health care – Page 5

Intellectual dishonesty

Max Baucus yesterday offered one of the more bizarre rationales for voting against including a public option — publicly administered health insurance plan — in healthcare reform:

Finance committee members rejected two amendments that would have created a public option. The votes were 15 to 8 and 13 to 10. Baucus, who has emerged as the central player in shaping the bill, was one of three Democrats who voted ‘no’ on both proposals. Baucus said he supports the principle of a public option as an alternative to private insurance. But he warned that including it could doom the bill to a Republican filibuster.

“No one has been able to show me how we can count up to 60 votes with a public option,” Baucus said. “I want a bill that can become law.”

So, to be clear: Baucus supports the public option but can’t vote for it unless everyone else does. So much for intellectual consistency.

The Baucus contradiction, of course, is one that most progressives have been criticizing (Rachel Maddow last night, in a comment laden with derision and snarky sarcasm, described the Baucus position as “leadership”).

Another intellectually suspect argument has been making the rounds, however, and it comes from the left, from the people seeking to get a public option into the bill. As anyone knows who has read this blog or my columns with the Packet Group or The Progressive Populist, I view the public option as a stop-gap but necessary measure. What I find disturbing is this argument, made last night by both Sen. Charles Schumer and Howard Dean on Maddow — and made by other progressives at other times regarding this bill: That Democrats should vote with the leadership on cloture and with their conscience on the bill.

MADDOW: You just heard my interview with Senator Schumer. And he said something that I haven‘t heard him articulate before, which is that Democratic leadership should be able to expect that even Democrats who are going to vote against health reform should vote for cloture, should vote to end the Republican filibuster, thereby making the threshold 51 votes instead of 60. What‘s your reaction?

DEAN: That‘s true. Core procedure in almost every legislature I have ever had anything to do with, including the national legislature, is, you can vote however you want on a bill, that‘s a conscience matter, but you owe it to your leadership who gives you your chairmanship and to vote with the leadership on procedural votes. And a filibuster is a procedural vote.

So, I would expect all of the people caucusing with the Democrats to allow a vote to go forward.

MADDOW: And.

DEAN: And so, you know, the chairman‘s argument is auspicious. You don‘t need 60 votes for a public option, you need 51 — under any circumstance, if the people who caucus with the Democratic Party and owe their chairs to the Democratic leadership are willing to do the right thing.

It’s a specious argument that unfortunately echoes the ones made by Republicans when Democrats threatened (they always threatened but rarely followed through) to filibuster hard-right judicial nominees. Let the nominee get an up-or-down vote.

That’s what Dean is arguing here, that whatever you believe you should allow a floor vote to occur. Sounds good in theory, but what if you know that allowing the floor vote will allow legislation you disagree with vehemently to pass. The cloture vote is the only power you have to stop the bill.

I’m not defending folks like Ben Nelson or Blanche Lincoln. Their stance on healthcare is indefensible. But they have a responsibility to use every tool they have in their arsenals to ensure that legislation they oppose does not become law.

The issue here is not that all good Democrats should fall in line. Rather, the issue is the filibuster itself and whether it really is anything more than an opportunity for a minority of senators to hold the rest of the Senate hostage.

I’ve written about this before (there was a point in time when I defended it, but shifted my view about four years ago$, when the Republicans threatened to jettison the filibuster to get their court nominees through. My reasoning was simple: It was an archaic technicality generally used to stop progress and thwart the democratic process. Rather than a simple majority of Senators (an unrepresentative body in and of itself), you potentially needed a supermajority of 60 — something that can be difficult when controversial legislation is on the table (think about the civil rights filibusters of the ’60s).

So, here we are, with a public healthcare option being incredibly popular (65 percent according to a recent CBS/NY Times poll) and offering the only real chance we’ll get to keep the health insurance companies honest, but failing to get through a committee because a handful of small-state Senators with power disproportionate to the size of their constituency are unwilling to get behind it.

All of this is possible because we continue to hang on to an archaic procedural “safeguard.”

The public knows better than the pols: Reform health care now

There is no doubt that the American healthcare system needs to be changed.

The problem is that the public — the people who the reforms are supposed to help — doesn’t seem to understand how the amorphous change that has been placed on the table will fix things.

A mix of over-the-top and unhinged opposition from the far right and the GOP (are they the same thing at this point), a hands-off approach on the part of the president (until recently) and an overly technical and ridiculously complicated plan that may or may not include the one thing the public does understand (the public option) has created a level of confusion that is going to be difficult to overcome.

Consider this information from the poll released today by The New York Times:

Majorities of respondents said that they were confused about the health care argument and that Mr. Obama had not a good job in explaining what he was trying to accomplish.

“The Obama administration seems to have a plan, but I’m not understanding the exact details,” Paul Corkery, 59, a Democrat from Somerset, N.J., said in a follow-up interview.

However, and this is key, he continues to work in an environment in which the public is more likely to believe what he has to say than his opposition.

