If you’re interested in the broad outlines of what House and Senate conferees will be grappling with in reconciling their health care reform bills, take a look at Paul Waldman’s American Prospect piece on the top ten conference issues.
What’s most interesting about the less-visible but important issues at stake is that several have big implications for the future shape of health care in this country. One is pretty much settled: the bill if enacted will almost definitely put a final stake in the heart of Medicaid’s vast inequalities between states in eligibility (unless, of course, some sort of general state opt-out is authorized). Another is the collateral attack on the employer-based system of private health insurance via the Senate’s excise tax on high-cost plans, and its small opening to Sen. Ron Wyden’s proposal to let some employees covered by particularly bad employer plans to join the new health insurance exchanges. And still another is the principle, all but gutted in the Senate bill but still maintained by the House, that the health care system, beginning with Medicare, should finally begin separating the sheep from the goats in terms of effective and ineffective treatments.
It’s very likely that media coverage and public controversy over the conference will continue to focus on total public costs, new taxes, subsidy levels, the individual mandate, and the ghost of the public option. But in the long run, other deals may represent the real deal on health care reform.
Ed Kilgore
Even before Congress negotiates the still-difficult straits of final action on health care reform, a debate is heating up, not least among Democrats, about whether or not to move on to climate change legislation.
Said legislation has already very narrowly passed the House, albeit in a form that disappointed many progressives to the point of near-disgust. But it’s important to note that there are two very different perspectives among those Democrats urging the administration and the congressional leadership to defer Senate action on climate change to later in 2010, or beyondf.
The first perspective is indeed ideological, but doesn’t neatly follow the moderate/progressive battlelines of the health care debate, despite Politico‘s claim today that “Senate moderates’ are the ones objecting to immediate action on climate change. As is always the case with energy and environmental issues, this is one matter where regional and home-state politics can still trump general ideology or partisanship. It’s no accident that “moderate” Mary Landrieu from the energy-producing state of Louisiana is in the front ranks of those calling for a delay in climate change legislation, or that “moderate” Joe Lieberman from the energy-consuming state of Connecticut, and no friend of the Obama administration or the Democratic Party, is heavily involved in efforts to move a bill. On the positive side of the ledger, this is the rare issue where some Republican votes are potentially gettable, which has been the focus of Sen. John Kerry’s efforts to work with Sen. Lindsey Graham of SC on a nukes-for-climate-change deal.
So a good understanding of each senator’s energy-industry links, or the lack thereof, is as important as ideological lables in predicting his or her behavior on climate change.
But the second go-slow or no-go perspective on climate change has little to do with ideology, and everything to do with political calculations. Like TDS Co-Editor William Galston, some Democrats think it is absolutely essential that the administration be seen in 2010 as obsessively focused on jobs. Yes, it’s possible to sell climate change legislation as a “green jobs” initiative that’s actually essential to long-term economic growth, but so long as we are dealing with double-digit unemployment rates, anything that can be caricatured as elevating the “green” over the “jobs” could be politically very hazardous.
One of the most commonly heard counter-arguments to the political case for putting climate change legislation on the back burner is the observation that this is the sort of initiative that progressives are elected to office to promote, and if they can’t get it done with a Democratic White House and 60 Democratic senators, when will it ever happen?
But in any event, it’s helpful to sort out the various substantive and political arguments on this subject, instead of imposing a cookie cutter based on the fault lines of the health care reform debate.
If you will pardon a personal note, we’re celebrating my father’s 80th birthday today. Ed Kilgore, Sr., instilled in me a powerful interest in politics from an early age, during the turbulent civil rights era of the Deep South, when he (and my mother) were atypically liberal. For years, we had a Sunday ritual of eating breakfast, reading what was then a big, fat newspaper, and talking politics for as long as it took.
My father also had an extraordinary knack for seeing all points of view. He often talked conservative, but then voted progressive, being the best critic of his own arguments. He and I were among the very few voters in Tucker, Georgia (where he still lives) who cast a ballot for George McGovern in 1972, and he was a proud Obama voter (along with his wife, my stepmother Patricia) last year.
