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Obama: If Democrats don't pass health-care reform, 'I don't know what differentiates us from the other guys'

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Today's televised session between Barack Obama and the Senate Democrats wasn't encouraging to those of us hoping the Democrats are spending their time worrying about how to pass the health care bill. There were questions on the deficit, on jobs, on partisanship, on energy and on judicial nominees. No one bothered to ask about health-care reform. The closest was New York's Kirsten Gillibrand, who asked about health care for 9/11 responders. It felt, for a moment, like we were back in the Bush years. Want to talk health care? Add 9/11 to the sentence.

To Obama's credit, he valiantly twisted questions on things like jobs and partisanship into opportunities to talk about health-care reform. He reminded Democrats that they have the second-largest majority since the 1970s. He mentioned the Village Voice's mocking headline, "Scott Brown Wins Mass. Race, Giving GOP 41-59 Majority in the Senate." Democrats laughed at that. Obama didn't. "Think about it," he said sternly.

If we don't pass this, he told the assembled Democrats, "I don't know what differentiates us from the other guys." It's nice to believe good things, but no one keeps their home, or pays for their doctor visit, because Democrats believe good things. "If anyone is searching for an answer to the lessons of Massachusetts," Obama continued, "I promise you, it's not to do nothing."

Evidence for that came in Tuesday's Illinois primary. Democrats were choosing their candidate to try to keep Obama's Senate seat. Republicans were looking for a standard-bearer able to take it. The turnout numbers were scary for the Democrats. As Jon Chait noticed, "GOP primary turnout is up 11 percent over 2004. Democratic turnout has dropped 29 percent." That's what elections looks like in a world where 59 Senate Democrats give up on health-care reform. The base gives up and stays home. And come the day after the election, those Senate Democrats will find themselves spending plenty of time home, as well.

Photo credit: By Jason Reed/Reuters


By Ezra Klein  |  February 3, 2010; 1:05 PM ET
Categories:  Health Reform  
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Comments

Which further supports my ongoing argument that the problem for progressives is not Obama, who is (surprise!) not perfect, but is making an honest, good faith effort to advance the agenda, and the Democrats in the house and senate, who are either entirely political (and timidly so) or entirely worried about their election campaigns.

Thus, Obama is right: there is no difference between Republicans and Democrats, in terms of motivations. They are all making political, not principled, calculations.

Frankly, I think Obama is on track and on message most of the time, but he can't do this alone, and he's not getting any help from congress.

So. Ahem. My congratulations to all the Democrats in congress. Good job. You could be a little more active in advancing the Republican agenda, but at least you're trying.

Posted by: Kevin_Willis | February 3, 2010 1:21 PM | Report abuse

Shorter version: Obama talks pretty.

That's anything but news. Let's see if he actually does something, actually expends some political capital and twists some arms in the senate. It's not all up to him, but I can't respect him if he doesn't try.

Posted by: alex50 | February 3, 2010 1:32 PM | Report abuse

"Democrats in the house and senate, who are either entirely political (and timidly so) or entirely worried about their election campaigns."

That's correct if you didn't know anything about what's happened up to right now. Since HCR began, Obama's done little in public to shore up support, while doing a lot in private to ensure the bill is super, super moderate. He wouldn't champion the PO, he wouldn't support single payer, he made deals with this and that group, and he helped drag out the process with Baucus because he was holding out for bipartisan support (and/or for a more watered down bill).

I mean, back in the beginning this thing was (1) underwhelming in terms of policy, (2) had very little payoff in its popularity w/ Dem voters but (3) had a somewhat big political payoff w/ the broader public should it have passed. That's a risky combination.

Now that (3) didn't go as planned, and because it's near impossible to fix (1), everyone is -- out of necessity -- focused on (2) and the Dem voters staying home in 2010.

But this is only ALWAYS the last thing to be considered by the Dems. While the GOP's actions always start from the bottom up, the Dems consider their base only at last resort. Without a base that'll fight at times like this, the party flounders and looks unprincipled to the public. It's all really, really depressing but really, really preventable.

Posted by: Chris_ | February 3, 2010 1:46 PM | Report abuse

I'm actually with the President on this one. I'm so over passing blame; I don't care anymore. Just get it done. Get. it. done.

