Believe it or not, it’s becoming possible to get a feeling for how the health care reform struggle may play out this fall.
The House will almost certainly pass a bill that includes a “public option.” The Senate won’t; any Senate bill will almost certainly be based on some version of the “health care cooperative” idea. Votes in both Houses will be very close, leaving little room for error. In the Senate, vast concessions will have to be made, on the bill in question and on other issues, to get to 60 votes, and even then, a couple of Democrats will vote “no” and a couple of Republicans will have to be pulled across the line. Perhaps a couple more Democrats will vote for cloture and then vote against the bill itself.
Then the real fun will start, in a House-Senate conference where the White House will be a very active player. As Jane Hamsher reminds us, enough House Democrats have pledged not to vote for any bill that doesn’t include the public option to sink a conference report. And Sen. Kent Conrad is probably right that there aren’t and never have been 60 votes for a plan with a public option in the Senate.
So somebody will have to flinch, and that’s where it will become important to pay close attention to all the less-prominent, but potentially critical, issues that will be at stake.
At TAPPED today, Dana Goldstein has a good list of those issues, including the size and strength of cooperatives, the breadth of a Medicaid expansion, coverage of legal immigrants, and the adequacy of subsidies.
It’s possible, of course, that House progressives and Senate centrists will get so dug in on the public option issue that no conference report can be crafted that can get a majority in the House and 60 votes in the Senate, and nothing at all will happen this year even if there is substantial agreement on other issues. That’s why it’s pretty important that the White House and the congressional leaders tell Members from all factions to stop issuing public threats that this or that provision is a deal-breaker. They should also strongly discourage participation by Democrats in any bipartisan “gangs” that purport to control the outcome (e.g., the one that has already formed to control the Senate Finance Committee markup). A deal that works in one House probably won’t work in the other, and promises to impose provisions on one House or the other in a conference committee aren’t worth a whole lot. So it makes abundant sense to push back the ultimate bargaining to big barbecue that will be held at the very end of the tunnel.

The remarkable 2008 presidential election isn’t that far in the rear-view mirror. But as many arguments about alleged contradictions between Barack Obama’s campaign message and his current agenda show, memories fade quickly, and history quickly becomes spin.
So it’s a very good thing that Dan Balz and Haynes Johnson have published an old-fashioned, Teddy-White-style Big Campaign Book that captures what actually happened in 2008, enriched by lots of insider interviews and some sure-footed analysis of events as they occurred.
I’ve written a review of the book (The Battle for America 2008: The Story of an Extraordinary Election) for the Washington Monthly, which in advance of their print edition is available online here.
I offered a lot of praise for the book’s command of details and its handling of several key issues, from Hillary Clinton’s fateful decision to go for broke in Iowa, to John McCain’s vetting process for Sarah Palin. I had a few criticisms as well, but the more I hear people mangling the facts about this election, the more I am grateful for Balz’s and Johnson’s efforts to set the record straight.

