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Political differences masquerading as philosophical ones

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"There's a philosophical difference in how we do this," Sen. Tom Coburn said at the Blair House Summit. "It does have to do with the philosophical difference," Rep. Eric Cantor agreed. "There are very deep philosophical differences in how we approach health-care reform," Rep. Marsha Blackburn emphasized. "There really is a difference between us," explained Rep. Paul Ryan. "And it's basically this. We don't think the government should be in control of all of this."

It's true, of course, that there are some philosophical differences between Democrats and Republicans. But Republicans did something interesting yesterday: They turned a lot of policy differences into questions of first principles. And it's harder to compromise on a first principle.

When Cantor pointed out his philosophical differences, for instance, he was talking about how "the Secretary defines what a health benefit package should be." That overstates the role the secretary of health and human services has in setting a floor for insurance in the exchanges, but nevertheless: When Republicans created health savings accounts, they had the government define what the package would be. And when they created the Medicare Prescription Drug Benefit, they had the government define what the package would be. And when Rep. Paul Ryan created his proposal, he set the minimum value of a benefit package. "You need to define what insurance is," Ryan told me. "I agree with that."

Marsha Blackburn was saying that Americans "want us to give them the ability to hold insurance companies accountable. One of those ways is through very robust competition." Her solution, and the GOP's, was "across-state-line purchasing of insurance." Other methods of competition -- from exchanges to a public option -- were not included.

But even purchasing across state lines is not always a matter of philosophy for the GOP. In 2009, the Credit Cardholders' Bill of Rights passed the House, with Blackburn voting for it. The bill preempts many state regulations on the credit card industry and replaces them with federal regulations. So even if you could get a credit card cheaper from a state that allowed companies to increase rates in the first year of a card, or apply payments to the lowest-interest balances first, you're no longer allowed to. The philosophic appeal of letting South Dakota decide the regulatory standard for the rest of the nation collapsed in the face of the practical problems.

The charge here is not hypocrisy, exactly. The GOP surely supports the policies it says it supports, at least at the moment. But they have elevated a variety of policies that they're willing to compromise on in other contexts to the level of philosophical difference. That makes compromise very difficult. After all, if you believe in purchasing across state lines (which means the national standard is equal to that of the laxest state) and I believe in federal regulation, a compromise could be that each state handles its own regulations (which is what we have now), or that states can choose to enter into compacts with one another that will allow insurers in one state to sell to all participating states (which is what is envisioned in the bill). But if this is a philosophical difference, well, too bad.

Similarly, if the question is the precise method of figuring out how to define insurance, than a compromise can surely be reached. After all, if Ryan's plan demands actuarial values equal to Blue Shield/Blue Cross and the Senate plan actually allows for more variation in actuarial values but says that certain categories of treatment (pediatrics, for instance) need to be included, that seems custom-designed for compromise. But if, as Cantor says, this is really about "a deep philosophical difference," then compromise is unlikely indeed. You don't bargain with Aristotle.

It was during the Cantor exchange that Joe Biden finally had enough. "Mr. President, can I have 10 seconds?" He asked. "Literally 10 seconds." The president nodded, or didn't answer fast enough to head Biden off. "We don't have a philosophic disagreement," Biden said. "If you agree that you can't be dropped, that there has to be dependent coverage, that there's no annual or lifetime cap, then, in fact, you've acknowledged that is the government's role. The question is how far to go."

But because the Republicans in the room didn't want the question to be "how far to go," they drew philosophical battle lines that will be erased next time they're in power, or find a bill they want to vote for. This was most clear, possibly, in Sen. Lamar Alexander's opening remarks, in which he explained that "we've come to the conclusion that we don't do comprehensive well."

Alexander's argument on that point is detailed and sophisticated, but it's telling that he came to the conclusion when Democrats took power and began proposing bills, rather than when he voted for the undeniable comprehensive Medicare Prescription Drug Benefit or co-sponsored Wyden-Bennett (in July, Alexander said "we should support legislation like the Wyden-Bennett plan I’ve co-sponsored," which is much more comprehensive than the legislation the Senate eventually passed).

Like the philosophical objections preceding it, Alexander's argument is not that this bill should be structured differently, but that it, and bills like it, should not be done at all. You can fashion a compromise between someone who supports the structure of Wyden-Bennett or the Prescription Drug Benefit but has qualms about the Senate bill. Alexander's argument against all comprehensive legislation, however, is a philosophical position about the proper workings of the United States Senate, and it is not one that he held in the majority, and it is not one that permits space for compromise now that he's in the minority. I'm not accusing anyone of insincerity on these points, but just as many people discover religion in the face of tragedy, the GOP appears to have discovered philosophy in the face of a Democratic majority.

Photo credit: White House Photo by Pete Souza.

By Ezra Klein  |  February 26, 2010; 9:52 AM ET
 
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Posted by: bocaaddress | February 26, 2010 9:59 AM | Report abuse

I continue to be amazed by the fact that the House has still not yet brought the amended health care reform bill to the floor for an up-or-down vote by the majority. If the bill is as good as its supporters claim, why would the Democratic Party obstruct a simple up-or-down vote by the majority?

From December 24 until today -- two full months now -- the Speaker Pelosi has refused to bring the bill up for a vote... or even debate. What aspect of majority rule does the Speaker fear so much that would cause her to place human lives at risk -- to murder, as some might write -- for so long?

When asking "how far to go", it seems like a single step might not be too far. Before asking why Republicans can't take further steps, it seems appropriate to ask why Speaker Pelosi and House Democrats can't at least take a small step.

Posted by: rmgregory | February 26, 2010 10:07 AM | Report abuse

Chat-question.Assuming house members don't trust the senate but dems trust the POTUS, could the following theater work? House dems approve the senate version, send the bill to Obama. HCR is real. Obama doesn't sign saying it's not good enough. Senate make Obama changes through recon, sends back to the house, everybody looks good.

Posted by: bocaaddress | February 26, 2010 10:08 AM | Report abuse

Stick with wonkery. Your philosophy is rendered worthless by projection.

It's interesting to watch you try to understand the right, but if you really understood it you wouldn't be on the left in the first place.

