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Return of the Plouffe


Barack Obama's campaign manager David Plouffe is reportedly being brought in to get the party into fighting shape for the 2010 midterms. He previewed his advice in Sunday's Washington Post, and it seems pretty sound. For instance:

Pass a meaningful health insurance reform package without delay. Americans' health and our nation's long-term fiscal health depend on it. I know that the short-term politics are bad. It's a good plan that's become a demonized caricature. But politically speaking, if we do not pass it, the GOP will continue attacking the plan as if we did anyway, and voters will have no ability to measure its upside. If we do pass it, dozens of protections and benefits take effect this year. Parents won't have to worry their children will be denied coverage just because they have a preexisting condition. Workers won't have to worry that their coverage will be dropped because they get sick. Seniors will feel relief from prescription costs. Only if the plan becomes law will the American people see that all the scary things Sarah Palin and others have predicted -- such as the so-called death panels -- were baseless. We own the bill and the health-care votes. We need to get some of the upside. (P.S.: Health care is a jobs creator.)

You'll notice that Plouffe doesn't spend a lot of time hedging that "this bill is not perfect, but it's better than nothing," or "this bill isn't Democrats' first choice, but it's still worth passing." Instead, he says it's a good plan that's been spun as a bad plan, and lists a lot of what it'll do to help families immediately. Democrats could take a lesson from that approach. It also relates to his final point, which is "no bed-wetting," but would be better phrased as "stop bed-wetting."

Right now, Democrats have a better agenda than Republicans. In fact, of the two parties, they're distinguished by virtue of actually having an agenda, which is the sort of thing voters generally want in tough economic times. But Democrats don't act like it. Instead, they're appalled by the compromises they've had to make to actually pass anything, while Republicans are enthusiastic because they haven't named a specific agenda (much less had to compromise on it to get 60 votes) and so everyone just assumes it'll be the one they want to see the party adopt.

Photo credit: AP Photo/Lionel Cironneau.

By Ezra Klein  |  January 25, 2010; 7:05 AM ET
Categories:  2010 Midterms  
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Next: The importance of going back on your word


--"If we do pass it, dozens of protections and benefits take effect this year. Parents won't have to worry their children will be denied coverage just because they have a preexisting condition. Workers won't have to worry that their coverage will be dropped because they get sick. Seniors will feel relief from prescription costs."--

And working people will get to pay for all the freebies.

Posted by: msoja | January 25, 2010 7:41 AM | Report abuse

No wait! Its George Bush's fault!! Thats it! Its GWB... not our agenda. Lets just keep walking this plank.

Posted by: jercary | January 25, 2010 8:01 AM | Report abuse

"It's a good plan that's become a demonized caricature."

Note the nature of the deals cut on this bill. We didn't offer Nebraska farm subsidies to get Nelson's support. The unions didn't demand labor perks for theirs. Florida didn't seek sugar subsidies in exchange for their support. In case after case, support was contingent on being excluded from one provision of the bill or another. It is not "a good plan" if support revolves around securing an exemption from it.

The bill really does collect taxes for years before it pays a benefit. It really does double-count Medicare savings. It does not fund the doctor fix. If you like the plan you have, that plan includes Medicare Advantage, and you don't live in Florida, then you really can't keep it. Middle class taxes really will go up. Care really will be rationed. These are not mischaracterizations.

It's not a good plan that's been caricatured -- it's a bad plan that's (hopefully/thankfully) being stopped.

Posted by: whoisjohngaltcom | January 25, 2010 9:08 AM | Report abuse

"We own the bill and the health-care votes."

Which is what it's all about. I suppose.

"(P.S.: Health care is a jobs creator.)"

A purely theoretical assertion (and an optimistic one), until it happens. Wasn't TARP supposed to create jobs? Wasn't the stimulus supposed to create jobs? Wasn't the job summit supposed to create jobs? Not just save a portion while losing 500,000 additional jobs, but actually create new ones?

I think one could be forgiven for being skeptical about Plouffe's assertion that health care is going to actually create jobs in the real world, no matter how good it looks on paper.

