The Abyss

Christ, exactly right. Absolutely "insane" to think otherwise, like the person says. At least someone knows the score. Will House Democrats listen?

Politico, Schmolitico. That headline could have been predicted to 6 decimal places. That's the story they wanted to run, had to run, couldn't have missed running.

But yes. This has to happen. People will calm down. This news cycle, and the next will pass. And in weeks, slowly but surely, the two alternatives will become clear in people's minds. Do the liberal Dems in firmly blue seats think their constituents will be more likely to kick them out for passing incomplete reform, or for deep-sixing real reform for another generation? And do the swing seats think that mercy will be shown them for having wimped out?

...and another thing. Passing the bill quickly is important in three ways:

1. Time is the enemy of progress. Much of last year was taking up debating this. Painstaking efforts brought both houses to actually pass something, each. Going back to square one is just not possible - November is just too close.

2. Doing this thing quickly is like lancing a boil. It's going to hurt (think: Glenn Beck weep-a-logues), and be messy (ditto), but the damn thing is over & done, and the pain of waiting is past.

3. This is where Obama becomes central. As has been said, until he was elected, the thought of actually electing a black President seemed impossible. Now, we kind of wonder what the big deal was. That's health reform, too. Once the bill gets passed, the "impossibility" tag, the curse of reform is gone and consigned to history. Aside from the far-out "repealers" (think: "birthers"), the reality of actual reform will change the way people see the world. The story of "will it happen?" is gone, the story then becomes "how will it work?", "who will benefit?", and for the Democrats, making sure the early benefits are widely known.

Remember: this pain can stop. It can be ended with one swift stroke. Then it will be amazing how quickly that can-do feeling will come back.

This is why the attempt to ram through something, anything, on a purely partisan basis was so idiotic in the first place. The bill as it stands is, for a variety of reasons, unpalatable to the broad public. Unfortunately, Jonathan Cohn lost his objectivity, and became deeply personally invested in a bad bill, really a pig-in-a-poke (anything wrong we'll fix later...right). The country, through various proxies, from polling to recent elections has said 'enough, stop!' Only now it's too late for a decent decision. Instead of debating Wyden's bill, which actually HAD a republican sponsor, the Dems (Pelosi most of all) acted like children, decided to go it alone, and will now ram this down the throats of an unhappy public, and hope the great unwashed come to realize what wisdom they had after all. "All will love me, and despair."

The argument that Dems have already voted for the bill, and can't avoid having to explain that in the fall is correct, but rather the smaller part of the problem, with not moving ahead. Pass the bill, flawed as it is, and they can at least defend it. ("Here's what you'll get out of this, citizen.") Walk away from it, and they are re-enforcing the narrative the Republicans want to use: Democrats came within an inch of passing this bill, but the Republican party SAVED THE COUNTRY at the last minute. "We beat them last winter and vote for me today, and we can make sure that they stay beaten."

There are very few situations where you can improve your own standing by handing your opponent a visible, dramatic victory upon which to build. Nothing succeeds like success, and nothing debilitates like failure.

Galston is right on the politics and Cohn is right on the policy. If the Democrats don't pass the Senate bill, it will confirm in the public's mind their suspicion that it was a bad bill and punish the Democrats in the fall. If the Democrats pass the Senate bill, the Democrats have ten months to convince the public it is a good bill, failing which the Democrats are no worse off politically than not passing the bill. On policy, if the Democrats don't pass the bill, any similar reform is dead, maybe forever, likely replaced by the Republican's plan for reform, which is to put everybody in the individual insurance market, an unenviable place (this from someone who has been in the individual market for over 20 years). As I have stated many times, the Democrats did a lousy political job selling reform. Don't compound the political error and commit a grievous policy error by failing to adopt the Senate bill.