Posted by: cpurick | February 26, 2010 10:09 AM | Report abuse

"When Cantor pointed out his philosophical differences,"


when cantor sat there with the health care proposal, and used it as a way to ridicule the president, it was ill will and unkindness masquerading as political and philosophical differences.
i think, giving cantor credit for deeply held philosophical or political commitments, gives him way too much credit.
in front of the cameras, cantor was looking for a way to belittle president obama. but what showed up instead was his disingenuousness and unkindness.
by ridiculing the size of the text of the plan, cantor just revealed his own jealousy and insecurity with obama's intellectual grasp of complex issues, and the possibility that president obama might succeed, and something good might come out of all of this for the country.
the largeness of the health care plan is in direct proportion to the smallness yesterday, of cantor.

like everything else in life, underneath the masquerades, this was all personal.

Posted by: jkaren | February 26, 2010 10:10 AM | Report abuse

and by the way, ezra....

congratulations on participating in a truly fine panel discussion yesterday evening, on the charlie rose show.
i particularly enjoyed the chance to hear joseph califano and donna shelala, speaking of personal experiences.
television at its best....for anyone who gets to see the re-run of it today, it will be time well spent.

Posted by: jkaren | February 26, 2010 10:13 AM | Report abuse

This dynamic has been glaringly evident since the stimulus debate and vote, when all of Obama's concessions on tax cuts for the rich garnered zero Republican votes in the House. For months the administration and its media enablers (EK, Dionne, Yglesias, Benen) clung mulishly to a bipartisan compromise strategy ( tort reform, insurance exchanges, no PO) and for what? The likelihood of failure and monumental losses in November.

Again, many of us recognized the danger as far back as last summer, but were told repeatedly to STFU; that the PO was expendable; that Olympia Snowe would heed the call of history; that a 60-vote strategy was preferable to reconciliation; that Stupak language would be the bitter pill pro-choice men and women must swallow to cross the finish line; that Paul Ryan's death-wish for Social Security and Medicare must be treated with the deepest respect. With friends like these, no wonder healthcare reform will die.

Posted by: scarlota | February 26, 2010 10:14 AM | Report abuse

The philosophical differences go deeper than just a question of the purpose of government. There seem to be even more fundamental differences concerning the obligations and responsibilities of representatives to their constituents.

Republican legislators these days see the purpose of federal office as something that an individual trades on for personal enrichment. Votes and legislative measures are determined almost exclusively on the basis of what the highest bid is (e.g. who other than an insurance industry ex could have dreamed up portability based on a race to the bottom approach? This idea certainly didn't emerge fully formed from any politicians mind).

Some elected Dems practice the GOP approach as well. However, I'd say that a narrow majority tends to take a less cynical and more disinterested view of their professional obligations.

Posted by: JPRS | February 26, 2010 10:14 AM | Report abuse

The unstated GOP position seems to be "leave well enough alone". They don't state this because of the 45,000,000 Americans without health care and the millions more with unsustainably expensive and/or inadequate insurance.

Part of this stems from their belief in markets, no matter how uncompetitive those markets maybe, and part of this maybe be as Congressman Weiner stated, that they are in the pay of Big Insurance.

The fact that they controlled the government for 8 years and didn't even attempt to address this obvious issue shows that their solution is to let it fester until who knows when.

Posted by: AxelDC | February 26, 2010 10:17 AM | Report abuse

GOP Philosophy: How much can we steal? How fast can we steal it? Who can we blame it on? How long can we keep it up? Who can we trick into supporting us by whatever lies it takes?

Posted by: larry9 | February 26, 2010 10:18 AM | Report abuse

It will take a little time to sink in, because it was long and most people will never watch all of it. Still, many things will be mentioned in the coming barrage of op-eds and video mash-ups, and the following points are likely to last, long after the spin has subsided:

(1) There will be a personal approval boost for Obama, for being able to lead a seven-hour conversation, and for letting Republicans have their full say. He let them talk, and he answered every point.

(2) The Republican substantive arguments are factually and intellectually weak, and surprisingly so. Their "philosophical argument" is really: no universal care, no law against pre-existing conditions. A big and bad Achilles' heel.

(3) The wavering congressional Democrats will feel that they have some political cover.

(4) The opinion poll on the healthcare reform will move back to a dead heat. It is now a 10 or 11-point spread (10 points, Pollster average; 11 points, Real Clear Politics average.) This has narrowed an average of 3 points since January 1 (i.e., without much else but people thinking about it) -- and it will now narrow to statistically insignificant.

Why? Because that 10 to 11-point spread is half composed (i.e. 5% or so) of independents and progressives who will change their minds. There are independents who like the details but are unsure of the coherence of the entire reform package, and there are disaffected progressives who want a public option and just heard at least four senators at the summit vow to press on with it, after passage of this bill. So some of these people will return to the Dem column. This makes a dead heat.

(5) Proceeding from #4, if the Dems pass the bill, they will also pick-up some team spirit, and this is going to limit their losses in November to the normal midterm turnover.

Posted by: Lee_A_Arnold | February 26, 2010 10:19 AM | Report abuse

-our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!

Posted by: cmt138 | February 26, 2010 10:20 AM | Report abuse

-our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!

Posted by: cmt138 | February 26, 2010 10:24 AM | Report abuse

Of course it's political differences. The President's 11-Page proposal for Health Care reform is a figurative carbon copy of the GOP proposal for Health Care Reform in 1993.

They supported the *exact same proposal* 15 years ago, but oppose it now because it's being proposed by a Democratic President.

Democrats could propose a bill proclaiming Rep. Boehner, Rep. Cantor, and Sen. McConnell to be awesome, and each one of those guys would take the podium to decry what jerks they are. "The President says I'm awesome, but the truth is, I'm quite an A-Hole."

Posted by: VTDuffman | February 26, 2010 10:26 AM | Report abuse

The right's "philosophy" can be summed up in 3 words: I've got mine.

That's all you need to know about them.

Posted by: solsticebelle | February 26, 2010 10:28 AM | Report abuse


Politics. The GOP has no principles. Is what GOP Sen. Jim Bunning said Thursday night on the Senate Floor, "Tough S.H.I.T.," one of the GOP's principles?

Posted by: edanddot | February 26, 2010 10:29 AM | Report abuse


-our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!

Posted by: cmt138
===============

our president is precisely interested in giving the American people want to need and deserve. Namely health care reform. This would be the greatest accomplisment of the 21st century.