Given the regulations and taxes, health care might actually cost jobs. But you wouldn't expect the folks advocating healthcare reform to score it for it's possible impact on jobs in a dynamic market, and they don't.

That being said, Ezra is right: Plouffe's positive rhetorical approach is a thousand times better than the quaking-in-their-boots-over-one-freak-election approach many on the Democratic side seem to be exhibiting.

Posted by: Kevin_Willis | January 25, 2010 9:27 AM | Report abuse

"Right now, Democrats have a better agenda than Republicans. In fact, of the two parties, they're distinguished by virtue of actually having an agenda, which is the sort of thing voters generally want in tough economic times."

This seems inaccurate to me. The Republicans have HR 3400 - an excellent approach to making health insurance as competitive, and therefore as inexpensive, as automobile insurance or term life insurance. HR 3400 is, however, being neglected or actively suppressed.

HR 3400 is budget-neutral, it gives no power or revenue to politicians, and forces the health insurance companies to actually compete, so it is not very popular. It would, however, help many Americans.

Posted by: MKS1 | January 25, 2010 9:29 AM | Report abuse

God I hope that Plouffe has the kind of pull at the Whitehouse that he had with the Obama camp during the campaign, because this is by far the most sensible thing that I have heard coming from the Left since last week.

The ONLY way that I can see us getting comprehensive health reform in the next 10 years is if Obama comes out strongly behind passing the current bill through the house and amending (either in public or in private with Pelosi, Reid, and some prominent house democrats)

It really is basically a great bill and SO much more than anyone would have predicted prior to the election of BO... Democrats would have jumped at this thing any time prior to right now! Idiots...

Otherwise, as John Stewart so aptly pointed out, the Republicans will be playing political chess while the democrats are in the nurses office having glued their balls to their leg again.

Posted by: lazza11 | January 25, 2010 9:30 AM | Report abuse

PS - it's pretty funny that all of the republicans are on commenting early - I guess that the lefties will get on around noon after a wake and bake?

Posted by: lazza11 | January 25, 2010 9:33 AM | Report abuse

Kevin Willis, I have always said that there are *too many* jobs in the industry. All those billing specialists and insurance bureaucrats and all the people dedicated to arguing with you over the phone in an attempt to get you to give up in a billing dispute need to find other jobs in more productive sectors of the economy. At the same time, those people aren't employed in more productive parts of the economy because they are "job locked" into these jobs because they depend on the health insurance benefits. No one is going to elect me on that platform, though... instead, you see several senators whining that HCR will have a negative impact on insurance companies.

Posted by: constans | January 25, 2010 9:38 AM | Report abuse

*- it's pretty funny that all of the republicans are on commenting early - I guess that the lefties will get on around noon after a wake and bake?*


There might be something to this, actually. First, regardless of genetics, older people wake up earlier in the morning than younger people, and older people skew conservative. Also, your "early riser/ late riser" habits are mostly determined by genetics, and that, in turn will guide you towards jobs which encourage that kind of lifestyle. You always hear interviews with business executives (skewing conservative) that they always wake up at 5:30 am and offer that as a key to their success. Meanwhile you have software programmers, scientists, and other information-economy professionals (skewing liberal) taking jobs with more flexible schedules allowing them to mosey in around 10.

Posted by: constans | January 25, 2010 9:45 AM | Report abuse


Always exceptions, I suppose. I get up early because I have to. I'm a database analyst/programmer. And I work for the (county) government. But I am definitely older (40), though my liberal-to-conservative conversion came when I was about 20.

Still, if I had my druthers, I'd sleep most of the day and stay up all night. Alas, I haven't had that scheduling option since my college days.

That being said, I agree there are too many jobs in the industry, in that I tend to think much of our healthcare problems have to do with the layers of bureaucracy that have been inserted between patient and healthcare provider by the insurance industry, the hospitals, and the government--and in that order. However, I don't think that platform would win many votes, either. Let's go to mandatory catastrophic care insurance! And you pay everything else out of pocket. Man, I'd lose in a landslide.

My point was just that saying healthcare reform is a jobs creator seems either overly optimistic or actively disingenuous to me. Not that there are too few or too many jobs in the industry already.