One of the best-known ironies of the health care reform debate is that beneficiaries of the government-run Medicare program are perhaps the least likely category of Americans to support universal health reform. There are many jokes and anecdotes about Medicare beneficiaries angrily telling Members of Congress to “keep the government out of my Medicare.” And unsurprisingly, some reform proponents suspect that folks on Medicare have an “I’ve got mine” attitude about health insurance based on indifference to the plight of the uninsured or a general antipathy towards Obama or “liberals.”
But I’m guessing there’s something more than sheer ignorance or selfishness at play here: a sense that Medicare, unlike the insurance that would be offered along with subsidies under the proposed reforms, is an earned benefit, while government-provided or -financed health insurance for non-retirees is welfare.
That’s at best partially true. Current payroll taxes and premiums cover a little over half of Medicare expenditures (though even there, it’s important to understand that it’s current workers’ payroll taxes, not “banked” payroll taxes from retirees, that we are talking about); the rest comes from general federal revenues. Moreover, only the poorer beneficiaries of a new system would get anything like full federal subsidies for their premiums. So Medicare’s not fully an earned benefit, and the new benefits won’t be fully “welfare.”
But these are powerful perceptions, and not the sort of thing that pollsters have been looking at lately, so far as I can tell. And the idea that many of the currently uninsured will be given something that Medicare beneficiaries don’t have–not the insurance itself, but the means to pay for it–helps explain why lots of retirees feel no particular solidarity with the uninsured, and are open to right-wing arguments that health reform is an exercise in “socialistic” big-government “redistribution.”
Now I do not recommend that reform proponents deal with these perceptions by lecturing Medicare beneficiaries that they are themselves “on welfare,” though it remains important to remind them that Medicare is a government program, and that government’s role in the new system will be more as a catalyst than as an owner-operator. But the better approach is probably to stress the fundamental idea of universal insurance against medical circumstances beyond anyone’s control, and the injustice of losing access to health care because you get sick, your employer drops coverage, or your premiums keep going up. The truth is that most beneficiaries of health reform will be middle-class working folk with bad luck; that reform is the best way and the only way to get costs under control; and that everyone will benefit from a country where everyone has health insurance.

With Obama now meeting friendly crowds as he tours the country and with other local town hall meetings becoming less confrontational, it is starting to look like the Dems may be regaining their balance and stabilizing the situation.
But it would be a major strategic mistake for Democrats to minimize or dismiss the setbacks of the last few weeks as just an unavoidable speed bump in the campaign for health care reform. The decline in public support for the current Democratic attempts to design a health care reform package — and more specifically of support for Obama’s handling of the issue — must be considered troubling – especially the drop in support among political independents. Moreover, in a deeper tactical sense the Dems temporarily lost control of the health care narrative – the national debate stopped being about the major elements of the proposed reforms and became a shouting match on the opponents’ issues and terrain
The increased opposition – which was particularly notable among the active town hall protesters but also visible among a significantly wider group of Americans – was not generally a response to the actual provisions of the various proposed bills. Rather, it has been about something else. At the town hall meetings the protesters generally raised much broader objections – against “the government taking over everything”, “the systematic dismantling of this country”, “the government playing God” or “turning us into Russia” or “undermining the constitution.” All these suspicions – which were deliberately stoked by the Astroturf firms but which were sincerely expressed by the individual protesters – reflected a deeply held fear that something was being foisted on average Americans that was far more than just a new social program. Their comments charged that the Democrats health care reform plans were actually a Trojan horse for something deeply and profoundly sinister.
It is easy to dismiss this as simply irrational, but it is important for Democrats to understand how this view became politically significant.
When he took office, Obama immediately had to manage massive government intervention in both Wall Street and the Auto industry – interventions almost entirely conducted in private, closed-door negotiations – and also to create a recovery program that vastly increased the federal deficit. Opinion polls revealed, however, that people basically blamed the Republicans and accepted that the government could not avoid taking significant actions.
Conservatives first tried to create opposition to Obama by calling his measures “socialist,” but this line of attack provided relatively little traction or resonance (Several polls actually demonstrated that “socialism” was no longer an effective “scare word” , particularly among the young, and focus groups conducted by the U.S. Chamber of Commerce revealed that for many Americans the word “capitalism” actually had very negative connotations of greed and of the powerful dominating the vulnerable)
Conservatives then switched to the term “fascism” and particularly the German, “Nazi” version of fascism. The one superficial analogy they offered for this accusation was that the major fascist countries during the 1930’s had also included extensive government intervention in industry but to liberals the accusation seemed obviously absurd because the two central features of Nazi fascism — the creed of Arian racial superiority and the ethos of glorious national military conquest — seemed so utterly and self-evidently right wing rather than left-wing ideals.
But in fact, what the conservative propagandists like Rush Limbaugh, Glen Beck and Bill O’Reilly had done was essentially to redefine the word fascism to something entirely different from its original definition. In their vocabulary it has now essentially become a synonym for “coercive liberal social engineering” or “creeping liberal totalitarianism” – it is the image of pointy-headed Harvard liberals using the coercive power of the state to impose left-wing values and behavior on average Americans