Posted by: slag | February 3, 2010 2:06 PM | Report abuse

Obama should've added: 'And oh by the way, if you don't do it, you'll be totaled in November.

Posted by: leoklein | February 3, 2010 2:20 PM | Report abuse

"That's what elections looks like in a world where 59 Senate Democrats give up on health-care reform."

No, but it is what elections look like in a world where 60 Senate Democrats have been trying to ram it through. You guys will never, EVER, have that kind of majority again. Good riddance.

Posted by: whoisjohngaltcom | February 3, 2010 2:26 PM | Report abuse

i just called the DNC and cancelled my donations there until they pass healthcare. perhaps if they start losing $$ they will get the message.

Posted by: brandow | February 3, 2010 2:32 PM | Report abuse

Galt- when the majority is trying to do something that you don't like, it is not "ramming it through"

Posted by: Quant | February 3, 2010 2:32 PM | Report abuse

Republicans have to feel good to not be the piniata as they have been over the last 3 years of the Bush administration and instead be the stick.

It is a lot easier to sit on the sidelines and complain, as the Democrats did from 2005-2008 than to actually govern. A lot easier.

Posted by: lancediverson | February 3, 2010 2:43 PM | Report abuse

I am very pleased to see Obama out there swinging several days in a row. He is responding appropriately to having his back to the wall: fight.

Too bad many in the House and Senate are slouching and trying to slip under the feet of the angry mob.

I went to my precinct caucus in MN last night. Very low energy, small turn out. Biggest moments of the night were resolutions: anti-corporate, anti-sports-stadium-subsidy, and a weird anti-Israel bits.

Everything else was dispirited, desultory and deadly boring. I think if we felt that our MN delegation was actually going to get stuff done, take action, fight, then maybe the room wouldn't have felt so flat. Obama can lead, but the next tier has to be willing to go with him and shoulder some of the work.

Pass. The. Danm. Bill. NOW.

Posted by: RalfW | February 3, 2010 2:53 PM | Report abuse

yea but, on the other hand, where was the white house in the critical days after Mass. when the party was desperately looking for a point to rally around? nowhere in sight or sound. That was the time to come out swinging.

There aren't many here who've believed in Obama more than I have, and I still hope for 7 more years of good back-end policy. But tactically, it all feels very weak to me. Weak seems to be the Democrat brand. The Republicans are still controlling the message.

Posted by: rosshunter | February 3, 2010 3:43 PM | Report abuse

Quant:
"when the majority is trying to do something that you don't like, it is not "ramming it through""

You confuse the fact that a majority want healthcare reform with a fantasy that the majority wants this bill. A clear majority solidly opposes this bill, and the more they understand it the less they like it. Dems had a year to make this thing more and more popular, and every day it got worse. In the end you can't even find anyone on DemocraticUnderground who wants it.

It is rationing. It's an accounting gimmick. It's higher taxes. It's inferior care. It's higher premiums and costs. And if you like your current plan, you won't be able to keep it.

All that to cover a fraction of the uninsured, while potentially throwing millions of insured Americans out of coverage.

It's a scam, and Democrats shouldn't feel disappointed that it's going down in flames -- they should feel guilty for trying to push it through anyway.

Posted by: whoisjohngaltcom | February 3, 2010 4:15 PM | Report abuse

Galt- repeated missteatements don't make them true. But then again, I fervantly disagree with Rand, so maybe we're just not going to agree on anything. Who do you like in the Super Bowl? Maybe we can at least agree on that. Saints?

Posted by: Quant | February 3, 2010 4:23 PM | Report abuse

whoisjohngaltcom: "You confuse the fact that a majority want healthcare reform with a fantasy that the majority wants this bill. A clear majority solidly opposes this bill, and the more they understand it the less they like it. Dems had a year to make this thing more and more popular, and every day it got worse. In the end you can't even find anyone on DemocraticUnderground who wants it."

What bothers me is that galt makes sense, and I'm a liberal Democrat.

Posted by: alex50 | February 3, 2010 5:03 PM | Report abuse

EK (or is that eek?): "And come the day after the election, those Senate Democrats will find themselves spending plenty of time home, as well."

