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.

Political junkies naturally like to project current trends in public opinion as far into the future as they can, joined by hacks and spinmeisters when the trends seem positive for their cause. So it’s no surprise that Republicans are already debating how big a win they’ll have in 2010. And more than ten weeks before the off-year elections in New Jersey and Virginia, you’d think the GOP had already banked victories in both states.
If only to confound those who think every political sparrow that falls to the ground is about national politics, it’s interesting ro report that a new poll from Greenberg Quinlan Rosner for Democracy Corps shows often-left-for-dead Democratic Gov. Jon Corzine of New Jersey beginning to significantly close the gap with Republican nominee Chris Christie. As voters get closer to an actual decision between candidates instead of a resolution on how they feel about life under the Corzine administration, Christie’s lead has dropped to five percentage points in a three-way race involving independent candidate Chris Daggett, and six points in a two-way race. Christie’s negatives are definitely moving up, which also augers a tightening race.
I’m not predicting that Corzine will win, but it is important to remember that late, counter-intuitive trends in political campaigns happen all the time, and those who count their electoral chickens before they hatch may be eating crow on when voters weigh in.

A big part of the fight against health reform right now involves the identification of specific provisions in the House bill that are then distorted, taken out of context, or otherwise twisted to create the impression of some scary or monstrous outrage. That’s how language authorizing the payment of providers requested by patients to advise on end-of-life treatment options turned into “death panels.”
So now, via Todd Gitlin at TPM, we read a column by Mike Huckabee’s bosom buddy Chuck Norris identifying another scary provision:

It’s outlined in sections 440 and 1904 of the House bill (Page 838), under the heading “home visitation programs for families with young children and families expecting children.” The programs (provided via grants to states) would educate parents on child behavior and parenting skills.

This voluntary program becomes, in Norris’ account, a lurid “home intrusion and indoctrination” program intended to usurp parental rights, impose “progressive-secular religiously neutered” values, and probably even “encourage abortions.”
What it actually sounds like to me is the sort of prenatal and neonatal “welcome wagon” services already offered in many states, often in conjunction with private non-profit and religious organizations.
Still, put all that aside for a moment and consider this: when Norris or Sarah Palin or anyone else cherry-picks some provision in one health care reform bill and then demonizes it, do they ever make the rather obvious suggestion that said provision simply be modified or eliminated during the very long process that would lead to a bill on the president’s desk? I mean, really: the House hasn’t even passed a bill yet. The Senate Finance Committee hasn’t drafted a bill yet, and it certainly isn’t using the House committees’ bill as any sort of template. The Senate allows virtually unlimited amendment of bills. And then even after House and Senate floor action, there’s a conference committee that can and will make changes.
But no: these cherry-pickers simply demand rejection of “Obama’s plan” or the “Democrat plan;” Norris urges his readers to “write or call your representative today and protest his voting Obamacare into law.” Sure, he, like every other opponent of health reform, claims Congress is “rushing” these bills, and says we need a “truly bipartisan group that is allowed an ample amount of time to work on a compromise health care law that wouldn’t raise taxes (for anyone), regulate personal medical choices, ration health care or restrict American citizens.” But that’s another way of saying he opposes anything vaguely approaching universal health coverage. And that’s his right. But please, Chuck, kickbox this suggestion that “Obamacare” is some sort of monolithic plan full of secret agendas that is being rammed through Congress on an up-or-down vote. That is, in point of fact, a lie, which is a term I rarely apply to people’s political expressions.
There’s plenty of opportunity to change health reform provisions, and those who are shrieking about this or that provision need to stop disguising their fundamental opposition to health reform as concern about the details.

