At HuffPo today, Sam Stein explores an irony that I’ve also been thinking about: many of the very conservatives who are ventilating claims that health care reform will interject the federal government into end-of-life decisions–with or without “death panels”–were hell-bent on Congress dictating an end-of-life decision in the infamous Terri Schiavo case in 2005:

Some of the same conservative figures taking potshots at Democrats for wanting to fund voluntary discussions about end-of-life decisions between doctors and their patients were leading the charge four years ago to contravene the decision by Schiavo’s husband and guardian to remove the feeding tubes from his wife after she had spent 15 years in a vegetative state.
Senator Chuck Grassley (R-Iowa), who this week declared that Obama was trying to set up a situation where the government would decide whether to pull the plug on grandma, missed the vote to give the government control over Schiavo’s fate. But he told reporters that he backed the measure.
“I support the effort to protect Terri Schiavo,” he said. “It’s the first case of its kind, a chance to choose life over death. I gave the option to life.”
House Minority Leader John Boehner (R-Ohio), who has also been highly critical of Obama’s health care agenda, told constituents in an online forum that he supported the government’s intervention into Schiavo’s life.

This isn’t just an amusing example of hypocrisy, however. It’s worth noting that both the demand for federal intervention in the Schiavo case, and the “death panel” smear, have largely emanated from the Right-to-Life movement (the latter via their most prominent spokesperson, Sarah Palin), which routinely suggests that legalized abortion will eventually lead to government-sponsored euthanasia. Indeed, though it hasn’t gotten nearly as much attention as the “death panel” talk, health reform opponents have often claimed (without any real evidence) that reform is intended to promote publicly-financed abortions as well as euthanasia.
The abortion-euthanasia connection matters because the people promoting the “death panel” meme are not, in fact, opposed to government intervention in end-of-life decisions, any more than they are opposed to government intervention in a woman’s decision whether to carry a pregnancy to term. They simply want the intervention to follow their own absolutist views about human life.
And just as right-to-life activists are forever trying to manufacture evidence that “liberals” in government are plotting to encourage, not simply permit, abortions, they are now manufacturing evidence that those same liberals are plotting to encourage or actually require euthanasia. It’s part and parcel of a political strategy aimed at denying that government can be neutral on “life,” and that decisions about “life” can be consigned to private decision-making.
So next time you hear a conservative talk about “death panels,” you might want to ask about Terri Schiavo, not as a “gotcha,” but to expose the highly interventionist thinking that motivates many of those who pose a defenders of individual and family rights against Big Government.
UPDATE: Since a commenter below, and then National Review’s Ramesh Ponnuru, have indicated they think I’m accusing conservatives of “hypocrisy” on end-of-life issues, I should make it clear this is not what I am saying. If I had to choose a negative adjective for those who wanted Congress to intervene in the Schiavo case and are now railing against “death panels,” it would be “disingenuous” rather than “hypocritical.” They are clearly appealing, with some success, to the large majority of Americans who didn’t favor the Schiavo intervention (many of whom also don’t favor government bans on abortion), using anti-government rhetoric about interference with personal or family decisions that they don’t, actually, believe in. That’s more than a mite dishonest, if not hypocritical, and is reminiscent of Sarah Palin’s talk about her “choice” to carry to term a child with a severe disability–a choice she would deny to other women.
Speaking of abortion, Ponnuru also suggests my claim that there’s “no real evidence” of health care reform legislative language providing for government funding of abortion is inaccurate. He makes a legitimate point; I should have probably used the term “no compelling evidence.” But as I’ve argued elsewhere, those who claim they are opposing health care reform because of this or that provision in this or that bill seem to have forgotten everything they’ve ever learned about the legislative process, including the ability to amend bills. There’s little or no chance that a health reform bill will get to the President’s desk without a ban on abortion funding.

What with conservative opinion-leaders beginning to concede that the “death panel” claim about health care reform is, as the editors of National Review put it, “hysteria,” it’s a bit depressing to note that a lot of Americans still buy it.
According to a new Pew poll, 86% of Americans have heard the “death panel” claim. Of those, 30% think it’s true; 50% think it’s false; and 20% don’t know. The partisan breakdowns? Nearly half (47%) of self-identified Republicans think that health reform legislation will, indeed, lead to “death panels.” The number drops to 28% among independents, but then a startling 20% of Democrats think it’s true.
Now when Sarah Palin started this nonsense with her famous Facebook post, lots of observers thought she had finally jumped the shark and had discredited herself for the foreseeable future. Anyone who dismisses her chances for the Republican presidential nomination in 2012 should reflect on the fact that half her party has gone along with her ravings. I’d be willing to bet the number goes a lot higher among the conservative activists–heavily dominated by her fellow hard-core right-to-lifers–who participate in the GOP’s Iowa Caucuses.