Aside from the love, support and patience he unfailingly provided over the decades, I also owe him my sense of humor (he more or less became Richard Pryor for a while there), and whatever perspective I bring to world events in my writing.
Happy birthday, Chief. I look forward to many more talks and laughs with you, no matter what happens in the wider world.
For southern Democrats, the news that freshman Rep. Parker Griffith of Alabama was switching parties brought back bad memories from the 1990s, when a goodly number of elected officials from the region who had been Democrats for no particular reason other than political convenience became Republicans for no particular reason other than political convenience.
But the exodus of party-switchers back then was both natural and healthy, painful as it was. Jay Cost of RealClearPolitics seems to think, or hope, that Griffith’s flip-flop could touch off another wave of party-switching. I have two reactions to that: (a) if, as appears entirely possible, Griffith loses his seat anyway, then I doubt he’s going to be a major role model for others; and (b) Griffith is from the rare southern district that is conservative but has never elected a Republican congressman. In other words, it’s like the venues of the party-switchers of the 1990s, when the realignment of the parties was reaching its peak. Most moderate-to-conservative Democrats in the South are from areas where genuine Democrats-In-Name-Only left the party years ago. The remainders are a pretty hardy bunch, even if more progressive Democrats don’t like their voting records.
But whether or not Parker Griffith is the wave of the future or the north end of a south-bound brontosaurus, one thing ought to be clear: his protestations that he had to change parties because of some shocking new ideological development in the Democratic Party is total, absolute, conscious b.s. Griffith’s not some crusty old long-time incumbent whose party changed without him; he was first elected in 2008, when Barack Obama was running on a platform promising climate change and health care reform legislation, and going along with George W. Bush’s decision to rescue the financial industry. Nancy Pelosi, whom Griffith is now attacking, wasn’t any less liberal then that she is today. Sure, he needs to play catch-up with his new party-mates in shrieking about socialism and the destruction of the U.S. Constitution, but nobody should be under any illusion that anything has changed since 2008 other than Parker Griffith’s calculation of his re-election prospects.
So however you assess the meaning of this development, nobody in either party should have any particular respect for Griffith–not because he’s a “turncoat,” but because he’s trying to disguise his opportunism as an act of principle, which it is not.
One of those topics that sharply divides observers is the immediate impact on public opinion of enactment of health care reform legislation. Some reform supporters believe that when the public realizes a lot of the wild, made-up claims about the legislation were, well, made up, approval ratings for the President and congressional Democrats will rise. Some reform opponents think that since few Americans will see any tangible benefit from the legislation (in no small part because of the long phase-in period), buyer’s remorse could set in for those who have supported the bill.
Mark Blumenthal of Pollster.com trains his jeweler’s eye on this controversy, and finds there is no obvious answer to the question of “what happens now?” to public opinion. Those who are hoping for a major “bump” in presidential approval ratings will probably be disappointed, says Blumenthal, since those are rare barring “rally ’round the flag” moments of national crisis. Another complicating factor is that Americans don’t really understand many key provisions of the legislation. Will time correct misperceptions, or will the long phase-in period freeze perceptions as they are?
The one definite task for progressives, Blumenthal suggests, is to promote a balanced understanding of the legislation to offset not just conservative mendacity but the heavy focus of the debate on the left on issues like the public option. The provisions that will take effect most immediately, and that are most popular–such as bans on insurance company abuses like exclusions for pre-existing conditions–haven’t gotten nearly the attention they deserve.
All I’d add is that whatever the immediate effect on presidential approval ratings, most progressives are convinced that an outright failure to enact health care reform would be a complete political disaster for Democrats, as a similar failure arguably was for Democrats going into the 1994 fiasco. Assuming the bill is enacted, we’ll never know what would have happened otherwise. And the inability to “prove a negative” is a problem with many aspects of health care reform. Insurance premiums, for example, were due to go up sharply over the next few years in the absence of reform legislation. They will still go up sharply under this legislation (most cost savings will occur down the road), since it costs money to cover 30 or 40 million additional people, but will Americans blame reform itself for this development, which would have happened anyway? Certainly Republicans will make every effort to promote this misperception.
