Monday, 8 February 2010

Wherein I Write Probably My Longest Healthcare Post Ever

I've been a bit quiet on the healthcare front recently. Partially that's been necessary down-time to allow me to get over my speechless outrage at Democratic cowardice. That's faded at least a little; the last few weeks of grinding back-room negotiation might be exhausting, but at least it's how I expect politicians to behave. It's one thing to soberly conclude that a political manoeuvre is impossible, but screaming it out the very instant you hit a roadblock (Barney Frank, I'm looking in your direction) is incompetence and cowardice, plain and simple. Like I said though, I'm somewhat over it. A bit.

The other reason I haven't said anything on the subject recently is that I really don't have any idea what the Hell is going on. At present the most likely state of play seems to that the Senate is balking at the reconciliation option, but it's also possible the House can't get itself together (or both, I wouldn't want to imply both Houses of Congress can't suck simultaneously). It doesn't really get talked about anymore, but flip three "yes" votes from the previous House bill to "no", and we are, once again, utterly fucked. Remember that the only way the Democrats managed to get their signature legislation through the House, legislation aimed at fixing the problems that got much of this Congress elected, and through the body designed to be responsive to public opinion, was to screw over an entire gender. Ten or so Democratic Congresspeople actually said "The only way our party gets what our party was elected to do is if everyone else agrees to stiff poor women." Plus, as bad as that is, I can at least understand the position of Stupak et al (as I mentioned the other day); their stance on abortion (so far as I know) is based on a logical progression from a faulty understanding of the initial premise rather than vicious political chicanery. The ones who should really be beaten with studded paddles are the Democrats who don't share Stupak's principles, but were happy to cast"no" votes that not only risked American lives but also empowered Stupak's "compromise".

Sorry, that was a bit long-winded (I know, I know, what are the odds?). Basically, there are a lot of reasons why we're not getting anywhere with the Senate bill.

One constant in all of this though is both branches of Congress demanding that Obama get in the game. Well, he's been sounding a bit more focused lately, and we might actually be heading up on something.
As regular readers know, I'm skeptical of Barack Obama's continued insistence that the way forward on healthcare is to keep talking with Republicans in the hopes that eventually they'll start cooperating... In any case, he's proposed yet another meeting with Republicans later this month to chew the fat over healthcare reform and incorporate the very best ideas they have to offer.
There's a number of things to say on this. First of all, this is either very good news, or very bad news. The case for very good news comes from the perspective that if the Democrats were planning on letting the bill die quietly in the hope no-one would notice (which, as I've argued before, is a pathetically inept political misjudgement, but actually significantly less of one than not passing the bill to begin with; no point asking the guy who just swallowed poison why he didn't use a clean cup) , arguing about the specifics in front of TV cameras is about the worst possible move they could make.

The case for very bad news is the worrying possibility that this isn't an attempt to resuscitate healthcare so much as a chance to tell everyone it was the big bad Republicans who killed it. This, needless to say, won't work either. In fact, I'm not even sure it deserves to. I mean, anyone whose spent any time at this site knows how much I despise the GOP, but Drum was dead wrong when he argued last month that HCR was being derailed "by the political equivalent of a meteor strike." The only reason HCR got as far as it has was that the Republicans screwed up so massively that the Democratic Caucus was temporarily gifted a filibuster-proof majority in the Senate. That was the meteor strike. For a while it looked like we might be dealing with a breakdown more along the lines of 58 - 42. And there was certainly no reason to believe hitting the big six - 0 was a lock, or even particularly likely. And if every Democrat running for office in 2008, or helping their colleagues run, spent those months saying "We will deliver healthcare reform" whilst crossing their fingers and thinking "Unless we don't manage to secure an almost unprecedented Senate majority, of course" [1], then they deserve the disgust currently being heaped upon them by progressives right now even more than I'd already assumed. They knew what the board looked like, and they told people, desperate, broken people, that they could help. So, sure, Massachusetts was a second strike, but there's an adage in Warhammer that if your entire battle plan requires rolling a 2+ on one dice, it is not bad luck when you roll a 1. It's stupidity for forming a battle plan that hinged on a single dice roll (which is to say nothing of the fact that 60 in the Senate isn't 2+, more of a double 6).

All of which means two things. First, whatever this is, it isn't Obama fighting for a way to save HCR. We have that. What he'd be fighting for is a way to save HCR that allows the House to save face and doesn't require the Senate to show the slightest sign of having any kind of spine whatsoever. Second, if the Democrats are hoping they can use the sudden appearance of TV cameras to point figures, they are totally deluding themselves. Again, though, it's the poison-drinker with the dirty cup. If you can't persuade someone passing the legislation their party has been working towards for decades would be a good political move, what can you persuade them of?

It could go either way. Still, though, it would be nice to have all this over, and my money is on the former. At least, it's on the former in terms of the plan. Whether or not it will work is another matter entirely.

I'm trying to decide whether or not Obama's previous appearance on live TV facing off against the Republicans was a good idea in light of this new plan. At the time, I most certainly thought it a savvy move, and judged in isolation it still is. There's a strong argument to be made though that slapping down the Republicans then will forewarn them this time around. I doubt Obama will find it nearly so easy the second time. Of course, it would be entirely consistent with Obama's nature to have arranged the previous meeting as a dry run for this next one (it would also explain the comparatively short shrift HCR seemed to get in the SOTU, if you want to put that much faith in Obama's mid-term strategy; not to be confused with his mid-terms strategy). There's also the fact that a general Q&A provides Obama with a much bigger advantage than a healthcare debate, which means setting up in advance (and on national television) the idea that Republican talking points just don't work when offered to someone who actually knows what they're talking about might give him some kind of advantage whilst wading into the HCR mess.

That has it's own problems, though. Drum goes on to say:
The problem, as Ezra Klein points out in detail this morning, is that the current Senate bill actually incorporates most of the four big ideas that Republicans have put on the table: buying insurance across state lines, allowing small businesses to pool together to buy insurance, allowing states more autonomy to implement their own ideas, and tort reform.
I don't think this is the problem at all. That, if anything, is a modest bonus, because it would make very clear that the Republicans are bawling like spoiled children. The problem (and the reason the bonus above won't be all that impressive) will be this: it's going to be almost impossible to persuade people that the Democrats are in the right on this. Not because they aren't (though it's not like crappy bill vs. no bill is the best pitch in the world, or anything), but because it's just too hideously complicated a package for the discussion to not end up boiling down to he said, she said. Unless the Republicans are absolutely out of their minds (and remember, short-term political battles are where they excel), they won't bring up anything so crazy as death-panels. It'll be constant sniping in areas which are tough to defend with soundbites. While a dry run was Obama's style (and perhaps even required to get Congress on board), it's knocked the false confidence out of the enemy. In fact, there's talk that the Republicans won't even show up for this at all. Drum is right when he says that that would come with its own cost (and at this point I think one of the best things the Democrats can do is to paint the Republicans as unambiguous cowards), but you can be sure that if they do, they'll have a game plan.

So... colour me unconvinced. I think the fact it's being planned at all is a good sign, and it's nice to see the Democrats actually trying to get in on the PR game instead of cowering under their desks wondering why they can't get what they want without anyone being mean to them, but I'm pretty concerned that it isn't going to go as well as the Democratic leadership thinks.

[1] In truth, I don't actually know that it isn't unprecedented. I dimly remember it not being, but I could well be wrong.

No comments: