Losing a sucker’s bet

With every passing day, Barack Obama is making it clear that he is willing to sell out his left flank.

The latest is this, from The New York Times:

The White House, facing increasing skepticism over President Obama’s call for a public insurance plan to compete with the private sector, signaled Sunday that it was willing to compromise and would consider a proposal for a nonprofit health cooperative being developed in the Senate.

The “public option,” a new government insurance program akin to Medicare, has been a central component of Mr. Obama’s agenda for overhauling the health care system, but it has also emerged as a flashpoint for anger and opposition. Kathleen
Sebelius
, the health and human services secretary, said the public option was “not the essential element” for reform and raised the idea of the co-op during an interview on CNN.

Mr. Obama himself sought to play down the significance of the public option at a town-hall-style meeting on Saturday in Grand Junction, Colo., when a university student challenged him on how private insurers could compete with the government.

After strongly defending the public plan, the president suggested that he, too, viewed it as only a small piece of a broader initiative intended to control costs, expand coverage, protect consumers and make the delivery of health care more efficient.

“The public option, whether we have it or we don’t have it, is not the entirety of health care reform,” the president said. “This is just one sliver of it, one aspect of it.”

Keep in mind that the public option was a rather weak alternative to real reform (single-payer), but that it was a mechanism that could expand coverage and keep the insurance companies that have been running our healthcare system honest.

The reality is that he lost his healthcare bet before he started — by allowing the muzzling of single-payer advocates and throwing his lot in with the conservative Blue Dogs in his own party. The Blue Dogs have never been serious about reform, and the more they control the process the more likely it is that we will get something the politicians will call reform but that patients and taxpayers will not.

Whose fuzzy math?

From the rightwing blog, Get Liberty, comes this little bit of wisdom and funky arithmetic:

According the U.S. Census Bureau’s 2006 report, “Income, Poverty, and Health Insurance Coverage in the United States,” 46.9 million people are uninsured in the U.S. There’s only one problem with this statistic: approximately 31.85 million of them do not actually exist.

The numbers really cannot lie, although the report does. Out of a total population of 297.05 million, the report states on Page 20 that the “number of people covered by private insurance was… 201.7 million in 2006” and the “number of people covered by government health programs was… 80.3 million in 2006.”

Therefore, 282 million had insurance. Which means that out of a total population of 297.05 million, 15.05 million did not have insurance. Right?

Not at the U.S. Census Bureau. There, 297.05 million minus 282 million equals 46.9 million Americans uninsured. How?

Well, call it “fuzzy math.” In the above figure, taken from Page 20 of Census’ report, the fine print reads, “The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of insurance during the year.” But, nobody can be covered by insurance and not covered by it.

In other words, some 31.85 million people reported as uninsured in 2006 did have some coverage, and the Census included them in both categories. Why? They were probably between jobs at some point during the year, which is not abnormal.

I debated whether I should comment on this, but it was so over-the-top disingenuous and has the potential to leak into mainstream arguments about health care that I thought it best to offer some commentary. It is an interesting way to look at the report, I guess, if you don’t mind ignoring what the numbers actually say.

Basically, the Census data shows about 47 million uninsured and and 250 million insured. The discrepency comes from the overlap — almost 32 million people were covered both by private and government plans, possibly at different times during the year.

This is what Robert Romano, the author of the blog post, is referring to above. He acknowledges what is happening, but then decides he has a better way of looking at the numbers than the report’s authors.

Again, I would have ignored this but disinformation has been the driving force for much of the healthcare debate, especially among those opposed to a public option (witness the public relations blitz trying to scare seniors into thinking the government wants them dead, or the attacks on public-run care that ignore Medicare and the VA).

If we don’t counter this kind of nonsense, it just floats out there into the mainstream.

Time for boldness on healthcare and everything else

President Barack Obama finally may be getting it. Seeking bipartisan support for healthcare reform will be impossible.

The president told fellow Democrats during a lunch “they might have to pass a bill with only Democratic votes if Republicans stood in the way.”

Senator Ron Wyden, Democrat of Oregon, said Mr. Obama was ready do battle. Mr. Wyden quoted the president as saying, “The White House is not a bad bully pulpit.”

Isn’t this what progressives have been saying since January?

And yet, maybe he’s not. The president remains unwilling to go to the mat for any specific healthcare goal, which could leave reform gutted and ineffective. The key to the plan outlined by the president is the public option, the government-run plan designed to compete with and drive down costs at private insurers.

The public option, to my way of thinking, falls far short of real reform — only a single-payer system can fix the mess that our healthcare system is in — but it is still better than the various
neutered plans being offered in its stead by so-called moderates.

The consumer-owned nonprofit cooperatives being floated, for instance, would lack the scale of the public option, making it far less effective as a counterweight to the insurance companies.

John Nichols of The Nation says progressives need to change the tenor of the discussion, extricating ourselves from “the narrow ‘debate’ between ‘party of no’ Republicans who favor no reform at all, and Blue Dog Democrats, whose ‘reform’ is to make a bad system worse.” Progressives, he says, “should just say ‘yes’ to real reform.”

Campaigning for single-payer in August – by demanding that members of the House agree to support such a plan when it comes up for a vote, and by urging senators to schedule and support a similar vote in their chamber – is the best was to assure that whatever reform ultimately comes will err on the side of Americans who need healthcare rather than insurance companies that would deny them that care.

Keeping single-payer off the table — done at the behest of the insurance industry by Congressional leaders whose campaign chests have been packed with insurance-industry cash — has meant that the debate has veered wildly to the right, despite the obvious support for reform among the public.

The polls, while not as favorable to the president as they were when the healthcare debate started, show that the public remains strongly in favor of reform.