The bill is not "unpalatable" to the broad public because the broad public has no idea what is in it. That's because, in the course of negotiating with the Republicans rather than taking the fight and using health care to destroy them, the Dems allowed the Republicans time, space, and opportunity for their inevitable campaign of lies and smears. It is a fact of American political life that people simply cannot seem to understand that if you are allowed the opportunity to repeat any lie, no matter how preposterous, without your opponents immediately getting in your face and at least cluttering the airwaves with counter-spin, in a very short time a significant percentage of the population will believe the lie. The more outlandish the better. Then you get the people who think that no one would say such a thing if it weren't true.

As for the claim by ds that the bill was "rammed through on a partisan basis," that is complete nonsense. As the Republicans in the senate were always going to work for no purpose other than to prevent any success by the governing party of any kind -- and have proven it to all but the most innocent and ingenuous -- NOT passing a bill on a partisan basis is the same thing as having no bill, meaning simply allowing the Republicans to govern the country and make a mess out of it, both when they are in the majority and when they are in the minority. That is absurd, no idiotic, no worse.

The smart thing to do is pass the senate bill -- which is the more conservative of the two and should be more to the liking of the country if the claims being made about what the public wants are to be believed (of course, those claims about what the country wants are objectively absurd, more self-serving crap for timid Democrats to choke on). Then the Dems can put up a bill to "fix" everything in the senate bill that the public supposedly doesn't like. Watch the Republicans filibuster that too.

"If we can't sell these things this year and before the election, we deserve to lose. "

Somewhere Ralph Nader is smiling, but it's hard not to feel this way. In 1993 the Dems committed political suicide to give the nation a decade of prosperity. The 2010 Democrats lesson from that should be "learn how to sell the long game to voters rather than treat them like myopic idiots." Instead, they seem to be saying to us "no good deed goes unpunished."

Roi, I think your animosity for "Republicans," whatever "they'" are, built up over years of political wars no doubt, clouds your thinking. As I said, Wyden's bill had a REPUBLICAN sponsor, and would likely have had broader acceptance with the public, in part because of that, than this absurdly complicated piece of crap. Yes the repubs were not going to agree to a bill in which they could not share the credit, a la the prescription drug bill. They are being obstructionist because the Dems decided to go it alone, albeit with a lot of dithering. Your "go to the mattresses" approach is exactlly what the public, through recent elections and polling (not making this up) has roundly rejected, yet you persist.

Am I the only one who saw that Cohn had posted an article titled "The Abyss" at 12:30 a.m. and thought he'd lost it due to the depressing developments this week? I figured he had gone goth or something.

Brown was elected because congress can't get anything done. To prove him right now is indeed suicide. And besides, who cares whether we hold the majority if we can't do anything with it?

Will

"They are being obstructionist because the Dems decided to go it alone"

Exactly wrong. The Dems have to go it alone because the Republicans are being obstructionist. Those few Republicans who have bothered to involve themselves in the negotiations kept finding new reasons to oppose or delay whenever the Democrats made an offer to address their concerns.

ds111 - how would you make this bill less complicated?

In what way did the Republicans ever offer to help in this bill?

Jonathan,
The only problem with your argument is that it suffers from the Antoinettesque assumption so typical of the progressive wing of the Democrat Party that the electorate doesn't like the bill because they're dumb. In reality they don't like the bill because it's a bad bill.

If someone tries to feed you turnips and you tell them you don't like them, are you going to react more positively if they say "Shut up and eat them because they're good for you," or are you going to react more positively if they say "I'm sorry I made a mistake. How about ice cream instead?"

Get real. Your judgment has become totally distorted because you are so invested in HCR and can't stand to admit that you've latched onto a political loser.

dthoh, you have not addressed the particulars of the bill, I mean: turnips? turnips? show me where in the bill it says anything about goddamn turnips? You know you got a weak hand when you go with bullshit analogies.

