you. If this was meant as a takedown of useless utopian thinking, then fine, I apologize for wanting to so seriously p-slap you upside the head, but if not, then what is your deal? F-ing take a stand and stick with it and stop trying to be cute.

- blackton

November 11, 2009 at 10:55am

Right on, Blackie. As someone once said, "The perfect is the enemy of the good". We have to start somewhere. This year's bill will not be immutable; it can be improved and built upon over time. I will be satisfied if we get health insurance for another 38 million currently uninsured people, if we outlaw rejection for pre-existing conditions, and if we establish automatic portability. If we can accomplish those goals now, next year and the next, we can work on continuous improvement. But the essential thing is to break ground and begin the project now.

- JackR

November 11, 2009 at 11:39am

I think this criticism of Mr. Galston misses his point. Mr. Galston is an expert in "governance studies," not health care per se. Thus, I interpret his comment as being addressed to the politics of this process and concern that, without the leadership from the Administration he is recommending, the health reform legislation (in whatever form) will not pass. Specifically, that without a convincing case that the legislation will achieve the desired (or necessary) cost reductions, the votes are not there.

- raylward

November 11, 2009 at 12:03pm

Galston is quite correct. Obama and his senior executive colleagues have provided next to no leadership, spent little political capital, to advance a bill with better policies that is also better politics. A similar political style of constantly looking for compromise was taken on the stimulus package -- and it looks like it will apply to bank regulation and Afghanistan. Obama ios acting like a Chamberlain when the times call for a Churchill.

- gdbittner

November 11, 2009 at 12:10pm

Now hold on a minute, guys. Have you read Judis's piece on anti-statism? In it, we learn that our country is rooted in an ideologically-conservative, or "Lockean liberal" mindset that ends up prevailing if reformers do not make a specific enough case that cuts through the blind tradition of government-distrust. After all, how can you trust a contract or salesman that does give exact details? Judis finds that progressives were most successful in overcoming the "atmosphere" of ideological conservatism by presenting goals of proposed legislation in specific, dispassionate detail. Boring numbers and exact--not abstract--goals. Whether or not you agree that America is fixed in Lockean liberalism or not, it is difficult to dispute the ability of specifics to tame the shrew. That said, Galston is not asking for an eloquent, atmospheric campaign speech; he is making a case for the exact, dispassionate opposite.

- dylanposer

November 11, 2009 at 12:10pm

raylward, gdbittner, have you been reading Cohn's takedown of Joe Lieberman and his rationalizations as to why holy Joe will filibuster? The convincing case has been made by the CBO, Democrats, etc. What kind of leadership can Obama possibly use to convince Lieberman not to be Lieberman? gdbittner, you say Obama should be Churchill, but what the hell does that mean in this case? Tell me what he should say that will sway holy Joe? Need I remind everyone if Lieberman does not vote for cloture, the whole thing falls apart. Unless anyone can convince me that Snowe will buck her party and vote for it, dubious at best.

- blackton

November 11, 2009 at 2:41pm

I would remind everybody that it was the Administration and the Democratic leadership who chose to focus the health care reform debate on universal coverage and the costs/cost savings to achieve it. It's not the strategy I would have chosen, but it's the strategy they chose and it's too late to change that now.

- raylward

November 11, 2009 at 3:10pm

blackton, Why the complete focus on Joe and 60 votes. Reconciliation takes 50 (not counting Joe--- Biden, that is). 60 votes has been a losing strategy from the get go. In the thirties, Churchill was never going to verbally convince Adolph, Benito, or Joe (Stalin that is) of anything. Churchill needed to convince those opposing them to act much more forcefully-- by Britain's actions (not just great verbiage, albeit great verbiage helps in the convincing). Obama (and the Democratic leadership) need strongly convince other Democrats and Independents by actions that carry more risk if need be that they really are working toward a strong health care bill ... not just any old bill where they can claim to have done something around the edges of reforming health care that maybe in a decade or two can turn into something meaningful. Read today's post on the Senate filibuster in Political Animal.

