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Imagining the world of inaction

A nice point from Jonathan Cohn:

When corralling sixty votes depends on winning over some combination of Senators Susan Collins, Joe Lieberman, Ben Nelson and Olympia Snowe, passing truly liberal legislation is going to be difficult, if not possible. The only way to change that is by electing more liberals to the Senate, changing the way the Senate runs, or some combination of the two.

That project will require time. It will also require convincing voters of something too few of them believe already: That government action can be make a difference in their lives. Passing health care reform, even a deeply flawed one, will help enormously in that regard.

There's really nothing about this situation that gets better if health-care reform doesn't pass. Barack Obama doesn't get more momentum for cap and trade. Democrats don't pick up more seats in the next election. Politicians don't become more ambitious in their attempts to reform the health-care system. The media doesn't get more dismissive of unceasing obstructionism as a minority party philosophy. The public doesn't become more confident that government can get anything done. And beyond that, all the problems that the bill is meant to fix continue getting worse, instead.

By Ezra Klein  |  December 4, 2009; 6:31 PM ET
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And Sarah Palin can claim she won with "Death Panels."

Posted by: glewiss | December 4, 2009 7:53 PM | Report abuse

This has been Rahm's position from the start ("The only thing non-negotiable is success"), and was also the gist of Bill Clinton's pep talk on the Hill. But the problem remains: where do you draw the line? How flawed can it be and still "help enormously," or provide momentum for Obama's agenda, or help Dems pick up seats?

In my view, either removing the public option--even in a trade for better subsidies or a strong national exchange--or gutting it further by turning it inside-out into a triggered, opt-in, state-by-state NGO co-op, will NOT allow the bill as a whole to help enormously, or build momentum for Obama's agenda. That's because the millions of poor, sick, or just plain scared people who would have been helped by the public option, will STILL be forced to buy insurance from Aetna, Wellpoint, Blue Cross, etc. It will most likely be from the rock-bottom tier of the exchange, utterly crappy coverage, certainly still too expensive for many, and lacking any legitimate price controls or even downward pressure.

This population will be a small percentage of Americans, but they will be proxies for a MUCH larger swath of mainstream, middle-class Americans, mostly Democrats but a lot of independents too, who want a public option now--60% of the country at last count. They will be happy about the insurance reform, but utterly disappointed and demoralized at the failure to create a government-backed safety valve of *coverage they can trust.*

I don't agree with Dean that a bill without the public option will be worthless, but I do believe the medium-term political fallout will be mixed to negative, and THAT will scuttle any hope of coming back and establishing a true public option within the next 6 years. Or, for that matter, any hope of improving the other flaws in any meaningful way.

Posted by: andrewlong | December 4, 2009 8:17 PM | Report abuse

I am liking Jonathan Cohn more and more and you as well for continuing to post his stuff. You go to war with the Senate you have not the Senate you wish you had! If we want this changed, we have to get different people elected, and if the left doesn't understand that, they are truly out of it.

Posted by: LindaB1 | December 4, 2009 9:57 PM | Report abuse

"And beyond that, all the problems that the bill is meant to fix continue getting worse, instead."

The problems the bill is meant to fix are going to get worse anyway because it doesn't actually fix anything. And 7+ years from now when liberal bloggers are moaning about not having focused on root problems (rather than the symptoms), it will be even harder to fix because this fix, and the party behind it, will have been totally discredited.

Posted by: Athena_news | December 4, 2009 10:50 PM | Report abuse

Agreed Ezra. Then why these elected Democrats do not understand this? Just because we electorate are in a 'bind' does it mean these Democrats to continue their 'rape' of our fiscal situation when they insist to foist upon us some totally illogical and discredited ideas as some kind of policy?

You yourself have admitted that the root problem of 'provider cost inflation' is not directly addressed by these bills. So to start with we have only indirect or secondary means to control the costs. Beyond that even these meager measures are screwed and compromised. While this lunacy is happening, of all the people, you are carrying their water and preaching us that it is 'OKAY' to back this bill!

In the end that very well be the case. But just because 'defeat of fiscal prudence' is there with all it's humongous jaw open, does not mean we should quit our fight to bring some sanity among those Democratic Congressional folks who are sitting naked on Capital Hill.

These are avoidable mistakes by Democrats on Capital Hill and those need to be corrected in the final bill. I wish President was more vocal in demanding 'fiscal sanity' from Democrats. But that is not happening too.

Electoral defeat in 2010 and 2012 is yet another answer and that may very well happen in the end.

Posted by: umesh409 | December 5, 2009 12:25 AM | Report abuse

"You go to war with the Senate you have"

Are you for real? Quoting Don Rumsfeld to attack the Ted Kennedy wing of the Democratic party? I'm 100% with Athena on this one.