This item is cross-posted from The New Republic.
The conservative attacks on health care reform and Barack Obama’s economic plan seem to have reached a fever pitch this week. Their obsession with the topics has been matched only by the inanity of most of their critiques. Why are the conservative talking points on these issues grounded in such weak arguments? Is there something else at play here?
This reaction seemed strangely familiar as I read Matthew Yglesias’s recent post about the Christian Right’s obsession with gay marriage. As a matter of course, your average Christian Right crusader against gay marriage acts as though the issue vitally affects non-gay people: It cheapens “real” marriage and threatens the “traditional family,” they argue. Others claim that it enshrines relativistic morals and violates the religious rights of Christians. What unites most of these arguments is that they claim not to be about denying gay people their rights, but protecting non-gay people.
None of these arguments are particularly strong. And not coincidentally, if you spend much time around regular conservative folk (rather than pundits or spokesmen) who oppose gay marriage, they won’t be making them. Rather, you hear various forms of personal and Biblical condemnation of homosexuality, usually combined with outrage that these people demand legal protection for their unsavory behavior. You don’t hear this in public in part because dehumanizing gay people isn’t as generally acceptable as it used to be. But it’s still there, under the surface, and may be one of the reasons why critics of gay marriage keep fighting against gay marriage despite the ludicrous nature of their public arguments.
This may actually help explain many of the absurd conservative attacks on Obama’s economic and health care agenda. We’re painfully accustomed to hearing that Obama is herding Americans into socialism, is destroying the private-sector economy, and is determined to create a health care system that combines the bureaucracy of Great Britain with the ethics of Nazi Germany. Do the people repeating and encouraging this sort of talk really believe it?
Maybe, but there may also be something a little more direct going on in the conservative psychology. There was an interesting vignette at one of the infamous town hall meetings last week in which a disabled woman on crutches who had lost her health insurance was accosted by another woman who shouted, “I shouldn’t have to pay for your health care!” amidst jeering applause from other health reform opponents. That was no more than a crude expression of what some conservative elite spokesmen have explicitly said, such as ABC’s John Stossel, who describes Obama’s plan as “a form of expensive, taxpayer-funded welfare.”
If this sounds vaguely familiar, it echoes what we heard repeatedly among angry grassroots conservatives during the 2008 campaign, particularly after the financial collapse: Irresponsible people (many of whom happen to be minorities) have wrecked the economy by taking out mortgages they couldn’t afford, and were subsequently trying to elect Obama to get themselves more welfare at the expense of good, productive people who didn’t live beyond their means. Indeed, long after welfare reform supposedly took this conservative wedge issue off the table, anger about “welfare”–as applied to mortgage relief, progressive taxes, and now health reform–has made quite a comeback. One of the most potent things about the 1980s-vintage attacks on “welfare” was that they endowed some pretty ugly emotions with self-righteousness, and even a sense of victimization, for people who felt they were being punished for being productive. It seems clear that many of Obama’s right-wing critics are motivated as much by moral judgments about the beneficiaries of his polices as by their alleged impact on the economy or the health care system.
But in the same way that it’s no longer acceptable to publicly hate on gay people, it is not terribly respectable to publicly hate the poor, to consider minorities inherently inferior, or to express indifference towards the sufferings of fellow citizens. And so instead of the woman screaming “Why should I pay for your health care?” we get a host of specious public-spirited arguments about the destruction that health care reform will inflict on us all, be they elderly Medicare beneficiaries or the middle-class mother of a disabled child.
Conservatives are hardly unique in reacting selfishly or self-righteously to political issues, or dressing up personal prejudices with public policy arguments; we all do that from time to time, and to one extent or another. But whether we are talking about gay marriage, government-backed mortgages, or health care reform, there may well be a strongly dynamic relationship right now between privately held feelings of strong disdain for the purported beneficiaries of Obama’s agenda, and some of the wilder arguments being made publicly to attack it.

Ezra Klein at the Washington Post has nicely crystallized today the frustrations involved in trying to answer some of the crazier “questions” being raised by opponents of health care reform:

[T]he questions reformers have to answer is not “when did you stop beating your wife?” It’s “what will prevent you from beating your wife?” Given that there is no such thing as a “death panel,” nor any policy provision that would establish such a thing, it is hard to explain the institutional checks that would prevent a “death panel” from coming into being. When you have to explain why your bill won’t create death panels, and what will make sure that it doesn’t, you’ve pretty much lost the argument.
The fact that an idea as loony as death panels has found even the slightest purchase in the public consciousness shows how distant the minority feels from our democracy. Members of Congress are terrified of voter backlash and industry opposition. They are leaving virtually the entire health-care system untouched. They will scuttle the bill if a rural hospital in their district doesn’t receive sufficient reimbursement or if a local device manufacturer is harmed. Yet there is a certain portion of the country that believes that Max Baucus and Mike Ross are willing to vote for death panels and defend them before their constituents in the following election.

Aside from the “what will prevent you from beating your wife?” problem, Ezra is also on target in identifying the large disconnect between the realities of how this legislation is being developed and the apparent perceptions of health reform opponents. Many reform advocates are perpetually in a state of semi-depression about the compromises being made to bring the requisite number of House Blue Dogs, plus the “Gang of Six” in the Senate, on board for any bill. Yet protesters against the “Obama plan” are telling us it’s a replica of the worst features of the British Health Service, which it doesn’t even begin to resemble, and that centrist Democrats are secretly on board with a far-left scheme. This makes much of the health reform “debate” an exercise in shadow boxing.

