HHS Secretary Kathleen Sebelius has an op-ed, “Lifting A Burden Of Worry” in today’s WaPo, with simple, elegantly-stated message points that health care reform advocates can tap to both challenge reform obstructionists and help win support from those who have concerns. It’s not hard to imagine Sebelius’s op-ed being re-worked into multiple formats — persuasive ad spots for traditional and new media, as well as speeches by and media interviews with reform supporters. As Sebelius defines the central problem in simple terms:

The current health-care system gives insurance companies all the power. They get to pick and choose who gets a policy. They can deny coverage because of a preexisting condition. They can offer coverage only at exorbitant rates — or offer coverage so thin that it’s no coverage at all. Americans are left to worry about whether they’ll get laid off and lose their insurance or wake up from surgery with a $10,000 bill because they didn’t read the fine print on their policy.

That concern is shared by millions of Americans, even those who have some skepticism about the way reform legislation is shaping up. Sebelius also highlights a huge “hidden” expense of the current system:

…Right now, many entrepreneurs are paralyzed by our fractured health insurance system. They know that if they leave their job, they might not be able to get insurance for their families. So they, and their innovations, stay put. Health reform means unleashing America’s entrepreneurs to chase their big ideas.

It’s a hidden cost which cripples American entrepreneurs in competition with their counterparts in nations that have portable health security for all. Sebelius also does a nice, succinct job of calling out the fear-mongers:

…We’ve learned over the past 20 years that “socialized medicine” and “government-run health care” are code words for “don’t change anything.” With some insurers raising premiums by more than 25 percent and 14,000 people losing their health insurance every day, Americans want to hear something more from their leaders than “wait and see” and “more of the same.”

She then provides one of the best short statements that encapsulates what Americans want:

Health insurance is fundamentally about peace of mind. If you have good insurance, you don’t have to worry about an accident or sudden illness. You know that whatever happens, you and your family will be taken care of.

The public option provides a reasonable alternative to unbridled domination of our health care by the insurance industry, explains Sebelius:

By giving Americans choices, health reform will switch the roles. Americans will get peace of mind and insurance companies will start getting nervous. They will know that if they don’t deliver a great value, their customers will flee. So they will start offering better coverage.

And the vision:

…We have a huge, once-in-a-lifetime opportunity to improve the lives of all Americans, insured and uninsured alike….We can make investments in prevention, wellness and health information technology that will allow the health-care system to deliver incredible results at prices we can all afford. Imagine a system in which your doctor spends as much time trying to keep you healthy as treating you when you’re sick, in which you and your doctor have all the information you need to choose the treatments that work best for you, in which you never have to fill out the same paperwork twice. Health reform is the first step in that direction.

Secretary Sebelius has done an outstanding job of simplifying the message that can help cut through the obstructionist fog and bring health security to millions. The August recess provides the opportunity for Dems and reform advocates to spread it far and wide.

Those Republicans who are already predicting a landslide win in 2010 might want to put down the champagne glasses for a minute and take a look at Gallup’s latest survey on party identification by state. True, the numbers are from interviews over the entire brief course of the Obama presidency, but they’re still interesting.
With leaners duly leaned, Gallup finds Democratic identifiers with a plurality in 44 of the 50 states (plus DC). The six GOP redoubts, in ascending order of Republican strength, are Mississippi, Alabama, Alaska, Idaho, Wyoming and Utah. Democrats have a majority of the electorate in half the states; Republicans in two (Wyoming and Utah).
The numbers are an ever-present reminder that any weaknesses shown by President Obama or congressional Democrats do not automatically translate into Republican gains, short-term or long-term. We’re a long way from November 2010, and Republicans haven’t won back much trust.