Posted by: demtse | February 26, 2010 10:31 AM | Report abuse

-our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!

Posted by: cmt138
===============

our president is precisely interested in giving the American people want to need and deserve. Namely health care reform. This would be the greatest accomplisment of the 21st century.


Posted by: demtse | February 26, 2010 10:32 AM | Report abuse

If Obama and the Dems can't figure out now that the GOP are saboteurs, then God help us all.

Posted by: Lomillialor | February 26, 2010 10:40 AM | Report abuse

Obama and the Democrats are Nazi thugs who have declared war on the people of the United States.


Posted by: Jerzy | February 26, 2010 10:45 AM | Report abuse

Let me see if I get this right. Erza Klein, a committed Socialist, is going to give advice to the Republican Party on "politics or principle?"

Washington Post, you are pathetic.

Posted by: Indpnt1 | February 26, 2010 10:46 AM | Report abuse

The republicans have no principles that's one of their problems--having no plans except tax cuts for the wealthy and Big Business is another.The republicans need to get rid of their two biggest losers Mitch McConnell and John Boehner of course Harry Reid on the democrats side is not a winner either.

Posted by: LDTRPT25 | February 26, 2010 10:47 AM | Report abuse

"The GOP appears to have discovered philosophy in the face of a Democratic majority." That would not be unusual. Many Americans discovered philosophy in the face of Nazi and then Communist tyranny. The prospect of government control of the health care system has caused may of us to rediscover what we believe. Oh yes, Americans are aware as well that the national debt is in the stratosphere and that the deficit is at the unrepayable level. Is opposition to spending 3 trillions more policy or philosophy? It doesn't matter.

Posted by: mhr614 | February 26, 2010 10:48 AM | Report abuse

President Barrack Obama, the first MARXIST president in American history, according to ALL of the polls, is the most polarizing figure of American politics of the last one hundred years.

IMPEACH HIM NOW

Posted by: Indpnt1 | February 26, 2010 10:48 AM | Report abuse

Politics, of course. The GOP has a special constituency, the very rich. They have to craft everything to please that audience while seeming to appeal to a larger group.

The GOP claims to be fiscally conservative, but the two presidents in my lifetime who added more to the debt than all the other presidents before them combined were Ronald Reagan and George W. Bush.

The truly fiscally conservative one is Ron Paul. He would starve the government to death. The Republicans would just preach thrift while funneling billions to their own constituents. Remember the senator who held up all of Obama's nominees to get billions in unnecessary earmarks for his state? That's the GOP.

Posted by: tinyjab40 | February 26, 2010 10:49 AM | Report abuse

Jerzy: "Obama and the Democrats are Nazi thugs who have declared war on the people of the United States.

Just thought I'd repost this to remind people what a piece of lowlife scum you are.

Posted by: koolkat_1960 | February 26, 2010 10:52 AM | Report abuse

The GOP has one philosophy: sink Obama. That's it. Country be damned. They are the most reprehensible crew I've seen in my lifetime.

Once upon a time, the parties at least SOME of the time put aside their differences to help us.

Today, these republicans could. not. care. less.

It's all about scoring points. It started with the nastiness of the Bush/Cheney administration.

It's digusting. I don't know how these people sleep at night.

Posted by: monk4hall | February 26, 2010 10:53 AM | Report abuse

Correct Sir, I agree the REpublicans are out of touch and out of step! They used the reconciliation Process over 22 times to pass their disasterous/agenda, that has lost the United States over 8 Million jobs, left you/America a record debt/deficit/BILL of $1.5 TRILLION Dollars, and my favortie Republican fact, left office with the lowest job approval rating in the history of the United States Presidency 20%!

Be sure now YOU/RUN and vote Republican
again...."APPRECIATE IT!

Wow, America the record/facts of Republicans show they have ruined you but GOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOD!

Posted by: ztcb41 | February 26, 2010 10:55 AM | Report abuse

"With all due respect" to the GOoPer Senators and Congressmen, the teabagger movement, that opposes health care reform, does not represent a "vast majority of Americans." In fact, it represents a noisy minority of low-information individuals. Equating the two is a grand fallacy.

Posted by: fizzy1 | February 26, 2010 10:56 AM | Report abuse

cantor basically said the difference is this -- we think that the insurance industry wil fix this on its own if we just let them have even more autonomy, and Democrats said we think having rules that protect American consumers is a better idea since we have tried the letting the insurance industry route for 60 years and look where we are.

Posted by: John1263 | February 26, 2010 10:56 AM | Report abuse

Lee A. Arnold Great Post. I agree 100%

Posted by: LDTRPT25 | February 26, 2010 10:56 AM | Report abuse

Harry Reid's response yesterday might not been good, but the simple fact that for last few days he has been pointing how GOP used reconciliation substantively; has finally made Middle America to warm up to that approach. President Obama clearly hinted that yesterday and overall acceptance has increased.

What needs to be done for Democrats next is:
- to argue successfully, in political language / medium, that reconciliation has been used for 'large bills' in past as well as this bill can very well qualify for that as well; and
- philosophical difference is nothing but GOP way of saying that Fed cannot to do any regulations or any complex laws. Obama in another meeting with CEO's before the Health Summit, touched on this topic substantively with CEOs. He and Dems need to pick up there to clear this 'canard' which GOP is perpetuating.

GOP attacks are coming along multiple lines:
- government take over
- reconciliation is rare and not used for such a big bill
- philosophical opposition to undertake Fed to do anything
- cost control, budget gimmicks.

Each of these charges need to be systematically, consistently and deeply to be turned over if House Dem members to coalesce around passing HCR.

Posted by: umesh409 | February 26, 2010 10:57 AM | Report abuse

The political power play is by the GOP. The Dems kept emphasizing that there are plenty of points where they agree. Doesn't it make sense to start with those points of overlap and build from there? The fact that the GOP is drawing a line in the sand and saying that their participation is only going to happen if they throw out the existing Senate plan and start all over again. Make no mistake, this is the GOP way of saying that things will have to be done their way, that they will have the final say on what goes into the bill and the process that gets it in there. They are trying to hold the entire effort hostage. As Obama concluded towards the end, this is why we have elections. The only thing the Dems have to do is show some direction and backbone, something we haven't seen all that much so far.