A Time poll conducted late last month shows that 69 percent of Americans believe it is somewhat or very important that Congress pass reform within the next few months. The same poll found that 55 percent of voters believe the healthcare status quo was only fair or poor and that 60 percent believe the private health insurers are doing only a fair or poor job.

Voters also back expanded coverage by a two-to-one margin, even if that requires subsidies, and by an almost six-to-one margin they support a ban on denying coverage based on a pre-existing coverage.

And, perhaps most importantly, the polls shows support — 56 percent to 36 percent — for a public option and a bare plurality (49-46) favoring, yes, a single-payer system.

Basically, the public is on the right side of this debate and well out in front of the politicians.

But that should not be a surprise. The public is not getting campaign contributions from the health insurance and medical industries.

Which brings me back to the Nichols piece. He writes that the current outlines of the debate are more likely to lead to disaster than real reform.

The worst mistake that progressives could make in August would be to put their time and energy into getting members of Congress to agree to back a barely-acceptable compromise that could end up being unacceptable by the time the lobbyists and their political handmaidens finish with it.

Better to get representatives and senators to commit to back single-payer bills.

That does not prevent them from ultimately agreeing to compromise measures.

But it gets them to begin on the side of real reform, and lessens the likelihood that the eventual deals will be as bad as the schemes that the Blue Dogs tried to impose before the break.

And it could break the hold that the conventional wisdom has on Washington — including that notable change agent, Barack Obama.

The problem is, however, too many progressives are too wed to the president, too invested in his success to see that he has yet to make a real break with what Kevin Baker “the dogmas of the past.”

Baker, writing in Harper’s, compares Obama to Herbert Hoover, saying he has been unwilling to accept “the inevitable conflict” that has been bubbling up and that “Like Hoover, he is bound to fail.”

He has allowed “a parade of aged satraps from vast, windy places stepping forward to tell us what is off the table.”

Every week, there is another Max Baucus of Montana, another Kent Conrad of North Dakota, another Ben Nelson of Nebraska, huffing and puffing and harrumphing that we had better forget about single-payer health care, a carbon tax, nationalizing the banks, funding for mass transit, closing tax loopholes for the rich. These are men with tiny constituencies who sat for decades in the Senate without doing or saying anything of note, who acquiesced shamelessly to the worst abuses of the Bush Administration and who come forward now to chide the president for not concentrating enough on reducing the budget deficit, or for “trying to do too much,” as if he were as old and as indolent as they are.

Obama, rather than using a bully pulpit to push through a bold agenda, he has allowed boldness to die in the Senate and in discussions among what Baker calls the “’key men’ of the 1990s,” the men who helped create our current financial mess.

None of this should be surprising. Obama always has been a conciliator, rather than a battler, and has always needed a powerful push from his left before he has acknowledged — let alone followed — his more progressive instincts.

A major theme of Obama’s 2006 book The Audacity of Hope is impatience with “the smallness of our politics” and its “partisanship and acrimony.” He expresses frustration at how “the tumult of the sixties and the subsequent backlash continues to drive our political discourse,” and voices a professional appreciation for Ronald Reagan’s ability to exploit such divisions. The politician he admires the most — ironically enough, considering the campaign that was to come — is Bill Clinton. For all his faults, Clinton, in Obama’s eyes, “instinctively understood the falseness of the choices being presented to the American people” and came up with his “Third Way,” which “tapped into the pragmatic, non-ideological attitude of the majority of Americans.”

He adds that “Obama will have to directly attack the fortified bastions of the newest ‘new class’ — the makers of the paper economy in which he came of age — if he is to accomplish anything.”

These interests did not spend fifty years shipping the greatest industrial economy in the history of the world overseas only to be challenged by a newly empowered, green-economy working class. They did not spend much of the past two decades gobbling up previously public sectors such as health care, education, and transportation only to have to compete with a reinvigorated public sector. They mean, even now, to use the bailout to make the government their helpless junior partner, and if they can they will devour every federal dollar available to recoup their own losses, and thereby preclude the use of any monies for the rest of Barack Obama’s splendid vision.

Franklin Roosevelt also took office imagining that he could bring all classes of Americans together in some big, mushy, cooperative scheme. Quickly disabused of this notion, he threw himself into the bumptious give-and-take of practical politics; lying, deceiving, manipulating, arraying one group after another on his side—a transit encapsulated by how, at the end of his first term, his outraged opponents were calling him a “traitor to his class” and he was gleefully inveighing against “economic royalists” and announcing, “They are unanimous in their hatred for me—and I welcome their hatred.”

Obama should not deceive himself into thinking that such interest-group politics can be banished any more than can the cycles of Wall Street. It is not too late for him to change direction and seize the radical moment at hand. But for the moment, just like another very good man, Barack Obama is moving prudently, carefully, reasonably toward disaster.

Quote of the weekend, healthcare department

Gail Collins, in her back-and-forth with David Brooks on The New York Times Web site, has this to say about the absence of a single-payer option from the discussion on healthcare reform:

Since something like a third of the cost of health care is in administration, and the problem with reorganizing health care has to do with all the multitudinous plans and policies, a single-payer system would be far and away the most cost effective answer. We don’t talk much about it because it isn’t politically possible. But it isn’t politically possible because we don’t talk about it.

Well said.

The window’s closing on healthcare reform

Presidents only have a small window opportunity to get their agenda through, especially when it entails major shifts in public policy. President Barack Obama, unfortunately, has allowed the healthcare debate to drag on longer than he should have and now the road is growing more rocky with each day.

And yes, the president could have done much more much earlier, using the bully pulpit and riding his Congressional allies, even if the legislation ultimately is written in Congress.

If we don’t get the legislation we need, he will deserve a huge chunk of the blame.