Everyone agrees the bill is not perfect, but we have no way of finding out how effective it is until it is tried, doing nothing is simply unacceptable. The US spends 17% of its GNP on health care, far more than every other OECD nation with middling results, and the cost will only go higher. Every other nation that has better results has a far, far more liberal policy than even this is. France spends 11%, has universal coverage, and better outcomes (and they are second in spending)
You have to either be mentally defective or a Republican to think things can continue the way it is. What is it with Republicans burying their heads up their asses so far that they can learn nothing from the rest of the world?

You simply can't rebut reality.

Wandrey, Wyden's Healthy Americans Act had multiple sponsors from both parties. It would have been universal, and dramatically simplified the system in the US, replacing medicaid, FEHBP, and Schip, and possibly medicare, with one easy to understand system, with discrete and honest funding. Managing the legislation soon to be approved will prove a mess, with enormous distortions, a likely substantial increase in costs, a likely comcomitant decrease in services and innovation all while still costing two or three times what other countries spend. Just like with education, another public good, where we spend substantially more than other countries with mixed results. We simply don't do these things well, owing in part to the structure of our political system. Set up simple ground rules with honest funding sources (primarily self-funding with some income smoothing), don't try to manage it from above, and leave consumers, providers, and even states to figure out the rest...they will. Same with education, same with pensions. Keep it simple stupid. Medicare is unsustainable, Social Security is unsustainable, public pensions are unsustainable, because it is too easy to make promises today and worry about funding them in the future, and now we're going to add this new open-ended commitment? I see the cat in the hat, balancing all those objects, until the moment they all come crashing down. It won't be pretty, I'm afraid. On a lighter note, nice nod to Yard the other day, wish we could all write with his flair.

I'm cross posting this (forgive me), but how about a discharge petition? These aren't secret -- all you need is one Dem to introduce the senate bill and then a discharge petition. If the Dems are going to kill this once in a lifetime opportunity for sea-changing health care reform, I'd like them to do it on the record and not be able to pass the buck to each other.

lymon, good idea, but I think Pelosi wants to keep her options open, this bill is good for the rest of this session, a lot of congressmen might see they are going to get clobbered without passing it, but in the heat of the moment they might panic and then it really is goodbye

ds111,

My animosity toward Republicans is the only thing that keeps my head clear and able to separate the rhetoric from the reality of American political life. What makes your thinking so fuzzy that you are unable to notice that the Dems did everything including backflips in order to gain even a single Republican vote in the Senate and only ended up handing the Republicans the means to screw them?

If you do not understand that the Republican party, as it has since 1932, will do anything in its power to screw things up on any Democratic watch, you are just not tracking the ball and will be continually confused by events -- as are our Democratic congresspeople.

ds111,

My very quick internet search on the Wyden-Bennett bill suggests that it was a decent alternative, probably a better alternative, to what emerged.

So, you explain to me, as I cannot see on the face of things, why this bill did not move forward. What was the source of the political opposition? I don't believe for an instant that it was because the Republicans would share credit, as you suggest, since that is what the Democrats have been desperately trying to get the Republicans to do. To believe your story, one has to believe that the Democrats spent six-months trying to get a even a single Republican supporter in the Senate with the real agenda of alienating all the Republicans so that the bill could only be passed with 100% Democratic support that required some hideous compromises that no one could stand. Not plausible.

By the end of debate, when decision is due, Republicans did what they always do in response to any policy initiative proposed by Democrats - they opposed it unreservedly and unconditionally. Practical healthcare reform remains a popular idea with the public, something that will benefit them. Increasingly over time, however practical healthcare reform debate became a debate of health care policy reform, something that interests the public not at all, something in fact the public is distrustful of, something that promises a changed system of healthcare insurance and delivery, that may serve the public's interest and needs , or may not. That was the abracadabra (or legislative jiu-jitsu) the GOP performed on healthcare reform. Reform itself was turned from something specific, concrete, prescriptive, into an abstract design. Then all it took, starting with Death Panels, was an attack on design - "Democrat design" as they might put it. That sounded suspicious, even sinister to worried consumers of healthcare. If there were so many dollars to be spent, how many would actually pay for better access to insurance that would in turn insure better care. Too indirect, too abstract, too *complicated* for the layperson to understand, therefore to trust. Even I got skittish as compromise on compromise, deal upon deal, altered the design of reform (as it certainly would have to), and how might those changes affect me, individually. Would I get anything good out of the bill, I asked myself, and despite all the assurances from this magazine and the best policy experts, I became worried that in the end there might well be no benefit to me yet I would be called on to bear my part of the cost, which could be in addition to my healthcare costs as they stand now. All cost, no benefit. That's what the campaign against was designed to do, raise the level of suspicion, but not a feeling of assurance.