Posted by: trk113 | February 26, 2010 10:58 AM | Report abuse

The only "philosophy" the GOP embraces is "win at any cost." It is ridiculous to think, after what we have seen, that the GOP members care about anything but their own pocketbooks and those of their corporate masters. The Republican Party, as such, is willing to sacrifice everything, including the lives of the people and the health of the planet, for an ideological win. I sure hope the laws of karma kick in on all of them.

Posted by: greeenmtns | February 26, 2010 10:59 AM | Report abuse

Obama reached out ... again ....
Republicans turned their backs ... again.

Republicans are unwilling or unable to attempt reconciliation. They have sealed their fate.

Posted by: aorj | February 26, 2010 11:00 AM | Report abuse

cmt138:Why do you think this health care bill isn't real reform?,is it because the democrats put it together?the republicans aren't intelligent enough to put a health care reform bill together so they are against everything the democrats do. If you listen to Mitch McConnell and John Boehner they would have this country go back to 1812,if you don't know what that is look it up.

Posted by: LDTRPT25 | February 26, 2010 11:04 AM | Report abuse

The fact that Republican Tom Coburn suggested that the federal government massively expand by hiring hundreds or thousands of new employees to go out "undercover" into the health care system to weed out waste and fraud shows that this is not a philosophical difference.

Posted by: flounder2 | February 26, 2010 11:04 AM | Report abuse

The Republicans really missed out on a huge political payoff by choosing the wrong principles to stand on. The fundamental flaw in the health care scheme is demanding that younger, healthier and POORER people carry the insurance costs of an older, sicker and already propertied group. It is wrong on principle but the GOP did not capitalize.

Posted by: edbyronadams | February 26, 2010 11:04 AM | Report abuse

Meanwhile, Bunning (R-Ky) has been holding up the unemployment benefits extension all by his lonesome for the past two days. Even the Republicans are in favor of passing this (because they aren't entirely venial or stupid) but there's Yosemite Sam being the cork in the bottle for no good reason.

It is difficult to change Senate rules but this kind of single-senator-hold needs to have its teeth drawn. It is the equivalent of a child holding his breath til he gets what he wants.

Posted by: WonderfulWorld | February 26, 2010 11:04 AM | Report abuse

You say, "The charge here is not hypocrisy, exactly. The GOP surely supports the policies it says it supports, at least at the moment."

Is this not pretty much the definition of hypocrisy? Isn't this the "situational ethics" that George Will always rails against? When the GOP is out of power, it suddenly discovers all sorts of "principles" and "philosophies" they promptly jettison when they're back in power again.

All these so-called "principles" should be seen for what they are: LIES. The only principle going on here is that they want to destroy Obama and weasel their way back into power.

Posted by: rbmurals | February 26, 2010 11:06 AM | Report abuse

The Republicans obviously live on their own planet. All this blather about "principles" and "philosophy" completely misses the point, which is why the GOP never seems to get much done aside from lowering taxes on the affluent or misleading the country into needless wars. While they are not identical, no other country in the developed world has a healthcare system remotely like ours. There's a reason. We spend more and get less; they spend less and get more. Nobody's out in the street clamoring for a U.S.-style system. That's because everybody knows it's lousy. Even a highly principled, bonehead Republican should be able to grasp that.

Posted by: CopyKinetics | February 26, 2010 11:07 AM | Report abuse

"Similarly, if the question is the precise method of figuring out how to define insurance, than a compromise can surely be reached."

"[T]han"? For a second there, I thought I was reading Yglesias. Not that I haven't done it myself, mind you, but that doesn't mean I can't criticize you for doing it. Instead of calling this practice of criticizing that which I do myself "hypocrisy" on my part, we'll call it "pretense". I can criticize you for doing something that I sometimes do myself under the pretense that I'm superior to you. In the process, I'll argue that my criticism is a morally correct, rather than conventionally correct, position. And then, I will use your single instance of misusing the word "than" as evidence that you might always misuse the word "than" and can't be trusted to follow any of the grammatical standards of the language. But is your sloppiness with language intentional or accidental? Questions "are raised". From what I understand, Chairman Mao used to misuse the word "than". Isn't that interesting?

In all seriousness, this is standard GOP practice. Turning their idiosyncratic preferences and traditions into a moral virtue. It's what they do. It's what they've always done. It's why they're conservative. Or, more accurately, it's why they're radical.

Posted by: slag | February 26, 2010 11:07 AM | Report abuse

Some 30-35% of the public will oppose Health care reform just because it is Obama and the Dems. These people will never support it no matter what it is and will never suipport the Dems no matter what they do.

But the number supporting will go up as Dems realize this is as good as it gets and leaving people to rate increases and recissions isn't acceptable, and independents come on board as they understand better what is in the bill. It will pass with majority support in the Senate, House and in the country. It will help the Dems, but the economy is more important. The Dems will lose seats, but not either chamber.

The GOP really has no principles other than holding power and lowering taxes on the rich, plus feed the military and their donors. Cantor is creepy and petulant. But if the GOP had better leaders, we'd be in worse shape.

Posted by: Mimikatz | February 26, 2010 11:10 AM | Report abuse

This has nothing to do with philosophy; this is all about politics.

There is just too much history of Repbublicans passing bills that directly contradict this "philosophy" of theirs.

Posted by: nisleib | February 26, 2010 11:13 AM | Report abuse

Let's be historically accurate and real about this health reform thing for a change, people. One quick glance into history tells you all you need to know, actually. Only a naive fool would believe the Repuiblican party ever had any sincere intention of offering proposals that truly rectify the iniquities and flaws in America's health care and medical insurance systems. And, true to their historical form, the current iteration of them have remained absolutely intransigent to any real change that would benefit the majority of the American people, over their corporate interests. Also, invariably in this nation's history when dealing with the Republicans, the only procedure that has ultimately been effective to install necessary changes that benefit American society at large, is very simply to RAM IT STRAIGHT UP THEIR CONSTRICTED A$$E$. And now, after wasting over a year in futile efforts to obtain Republican inclusion, it's time for President Obama to do his inevitably prescribed duty as our national leader. As repugnant as the chore is, Mr. President, it's time to put the rubber gloves on. We all realize it's a nasty job, Mr. President, but a large majority of Americans just like myself will be right beside you in spirit, cheering you on and eagerly anticipating witnessing the only known form of Republican societal birth. So, bend over Repubs! You surely have earned it, and now HERE IT COMES!!!