This reflects a broader problem facing the president and congressional Democrats (or anyone assuming power when a previous administration has so thoroughly botched its job): will they get credit for keeping bad times from growing worse, or will they be blamed for the bad times themselves? To cite one obvious example, the best defense for the deeply unpopular TARP initiative is that it was necessary to avoid a complete collapse in the nation’s, and perhaps the world’s, financial system. That is clearly what Barack Obama thought at the time; he certainly did not relish massive subsidies for the least popular people and institutions on the planet. But it’s hard to prove what would have happened in any other scenario. The best solution to this dilemma is to make conditions in the country actually improve. Given the mess Obama inherited, that may be tough to do by next November, or even by 2012. And that’s why progressives need to spend as much time as possible promoting genuine public understanding of the nation’s complex problems, with reminders of our downward trajectory under the previous administration.
The course of events in Congress this year have generated a robust debate over the evolution of the Senate filibuster into a routine 60-vote threshold. I’ve been debating this subject over at ProgressiveFix with former TDS Managing Editor Scott Winship.
In the latest back-and-forth, Scott, who earlier argued that partisan polarization is a bigger obstacle to the enactment of legislation than the filibuster, takes on the proposition that polarization is a phenomenon created primarily by Republicans (hence there’s not a lot Democrats can do about it other than beating Republicans like a drum in elections).
My response focuses on a challenge to the perennial liberal-moderate-conservative typology of voter ideology–which invariably places the political “center” farther to the right than it actually is–and also expresses skepticism about Scott’s preferred remedy to polarization of laws that open up party primaries.
It’s a lot of reading, but well worth the time if you are interested in this perennial topic.
Dick Cheney may have won Human Events‘ “Conservative of the Year” award, but the Right’s more contemporary megastar, Sarah Palin, got her own big end of the year award. She’s the author of PolitiFact’s “Lie of the Year,” via her infamous Facebook post on health reform and “death panels.”
This was indeed an instant classic: completely fabricated, aimed at a particularly important constituency, and applying one of the favorite hallucinations of Palin’s buddies in the Right to Life movement (liberals want to extend their “holocaust” from the unborn to old folks) to the domestic policy issue of the day. And best of all, the lie was distributed not through some clunky and news-cycle-sensitive speech, but through Facebook!
TPM has a nice slide show illustrating how the “death panel” meme pre-developed before Palin invented the term and launched it into the national consciousness.
This item is crossposted from The New Republic.
I wrote a piece the other day examining the ideological underpinnings of the left/center split in the Democratic Party over the propriety of a universal health care system based on regulated and subsidized private health insurers. I suggested there was a burgeoning, if questionably workable, tactical alliance between “social-democratic” progressives and some conservatives to derail much of the Obama overall agenda. Then I made this observation:
[O]n a widening range of issues, Obama’s critics to the right say he’s engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. They can’t both be right, of course, and these critics would take the country in completely different directions if given a chance. But the tactical convergence is there if they choose to pursue it.
This statement has drawn considerable comment from people on both the Right and Left, mainly objecting to the argument that Obama’s critics can’t all be right.
Conservative theoretician Reihan Salam, writing for National Review, first argued that there’s not much substantive difference between the “New Democrat” deployment of private-sector entities in public initiatives and that favored by the privatizers of the Right. But then he pirouetted to make common cause with Obama’s critics on the Left:
It is entirely possible for both sets of critics to be correct. The concern from the right isn’t that the Obama approach will literally nationalize for-profit health insurers. Rather, it is that for-profit health insurers will continue evolving into heavily subsidized firms that function as public utilities, and that seek advantage by gaming the political process. Profits, including profits governed by medical loss ratios, can and will then be cycled into political action, which leads to the anxiety concerning a “corporate takeover of the public sector.”
Salam’s friend Ross Douthat of The New York Times added an “amen” to this argument:
The point is that the more intertwined industry and government become, the harder it is to discern who’s “taking over” whom — and the less it matters, because the taxpayer is taking it on the chin either way.