The more lies and distortions the conservatives threw at the bill from every angle, eventually enough stuck like barnacles and slowed momentum. Finally, random events such as Massachusetts electing a Republican senator, tipped the scale. No matter what senator elect Brown said or still says about being willing to keep an open mind on healthcare reform, reform was effectively dead on rhetorical grounds - the Democrats had lost their chance to change the system to their liking, and there was no real alternative to turn to, other than the House passing the Senate version, etc., which sounded like an end run, a hail Mary pass, a desperate and (oh I hate so much to say it) illiberal move.

If the Dems pass health care reform, they win and we're still spending twice what we should on health care. If the Repubs win we're still spending twice what we should on health care. The problem has been the bi-partisan staunch agreement to keep relying of for-profit insurance. Corporate campaign dollars and lobbying assured that. The Dems are in trouble because the country is seeing, fairly rightly, that they are about as beholden to short term corporate profits as the Repubs.

A prescription: Obama and the Dems go full bore on pushing a constitutional amendment to declare that only people are persons.

I am grateful to ds111 for reminding us about the Wyden-Bennett Healthy Americans Act. I doubt if anyone in Congress knows more about, or has worked harder on healthcare reform than Ron Wyden, and the bill has many positive features--perhaps most positive, TEN REPUBLICAN CO-SPONSORS, absoulutely destroying the sour-grapes meme that Republicans just want to say no to anything.

In all the sturm-und-drang about the Reid/Pelosi monstrosity, I forgot about Wyden, who had my support in his efforts long ago. Is it not possible to simply drop the current fiasco and vote in Wyden-Bennett. If not, why not?

And while we're at it, can't we also drop Reid and Pelosi?

I just perused Wyden's website and its explanation of the Healthy Americans Act. I frankly don't see much difference between it and the two bills that were recently passed by the respective houses. It purports to provide consumers with a "choice" of insurers, including employer sponsored policies, via some state-administered programs (exchanges), purports to provide more information about the policies through the state agencies, includes a mandate, and includes subsidies along the lines of what the two pending bills provide for. What I don't see anywhere in the summary is how the subsidies and state programs will be funded, even though the site claims that it will pay for itself.

So what's the difference? The Wyden bill never got out of committee. I am highly skeptical that, had the bill come out of Baucus' committee, it would not have met the same uniform resistance by the Republican 40.

I doubt that ten GOP co-sponsors would be on board when push comes to shove.

If you cannot see the difference, maybe the Wyden bill more or less is what came out of committee, by whatever rubric -- shorn of its GOP supporters of course.

Well, it's fairly evident that the GOP's strategy is uniform opposition based more on politics than on the merits. But even if one assumes that the GOP opposition to the current bills is substantive, I can't see how the Wyden proposal is sufficiently different to overcome the opposition. If the GOP is taken at face value, it wants to see greatly expanded coverage, but believes the current proposals will cost too much; they will increase the deficit, require increased taxes (either on the wealthy or on the more expensive employer-based insurance plans), and will not succeed in slowing the growth of medical costs or insurance premiums.