A David Paul Kuhn column over at RealClearPolitics offers the thesis – stated in his title – that not just Republicans, but “Both Parties have their Fanatics.” While recognizing that substantial numbers of Republicans indeed believe against all evidence that Obama was not born in the U.S. , Kuhn argues that Democrats are equally –and in fact even more — delusional than the Republicans because a spring 2007 Rasmussen poll showed that 35% of Dems believed that “George W. Bush had advance knowledge of the 9/11 attacks.”
On this basis Kuhn unleashes a veritable fountain of pejorative adjectives, even dusting off Richard Hofstadter to promote his “Dems are even more nutty and fanatical than Republicans” equivalency thesis.
He says:

“The Paranoid Style in American Politics,” was title of historian Richard Hofstadter’s famous Sixties essay. “I call it the paranoid style,” [Hofstadter] wrote, because “no other word adequately evokes the sense of heated exaggeration, suspiciousness, and conspiratorial fantasy.”

Kuhn continues:

Most conspiracy theorists’ fidelity is to theory, not truth. They tend to uphold a belief despite the facts. The possible, however improbable, trumps the logical. And it’s futile to attempt to disprove their belief. It’s like debating with those who believe the world is flat.

Having thus set the stage with these hefty portions of hyperbole and Hofstadter, Kuhn then says the following:

The disparate treatment of the two conspiracy theories is unmistakable. More Democrats fell into the “truther” camp than Republicans fall into the “birther” camp. But the mainstream media has covered the “birther” poll far more vigorously. It’s easy to understand, unless one is invested in the opposing camp, why these incongruities irk the political right.

Wow. Take that, you damn Democratic nutcakes. Democrats are not only nuttier than Republicans, but the liberal media, as usual, is giving them a free pass.
This is dramatic, to be sure, but unfortunately there’s a huge and basic fallacy in the argument.

Read more…

I don’t know what it is about getting a New York Times column, barring deals with the devil to obtain them in the first place. But it seems to be having a corrosive effect on Ross Douthat’s analytical skills, as it earlier did for his colleague David Brooks.
Douthat’s column today touting Texas as an economic “model citizen” for the nation is just plain wrong. Ezra Klein peforms an efficient smackdown on the idea that Texas is booming while “blue states” are wallowing in economic despair, and just as importantly, reminds us that the Lone Star State is famed for its poor treatment of poor people, which helps it keep the state budget balanced.
But I have a more fundamental beef with Douthat’s breezy assumption that state policies have made conservative Texas do well while afflicting “liberal” California. The truth is that state policies have little or no effect on short-term economic trends affecting their populations. Texas and California exist in national and global economies. Unemployment rates in Fresno or El Paso are largely controlled by forces affecting manufacturing exports and imports; prices for housing, oil and gas; and credit availability that have almost nothing to do with the policies of Arnold Schwarzenneger or Rick Perry. Republican-governed Florida is getting hammered, and Democratic-governed Iowa is doing well.
Governors and state legislators do have a big effect on how their constituents are affected by such external forces–on the distribution of wealth, if not its existence–and on that front, regressive Texas has nothing to brag about.
But Ross Douthat’s identification of “low-road” economic development strategies as vindicated by the current recession is deeply flawed and dangerous. If the no-regulation regressive-tax approach really represented the keys to the kingdom, then Mississippi and Alabama would have long since become the economic dynamos and social showcases of America. That hasn’t happened, and isn’t happening, regardless of short-term growth and unemployment rates. With far more resources than its country cousins to the east, Texas has managed to create similar social conditions. Touting the Lone Star State as a lodestar state is a terrible mistake. Ad as a southerner, I’d have to say that it takes a conservative Yankee to celebrate so unreflectively the South’s high ratio of private affluence to public squalor.