Read more…

Hopefully, most TDS readers saw at least a news clip or two of President Obama’s successful town hall meeting in Montana on Friday. For those who didn’t, the next best thing is to read Mike Lupica’s column in today’s Daily News. Lupica leads with the view of a woman who watched the town hall in an airplane hangar in Belgrade, Montana:

“Yes, there were a few protesters en route. But the Montanans who were excited to hear the President far outnumbered the fringe groups.”…Then she said this about Obama: “He was smart, fair, funny.”

Lupica adds,

…This wasn’t an occasion when people with legitimate concerns and legitimate points to make were overwhelmed by the wing nuts and screamers who take their marching orders from right-wing radio and television and the Internet…Those idiots come to these town hall meetings more to be seen than heard, and think creating chaos makes them great Americans.

Lupica, known to most of his readers as a tell-it-straight sports writer, doesn’t mince words:

Those people have been convinced by the current culture that we are dying to hear from them, and the louder the better. People who think that all they need to star in their own reality series is a couple of TV crews…We hear that all of this is democracy in action. It’s not. It’s boom-box democracy, people thinking that if they somehow make enough noise on this subject, they can make Obama into a one-term President…The most violent opposition isn’t directed at his ideas about health care reform. It is directed at him. It is about him. They couldn’t make enough of a majority to beat the Harvard-educated black guy out of the White House, so they will beat him on an issue where they see him as being most vulnerable.
…With that kind of zealotry, screaming about government programs as if Medicare isn’t one. It is why so many of them, all these wild-eyed red faces in the crowd, look completely certifiable, screaming about how Obama wants to kill Grandma, as if he’s suddenly turned into Jack Kevorkian.
…They couldn’t win the fight last November, when he laid out John McCain and Palin and a whole party with one election, so they try to do it now, with lies and rather amazing distortions. They want everybody to believe that if Obama gets his way, he’ll eventually be in charge of insurance and doctors and whether you use CVS or Duane Reade. He’s a Socialist selling socialized medicine. He’ll kill Grandma. Come on. The notion that this is all honest dissent is just one more lie.
Even in Montana, the Swift Boaters who would line up against any health care plan endorsed by Barack Obama ran one television ad 115 times over a day and a half before the President arrived.

The President himself, quoted by Lupica, summed it up well:

“Every time we are in sight of health insurance reform, the special interests fight back with everything they’ve got,” the President said outside Bozeman. “They use their influence and run their ads. They use their political allies to scare the American people.”

Yes, we know, some protestors are sincere and fair-minded, even when not well-informed. But the health care swiftboaters being mobilized to preserve the status quo need to be called out, and this morning Mike Lupica did just that. You can watch President Obama’s Saturday town hall meeting on health care reform in Grand Junction, CO on Saturday, on C-SPAN right here.