- gdbittner

November 11, 2009 at 5:51pm

From Political Animal 11/11/09 HINING A LIGHT ON THE INSTITUTIONAL PROBLEM.... Harold Meyerson notes the paralysis that has overcome the political process, and points to a Senate in need of institutional reform. A catastrophic change has overtaken the Senate in recent years. Initially conceived as the body that would cool the passions of the House and consider legislation with a more Olympian perspective, the Senate has become a body that shuns debate, avoids legislative give-and-take, proceeds glacially and produces next to nothing. The problem, in part, is that Republicans have routinized the filibuster. They have given their leader, Kentucky's Mitch McConnell, the power to bring virtually all legislation to a halt.... Establishing a new normal: If we have anything to do with it, nothing moves. Unless you can get a 60-vote majority to end debate, all major bills (and some minor ones) are dead in the water. Meyerson notes the Democrats' three great governing opportunities/challenges of the last century. The first was in 1933, when FDR and a Democratic Congress delivered on a New Deal. The second was in 1965, when LBJ and a Democratic Congress advanced the Great Society. The third is right now. And while the first two saw a flurry of legislative successes that came to define a generation, 2009 isn't working out the same way -- partly because Republicans have embraced obstructionism on an unprecedented scale, partly because some Democrats are conservatives who are comfortable with failure, and partly because of legislative procedural hurdles that FDR and LBJ didn't have to worry about. Steven Pearlstein notices the problem, too. Because of the quaint traditions of the upper chamber, there are today scores of top positions in government that routinely remain unfilled for months because one senator or another has decided to put a "hold" on a nomination. And on any controversial issue, and even some that are not, 60 votes are now required to overcome the threat of endless "debate" and actually pass a piece of legislation, along with 60 votes on as many amendments as senators can dream up. It's gotten to the point now where all it takes to kill something in the Senate is the mere threat of a filibuster, without anyone actually having to mount one.... Despite what you hear from legislative leaders, there is nothing preordained about this wholesale disregard for majority rule. In fact, it violates the letter and spirit of the U.S. Constitution, which expressly delineates a limited number of instances in which anything other than a majority vote is required. And it makes a mockery of Senate rules and precedent, which for nearly two centuries were grounded in a tradition of comity and mutual respect between majority and minority. Matt Yglesias noted this morning, "I've gotten a few queries over the past week asking me to go beyond mere whining about the sorry institutional set up in the United States Senate to asking if there's anything that can be done about it. The answer is that yes there is. Key elements of Senate procedure have been altered repeatedly throughout history and there have been failed efforts to do it that might have worked had folks been a bit more determined. What's missing right now is any sign from anyone politically important of any interest in turning up the heat." Which is a) one of the reasons I keep writing about it; and b) why I'm glad to see columns like these from Meyerson and Pearlstein. The political establishment considers the status quo to be normal, routine, and legitimate. It's none of those things. As Pearlstein noted, "most days" the D.C. insiders "barely notice how utterly ridiculous and ineffective the legislative process has become." Facing extraordinary crises and challenges, the United States has a legislative branch that is barely able to legislate at all. The system can see the problems, but is struggling badly to address them. The first step in changing the way Congress operates is creating the demand -- most of the public has no idea that the Senate no longer operates by majority rule. Public frustration can lead to proposals, which can lead to debate, which can lead to solutions. —Steve Benen 1:35 PM Permalink

- gdbittner

November 11, 2009 at 5:59pm

look, I don't want to go into Churchill comparisons, wandering too far afield for me. I just don't see reconciliation happening because of the institutional hurdles. They would have to recraft the whole bill, face endless points of order, etc. And the parts that would not be part of reconciliation would flounder for months (like recission, denial of care, etc.) if not much longer. I think the bill will pass, that Joe will get half of what he wants, and cave on the rest, and the bill will ultimately go on to pass. It will leave much to be desired, but incremental reform will take care of the rest.