There’s not much doubt right now that conservatives are feeling their oats, now that the President’s approval ratings have dropped, health care reform and climate change legislation are in doubt, and in general, Republicans have no responsibility for governance in Washington.
But they’ve got a problem. Their activist “base” remains too small and too wacky to represent an effective grassroots force. We saw that in the earlier Tea Party protests, and we may soon be seeing it again in August Recess events where small groups of angry people demonize Democratic members of Congress. Certainly the shrieking protest held in Austin over the weekend against Rep. Lloyd Doggett, isn’t likely to influence him, insofar as he denounced it as a “mob” put together by the local Republican and Libertarian Parties. Like the angry crowds that materialized at McCain-Palin rallies in the latter stages of the 2008 campaign, such hate-fests tend to draw more attention to their own participants’ behavior than to the targeted Democrats.
On another front, efforts to create a “rightroots” to rival the progressive blogosphere as a force in American politics are moving rather slowly. This last weekend RedState.com, the site often touted as the conservative counterpart to DailyKos, held its first “Gathering” in Atlanta. 200 people showed up, and mainly spent time listening to conservative primary candidates fighting uphill battles against other Republicans, along with familiar right-wing firebrands like Jim DeMint. In a couple of weeks, 1500-2000 attendees are expected at the Kos-inspired Netroots Nation event in Pittsburgh. It’s not clear who the headline speakers will be (as is appropriate for an event focused on workshops and small panels, not speeches), but in 2007 the event attracted a major presidential debate.
It all comes back to a point that conservatives really need to internalize: “base” energy and “noise” can be a significant political asset, but only if it’s focused, strategically deployed, representative of actual rank-and-file sentiment, and attractive to “outsiders.” If it’s none of these things, it’s worse than useless, because it simply serves as a reminder of why so many voters don’t like the Republican Party in the first place.

Ron Brownstein’s weekly column on Thursday looked closely at the contours of the President’s approval ratings (as measured by the Allstate/National Journal “Heartland Monitor”). And it confirmed what Alan Abramowitz was saying here at TDS back on July 14: Barack Obama’s support levels in various demographic groups largely reflects where they were the day he was elected president.
Looking at six groups that backed Obama in 2008, and five that did not, Brownstein shows that some groups in both categories continue to give Obama a positive job rating at levels higher than last November: college-educated white women (+6), Latinos (+6), non-college educated white women (+8) and seniors (+7). The only category with whom he has significantly less support than on election day is African-Americans, but there support levels have declined from 95% to 88%, hardly a catastrophe.
Brownstein does see some peril for Obama in trends among white men, where tepid support levels coincide with “pessimism about the country’s direction bordering on alienation,” and an upsurge of anti-government attitudes.
He quotes TDS Co-Editor Ruy Teixeira as warning that the condition of the economy is central to non-college-educated white voters. If it doesn’t show improvement soon, “the potential for an anti-government backlash is very real. You could see his support really crater out among these non-college whites.” But to those who predict a 1994-style conservative surge fed by these voters, Brownstein reminds us:

Working-class white voters still represented just over half of all voters in the early 1990s. Now they constitute just below 40 percent of voters, while minority voters, who still back Obama overwhelmingly, have doubled their share of the electorate to about one-fourth. (College-educated whites have held steady at about one-third of all voters.)

In any event, it’s reasonably clear that Obama’s 2008 coalition is intact. It remains to be seen if that will be enough, along with Democratic majorities in Congress, to enable him to show some legislative successes by the end of his first year in office.

Oscar Wilde said that “the best thing to do with advice is to pass it on; it is never of any use to oneself.” And pass it on we do, hoping that it will be of some use in the struggle for health care reform. And, judging by the surfeit of health care reform strategy advice from all points of the political spectrum, few advocates can fairly complain that their views are not being heard. Here follows some of the more interesting nuggets from recent editorials, articles and blogs:
The Editors of The New York Times forum on”Selling Health Care Reform to Voters” included contributions from seven diverse opinion leaders. In one article, Julian E. Zelizer, a professor of history and public affairs at Princeton University, voices an oft-heard concern these days:

President Obama has allowed Congress to work out the details of the legislation…The problem is that he has neglected to keep working on the message. As Congress deliberates, reports inevitably emerged about the potential costs of the program and the limitations of the expected impact. Opponents of reform have steadily gained ground by warning of a government takeover. Support for reform has diminished. A coalition of centrist Democrats and Republicans are pushing legislation that falls far short of President Obama’s promise.
During the most successful struggle for health care reform — the passage of Medicare and Medicaid — Presidents Kennedy and Johnson were never shy in talking to the public about what they hoped to accomplish…Both of these presidents delivered speeches about what health care reform could accomplish. This was an era when liberals were comfortable talking to Americans about why government worked. At a rally at Madison Square Garden in May 1962, Kennedy rebutted every argument of his opponents and said, “This bill serves the public interest. It involves the Government because it involves the public welfare. The Constitution of the United States did not make the President or the Congress powerless. It gave them definite responsibilities to advance the general welfare, and that is what we are attempting to do.”