Posted by: bmull | December 5, 2009 2:50 AM | Report abuse

It is a long fight. The conservative movement started with a spectacular failure (Goldwater's campaign). Then Nixon won the White House and governed from the center because there was no other chance to get things done. But he planted the seeds of everything that was about to follow. Judicial appointments, imperial presidency, the first attempts at free-market radicalism (in Chile), wiretapping and sleazy campaign strategies. Reagan went down that road a little further. But with a democratic house he also couldn't get everything he wanted. But Gingrich's victory was the next step. Clinton already had to govern from the center because there was no other way. The policies so far created a vulnerable middle-class deeply susceptible to short-term thinking and hostile to the government. Then Bush II capitalized on all those developments.
It took movement conservatism about 35 years to install itself as the leading ideology. They now have their own propaganda network (FoxNews), their own think-tank universe (Cato, Heritage, 60+, the teabaggers etc..), their own echo chamber (from Michelle Malkin to David Broder) and a populace full of resentment.
Luckily, the Bush administration failed as spectacular as they did. The next conservative president would have blown up the safety net and installed a deeply conservative supreme court to overturn Roe vs Wade and the civil rights legislation.
Movement conservatism hasn't recognized its failure yet, no wonder after 30 years of success, and that's why they are still so ferociously defending their positions, because the movement needs to go on.
But the progressives need to remember that they will also have to wait some years until they can achieve their goals. The judicial system is full of conservative ideologists. The media are full of people who have built their careers on alignment with conservatism (like David Gregory, or Mark Halperin). The people don't trust the government, especially AFTER the failures of the Bush administration (self-fulfilling prophecy). The conservative special interest groups are still in full power inspite of their spectacular failures (banks, insurance companies, military contractors).
Progressives have to be patient and they have to fight the old regime bit by bit. Each result in a progressive direction, no matter how small, will change the playing field for the next struggle. At the beginning, the victories will be small. But they'll grow over time.

Posted by: GCReptile | December 5, 2009 10:24 AM | Report abuse

All true - but if people who need health care still can't get it (likely and certain for 5 years or so) and people who want people to be able to get health care just feel screwed, that too is a devastating loss.

Posted by: janinsanfran | December 5, 2009 12:32 PM | Report abuse

on whether a flawed bill will be worth it or not, I'm happy to agree with Jacob Hacker:

"Those who believe in the public plan—and, more important, who believe in the principle it embodies: that no American who lacks access to good insurance should be forced to buy coverage from the private plans that got us into our present mess--should stand firm in the face of these non-compromises.

This includes President Obama. He made the public plan part of his promise of change in 2008. Now he needs to put his weight and influence behind the public plan and its essential goals, rather than allow them to be gutted. This is in our nation’s interest. It is also in his and his party’s political interest. A bill that forces people to take private insurance but doesn’t create competition or a public benchmark is a prescription for unaffordable coverage, runaway costs, and political backlash. The “middle ground” is nowhere to stand if it’s going to crumble beneath you."

Posted by: andrewlong | December 6, 2009 4:08 PM | Report abuse

Forcing people to buy crappy insurance they can't afford and that doesn't pay for anything...passing an epically awesome "health care reform" and premiums still go up 10-20 percent a year for most people....reforms that don't kick in until after the 2012 elections. This is political gold for the Democrats? Really?

Posted by: AlanSF | December 7, 2009 1:00 AM | Report abuse

"This is political gold for the Democrats? Really?"

Compared to coming away with nothing at all? Absolutely.

I don't see a good argument on the other side. If we come away with nothing at all, the base stays home this fall, we lose several Senate seats, and the Dems go a long time (if ever) before their numbers in the Senate get this good once again. Which means the complete and total flatlining of the liberal agenda for years to come.

Being able to extend even as much awkward ability to move things forward as we have now, depends entirely on being able to at least break even in Senate elections in 2010.

If we were so lucky as to pick up a couple of seats, we might even be able to amend health care reform in a positive manner before it even begins, and the vote we'd need would be the *third* most recalcitrant member of the Democratic caucus: we could tell Nelson and Lieberman to kiss off, if need be.

Obviously, that's unlikely. But think of if we lose three seats. Then we need every Democrat and pseudo-Dem, plus Snowe and Collins, plus one hardcore Republican. And at that point, it's game over.

So I'm with Ezra: health care reform, even with no public option, is better than no health care reform.

Posted by: rt42 | December 7, 2009 10:23 AM | Report abuse

I came late to this, but I wanted to address the issue/concept of "Passing health care reform, even a deeply flawed one, will help enormously in that regard"

First, I don't believe it - I don't believe that people will, after whatever Lobbyist-satisficing sausage is produced, improve their perception of Government. There are two reasons for this:

1. The unintended and unanticipated consequences of the various elements of the reform bill.
2. The loud and media-amplified vocal outcry from people who perceive an injustice in the reform bill.

I can't really speak to exactly what is in (1) - otherwise it would be anticipated. One thing that technocrats are very, very bad at is anticipating public reaction to their proposals. This one is no exception.

#2 is perfectly obvious, however - just like the Breast Cancer screening fiasco, someone will make some sort of rule, and some small-but-media-attractive group of people will be affected negatively by it, and they will raise a hue-and-cry about how unfair and unjust the new system is. And the politicians will duck and run for cover, and point fingers, throw money at the problem and probably plug that particular hole. But that will encourage other groups to raise their own tantrums, more finger-pointing, more money, and after a few of these the general opinions will be:

a) Th government produced a horrible plan that left all these people out
b) Health care costs were supposed to moderate, but they're spiraling out of control!

Posted by: johndbro | December 7, 2009 1:14 PM | Report abuse

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