For months now, hardly an hour has gone by without someone in the progressive chattering classes complaining about President’s Obama’s “bipartisanship” talk. One of the strongest recent complaints was from the estimable Robert Kuttner at HuffPo, where he plausibly asked what the administration has gotten for its willingness to reach out to the GOP, and concluded, also plausibly, that it hasn’t produced much in the way of tangible benefits.
But at some point, it’s equally important to flip the question and ask: Has the bipartisanship talk done any real damage?
On the stimulus legislation, concessions were made to a few Senate Republicans (along with several Democratic allies) to get their votes, which were necessary for passage of the bill.
On climate change in the House, concessions were likewise essential to passage of the bill.
On health care reform, has the administration made any concessions to Republicans so far? Not that I’m aware of. Henry Waxman (presumably with White House approval) did make some concessions to Blue Dog Democrats to get enough of them to support a bill in order to lift it out of the Energy and Commerce Committee to the House floor. In the Senate, the administration has allowed Max Baucus and Kent Conrad to negotiate with a handful of GOPers, but to the extent there have been substantive concessions (e.g., hints that coops might be an acceptable substitute for a public option), they’ve been necessary to secure Democrats, while keeping open the possibility of defections from two or three Republicans, which may well prove necessary to enact a bill, depending on how the reconciliation gambit works out. But at the same time, publicly and privately, the White House has made it clear it’s willing to pursue a Democrats-only strategy if that proves possible, and if that’s what it takes.
Now you can make the argument that the bipartisanship talk has “discouraged the base,” but frankly, at this point, the enthusiasm level of “the base” is germane only to the extent that it translates into votes in Congress. Throughout the 2008 campaign, there were also fears expressed that Obama’s bipartisan or post-partisan talk would “discourage the base,” and that didn’t actually happen, did it?
Beyond that, as I’ve argued many times before, Obama appears to be pursuing a long-term strategy of constantly forcing Republicans to either cooperate with him or obstruct him openly, on the theory that the former option might produce a few key votes, and the latter option will further paint the GOP into an extremist corner.
A little further down the road, when attention focuses largely on wavering Democrats in the House and in the Senate, the administration and the congressional leadership will have to make a judgment call as to whether a directly partisan “disciplinary” approach, or the “cover” of securing a few Republicans with a few concessions that those same Democrats happen to support, will work best. Until then, progressives would be best advised to maintain some perspective in complaints about “bipartisanship.” It’s not costing progressives much of anything we don’t already have to pay to keep Democrats in line, and we’ll need just about all of them if the fight does become strictly partisan.
UPCATEGORY: Democratic Strategist

There’s very little question that two basic decisions by the Obama administration on health care reform have significantly complicated efforts to mobilize public support for actual legislation. The first, which was actually made during the early stages of the 2008 presidential campaign, was to adopt a relatively complicated approach to reform that involved competing public and private plans, health insurance “exchanges,” and subsidies, among other technical-sounding features. The second, after the election, was to promote reform generally through the congressional committee system, without issuing a detailed blueprint the President would insist that Congress follow.
There were very good substantive and political reasons for both these decisions, but inevitably, they have made it harder for Americans who only vaguely want health care reform to embrace Obama’s approach, and easier for reform opponents to cherry-pick provisions in various bills that can be blown out of proportion or demonized, and to simply lie about features that are difficult to explain.
This has created a gap in public opinion between what people might support if they understood it, and what they support in the absence of any understanding. In a new post at The Atlantic on recent polling, Ron Brownstein takes a closer look at that gap:

The NBC/Wall Street Journal national survey also released this week…found that just 31 percent of independents now approve of Obama’s handling of health care, while 54 percent disapprove, according to crosstabs from the poll provided by Public Opinion Strategies, one of the pollsters. Asked their view of Obama’s health care plan, just 28 percent of independents said they consider it a good idea, while 43 percent described it as a bad idea, and the rest said they didn’t know.
Yet when the pollsters read a description of the Obama proposal to respondents, the attitude among independents sharply shifted. Opposition among them remained roughly the same at 44 percent. But support jumped to a 52 percent majority. The gap between potential and actual support for Obama’s plan among independents suggests two things: that the White House is losing the struggle to define the plan so far, and that they may have room to increase their support if they can regain the initiative.
Obama faces a formidable gap between potential and actual support even among Democrats in the NBC/WSJ poll. Just 62 percent of Democrats described his plan as a good idea; but after hearing the explanation, 78 percent of them said they would support it. (Even among Republicans, support jumped from just 9 percent to 23 percent when they were provided a description of the plan.)