Most Dems will disagree with the forum contribution of GOP strategist Michael Murphy, but he may have a point or two worth mulling over nestled in his predictably partisan screed:

…When you do anything in Washington of such size that it directly touches the lives of most Americans, you had better be authentically bipartisan. Big changes are scary and difficult. Their fragile nature can only survive politics if both parties are chained together in a lifeboat of mutual survival. Otherwise one party will certainly torpedo the other.
True bipartisanship is difficult. It demands real compromise, an anathema to the drunk with victory ideological partisans who lead the Democrats in the House and Senate. Unfortunately, these are the people that President Obama has outsourced his health care plan to…Measures that only make broken things bigger and more complicated, without fixing or reforming core problems are an easy kill in Washington.

Harold Pollack, faculty chairman of the Center for Health Administration Studies at the University of Chicago, says of President Obama

…He should puncture complacency about an unsustainable status quo. You may believe that you have good insurance. Absent effective regulation, you have no real way to know. You certainly can’t know that it will remain affordable for you or your employer. As costs escalate and financial insecurity moves up the economic ladder, this really matters.

Robert Blendon, professor of health policy and political analysis at the Harvard University JFK School of Government and the School of Public Health, adds

…For about half of Americans, the critical issue is ensuring that their health premiums go down, not up. At the moment, people are worried that the trend is up. The president has to stop talking about the national problem of “bending the curve” — and instead talk specifically about how he will lower insurance premiums for average families.
…The president has continually talked about cutting back on Medicare to save money for health reform. He has to reassure seniors that the cutbacks won’t affect the benefits they are currently getting. Some of the problem is how people absorb the message. When they hear President Obama talking about “cutting back Medicare,” they think “benefits” when he means to aim his savings at paying physician, hospitals, and nursing homes less money.

Also in the New York Times, Carl Hulse has a revealing article about the difficulties involved in Dems using the ‘reconciliation’ process to pass health care reform by a simple majority vote. Hulse sees a possibility of a sort of hybrid strategy for Dems:

…Democrats are envisioning an unusual two-track approach. Under this strategy, some of the most contentious elements of the health plan — new taxes and fees as well as savings from Medicare, Medicaid and other federal programs — would be packaged in one bill that could be passed by a simple majority.
A second measure would contain the policy changes and program expansions and would be treated like an ordinary bill, subject to filibuster and amendment. But the thinking is that this legislative sidecar would contain enough popular programs to attract the 60 votes needed to overcome a filibuster. Voilà — a health care bill.

In the Sunday L.A. Times, Doyle McManus joins the chorus of pundits decrying President Obama’s “bend the curve” (slow the rate of increase) on health care spending as a yawner unlikely to excite popular support. McManus offers an alternative strategy:

Obama and his aides know they need to win this debate; they’ve known that all along. So what can they do?
First, reframe the issue — not as an arid fiscal question of “bending the curve” but as a moral and economic imperative to provide reliable coverage to those who have insurance as well as those who don’t. Obama began to do this last week when he unveiled an eight-point “bill of rights” for health insurance consumers and promised “stability and security.”
Second, endorse a specific plan — even though that means making someone unhappy. Obama hamstrung himself by allowing centrists in the Senate to attempt to fashion a genuinely bipartisan proposal… The goal was to see whether an earnest show of bipartisanship could win a few Republican votes. As long as Montana Democrat Max Baucus and Iowa Republican Chuck Grassley were negotiating — and it has been a very long time — Obama didn’t want to get too specific with his own “red lines,” lest he drive Grassley away. The time to jettison Grassley is near.
Third, mobilize Obama’s Democratic supporters. That won’t be as easy as it sounds. Many liberal Democrats would prefer the single-payer model that was never seriously debated in Congress this year. Many more will find fault with parts of whatever plan Obama finally settles on — for example, if he accedes to the Senate centrists’ proposal for health cooperatives instead of a single federally administered “public option” insurance plan. But the president can explain to the faithful that the Republicans would love to “break him” and that liberals shouldn’t make the perfect the enemy of the good.