UPCATEGORY: Democratic Strategist

This item by TDS Co-Editor William Galston was first published at The New Republic. We offer it as part of the ongoing debate over President Obama’s political strategy.
While the attention of politicians, pundits, and the people is focused on the increasingly bitter debate over health insurance reform, economic developments will have a more profound effect on the well-being of the nation and the fortunes of the Obama administration. Only an economy that provides a steady stream of new jobs and raises personal income can yield enough revenue to restore public confidence and finance the government we need.
As the economy struggles to stabilize, we find ourselves in a deep hole–even deeper than we knew. For the first time since the Great Depression, Floyd Norris reports that we have endured a decade with no private sector employment growth. In July 1999, there were 109 million Americans with jobs in the private sector; the comparable figure for July 2009 was … 109 million. By contrast, at the depth of the 1981-82 recession, private sector job creation over the previous decade still averaged about 1.5 percent per year. Until the current downturn, Norris finds, the long-term annual growth rate for private sector jobs had not gone below 1 percent for nearly half a century.
Some parts of the private sector did much worse. Manufacturing employment, which stood at 18.4 million in July of 1999, plunged to 11.8 million–a 36 percent loss.
What can we expect over the next few years? Although there are many imponderables, a few things seem clear. Household debt, which peaked in 2007 around 130 percent of disposable income (almost twice the 1985 level), must come down substantially. Household wealth, which has taken a $14 trillion hit over the past 18 months, must be rebuilt. To do this, the savings rate, which dipped below zero in the middle of this decade, will have to rise substantially, and consumer spending, which propelled economic growth for much of the past two decades, will constitute a lower share of GDP. We will have to grow the old-fashioned way, through productive investment in innovation and human beings rather than with money borrowed for current consumption. The economic gears are likely to grind for some time before they shift. Growth and job generation will probably be slower than in recent decades until we complete the transition to a post-consumer economy.
There’s no consensus on this point, however. Writing in The Wall Street Journal, Justin Lahart argues that employment is likely to recover more rapidly from this recession than it did in the previous two downturns. His reason: So many of the lost jobs have been in the service sector, which has a more pressing need than manufacturers to rehire workers as demand recovers. Moreover, the historical record suggests that the economy bounces back faster from steep recessions than from shallower ones. In the previous edition of the WSJ, Zachary Karabell suggested just the reverse: Larger companies benefit from their ability to focus on where the growth is or is likely to be. “As these companies profit from global expansion and greater efficiency,” he says, “they have little or no reason to rehire fired workers, or to expand their work force in a U. S. that is barely growing.”
Lahart and Karabell could both be right, of course–Lahart in the short term, Karabell in the long run. And in fact, a number of economists are raising their estimates for the next two or three quarters while predicting slow growth (2 percent or so) after that.
This is not a happy forecast, either for the country or for the Obama administration. It would mean stubbornly high unemployment, meager increases in disposable income, and continued revenue shortfalls at every level of government–hardly the formula for a contented citizenry in 2012, or for a comfortable reelection campaign.
In this challenging context, the president would be well advised to focus more on the economy over the next three years, and to persuade average Americans that the economy is as central to his concerns as is it to theirs. That means taking what he can get on health care and climate change and clearing the decks well before the end of the year. It means going on the road to highlight the job-creating results of the stimulus bill, with events each week for as long as it takes to make the sale. And it means crafting proposals design to stimulate new hiring, not just in the long run, but as soon as possible. A revenue-neutral swap of lower payroll taxes in return for broadening the base of the income tax code could command support even among some Republicans.
A jobless recovery helped undermine George H. W. Bush’s reelection prospects in 1992. Its continuation weakened support for Bill Clinton’s economic program and contributed to the Democratic Party’s rout in 1994. If President Obama’s political team is as good at governing as it was at campaigning, it will get on the jobs case–starting now.

Don’t be shocked. But apparently not all of the Town Hall Meetings being held across the country can be likened to episodes of the Jerry Springer Show, as John Stanton reports in his Roll Call article “Democrats Orchestrate Town-Hall Counterpunch.”

White House Press Secretary Robert Gibbs on Thursday argued that despite extensive media coverage of the protests at some lawmakers’ town halls, “I hate to break it to you: I don’t think all the town halls are as you’re seeing them on TV. … While I appreciate that you all have decided that every town-hall meeting ends in pushing, shoving and yelling, I don’t think many, well, I don’t know how many town halls you all have been to. They’re not completely indicative of what’s going on in America.”
The DNC released a statement arguing that “outside the echo chamber of 24-hour cable news, Americans all across the country are attending town halls, holding coffee shop conversations and engaging in respectful, honest debates about the best way to achieve health insurance reform.”
The DNC release pointed to events in North Carolina, Virginia, Pennsylvania, California, Indiana, Ohio, Washington state and other areas that have not featured the kind of ugly protests that have been the focus on national news reports…Similarly, Speaker Nancy Pelosi’s (Calif.) office Thursday afternoon released a similar “fact sheet” detailing events where no protests occurred.