I actually think the GOP may be right. I have no problem increasing taxes to pay for the subsidies required to achieve near-universal coverage in a private insurance market, but without some combination of a public option and/or repeal of the anti-trust exemption and/or caps on premiums and/or regulation of medical costs, I don't see what will prevent a spike in premiums and medical costs that will price millions out of the market, even with the subsidies. But all of those things are anathema to the GOP, and therein lies the GOP's hypocrisy.

And, again, I don't see how the Wyden proposal would contain costs, though his website conclusorily contends that it would.

I don't have a pipeline to the Republicans, but I think the main difference for them between Wyden and the current Senate bill is that it is much more oriented to state control over federal. At the end of the day, co-sponsorship of a bill is not something Senators take lightly, and Wyden has plenty of it.

I think it didn't make it out of committee because the agenda of the Congressional leaders was to grab more power for Washington, and more credit for "their" Congress.

dh - true, sponsorship does not equal a vote, especially given the likelihood of changes that a sponsor may dislike, creating an easy out - for it before i was against it.

roi - fuzzy thinking...and confused? dear me! thanks for the concern

Wyden-Bennett was opposed by single payer and public option advocates because it is a private insurance based model, and by Obama because he had campaigned that "if you like your insurance, you can keep it." Ideally, we should separate health care/insurance from employment, but he had committed to the opposite idea, and felt the change would be too radical, and dumped it along with single payer.

I'm not sure that WB wouldn't have turned out just as messy had it been taken up by congress and the WH. I'm just pointing out that it was the ONLY proposal to start out with bipartisan support - in the Senate, at least. It is a somewhat radical plan, but anything that can attract such an unusual cross-section of support deserved more support from the WH, whatever was said on the campaign trail. Biggest mistake to date in my view, missing a real chance to lock in a major political and policy success.

Not at all, ds111. It is I who should be thanking you for pointing out that my thinking is "clouded."

My unsubstantiated suspicion about WB is that it was the legislative equivalent of perpetual motion. It all sounded great, but was not executable. Thus, very easy for politicians to endorse but useless when scrutinized. I still do not find it remotely plausible that Democrats disdained an alternative functionally equivalent to what was adopted -- or better -- just for the purpose of claiming "sole credit." The head of an organization gets credit, and should take credit, for everything good that happens. The Democrats would still receive credit for a successful bill. That is exactly what the Republicans are hell-bent to deny them.

I am stilling missing something RP and ds. The GOP would like the Wyden bill because it is more oriented to state control? How is that so? Aren't the exchanges under the Senate bill state-run? And, in any event, how would the state-control orientation address the GOP's purported cost concerns? What does the Wyden bill do to contain costs that the Senate bill does not do?

As to keeping your insurance if you like it, though the Wyden bill purports to provide greater choice, does it not nevertheless permit one to keep whatever insurance they have, including employer-based insurance? As to being opposed by single payer and public option advocates because it is a private insurance based model, that is also true of the Senate bill. So, again, what is the substantive difference between the Wyden bill and the Senate bill that would cause the GOP not to oppose the Wyden bill?

"still" missing something

Very thorough of you, dhurtado, but you are barking up the wrong tree. These guys are merely wielding a chimera -- the magical Wyden-Bennett bill that would give everyone but the evil Pelosi and Reid what they want -- only for the purpose of discrediting the two extant bills. They don't know what is in W-B or the current bills that Republicans would either support or object to because the Republicans will never say -- that is, they will never state any concerns that could be addressed -- other than the 170 that resulted in the acceptance of their amendments -- because they might get what they ask for and have no more excuse to say no.

That's my perception as well roi. Some Republicans likely purported to support Wyden because it eschewed a public option at a time when the other proposals still had a public option. Then, when the Senate bill essentially coopted the Wyden bill, the GOP still opposed it. They got what they asked for and they still said no.

Hope to come back later, for now though you guys sure are cynical!

Well, I am no expert ds, and I am open to having it explained to me what would make the Wyden proposal acceptable to at least 10 Republicans, while the Senate bill was anathema to all 40.