Well, its tell the truth time. Most will not be spending more time at home, and they know it. It's the other guys in the Dem. party that might be. And they don't really care about that.

Since the GOP seems intent on civil-war-like self destruction, the Dems prolly will maintain a majority, or so they think. Being chair of a committee is all that they care about, so they can be addressed Mr. Chairman (Senator is not enough, it seems).

Well, this liberal Dem says that there is nothing to lose. Obama can veto the worst of the GOP majority's worst offenses against the country. And President Palin will be a clarion call of reason, intelligence, and all those other good things, starting in 2012.

The ship has several holes in the hull. Why repair them? Let the Dems sink or swim.

Posted by: JimPortlandOR | February 3, 2010 5:56 PM | Report abuse

Obama is right, and many Americans seem to over look the fact that Obama has never committed half of the atrocities the Bush administration is responsible for.

Obama wants what is best for America and Americans should take more pride in the fact that they actually have somebody that's working for them!

Health care is good for everyone, a healthy society is a more productive society and therefore more economically viable.

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Posted by: swapitencryptit | February 4, 2010 2:25 AM | Report abuse

whoisjohngault: "You confuse the fact that a majority want healthcare reform with a fantasy that the majority wants this bill. A clear majority solidly opposes this bill"

But a substantial portion of the "opposition" wants the bill to go further than it does. That doesn't mean they necessarily reject what's actually in the bill.

"It is rationing."

We ration now. We just do it really really badly.

"It's higher taxes."

On a small, and mostly wealthiest, portion of the population. And hey, you don't get anything for free. Taxes are the way we pay for programs we say we want; they're not inherently evil, though many like to portray them as such.

"It's inferior care."

I've heard nothing to suggest that. And it's better than no care, which is what a lot of people get now.

"It's higher premiums and costs."

I don't think the CBO backs that one up. It said premiums would drop for most people.

"And if you like your current plan, you won't be able to keep it."

Change requires...change on the part of some people. It means doing things differently, and hopefully better. And that's the real problem: a lot of people say they want change but aren't willing to do anything to help make it happen. In which case: what kind of change can we really expect?

Posted by: dasimon | February 4, 2010 10:04 AM | Report abuse

I usually don't get too excited about Obama, but I am totally with him on this one. They better not move on to other issues before they pass the Senate bill in the House. They really ought to be ashamed of themselves for still sitting on this legislation. They'll have neither my money nor my vote unless they pass health care now.

Posted by: opinionpieces | February 4, 2010 3:03 PM | Report abuse

"We ration now. We just do it really really badly."

I see. So what is the rationing model in Obamacare? Since you're realistic enough to admit that not everybody can have all the care they demand, please explain the mechanism by which infinite demand will be allocated scarce resources. Because I already understand the "really really bad" system we have now, and so I'd like you to explain the new improved way we'll be rationing.

"[It's higher taxes] on a small, and mostly wealthiest, portion of the population... Taxes are the way we pay for programs we say we want;"

I'm betting that wealthy minority already has insurance, and is largely opposed to this legislation. Meaning that taxes are the way you propose for *them* to pay for programs *other* people want -- other people who, I might point out, don't seem quite as willing to pay for the programs with their own money. You see nothing dishonest (intellectually or otherwise) about this?

"[CBO] said premiums would drop for most people."

Only after they receive transfer payments of other people's money to help pay. In fact, the premiums themselves do go up -- it's the universal welfare that makes it affordable.

"a lot of people say they want change but aren't willing to do anything to help make it happen."

Which is why we should not try to give it to them. If they really wanted it, they'd pay for it themselves. Out of their own pockets.

Posted by: whoisjohngaltcom | February 4, 2010 5:22 PM | Report abuse

whoisjohngaultcom: "Since you're realistic enough to admit that not everybody can have all the care they demand, please explain the mechanism by which infinite demand will be allocated scarce resources."

I know that just about all of our peer nations get comparable health outcomes (meaning their rationing works at least as well as ours does), cover everyone, and do it for far less. They have several models for doing so. Read T.R. Reid's "The Healing Of America" for several versions of how to do things better.

"Meaning that taxes are the way you propose for *them* to pay for programs *other* people want -- other people who, I might point out, don't seem quite as willing to pay for the programs with their own money."