At The Atlantic‘s ‘Politics Blog’, Chris Good adds:

…Freshman Rep. Eric Massa (D-NY), who unseated a Republican in typically conservative upstate New York to enter Congress this year, held a town-hall with 200 constituents that “felt Lincoln-esque in its nature,” according to the Rochester Democrat and Chronicle; Sen. Sherrod Brown (D-OH) thought the audience members were “respectful” at a recent event, despite sometimes contentious debate; opponents of health care reform filled up “about half the seats” at a town-hall hosted by Rep. Sam Farr (D-CA), according to a post on Daily Kos, but no disruptions occurred; “this is democracy,” Rep. Gwen Moore (D-WI) said after an event in her district that drew opponents and supporters of reform alike.
The liberal group Americans United for Change (part of the liberal interest-group coalition backing the Democratic/Obama health care reform initiative), likewise blasted out a similar list of peaceful town-halls via e-mail, including a video link to local news coverage of one in Charlottesville, Virginia, where freshman Rep. Tom Perriello (D) was backed up by a predominantly pro-reform crowd…The group forwarded a Philadelphia Inquirer story, highlighting how a health care town-hall hosted by Rep. Joe Sestak (D-PA) had gone similarly well.
“About 650 people – diverse in age, race, and occupation, but nearly all supporters of a health-care overhaul – last night crowded into a Center City church for a town meeting with U.S. Rep. Joe Sestak (D., Pa.) that, in sharp contrast to recent gatherings across the country, was overwhelmingly civil.,” the Inquirer reporters wrote.
Some of these examples are taken from strong Democratic districts; some are taken from swing districts and states recently represented by Republicans. The message is less that everyone is behind President Obama’s plan, and more that town-halls aren’t all messy, ugly disruptions–that while the media loves to talk about the frenzied unpleasantness, that’s not what’s going on everywhere, and August isn’t really just a big anti-health-care-reform bloodbath.
The new Democratic message is: civil discourse is happening around health care, and in that regard the White House is making progress on reform, with a healthy, national discussion. It’s not as sensational as a roomful of screamers, but if you read the papers, you’ll see it.

Stanton’s article cites polls indicating sympathy with the town hall protesters, after respondents viewed protests, and that is a concern. Wonder how they would have responded after watching the more numerous town hall meetings, like the one in Charlottesville, which were conducted with civility. Guess they weren’t deemed poll-worthy.

The single most frustrating aspect of the health reform debate is the tendency of journalists to report claims about the substance of this or that proposal as presumptively of equal validity, facts aside. Aside from its effect on this particular issue, “he said she said” journalism creates a general incentive to lies, gross exaggerations, and polarization, since outlandish claims will get equal time with reality-based analysis.
That’s why it’s very helpful to have people out there who are doing some serious, credible and sustained truth-squadding. As you may know, an outfit called Politifact has been conspicuously trying to play this role on health care reform, assessing arguments on a scale that ranges from “true” to “false” to “pants on fire.”
At the acadmic site Monkeycage, John Sides usefully looks at Politifact’s overall ratings of arguments for and against Democratic health reform proposals of late, and makes it clear which side has been playing fast and loose with the facts. He charts it up nicely, and then observes:

As you can see, and as Politifact editor Bill Adair has noted, the claims of Republicans and opponents of health care are much more likely to be false than true. Overall, 76% of their claims (16 of 21) are either “false ” or “pants on fire.”
They are also more likely to be false than are claims of Democrats and supporters of reform. Overall, 28% (5 of 18) of Democrats’ claims are “false.”
Finally, Obama has been more truthful than either Republicans/opponents or other Democrats/supporters: 22% of his claims have been “false” (2 of 9); more than half have been “mostly true” or “true.”

This probably comes as no surprise to progressives who have been following the debate and the increasingly crazy claims being made about “Obamacare,” but it’s good to see it validating by someone with no stake in the outcome.