Posted by: Doowadiddy | February 26, 2010 11:19 AM | Report abuse

I guess it must be nice to have the luxury of being able to legislate based on philosophy as opposed to reality.

The American people are not interested in thier philosophy on life we want them to govern effectively by the principles set up in the constitution. Not governance based on some dimwit who is isolated on Capitol Hill, philosopical beliefs....are you friggin kidding me.

Posted by: chynna12169 | February 26, 2010 11:19 AM | Report abuse

"I'm not accusing anyone of insincerity on these points,"

Then perhaps you are being too charitable.

Posted by: adamiani | February 26, 2010 11:29 AM | Report abuse

By staying on the high road seeking bipartisanship over the year, where none will be proffered, I think Obama has played the Party of Sloganeering brilliantly. They are taking every inch of the rope. And if their gambit on 'philosophical' differences blows up, it will be the rope that hangs them.

Posted by: para_docs | February 26, 2010 11:31 AM | Report abuse

It was clear in advance that there was no possiblity of compromise at this event. The Republicans who would be the best candidates for any real effort at compromise made it clear in advance that nothing would happen at this event. I don't think there is much question that the President's desire is for legislation that reflects a significant level of consensus from views across the political spectrum. The way he pursued this goal was through encouragement of the bipartisan effort in the Sentate Finance Committee late last summer. However, it was clear from the beginning that a substantial part of the Republican Party made this issue a political focus. It became clear that while some key Republicans like Charles Grassley would talk big and make some effort to contribute to the bill's creation, they would not vote for it in the face of the Republican demand for party unity in oppostion to the Democrats on this issue. That reality left Olympia Snowe and conceivably Susan Collins. I think the President would have preferred to use Olympia Snowe as a proxy for moderate Republican views on this issue. But the Howard Deans and Nancy Pelosi's of this world would not accept that approach and it looked like there were sixty Democrats in the Senate to negotiate a purely Democratic compromise. I suspect that in the last few weeks, the President considered the possibility of resuming work with Olympia Snowe but found that path was no longer available. So this meeting was just part of the political confrontation between the parties. The Democrats will either have the votes to get agreement of the House with the current Senate bill as modified through reconciliation or they will not. If they don't, they will have to start a new process to find enough common ground on a smaller bill to allow some progress to be made.

Posted by: dnjake | February 26, 2010 11:37 AM | Report abuse

The Republican Public Option in Property Insurance in FL. Bush, Crist Governors, Marco Rubion house member then Speaker in House, Republican Majority in both Fl legislative chambers. Additionally the state sells cheap property re-insurance to the insurance companies. FL could easily go bankrupt when the Cat 4 or 5 hits the gold coast just right. Yes Marco this is your territory.

The Florida Legislature created Citizens Property Insurance Corp. in 2002 when it merged two existing state-backed insurance pools, the Florida Residential Property and Casualty Joint Underwriting Association and the Florida Windstorm Underwriting Association. Commonly called Citizens, it is now Florida's largest home insurer. As of November 2007, Citizens insured more than 1.4 million homes, condos and businesses in Florida. Most of Citizens' policies are in South Florida. Citizens employs more than 900 people at its offices in Tallahassee, Jacksonville and Tampa. Citizens Property Insurance is a nonprofit company, run by an eight-person board of governors appointed by the Governor, the state Chief Financial Officer, the Speaker of the House and the Senate President. Board members serve three-year terms. The company also has an executive director responsible for Citizens' daily operations. Citizens once was required to charge rates above the highest price charged by the top 20 home insurers in a given region of the state. In 2007, the Legislature eliminated that requirement, allowing Citizens to be competitive with private homeowner insurance companies. The Legislature also allowed Citizens to start issuing policies to businesses throughout Florida. As the state-backed insurer, Citizens can charge all Florida property insurance policyholders to make up for deficits after catastrophes. All property insurance policyholders are paying a one-time charge $20.70 for every $1,000 of premium they pay toward Citizens' $1.7 billion deficit from the 2005 hurricane season. They'll also pay for the next 10 years another separate assessment of $10 for every $1,000 of annual premium, which will also go toward the 2005 deficit. After the 2004 hurricanes, all property insurance policyholders paid $68 for every $1,000 of premium to pay off Citizens' $516 million deficit. In 2007, the Legislature changed the law on Citizens' assessments to allow the company to charge auto insurance policyholders in addition to property insurance policyholders.

Posted by: chucko2 | February 26, 2010 11:40 AM | Report abuse

"The GOP has one philosophy: sink Obama.
Posted by: monk4hall"

Even if that was true, it would seem to be the only popular thing any one in Washington is working towards. And it's a bipartisan effort too with moderate Democrats, Republicans and independents all seeking and working together.

Posted by: cprferry | February 26, 2010 11:41 AM | Report abuse

Philosophical shmilosophical, the Repub party has been turned into a cult, and as cult leader GW Bush once famously said, "you're either with us or against us." Hard to think of much middle ground finding under these circumstances.

Posted by: rkerg | February 26, 2010 11:44 AM | Report abuse

Mitchell, Boehner, Ryan, Cantor, Kyl, Barasso....what kind of constituencey elects the likes of these people?

Posted by: tom_walker | February 26, 2010 11:45 AM | Report abuse

Let me see if I get this right. Erza Klein, a committed Socialist, is going to give advice to the Republican Party on "politics or principle?"


Washington Post, you are pathetic.

Posted by: Indpnt1 | F
==================================

Yeah Erza is a flaming self-rigtheus self-serving liberal/progressive that's for sure.

He's a regular on MSNBC.........go figure.

Erza......fyi......your liberal/progressive feathers are showing again.......lol

Posted by: allenridge | February 26, 2010 11:45 AM | Report abuse

For Republicans it is all or nothing. They cannot compromise. If they win at anything they will take all the marbles and screw the rest of us. The alternative is an admission that 140 years of fiscal policy and party philosophy is all failure. As if half a dozen major recessions and a handful of deep depressions aren't enough data.

Posted by: BigTrees | February 26, 2010 11:47 AM | Report abuse

Sounding intelligent is not the same as being intelligent. You have not thought this matter through very clearly.

You make Fox News look fair and balanced by comparison.