But do conservatives really oppose this intertwining of industry and government? Rhetorically, yes, operationally—not so much. Consider the default-drive Republican approach to health care reform, such as it is. It typically begins with federal preemption of state medical malpractice laws and health insurance regulation, the latter intended to produce a national market for private insurance (while also, not coincidentally, eliminating existing state provisions designed to prevent discriminatory practices). But the centerpiece is invariably large federal tax credits, accompanied by killing off the current tax deduction for employer-provided coverage, all designed to massively subsidize the purchase of private health insurance by individuals (with or without, depending on the proposal, any sort of group purchases for high-risk individuals). Another conservative pet rock is federal support for Health Savings Accounts, which encourage healthy people to pay cash for most medical services, perhaps supplemented by (very profitable) private catastrophic insurance policies. And most conservatives, when they aren’t “Medagoguing” Democratic proposals to rein in Medicare costs, favor “voucherizing” Medicare benefits—another gigantic subsidy for private health insurers.
Now some conservatives will privately tell you that all these subsidy-and-deregulation schemes are just an interim “solution” towards that great gettin’ up morning when tax rates can be massively lowered, all the tax credits, vouchers and other subsidies can be eliminated, and the government gets out of the health insurance business entirely. But don’t expect to see that on any campaign manifestos in the foreseeable future. In the meantime, Republicans generally support huge government subsidies to corporations without any public-spirited regulatory concessions in return.
Do anti-“corporatist” progressives really think they can make common cause with conservatives, beyond deep-sixing Obama’s agenda in the short term? Well, sorta kinda. Salon’s Glenn Greenwald, who rejected my “incompatibility” argument about left and right critics of “corporatism” as strongly as did Salam, is smart and honest enough to acknowledge there’s no real common ground with conventional conservatives or Republican pols. He instead offers a vision of an “outsider” coalition that includes anti-corporatist progressives and Tea Party types. This is, of course, the age-old “populist” dream (most famously articulated by Tom Frank in What’s the Matter With Kansas?) of a progressive takeover of the Democratic Party that attracts millions of current GOP voters (or nonvoters) who don’t share the economic interests of the Republican Party or the conservative movement but have seen little difference between the two parties.
All I can say is: Good luck with that, Glenn. Short of a complete and immediate revolution within one or both parties, complete with blood purges and electoral chaos, it’s hard to see any vehicle for a left-right “populist” alliance other than a Lou Dobbs presidential run. Barring that unlikely convergence, wrecking Obama’s “corporate” agenda would produce little more on the horizon than a return to the kind of governance we enjoyed during the Bush years, or maybe a bit worse given the current savage trajectory of the GOP.
Part of my intention in the original essay was to suggest that pro-Obama Democrats take seriously the views of intra-party rebels on health care and other issues, instead of insulting them as impractical and childish or obsessed with meaningless totems like the “public option” (which in the anti-corporatist context isn’t meaningless at all). But said rebels really do need to think through where they are going, and where they would take Democrats and the progressive coalition.
Meanwhile, conservatives need to be far less pious about their alleged objections to “corporatism.” Cheap rhetoric aside, their own agenda (when it’s not just preserving the status quo) is largely corporatism with any clear and enforceable public purpose cast aside whenever possible.
This item by Ed Kilgore was first published on December 17, 2009.
In a post yesterday, I argued that some intra-progressive fights reflect ideological differences, particularly over the role of private-sector entities in pursuing progressive policy goals, that need to be taken more seriously, in part because failing to acknowledge them often makes such fights nasty exercises in name-calling and character attacks.
There’s another broad area where differences of opinion often originate, and that must be understood as well: differing political strategies.
Two Examples of Strategic Disconnect
Consider two examples: Democratic political operatives and progressive “issue” advocates.