Read more…

The sight of major conservative commentators ranging from Bill O’Reilly to Ann Coulter and top Republican officials Like Michael Steele directly attacking the “Birther” narrative — that Obama was actually born in Kenya and is thus ineligible to be president — marks an extraordinary moment in recent political history. For the first time leading conservatives and Republicans are explicitly attacking a widespread grass-roots extremist narrative.
In the past, this has always been absolutely unacceptable. Among movement conservatives there is even a specific slogan that explicitly rejects ever splitting the conservative movement with attacks on extremist views – “There are no enemies on the right.”
Just consider the following:

• In the Clinton years, videotapes, pamphlets and books by conservative publishers accused Clinton not only of infidelity and theft, but of murdering his business partner and smuggling drugs for the Colombian cartels. Democrats were accused of planning a UN invasion of the U.S. and mass roundups of patriotic Americans. Neither the leading conservative commentators like Rush Limbaugh nor the Republican political leaders like Newt Gingrich ever publically challenged any of these clinically delusional accusations.
• During the 2004 elections leading conservatives and the Republican Party not only refused to disavow the patently dishonest “swift boat” attacks on the military service and military records of candidate John Kerry and Georgia senator Max Cleland, but tacitly endorsed them.
• During the 2008 campaign, slanders against Obama – as being a “Muslim”, “terrorist sympathizer” or even the “anti-Christ” were widely circulated in a parallel underground internet based campaign. These slanders became so virulent that John McCain himself was finally moved to deny them during one memorable campaign rally. Sarah Palin, however, immediately picked up the gauntlet and, in her rallies, continued encouraging the expression of “tin-foil hat” views.
• After the election, the “Muslim” and “terrorist” accusations faded into the background as they were replaced by swirling charges of impending “socialism”, “communism” , “fascism” or all three at the same time — culminating in the Teabag protests on April 15th.

Why then, with this consistent history of allowing extreme right-wing myths to go unchallenged have major conservative commentators and top Republicans suddenly begun to challenge the “Birther” narrative? What’s so special about this particular view?
The answer — speaking metaphorically — is that the creature the official conservative/Republican movement has nurtured all these years has broken out of the laboratory and is beginning to ravish the countryside.
The first indication of a serious problem was the catcalls and booing of Republican politicians during the teabag protests. But the issue suddenly became critical in recent weeks as opinion polls began to suggest that support for Obama’s health care plan was starting to decline among moderate voters. This raised the possibility that Republicans might have a chance to derail Obama’s key initiative, inflicting a major political setback on his entire agenda.
To have a chance to achieve this major objective, Republicans now desperately want to avoid being identified with the birth certificate issue because the notion is overwhelmingly rejected by moderates. In fact, to most moderates, any Republican politician who flirts with this notion looks like an irresponsible panderer to irrational extremists – hardly someone to be trusted with reforming health care.
Hence the sudden desperation in official conservative and Republican circles to drive the creature they have created back into the lab where it can be restrained. The problem, however — as every horror movie since the classic 1931 version of Frankenstein depicts — is that the creature never actually does get recaptured. With the uncontrollable nature of the internet and the desperate struggle for ratings among conservative TV commentators, there are now simply too many independent forces providing support for “tin-foil-hat” extremist views for either the Republican Party or the official conservative commentators to regain control.
All one has to do is remember the movies. The lab-coated mad scientist who creates the creature always ends up getting thrown off the windmill, blown up in the laboratory explosion or gobbled up by the flesh-eating zombies he was in the process of creating as his personal army. Republicans are starting to feel an uncomfortable resemblance to those movie characters these days when they come face to face with their “tin-foil-hat” conservative constituents.
Hey, I wonder if George Romero is available to take a meeting…….