How can you take either political party seriously? You're not exactly in a credible position to pose as an impartial observer when you've clearly checked your soul at the door of Democratic Party.

The media is not a branch of the Government.

Posted by: fallsmeadjc | February 26, 2010 11:48 AM | Report abuse

Philosophical differences=payoffs from big pharma and health insurers. Add a heavy dose of kow-towing to the Tea Party folks.
In spite of what Saint Ronald Reagan said, Republicans were in favor of big government until Obama took office. Now it's socialism.
Hypocrites.

Posted by: meand2 | February 26, 2010 11:50 AM | Report abuse

"When Republicans created health savings accounts, they had the government define what the package would be"


100% FALSE. They didn't say that "X" had to be covered and "Y" couldn't. They simply stated the maximum and minimum costs. The only stipulation which was that preventative care be covered first dollar which I believe we all agree makes sense. Its amazing to me that liberals have problems if conservatives have HSA's. We're not asking THEM to have them, just allow us to have them.

Posted by: visionbrkr | February 26, 2010 11:57 AM | Report abuse

"When Cantor pointed out his philosophical differences, for instance, he was talking about how "the Secretary defines what a health benefit package should be." That overstates the role the secretary of health and human services has in setting a floor for insurance in the exchanges"


Ezra,

you can't say this. that he OVERSTATES it. It is open to interpretation and depending on WHO is doing the interpretation it could be looked at very differently.

Posted by: visionbrkr | February 26, 2010 11:58 AM | Report abuse

our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!
??????????????????????????????????????????????????????????????????????????????????????
And it is plainly clear that Republicans have more interest in doing everything they can to see President Obama fail. They could care less abouy health care for Americans. And apparently many of you on the right are also very selfish. I have heard many of you saying on the various blogs, who cares about those who don't have health care. You all just don't want the Goverment to mess with what you have. Unfortunately the Republicans have convinced you all that by doing nothing or as little as possible everything will be okay. However, the insurance companies are going to screw you anyway. But, they could care less as long as this could be President Obama's Waterloo.

Posted by: catmomtx | February 26, 2010 12:00 PM | Report abuse


Barry the incompetent boob Obama's dog and pony show was an utter failure and his charade accomplished nothing, except the windbag talked himself out.

249 days until Election Day. See you at the polls, Dims.

Posted by: screwjob2 | February 26, 2010 12:02 PM | Report abuse

GOP Philosophy: How much can we steal? How fast can we steal it? Who can we blame it on? How long can we keep it up? Who can we trick into supporting us by whatever lies it takes?

Posted by: larry9 | February 26, 2010

_________________________________________

We saw this during the Bush Administration, when a $1.8 TRILLION Tax Cut was passed that is still in effect today, a tax cut that has not been paid for since and with interest, has actually cost the US Taxpayer closer to $THREE TRILLION over the past 10 years.

Or, try the war in Iraq, which has cost the US Taxpayer close to $TWO TRILLION (interest included) over the past seven years.

This doesn't even take into account the debacle in Afghanistan, or the Medicare Prescription Drug Plan, which is just a big giveaway to the drug companies and big insurance, more programs that never were paid for by the Republicans.

Point is, the Republicans do go out of their ways to the seek "free market" approach to governing that can't steal federal funds fast enough for their friends in the military-industrial complex, their friends in big insurance and the big pharmaceutical industry.

Posted by: dc1020008 | February 26, 2010 12:02 PM | Report abuse

"The Democrats will either have the votes to get agreement of the House with the current Senate bill as modified through reconciliation or they will not. If they don't, they will have to start a new process to find enough common ground on a smaller bill to allow some progress to be made."

If the Democrats fail to pass comprehensive legislation, I am skeptical that we will see a successful "Plan B" strategy of smaller, bite-sized reforms. As has been explained numerous times, significant reforms are inter-connected and can't work in isolation. Removing pre-ex, coverage caps and recission requires expanding the pool, expanding the pool requires madates, mandates require subsidies.

I think the more likely outcome is that Democrats will draw the lesson that they should never have started with such an already compromised position. We will continue to see more people become uninsured, we will continue to see more 39% rate hikes, and we will continue to see disastrous impacts on family budgets, state budgets, and the federal budget.

When the effort then begins anew, it will be a call for "Medicare for All" next time, and that simple proposal will be much easier to explain and to sell.

If the Republicans and conservative Democrats really are interested in the "philosophy" of preserving the current structure of private insurance-based health care care, they would see that the current form of reform is the best compromise they will ever get. The current system is not sustainable, and the longer it deteriorates, the more radical the eventual solution must be.

Posted by: Patrick_M | February 26, 2010 12:03 PM | Report abuse

Why did not the Republican reform health care, including tort reform when they held the House and Senate? They did not even attempt a vote. Medical torts are tried in state civil courts. For a party that likes to talk about the rights of the states, the Republicans want to step in and take the right of states to decide if they want tort reform. Texas did institute tort reform and yet their premium went up like every other state. The Texas health insurance companies are just keeping the extra profit, not providing rate relief or better pay to doctors. Don't assume cost savings to the health insurance companies means cost savings to the premium payer. In Arizona, a predominately Republican state, we have had a number of initiatives for tort reform over the years and they are consistently voted down.

Posted by: merrylees | February 26, 2010 12:04 PM | Report abuse

Perhaps the reality can be at least partially observed through a couple of examples.
On the Republican side there is Charles Grassley. He appears to have a substantial history of experience with working on health care legislation. He claimed to be committed to getting a bill done and passed in the interests of his constituents. His view of a desirable bill did not appear to be outside the boundaries of what the President could support. But, from his own statements, it is clear that loyalty to Republican political objectives is more important to Charles Grassley than completing a major bill on health care reform even if he personally could support the bill.
On the Democratic side, Howard Dean is an interesting example. He appears to be purely a destructive force who cannot see beyond his narrow ideological vision. His destructiveness does not appear to be motivated by any political calculation or special interest. He is just a destroyer because of his personal emotions and his narrow ideological vision of the world.