Many full-time political operatives undoubtedly have a personal ideology, or more generally, a reason for being a Democrat. Some have the opportunity to reflect those views in primary campaigns, or in where and on whose behalf they practice their craft. But by and large, when a general election comes along, it’s all about Ds and Rs and Us and Them, and this orientation tends to color how they feel between elections. Anything that promotes the election of a maximum number of Democrats–any kind of Democrat–to public office is more or less the Prime Objective. There are obviously major differences of opinion about how to achieve this result, short-term or long-term, and ideology play a role there as well. But the bottom line is probably best expressed by an old ditty from the presidential campaign of 1892, when Grover Cleveland’s comeback election marked the end of a period of fierce partisan competition and very little ideological differentiation between the parties:
Grover! Grover!
Four more years of Grover!
Out they go, in we go,
Then we’ll be in clover!
Not much deep thinking there, eh?
At the other end of the spectrum, there are “issue” advocates who are involved in politics not out of some broad commitment to a progressive coalition but out of concern for a particular cause, often arising from or rising to the level of personal identity. The relationship of issue advocates to a political party is by definition conditional and instrumental: I support you if you advance my cause, or at least smite the enemies of my cause. Such relationships were much, much weaker in the many decades prior to the Great Ideological Sorting-Out of the two major parties that culminated in the 1990s. As recently as the 1960s and 1970s, supporters and opponents of civil rights for African-Americans, women’s rights, antiwar movements, environmentalism, and to some extent even labor rights, were found abundantly in both parties. So progressive issue advocates might be Democrats, Republicans, or independents, but were often functionally independent in their basic relationship to political parties.
Nowadays, when a politician’s position on, say, Union Card Check is a generally reliable predictor of his or her position on abortion or climate change, progressive issue advocates are obviously constrained, and must focus on maximizing influence within the Democratic Party alone. That can be done in noncontroversial ways, such as grassroots organizing, petitions, the cultivation of favored candidates and elected officials, and of course efforts to promote or modify legislation or executive actions. But in the end, issue advocates are largely prisoners of a polarized political system, and must rely in the extreme on threats to sit out elections or even defect from the coalition. That’s where some LGBT activists, some civil libertarians, and some antiwar activists, seem to be right now.
To those whose commitment to the Democratic Party is less conditional, such threats often look selfish, destructive, or even childish. But they are perfectly rational, if sometimes short-sighted: if you are engaged in politics for a cause, that cause’s prospects have to be paramount, and absent the occasional threat to defect, your cause and its advocates can be taken for granted, which is the death-knell of political influence.
But what if a variety of “cause” advocates reach this point of frustration simultanously? Then you can have a genuine “revolt,” which some Democrats fear or hope is in the process of happening out of progressive unhappiness with Barack Obama and the congressional Democratic Party on issues ranging from civil liberties and health care to LGBT rights, Afghanistan, and the financial system.
This item by Ed Kilgore was first published on December 16, 2009.
The latest intra-progressive dustup over health care reform displays a couple of pretty important potential fault lines within the American center-left. One has to do with political strategy, and the role of the Democratic Party and the presidency in promoting progressive policy goals and social movements. I’ll be writing about that subject extensively in the coming days.
But the other potential fault line is ideological, and is sometimes hard to discern because it extends across a variety of issues. To put it simply, and perhaps over-simply, on a variety of fronts (most notably financial restructuring and health care reform, but arguably on climate change as well), the Obama administration has chosen the strategy of deploying regulated and subsidized private sector entities to achieve progressive policy results. This approach was a hallmark of the so-called Clintonian, “New Democrat” movement, and the broader international movement sometimes referred to as “the Third Way,” which often defended the use of private means for public ends. (It’s also arguably central to the American liberal tradition going back to Woodrow Wilson, and is even evident in parts of the New Deal and Great Society initiatives alongside elements of the “social democratic” tradition, which is characterized by support for publicly operated programs in key areas).
To be clear, this is not the same as the conservative “privatization” strategy, which simply devolves public responsibilities to private entities without much in the way of regulation. In education policy, to cite one example, New Democrats (and the Obama administration) have championed charter public schools, which are highly regulated but privately operated schools that receive public funds in exchange for successful performance of publicly-defined tasks. Conservatives have typically called for private-school vouchers, which simply shift public funds to private schools more or less unconditionally, on the theory that they know best how to educate children.