This item was cross-posted at The New Republic.
Tim Pawlenty made a much-anticipated speech to the Republican National Committee yesterday in an apparent first step towards a 2012 presidential bid. It wasn’t exactly greeted as a trumpet blast; a nice familiar tune from a kazoo might be a more apt metaphor. But after what’s happened in the last few weeks to putative 2012 GOP candidates John Ensign, Mark Sanford, and Sarah Palin, maybe he’s a “fresh face” in the sense of one that does not sport large blemishes.
The full text of his speech isn’t readily available yet. But from descriptions, it sounds like he performed the same dance that has been perfected by other Republican leaders such as party chairman Michael Steele: Republicans need to stand up to Obama, get back to their conservative principles, stop apologizing for their past, and oh, by the way, attract whole new categories of voters. It doesn’t say a lot for GOP outreach efforts that they think just throwing open the door and not being aggressively hostile to converts will do the trick, absent some change in message or policy. But the “not conservative enough” diagnosis of George W. Bush continues to exert an iron grip on GOP options for the future.
It does appear that Pawlenty talked a lot about “market-based health reform,” but it’s not clear yet whether he meant the kind of relentless return to the pre-insurance 1950s that John McCain’s 2008 campaign plan implicitly called for, in which Americans will be “empowered” to buy individual health care policies, or something a bit less antediluvian. But if Pawlenty came up with anything new, it clearly escaped his listeners.
One account of his speech said he received “mild applause” and a “polite standing ovation.” So it doesn’t appear he’s become Demosthenes overnight. This is a consistent problem for the Minnesotan. An upcoming book on the 2008 campaign (I’ve gotten a sneak peek) by Dan Balz and Haynes Johnson confirms that Pawlenty, not Romney or Lieberman or Ridge, was actually the co-finalist for the 2008 Veep nomination alongside Sarah Palin. McCain’s wizards settled on Palin after concluding that Pawlenty, while “safe,” didn’t add much to the ticket’s electoral appeal.
And that’s Pawlenty’s problem today. If it turns out that 2012 is one of those years when any credible Republican who is acceptable to the party’s dominant conservative wing can win, then someone who’s a right-to-life evangelical with an attractively middle-class background who has non-disastrously governed a Blue State might make a lot of sense. But unfortunately for Pawlenty, such a promising landscape would undoubtedly tempt the Republican Right to get behind a True Believer who breathes fire and doesn’t hide it with vanilla mints. After four years of shrieking at Barack Obama as some sort of Leninist agent, will a party whose members apparently doubt the President was born in this country really want a candidate like Tim Pawlenty? Probably not, unless the other viable options continue to drop like flies.

To hear most of the talk the last couple weeks, you’d think the drive for health care reform–and with it, perhaps, the Obama administration’s overall agenda–is running into a buzzsaw of adverse public opinion.
But accurately assessing public opinon on health reform requires a more careful look at polling data, and the recognition that thanks to the vagaries of congressional procedure, the “Obama plan” hasn’t yet congealed into a specific plan with a clear and consistent rationale.
Andrew Baumann of Greenberg Quinlan Rosner has a very helpful item up at Huffington Post that covers much of this ground. Here are his conclusions (see his full post for examples of each point from specific polling data):
* The public knows the status quo is unsustainable and they want fundamental change now.
* Voters don’t trust the Republicans on the issue at all and trust Obama and the Democrats far more.
* Most important, when voters get more information about the likely elements of the final plan, they like it.
But all these fundamentals of public opinion are at present being obscured by the complex maneuverings in Congress:

[A]ll voters are hearing are stories about how much the plan will cost (on top of the stimulus, budget and bailouts), that it will be paid for with high taxes and that Democrats are bickering and divided. Meanwhile, the attacks on reform coming from Republicans and their allies are much simpler and easier for votes to digest, especially when Republicans can train their fire on unpopular specifics that will not likely be in the actual bill.
All of this suggests that when Democrats can finally coalesce around a single plan and Obama can go out and forcefully sell it, support is likely to increase significantly and Obama and supporters of reform will be able to get more traction in their arguments.

Similarly, Mark Blumenthal of Pollster.com has an article out that examines the polling data on health reform in detail, and notes there is a significant “gap” between support for the principles Obama and Democrats have advocated, and the “health reform plans” as they are perceived by the public. His conclusion:

The case against health care reform is getting through; the case in favor is not.

In other words, there’s a lot of room for improvement in support for what Obama and congressional Democratic leaders are trying to do, if, and only if, perception of their “plan” begin to converge with the principles of reform that a majority of Americans already embrace.