So voters need to hear this explanation, from the President and every available ally, the moment the White House decides on a reasonably clear vision of what can be ultimately wrested from Congress. There won’t be a lot of time for this to happen, and in the end, some congressional Democrats from competitive districts or states will need to vote for reform in hopes that constituents will like the results even if they are doubtful about what they understand to be the plan. After all, most of the fears being fed by reform opponents will not actually materialize if a bill is enacted; the seniors who are so negative about reform will discover that little or nothing has changed in Medicare; death panels will not be convened; doctors will not lose their right to control treatments.
Reality ought to count for something in the health reform debate; reform proponents need to explain what they can, and also count on the consequences of the legislation to make its enactment a political plus.

This item is cross-posted from The New Republic.
As the Dog Days of August descended upon us, there developed across the progressive chattering classes a deep sense of malaise bordering on depression, if not panic–much of it driven by fears about the leadership skills of Barack Obama. The polling numbers seemed to weaken every day, and Democratic unease was matched by growing glee on the airwaves of Fox and in Republican circles everywhere.
Within ten weeks, however, Obama was elected president and joy returned to the land.
Yes, dear reader, I am suggesting that this August’s sense of progressive despair feels remarkably similar to last August’s. This week last year, the Gallup Tracking Poll had McCain and Obama in a statistical tie. The candidates were fresh from a joint appearance at Rick Warren’s Saddleback Church, which was widely viewed by progressives as a strategic error by Obama. More generally, Democratic confidence, so high earlier in the year, was sagging. “Liberals have been in a dither for several weeks now over Barack Obama’s supposedly listless campaign performance following his return from Europe,” influential blogger Kevin Drum summed up sentiments at that time, “and as near as I can tell this turned into something close to panic.”
These doldrums dissipated by the time of the Democratic convention later in the month, but reemerged in September, when McCain actually moved ahead in some polls. And the diagnosis of the problem was typically that Obama was too passive, and wasn’t articulating a clear enough message. This should sound familiar to connoisseurs of contemporary progressive concerns about Obama.
Now, this deja vu sensation I’m having obviously doesn’t guarantee that the current struggles over health care reform and climate change will have as happy an ending as the presidential contest. But it may well provide a plausible argument for giving the president the benefit of the doubt today as we should have done a year ago.
Part of the psychological problem now may be a matter of unrealistic expectations. Much of the trouble Obama has encountered in promoting his agenda has been entirely predictable. His approval ratings are gradually converging with the 2008 election results. Health care reform is a complicated challenge that threatens a lot of powerful interests and unsettles people happy with their current coverage. Major environmental initiatives lose steam in a deep recession. A new administration gradually begins to assume blame for bad conditions in the country. Republicans, adopting a faux populist tone, are fighting Obama tooth and nail. Democratic activists are frustrated by compromises and sick of having to put up with the Blue Dogs. The Senate is still the Senate, a monument to inertia, pettiness, and strutting egos.
Progressives are waiting for Barack Obama and his team to work the kind of political magic they seemed to work in 2008–except when they didn’t. Cutting through all the mythologizing of the Obama campaign, the real keys to his stretch-run success last year were his legendary calm (“No Drama Obama”); his confidence in his own long-range strategy; his ability to choose competent lieutenants and delegate to them abundantly; and his grasp of the fundamentals of public opinion and persuasion. There was zero sense of panic in the Obama campaign itself late last summer, because they stuck with their strategy and organization and didn’t let the polls or news cycles force them off the path they had chosen.
The administration’s demure approach should thus not be terribly surprising, nor a sign that it has lost its heart or its mind. Obama has not, presumably, lost the qualities he showed in the tougher moments of the 2008 campaign. As it planned its legislative agenda for 2009, Team Obama knew health care reform was going to be challenging, and also knew they could probably get away with blaming the economic emergency for paring it back or slowing it down. They decided this was the right time to act, and it’s far too soon to assume they were wrong.
This particular moment might be more endurable if, as it used to be, August was a political and legislative dead zone. We’d all get a breather, maybe calm down and look ahead to the real deal going down in the fall. But the “August Doesn’t Matter” era has ended–perhaps dating back to the grand jury testimony in the Clinton/Lewinsky scandal in August 1998, if not earlier. (It arguably began to fade when Washington got air-conditioning.) Now, even if nothing substantive is actually happening this month, the absence of action is itself painful, and feels like defeat.
While I certainly don’t know if the Obama game plan for the next couple of months is going to be successful, I’m reasonably sure a game plan exists. On the issue most on everyone’s mind, I certainly don’t know how to reconcile the sharply contrasting demands of House Democrats and Senate “centrists” on sticking points like the public option. But the odds remain good that the House will pass a bill, the Senate will pass a bill, and then we will find out if the White House and the Democratic congressional leadership have the skill to make something happen that we will be able to recognize as “change,” and perhaps even a victory for progressives. Until then, it’s probably a good idea to drink a tall glass of cold water and wait out the August political heat.