By a margin of 52 percent to 27 percent, Americans said Mr. Obama has better ideas about overhauling health care than Republicans. And the percentage of Americans who approve of how Mr. Obama has handled health care has gone from 40 percent in August to 47 percent now, about equal to where it was earlier in the year.

On one of the most contentious issues in the health care debate — whether to establish a government-run health insurance plan as an alternative to private insurers — nearly two-thirds of the country continues to favor the proposal, which is backed by Mr. Obama but has drawn intense fire from most Republicans and some moderate Democrats. The poll suggested that Mr. Obama’s big effort to deal with concerns about the health care plan has enjoyed, at best, mixed success. In the poll, 55 percent of Americans said Mr. Obama has not clearly explained his plans for changing the health care system, and 69 percent said they thought the health care reforms under consideration in Congress was confusing.

What does all of this mean? First, the numbers make it clear that the public wants a change in the healthcare system and trust the president more than they trust the GOP. And, perhaps more importantly, the public is smarter than the politicians. It is the public, after all, that views the dance happening in Washington over health care as unnecessarily uncomplicated.

The public understands the benefits of a public option — that competition from a government run program would keep the healthcare companies honest — and that forcing people to carry insurance without giving them someplace to go aside from the insurance companies is nothing more than a huge government giveaway.

The danger right now is that the current parameters of the argument are focusing on the wrong things — the deficit, for instance. We should be talking about what a lack of health insurance means for us and our neighbors, how it leaves too many vulnerable to illness and the economy, and how that vulnerability is bad for society as a whole. We should be focusing on how the system fails us every day and offering a clear plan to address it.

We should be talking about a single-payer system, which would remove profit from the system (health care companies boost profits by denying care) and place all of us on an equal plane. I know that is not going to happen at this moment in history, so we need to push hard for a public option and use the public option to prove to our neighbors and friends that a public plan is better for all of us.

First response: Obama makes his case and hits a long double into the gap

President Barack Obama laid down the ganlet tonight (drew his line in the sand, pick your cliche) on healthcare tonight, with an hour-long speech that finally made it clear that he is committed to “a not-for-profit public option available in the insurance exchange” that “would only be an option for those who don’t have insurance.”

That’s the good news. The bad news is that he’s leaving it to Congress to craft the mechanism that gets us there, meaning we could be left with a weak “trigger” compromise on a weak reform compromise — a public option, which falls far short of the single-payer system we need, that only kicks in if other reforms fail to extend coverage or reduce costs.

And just as worrying was his rhetorical nod to deficit reduction — a problematic way of framing a debate that should be about a societal commitment, a moral commitment to those in need.

Ultimately, however, the speech’s importance may lie in its role as personal marker. President Obama finally came out and explained why healthcare reform was necessary. (I was out and didn’t get home until after the speech, so I’m relying on the text published by NYTimes.com.)

Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point. Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can’t get insurance on the job. Others are self-employed, and can’t afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.

We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people. There are now more than thirty million American citizens who cannot get coverage. In just a two year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.

But the problem that plagues the health care system is not just a problem of the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, you’ll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won’t pay the full cost of care. It happens every day.

He hit the crazies — the people engaging in “demagoguery and distortion” — hard:

But know this: I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it. I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what’s in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.

So yes, a good speech, an effective speech, but it remains to be seen whether he’s already given up too much.

Grassroots: Health Fight is About Organizing

Progressive Populist column is on their site — here. It’s on the healthcare fight (what else?)

Contrary viewpoints — Part 2: More on Whole Foods

Michael Pollan, the great food writer, publicly stated his opposition to the boycott of Whole Foods. Not that he agrees with the company’s CEO, John Mackey on healthcare, he just believes that the good the company does in improving Americans’ diets is too important to jeopardize:

John Mackey’s views on health care, much as I disagree with them, will not prevent me from shopping at Whole Foods. I can understand why people would want to boycott, but it’s important to play out the hypothetical consequences of a successful boycott. Whole Foods is not perfect, however if they were to disappear, the cause of improving Americans’ health by building an alternative food system, based on more fresh food, pastured and humanely raised meats and sustainable agriculture, would suffer. I happen to believe health care reform has the potential to drive big changes in the food system, and to enlist the health care industry in the fight to reform agriculture. How? Because if health insurers can no longer pick and choose their clients, and throw sick people out, they will develop a much stronger interest in prevention, which is to say, in changing the way America feeds itself. When health insurers realize they will make thousands more in profits for every case of type II diabetes they can prevent, they will develop a strong interest in things like corn subsidies, local food systems, farmer’s markets, school lunch, public health campaigns about soda, etc. So Mackey is wrong on health care, but Whole Foods is often right about food, and their support for the farmers matters more to me than the political views of their founder. I haven’t examined the political views of all the retailers who feed me, but I can imagine having a lot of eating problems if I make them a litmus test.

There is something to this, I guess, though I think he’s missing the potential use of the Whole Foods question as an organizing focal point. But I respect his reasoning, given the difficulty of balancing his two beliefs.