Many if not most of those who don't have insurance don't have it because they can't afford it. And one can't provide services for those who can't afford it without some kind of subsidy. That's why we have public education for people who can't afford to educate themselves. We made the choice that everyone should have access to education, so some people have to be subsidized. That's why we have Medicare, because many elderly individuals could not afford the insurance rates applied to that pool. If we make that choice regarding health care generally, the well subsidize the sick and the young subsidize the old. I am very honest about that (especially since I'm one who would be doing the subsidizing), and I would support it.

If the complaint is that there's a wealth transfer, that happens in the emergency room. Should hospital ERs be permitted to turn away people because treatment is often paid for by other people's money? And why doesn't that reasoning also apply to schools, or police protection, which also involve wealth transfers?

If you have a mechanism by which people who can't afford insurance can get it anyway without some kind of support from others, please propose it. Or admit that we're rationing on the basis of wealth and that people will and do die on that basis.

Posted by: dasimon | February 4, 2010 10:00 PM | Report abuse

(prior post continued)

whoisjohngaultcom: "Only after they receive transfer payments of other people's money to help pay. In fact, the premiums themselves do go up -- it's the universal welfare that makes it affordable."

As I wrote above, other nations seem to be able to insure everyone at a far lower cost with about the same health outcomes as we do. And they all have a mandate; yes, spreading the risk is what makes it affordable. That's what insurance does. And it involves transfer payments. But any of us could be on either end of that transfer. The young will eventually be old. The well may become ill. Those with jobs may become jobless. If we didn't know where we would wind up beforehand, we might agree to such transfers so that we would be protected against those risks.

"If they really wanted it, they'd pay for it themselves. Out of their own pockets."

It's my understanding that most of the uninsured are uninsured not out of choice but because they can't afford it; they either aren't making enough money, or have a preexisting condition or are elderly which would make them uninsurable under any reasonable rate. I would like to hear how people who are working full time and are worried about making the rent and putting food on the table will pay for health insurance out of their own pockets. Or how the elderly who worked for minimum wage and no longer have jobs would be able to afford premiums out of their own pockets.

Again, if you think that not everyone should get access to health care, then that ends the discussion. But one shouldn't disregard the consequences of that decision, or pretend that it isn't also a very serious kind of rationing.

Posted by: dasimon | February 4, 2010 10:01 PM | Report abuse

"Many if not most of those who don't have insurance don't have it because they can't afford it."

To the extent that's true, it still needs two questions asked. First, "can't afford it" doesn't mean they aren't placing priorities on other expenses. People who *truly* "can't afford it" qualify for Medicaid.

Second, you imply that the best solution is to make insurance cheaper. The legislation at hand actually makes it more expensive, and only claims to make it cheaper because it throws money (welfare subsidies) to less wealthy people.

"That's why we have public education for people who can't afford to educate themselves."

Actually, many, many people who could afford to educate themselves are forced to settle for public education. But you bring up a good point: What if today's healthcare model is the equivalent of having the whole country's kids in private school. The public is concerned with rising private school tuition, and Democrats are offering a plan geared first and foremost to providing free (universal) education to everyone. Your kids are in private schools, Obama is promising everyone free public schools, and you guys all believe it's going to be better?

"If the complaint is that there's a wealth transfer, that happens in the emergency room. Should hospital ERs be permitted to turn away people because treatment is often paid for by other people's money?"

Nope. But it should be limited to emergent care such as that rendered in emergency rooms.

"admit that we're rationing on the basis of wealth and that people will and do die on that basis."

Every system rations. Rationing on the basis of wealth is better than denying care that could prolong Grandma's life just so someone else won't have to file bankruptcy because of their cancer. You think that's a better basis for rationing than wealth, do you?

Posted by: whoisjohngaltcom | February 4, 2010 11:59 PM | Report abuse

It's not like the Democrats have been using "above board methods" to encourage passage of even a basic health care reform bill. Early on Obama crawled into bed with the pharmas and cut a deal that ensured higher priced meds for seniors, opening the door to the internet predators.