Posted by: dnjake | February 26, 2010 12:09 PM | Report abuse

Time to take a step back. Lets start over. We need Tort Reform.
Buy insurance across State Lines, The government t Take Over of Health Care. Socialized Medicine The 2700 Page Bill. All Republical Party talking points.
Once again President Obama towered Head And Shoulders above the Republican Delegation. Alexander, McCain,Kyl, Cantor They are NO Match for Obama.
The Republicans keep saying "They are going to ram this through"
Hey Folks Both Houses have already PASSED the Health Care Bills.
Basic Civics. Government 101: When both Houses pass legislation
it goes to Conference and the Conference Committe make the necesary modifications to gain passage in both houses.
There is NO RAMMING MR Republican the bills have already passed.
Get over it. "The election is OVER"
If we have to use RECONCILLIATION so be it. Since when is Reconcilliation a bad word-? Oh I forgot, only when the Democratic Party uses it When the Republicans use it- its OK.
Reconcillation has been used 23 times in recent times. 19 have been by the Republ;icans.
the Two Bush Tax Cuts were passed by reconcilliations Go figure.

Posted by: Carprin | February 26, 2010 12:16 PM | Report abuse

Yeah. The republicans should take advice from a liberal pinhead like ezra.

Posted by: carlbatey | February 26, 2010 12:19 PM | Report abuse

Yes, Republicans masquerade what the public doesn't like to see -- a political self-interested power struggle -- under a more acceptable high ground philosophical difference.

Another political benefit is that having a clearly defined position appeals to their base. Republicans (and other minority parties) fear that cooperating with the opposition will be labeled as selling-out rather than as problem solving.

Is there a Republican of the stature of Ted Kennedy who will step up and support health care for the uninsured in the way that Kennedy supported younger Bush on "No Child Left Behind"?

Posted by: Instructor5 | February 26, 2010 12:21 PM | Report abuse

The only compromise the DISGRACE Obama is looking for would be his own definition of compromise, which is: Full compliance with his liberal progressive extremist agenda, and damn all of the Independents, Moderate Democrats, and Republicans.

The words out of his own filthy mouth yesterday exclaimed to the American people that, "Thats what voting is for", and we will see that voting this Fall, when the liberal democrats and those that vote with the liberal democrats, are wiped from office in large numbers.

There is absolutely no reasonable reason that can be offered why they should not throw out the debacle of a fiscally irresponsible bill that they are now proposing, and come up with small Bills 100 pages or less, in plane english, dealing with Tort Reform, and any fiscally responsible measures to advance changes to our current health care system.

I want to know how and why people want the Govenrment to have such a large roll in the healthcare industry, and start new fiscally irresponsible programs, when they can't even seem to make the current entitlement programs solvent. They need to properly manage existing programs and make them solvent before adding more boondoggles that will be laid at the feet of the American working class taxpayer.

Obama and the liberal Democrats are a complete disgrace.

Amercia doesn't want the Government in

Posted by: ignoranceisbliss | February 26, 2010 12:25 PM | Report abuse

This is definitely political and not ideological. All you have to do is look at the GOP's top priority - federal tort reform. They're soooo worried about government control, but yet they have no problem allowing Washington to decide who gets to have their day in court and who doesn't? The states decide now, which is consistent with their supposed ideology. But they want the big, bad, evil federal government to do it.

The reason, of course, is simply political - the trial lawyers and the fact that they give 80% of their political donations to the Dems. The GOP would sell out their supposed "principles" against "big government" just to inflict a political wound on the Dems.

Posted by: mikebythesun | February 26, 2010 12:33 PM | Report abuse

@cpurick said: "if you really understood [the right] you wouldn't be on the left in the first place."

Hm. Translation: "anybody who disagrees with me is just too stupid to truly understand what I'm saying."

And the Post has endless discussions of intellectual snobbery on the *left* ?!?

Posted by: emjem1963 | February 26, 2010 12:34 PM | Report abuse


Obama and the Democrats are Nazi thugs who have declared war on the people of the United States.

Posted by: Jerzy
-----
That can be said of the Republicans too. As usual, another bantering without substance.

Posted by: beeker25 | February 26, 2010 12:40 PM | Report abuse


MADAM SPEAKER,

PASS THE BILL

ENOUGH IS ENOUGH

Posted by: COWENS99 | February 26, 2010 12:42 PM | Report abuse

I love how much people try and blame Obama and Democrats for not "compromising" with no sense of irony at all. Somewhat depressing to be honest.

If Obama and crew really were not compromising and trying to ram through something wholy totalitarian and socialist, we would be arguing over single-payer, not some bastardized version of the bill that doesn't even have a public exchange option.

Posted by: kryptik1 | February 26, 2010 12:43 PM | Report abuse

"Ideological" and "Political" both miss the real issue.

Eric Cantor was pushed by Obama's sincerity into just saying it plainly:

"We just can't afford this."

Only this one question matters in the actual real world of voters and the coming election, because this is the only substantive issue that independent voters are really wondering about....

The swing independent voters, who will decide the outcome, don't care about the ideological or political noise.

They wonder pragmatically if we can afford the proposed reform.

That's all, nothing more.

And here's the answer:

http://findingourdream.blogspot.com/2010/02/eric-cantor-fingers-key-sticking-point.html

Posted by: HalHorvath | February 26, 2010 12:46 PM | Report abuse

INSURNCE COMPANIES Raise Rates: OBAMA planned this

DO YOU THINK they are doing this on Purpose?

*From the neo-socialist Chicago Mob Style people that brought us ... ACORN "funding" ...

- The Nebraska Payoffs
- The Lousiana "purchase"
- The Florida "Buyout"

- Mmm - Obama promised these companies Millions of extra customers paid for by the taxpayers ....

..... Jeopardy Theme song ... Dong


.

Posted by: highkey11 | February 26, 2010 12:49 PM | Report abuse


The Lib Dems are taking their final last desperate gasp of air as they sink under the weight of their own Arrogance, Ignorance, Incompetence and Liberalism. It is a beautiful thing to witness.

Elections of 2010 & 12 Cannot Come Soon Enough !!

Posted by: jas7751 | February 26, 2010 12:49 PM | Report abuse

Wow.. reading these posts I wonder if these people watched the same thing I did yesterday. Obama came across as desperate and angry.

As usual you get the same " party of no" type of stuff. The GOP has not said they do not want reform. They have not said they care nothing for american and the healthcare problem. What they have said is that this is too expensive.. we cannot afford to do this and we need to look at ways we can compromise and work together. Obama, Pelosi and Reed are dead set on their agenda and will only be happy when they get their way.