Even so, I have given it some thought. Real nationalized healthcare systems have huge bureaucracies administering them in the U.K. and elsewhere, so maybe there could be a lot of real job creation--just all in the public sector.

Which, given where I'm employed, I shouldn't complain. ;)

Posted by: Kevin_Willis | January 25, 2010 10:39 AM | Report abuse

Ezra, why do liberals insist the Republicans “have no agenda” or “have no plan” or are “the Party of no.” Republicans have pages and pages of plans. You may not like them, but they have offered plenty of alternatives.

Posted by: kingstu01 | January 25, 2010 12:30 PM | Report abuse

I worked as a nurse for over 34 years, retiring less than a year ago. But I've heard no one mention one major source of increased healthcare costs...that is Joint Commission regulations. Thousands of dollars are spent in equipment, manpower, etc to address patient care issues designed to address situations no matter how rare or bizarre the circumstance. There has got to be balance. It appears to be overkill. You can not regulate everything bad our of healthcare..things will happen. Birds will fly into planes and people will slip in's called life. There is human error, equipment malfunction, personnel shortages. There is an enormous amount of time and $$ spent to comply with every little Joint regulation or risk losing accreditation The savings would be enormous if this would be steamlined and pared down. Balance please!

Posted by: dotherightthing4 | January 25, 2010 1:06 PM | Report abuse

Plouffe, as is everyone else who says that seniors will benefit on their prescription costs, is dead wrong. This is such a farce!
I explain....This is something I have experienced as a senior. In Dec.,2009, I needed a pain killer,Celebrex. I called my prescription plan insurance & asked the cost of 30 pills of Celebrex, since I was in my donut hole. I was told $300.I couldn't pay & I wouldn't pay that much so I suffered with the pain. I went to a local drug store & was told the 30 pills would cost me $43. Then I went to another druggist & was told the pills would cost me $26, provided the plan approved. On the Internet, the cost was $24.I opted to wait for the new year when my plan started again. But, if the same conditions prevail in 2010 & I enter the donut hole, my plan would still be charging me $300. The drug industry would pay 1/2, $150, according to the health plan. I would still have to pay $150 for it when, without the plan, I could walk into a pharmacy & pay a fraction of the cost, about $26, without taking a dime from Phrma, the pharmaceutical industry representative.
Meanwhile, after having raised their prices during the past year, my drugs are costing me 33% above what they were costing the year before, so the drug company will still be making a greater profit than they have ever made before, prior to my getting into my donut hole.
Having raised their prices over the past year, all people, not only seniors, will be paying higher prices for their medications, including the drugs that the feds pay for Medicaid, for the military forces, for the V.A. etc. No one talks of how these drug buyers will be recompensed for their overpayments. The pharmaceuticals were given a golden gift with this plan.
The insurance industries' offers to seniors are just as phoney. We are promised "free" preventive care & "free" office visits. As seniors with large deductibles & large co-pays, we buy a medical supplemental policy. These policies pay for preventive visits & office visits. Seniors pay nothing except for the insurance that is needed for other things, anyway. Seniors are getting from the insurance companies, "bupkis", a word we Jews use to speak of garbage or something a lot smellier.To me, with all its favoritism, with all its graft & deal making, with all its excessive costs & the taxes that will placed into it or because of it, this plan is also "bupkis" or that smellier thing....a.f.

Posted by: afed27 | January 25, 2010 6:25 PM | Report abuse

I just hope Plouffe can figure out how to make Republicans pay a political price for their stonewalling, filibustering, blocking confirmation votes, etc. Olympia Snow pretended to negotiate for months on health reform, and when she didn't get everything she wanted, she chose not just to oppose the bill but to vote against letting it come up for a vote. That's how 2-year-olds behave ("If you won't let me win, I'm taking my marbles and going home!"). But once the pundits and reporters started saying "60 votes" as if that were the normal operating procedure in the Senate, then it sounded as if she was just doing her job, rather than throwing a truly destructive temper tantrum. Oh, how I wish Obama would come out swinging at the Congressional GOP on Wednesday-- and how little I expect that to happen.

Posted by: RachelM2 | January 25, 2010 10:13 PM | Report abuse

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