If you’re wondering why the so-called “public option” in proposed health reform plans is such a line-in-the-sand non-negotiable requirement for so many progressives, you should definitely read Mark Schmitt’s brief item for The American Prospect explaining the history of this concept.
It all started, Schmitt explains, among single-payer advocates who had been convinced by pollster Celinda Lake that their approach just didn’t have enough popular support to carry the day:

One key player was Roger Hickey of the Campaign for America’s Future. Hickey took UC Berkley health care expert Jacob Hacker’s idea for “a new public insurance pool modeled after Medicare” and went around to the community of single-payer advocates, making the case that this limited “public option” was the best they could hope for. Ideally, it would someday magically turn into single-payer. And then Hickey went to all the presidential candidates, acknowledging that politically, they couldn’t support single-payer, but that the “public option” would attract a real progressive constituency.

John Edwards signed on, and then Obama and Clinton, and a hybrid proposal that added the public option to the prevailing concept of a competitive system of private insurance plans became the standard Democratic approach.
But baked into the cake was a subtle but important difference in perspective between single-payer fans who viewed the public option as the sine qua non, and other progressives who viewed it as just one of many moving parts in a comprehensive system.
That division continues today. Here’s how Schmitt describes the passion of single-payer advocates for a “robust” public option, as many House Democrats call their demand:

So now this energetic, well-funded group of progressives is fired up to defend something fairly complex and not necessarily essential to health reform. (Or, put another way, there are plenty of bad versions of a public plan.) The symbolic intensity is hard for others to understand. But the intensity is understandable if you recognize that this is what they gave up single-payer for, so they want to win at least that much.

So hard-line defense of the public option is about substance, but it’s also about emotion, and about people who think they’ve already compromised enough by accepting a system built around private health insurance. This is all worth remembering when the final deals get cut in Congress on health reform.

Robert Novak, who died today of brain cancer at the age of 78, had such a long and varied journalistic career that different people probably remember him in different ways. Some younger readers may completely associate him with the Plame saga, or with his career as a conservative gabber on cable. Others may recall the many years in which his syndicated newspaper column was (as David Stockman once put it) a “bulletin board” for movement conservatives who wanted to make their views known to members of the Washington establishment–or sometimes, vice versa. And a few of us oldsters will remember his earlier days, when he was actually a Democrat and an old-fashioned shoe-leather muckraking reporter, in association with his Odd Couple co-columnist (and co-participant in his pioneering cable television show) Rowland Evans.
The book Evans and Novak wrote about LBJ, Lyndon Johnson: The Exercise of Power, remains one of the best political biographies around, particularly if you are interested in the arcane operations of either the U.S. Senate or the White House. I haven’t read his recent autobiography (entitled, in a reference to his longtime nickname in Washington, The Prince of Darkness) but through other obituaries I am hearing that it’s a fascinating book even if you deplore the author’s politics, and intend to go out and buy it directly.
I only met Novak once, just a few years ago, when I had the strange experience of being on a political panel seated between the Prince and another right-wing legend, Paul Weyrich. I found Novak to be smart, cynical, and appropriately scary. By then he had undergone a late-life conversion to Catholicism, reportedly via the agency of the mysterious conservative organization Opus Dei. That, too, was fitting, given his long association with the Cultural Right. I gather his final illness was characterized by excrutiating pain. Much as I dislike large elements of the man’s journalistic and political legacy, I hope his faith gave him comfort, and may he rest in peace.

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.