The most aggressive internet Scammer/Spammer is “Canadian Pharmacy”. It presents itself as a Canadian Pharmacy Internet Store, using a Russian internet website, with a San Bruno, CA “tie-in” telephone number. http://5cb7e8753.backson.ru/ Contact: 1 650 452 6975

It is not at all unreasonable to presume these drugs are ineffective placebos with little if any healing properties, or worse yet, may contain deadly ingredients.

Ironically, there are some in Congress who actually want to buy drugs on the open market for people using Medicare/Medicaid.

Posted by: asmith1 | February 5, 2010 7:50 AM | Report abuse

"Many if not most of those who don't have insurance don't have it because they can't afford it." To the extent that's true, it still needs two questions asked. First, "can't afford it" doesn't mean they aren't placing priorities on other expenses. People who *truly* "can't afford it" qualify for Medicaid. Posted by: whoisjohngaltcom |

Not true. I have a pre-existing condition that I can do absolutely nothing about – AGE. At 61, I am healthier than most 45 year olds, but that is of little consequence to the insurance industry– age is the determining factor that jacks up my health care premium triple what a 40 or 50 year old self-employed will pay for the same coverage.

Even if your income level meets the qualifications guidelines, if you have assets (savings account or own a home) you are automatically kicked out. If I were to lose my home and lived in a refrigerator box over a street heat grate, I would qualify for just about everything social services had to offer. But if I need a helping hand to get over the rough spot, our government will slap it away.

The only way health care/insurance reform will survive is if government regulates the insurance industry as it plans to regulate the banks. Capping health insurance premiums, based on income (using income tax return) will go much further to assist the uninsured. Unfortunately, our President and Congress are too deep into the insurance industry’s and pharmas’ back pockets to ever expect that to happen.

Posted by: asmith1 | February 5, 2010 8:05 AM | Report abuse

asmith1, I did not say "all." But I think we would find the real problem more workable if we truly had it in scale.

And I want to point out that the most important part of the 47 million is millions of healthy young people who consume very little care but who could be paying lots of money for everyone else's treatment.

I'm inclined to subtract them from the ranks of "the uninsured," since they're not exactly victims.

But liberals want them counted because in socialist terms they are, well, escapees.

Posted by: whoisjohngaltcom | February 5, 2010 9:17 AM | Report abuse

whoisjohngaultcom: "People who *truly* "can't afford it" qualify for Medicaid."

That's obviously not true. Medicaid thresholds vary from state to state. If you've got a preexisting condition, the premiums are so high that those people are essentially uninsurable. I advise trying to live just above the Medicaid threshold and see if you can afford insurance on the open market.

"Actually, many, many people who could afford to educate themselves are forced to settle for public education."

If they can afford to educate themselves, why are they "settling" for public education? And, by the way, many communities are very happy with their public schools, though there are obviously other communities with problems.

Again, how would you provide education for those who can't pay for it themselves without at least some kind of subsidy? Or should those people simply go without?

Nor have you explained why people who can't afford to pay shouldn't be turned away from the ER, since that's just another wealth transfer. (And rendering ER treatment for those people drives up costs when they could get continuing care that might keep them from getting catastrophically sick in the first place.)

Rationing on the basis of wealth is better than denying care that could prolong Grandma's life just so someone else won't have to file bankruptcy because of their cancer. You think that's a better basis for rationing than wealth, do you?"

Again, read T.R. Reid's "The Healing Of America." They don't ration on the basis of wealth. They get just about the same health outcomes as we do. And they spend tons less. So whatever they're doing, they're doing pretty well and not on the basis of wealth. And by and large they're not killing grandma either.

Moreover, if you have wealth, you can always go outside of the system and get whatever care you want. So that argument is really a canard.

Again, what's your solution? Or do you think that some people should just go without access to health care (or they should just go to the ER, which we all pay for, and then die prematurely because they don't get the continuing care that would help them)?

"the most important part of the 47 million is millions of healthy young people who consume very little care but who could be paying lots of money for everyone else's treatment."

Yes, that's true. As I wrote above, if you're going to have universal coverage, there has to be a mandate. The young subsidize the old. But the young will eventually be the old, so it evens out. That's how all of our peer nations do it because they've made the decision that no one should die or go bankrupt because they got sick. And as just about any measure shows, they do as well or better than we do for a lot less money.

Posted by: dasimon | February 5, 2010 2:30 PM | Report abuse

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