The continuing arguments over congressional “town hall meetings” and protests against health reform have largely focused on the relative authenticity of the protests. Are the people chanting against Obama and health reform at these events motivated by spontaneous civic-minded feelings, or were they rounded up and deployed by “astroturfing” p.r. outfits paid by health industry lobbyists? The previous post by James Vega goes into the questions of authenticity in some detail.
But I have a different question: authentic or phony, should these protests matter to Congress? We are talking, after all, about relatively small groups of people vociferously expressing a point of view (yes, some ask “questions” of their representatives, but generally of the loaded and rhetorical sort). Should these expressions be given disproportionate weight, perhaps more than, say, the party or ideology of Members of Congress, their understanding of their districts’ needs, or surveys of public opinion?
The question pretty much answers itself if you don’t start with vague notions, as many conservative commentators have been offering lately, that the protesters somehow represent the heart and soul of America, or Concerned Citizenry, or the Middle Class, or some such other abstraction. It’s particularly amusing to hear those who doubt the significance of the protests being denounced as “elitists.” What could be more “elitist” than the belief that democratic procedures should be trumped by the appearance of a few hundred highly opinionated people at a public event?
I dunno–maybe my jaundiced attitude on this subject was developed when I worked for a United States Senator back in the late 1980s and early 1990s. Yes, my boss held public forums pretty regularly, and yes, we carefully toted up calls and cards and letters sent from constituents on various issues of the day. But we were under zero illusion that these expressions of public opinion were necessarily representative of public opinion itself. At public events, the bane of every Member of Congress’ existence in those days were the so-called “Notch Babies,” a cohort of people born between 1917 and 1921 who were convinced they had been denied Social Security benefits that people born just before or after received. “Notch Babies” showed up at every available forum demanding financial reparations. Members and staff patiently listened to, and tried to reason with, these disgruntled citizens, with limited success. But you know what? Legislation to “fix” the “notch” was never enacted.
Elected representatives do have a responsibility to give constituents opportunities to ask them questions and express their own views, as a simple matter of accountability. But those voices should not be confused with the “voice of the people,” measured a bit more scientifically by elections, in which, as you may recall, the candidates clearly preferred by most if not all of the health reform protesters lost. This probably made them feel “disempowered” and perhaps even angry and inclined to answer that email and go out to shake fists at the Democrat Socialist representing them so badly in Congress. That’s all well and good, and any Member of Congress who can’t take heckling now and then is probably in the wrong line of work. But the idea that the chants and signs and head-counts at these highly selective events ought to sway votes on real issues is just wrong.

At a time when right-wing conspiracy theories about health care reform and the Obama administration are running rampant, there’s a much less visible development that shows, with a particularly ironic twist, how such theories can affect more mundane matters like the appointment of a distinguished academic to relatively obscure White House job.
The academic in question is Harvard professor Cass Sunstein, a legal scholar generally considered to be a “centrist,” and an old friend of President Obama. His appointment to head the White House Office of Information and Regulatory Affairs has been repeatedly stalled by “holds” placed by Republican senators who are reacting to viral lobbying that suggests Sunstein is a gun-hating animal rights fanatic, mostly based on some out-of-context quotes from a 2004 book. Amanda Ripley has the story at The Daily Beast:

Asked about these arguments by senators at his May 12 nomination hearings, however, Sunstein explained that he is a strong believer in the Second Amendment, and he promised that he will not promote litigation on behalf of animals. Nevertheless, shortly after those hearings Senator Saxby Chambliss (R-GA) put a hold on Sunstein’s nomination, citing the very concerns the nominee had addressed in his testimony. Meanwhile, sinister accusations about Sunstein’s radical left-wing agenda were whipping around the blogosphere, fueled by Sean Hannity and Glenn Beck on Fox News.

After a meeting with Sunstein, Chambliss released his hold, but two new ones have been issued, one by John Cornyn (subsequently released) and now a second by an anonymous senator.
The ironic twist in this case, as Ripley explains, is that Sunstein is the author of a well-known and very recent book about partisan and ideological conspiracy theories, entitled Going to Extremes. Sunstein’s hypothesis is that the “echo chamber” effect whereby ideologues associate and listen to like-minded people rather than to others tends to make objectively ludicrous assertions about “the enemy” subjectively credible.
That seems to be the case with the assertion that Obama chose Sunstein in order to help take away everybody’s guns and let Fido go to court. Thanks to the peculiarities of Senate procedures, while allow confirmable appointments to be held up by one senator, right-wing theories about this man they don’t really know anything about could eventually cost him a job for which he is abundantly qualified.