Now clear as this distinction seems to “New Democrats,” there are a considerable number of progressives who think it’s largely a distinction without a difference, in education policy and elsewhere. And we are seeing that fundamental divergence on opinion on other, more prominent issues right now. On the financial front, the Obama administration reflexively pursued a strategy of regulation and subsidies for the financial sector, without modifying the fundamental nature of financial institutions, even as critics on the left argued for nationalization (at least temporarily) of key financial functions. At the more popular level, critics of TARP from the left joined critics of TARP from the right in deploring “bailouts” of failed financial institutions, even though the two groups of critics held vastly different views of the right alternative course of action.
Similarly in the health care reform debate, the Obama administration pursued legislation that utilized regulated and subsidized private for-profit health insurers to achieve universal health coverage. This approach was inherently flawed to “single-payer” advocates on the left, who strongly believe that private for-profit health insurers are the main problem in the U.S. health care system. The difference was for a long time papered over by the cleverly devised “public option,” which was acceptable to many New Democrat types as a way of ensuring robust competition among private insurers, and which became crucial to single-payer advocates who viewed it as a way to gradually introduce a superior, publicly-operated form of health insurance to those not covered by existing public programs like Medicare and Medicaid. (That’s why the effort to substitute a Medicare buy-in for the public option, which Joe Lieberman killed this week, received such a strong positive response from many progressives whose ultimate goal is an expansion of Medicare-style coverage to all Americans).
Now that the public option compromise is apparently no longer on the table, and there’s no Medicare buy-in to offer single-payer advocates an alternative path to the kind of system they favor, it’s hardly surprising that some progressives have gone into open opposition, and are using the kind of outraged and categorical language deployed by Marcy Wheeler yesterday. As with the financial issue, there’s now a tactical alliance between conservative critics of “ObamaCare,” who view the regulation and subsidization of private health insurers as “socialism,” and progressive critics of the legislation who view the same features as representing “neo-feudalism.”
To put it more bluntly, on a widening range of issues, Obama’s critics to the right say he’s engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. They can’t both be right, of course, and these critics would take the country in completely different directions if given a chance. But the tactical convergence is there if they choose to pursue it.
For those of us whose primary interest is progressive unity and political success for the Democratic Party, it’s very tempting to downplay or even ignore this potential fault-line and the left-right convergence it makes possible. It’s also easy to dismiss critics-from-the-left of Obama as people primarily interested in long-range movement-building rather than short-term political success; that’s true for some of them. But sorting out these differences in ideology and perspective is, in my opinion, essential to the progressive political project. And with a rejuvenated and increasingly radical Right’s hounds baying and sniffing at the doors of the Capitol, we don’t have the time or energy to spare in dialogues of the deaf wherein we call each other names while getting ready for the elections of 2010 and 2012.
UPDATE: In discussing this post with several friends, I recognize I should be very clear about my motives here. I am not trying to promote an ideological fight within the Democratic Party or the progressive coalition, and don’t want to exaggerate ideological differences, either. But ideology, however muddled, is part of what makes most politically active people tick. And if we don’t talk about it–and about differences in strategic thinking as well, which will be the subject of future discussions here–then all we are left with to explain our differences on this issue or that is questions of character. And anyone paying attention must recognize there’s far too much of that going on. “Progressive pragmatists”–the camp with which I most often personally identify, as it happens–often treat “the Left” condescendingly as immature and impractical people who don’t understand how things get done. Meanwhile, people on “the Left” often treat “pragmatists” as either politically gutless or personally corrupt. This is what happens when you don’t take seriously other people’s ideological and strategic underpinnings; whatever you gain in ignoring or minimizing differences in perspective or point of view is lost in mutual respect. Sure, the character attacks on both sides are sometimes accurate, but nobody should assume that in any particular case without further examination of each others’ ideological and strategic views. That examination is what we are trying to promote here.
Latest Research from:
tds-wwc-roundtable