- blackton

November 11, 2009 at 6:48pm

OK.. forget Churchill. But... What DOES Joe want?? Pages have been written on that... the bottom line generally being, whatever Joe (and SNOWE??) wants it ain't for rational reasons. The incremental approach being an eventual (like when??) success also assumes that the latest Judis post ISN'T correct (see below). I have thought for some time that the basic political points being made in that post are correct... When your average Joe sees what isn't in it for him for God knows when after ALL this fuss, goodby Dems. From Judis: Just read your latest TNR piece on anti-government sentiment. I thought it was excellent, and agreed with its central point. But I do think there’s a danger of reductionism--seeing attitudes and positions through the prism only of attitudes toward government. I don’t think you do that, but I see it a lot on the left. My own view is that the middle class opposition, or if that’s too strong, fear of the health care bills have more to do with classic “what’s in it for me” analyses. Supporters of the Senate bill have a hard time explaining how it’s not simply a transfer of benefits from people with good plans, including all manufacturing and construction union plans, and seniors who use Medicare advantage, to the uninsured--read, the poor. Add to that legitimate fear about the deficit, and no plausible prospect of reduced premiums. The Senate theory is clearly that the way to reduce costs is to have people cut back on use. Apparently they believe there’s all these folks who just love going to the doctor because their insurance covers it. On the House version, most people like the specific benefit improvements--preexisting conditions, elimination of lifetime maximums--but beyond that people are hard pressed to say what’s in it for them, unless they’re uninsured and entitled to a subsidy. Usually I fall squarely in the incrementalist camp--some change is better than none. But what I see so far is shaping up to be a disaster. I suggested to some progressive Congressmen they should just bring up standalone anti-insurance company bills, and change the political debate. They liked the idea, but don’t want to undermine Obama. The truth is that unless you take the profit out of the mix, the only possible cost containment is cutting benefits. Goodbye 2012.

- gdbittner

November 11, 2009 at 8:21pm

Blackton... What Obama can say to Holy Joe to convince him to drop the filibuster is what can only be said in private......."Joe, if you go through with this disloyalty then you can kiss that Homeland Security Committee chairmanship, as well as any other positions of authority and that nice office goodbye." No campaigning, no fundraising, no staff support, nothing. If Joe wants to be a contrarian, then let him try his hand at grovelling for attention from the right-wing zealots over at the RNC. My money says he'll get zip from them. I know the Prez doesn't like to operate this way, but the time has come for him to start playing rough. His continued viability as the world's foremost leader depends upon it and he won't get another chance on health care with the mid-terms coming up.

- desertdog

November 12, 2009 at 1:37pm

Fairly early in the process, it became clear that the right would torpedo any serious effort at cost control, of either medical care itself or health insurance. The administration made the correct choice which was to expand coverage as much as possible and thereby retrieved what was beginning to look like another doomed effort at (nearly) universal health insurance coverage. This was both politically astute and the proper ethical response to the über-hypocritical rightwing which decries the cost of the public program but then renders impossible any effective means of controlling costs because these would impair profits. The result will be a large expansion of coverage which will be both politically popular and impossible to repeal. The costs will be out of control, perhaps wildly so. At that point enacting the cost control measures that should have been part of the original program will become a political necessity. In that manner, the administration will have achieved in two steps what cannot be achieved in one. My hat's off to them. They just need to get it finished so that they can move on to other matters as or more pressing -- jobs recovery and a strong response to the threat of climate change, not to mention the two ongoing wars. As a policy matter, I deplore the messiness, gaping holes, and inequities in the administration's financial bailout, stimulus package, and now health care bill. But I applaud them for recognizing that, in these cases, something far from perfect was and is still vastly more important and better than nothing. That IS the art of the possible. Meanwhile, someone should figure out a way to abolish the US Senate which plays the same anti-democratic role as the Roman Senate did while dressed in robes of republican virtue.

- roidubouloi

November 15, 2009 at 8:36am

On the substance, I agree with roi. On matters of climate change and abolishing the Senate, I respectfully disagree.

- Robert Powell

November 15, 2009 at 11:44am