I think everyone in this country agrees something has to be done. But is passing a REALLY bad bill better than not passing it? How much money is too much? We hear all of this talk about fiscal responsibility but I never see DC demonstrate it... regardless of a GOP or a Dem in the WH. It is always easy to sit there and blame Bush, Clinton or Reagan for everything.. it is the easy way out.

It is kind of like saying.... well he spent money and put us in debt so it is ok if I do it too. I have to because he did. That argument doesn't hold water. It is childish.

If Obama really wants change.. start with being fiscally responsible with a budget.

Posted by: tbastian | February 26, 2010 12:50 PM | Report abuse

BRAVO, KLEIN

Your headline tells it like it is. If there were REAL philosophical differences, they would not have allowed Bush to double the national debt in 8 years.

THE NEOCONSERVATIVE IDEOLOGICAL STRATEGY TO "STARVE THE BEAST"

run an UNFUNDED useless Iraqi war
give the wealthiest UNFUNDED tax "relief"
and pass an UNFUNDED prescription drug benefit

Bush and most Neocon increased the debt from 5.7 $Trillion to 11 $Trillion in 8 years.


IN FACT DEBT WAS PART OF A LONG TERM STRATEGY

It was called "starve the beast" folks.
A Neocon strategy hatched decades ago.

Here's how it works. Republicans in office should run up the national debt and deficit with tax breaks. When there's a popular demand to balance the budget, and/or when Democrats take over (that's when Republicans become deficit hawks), then the Democrats won't be able to have social programs, because they have to pay the debt. They might even have to cut back on existing social programs (republicans will encourage this), to pay off the national debt (that Republicans created.)

Republicans driving up the national debt in 8 years also devalued the dollar against the EURO from ~$.83 to ~$1.40 from 2001 to 2008 - Americans are now "cheap" to the "socialist" universal-health-care Europeans. It now costs about $1.36 for a "socialist" EURO.

the "beast" is poor and middle class Americans. It is the government OF, BY and FOR these people.

http://en.wikipedia.org/wiki/Starve_the_beast

Posted by: owldog | February 26, 2010 12:51 PM | Report abuse

I believe the house should get moving on the reconciliation process and get a health reform bill passed as quickly as possible. Too many people have inadequate insurance, or no insurance, to allow this problem to continue to exist. I agree that the health system we currently have is the best in the world only for the wealthy. Less fortunate folk are dying because of lack of adequate insurance. Let's get on with it! It is the right thing to do.

Posted by: ThelmaMcCoy | February 26, 2010 12:53 PM | Report abuse

The biggest problem with the summit yesterday was the transparency of the Republicans. For just a moment please disregard whether you are pro reform or anti-reform. The overwhelming theme of the Republican side yesterday was to scrap the plan and start over piece by piece. Problem with that rhetoric is what the true translation of that is. Translation to that rhetoric is kill the bill (start over) and then stall until November (piece by piece) and hope that you win more seats. The Democrats saw right through this instantly as the their true objective wasn't exactly hard to figure out. Unfortunately, for Americans this garbage means political gridlock. It is exactly this type of political game that produces a lack of results in Washington. I myself am so sick and tired of politicians and cronies on the far left and far right delighting in their ability to thwart the agendas of the other side. The end result is gridlock and we suffer. As everyone in attendance agreed with yesterday (with the exception of Cantor) we must do something about individuals with pre-existing conditions who are denied health care either overtly (through denial of coverage) or covertly (through price gouging). We also must do something about the practice of capping coverage to the sick. The only thing these people are guilty of is getting sick. It's simply immoral how the health insurance companies treat these people and it can't continue.

Posted by: blackandred777 | February 26, 2010 12:58 PM | Report abuse

I love how all the sore losers are blaming the President for the nation's problems. Let's do some simple math: he's been in office for just over a year. Pinhead and bush were in office for 8 years (and actually worked for 5 of those years) It will take a long time to undo the f-ing mess that bush and dick left for us. It is too bad that dick n bush will never be tried for war crimes and attempting to overwright the Constitution.

Posted by: JoePantes | February 26, 2010 12:59 PM | Report abuse

HARRY TRUMAN SAID


When someone starts preaching, lock up the valuables.

Capt. Harry always hated the Harvard elite crowd.

START OVER -- THIEVES AND LIARS ABOUND.

(Where's John Edwards?)

Posted by: russpoter | February 26, 2010 1:09 PM | Report abuse

If abortion is truly not part of the HCR bills, as Madam Speaker Pelosi stated in the HC summit, then there should be no problem adding the Stupak language to the bills.

The Senate bill leaves several abortion provisions in place: in Section 1303 it allows tax credit subsides for plans that include abortion

Section 1303 also leaves the abortion charge for these plans in place.

The bills propose to create a statewide plan that includes abortion in Sec. 1334.

The WH plan increases the Senate bill funding from $7 billion to $11 billion for community health centers in Sec. 10503 without any abortion funding restrictions.

Posted by: Katheen777 | February 26, 2010 1:11 PM | Report abuse

OBAMA and the insurance companies PLANNED this ..

... Obama / Pelosi kickbacks to DEMOCRATS

... Insurance Companies get rich

TAXPAYERS fund the whole Resko / Obama operation .... give it a week there is slimy Democrats in this

Posted by: highkey11 | February 26, 2010 1:12 PM | Report abuse

The GOP has demonstrated that they are unwilling to compromise. The solution is simple. We cannot go back and restart the process of developing a new bill while 46 million Americans are without any insurance. That is an unconscionable waste of time and taxpayer money. The Democrats have tried their best. Now, let's use RECONCILIATION to pass this bill to improve the situation of those who cannot get insurance due to either being forced out of the market because of ridiculously high costs or pre-existing medical concerns.

Posted by: kerryberger | February 26, 2010 1:12 PM | Report abuse

emjem1963:
"Hm. Translation: "anybody who disagrees with me is just too stupid to truly understand what I'm saying.""

Not too stupid, emjem -- too *ignorant*.

And I said it as politically correctly as possible; there's no need to go looking for an insult.

It was intended as a statement of fact. If facts are insulting, maybe that's just a sign I'm right. Facts certainly don't insult me.

Posted by: cpurick | February 26, 2010 1:13 PM | Report abuse

We demonstrate again how easilly we are drawn away from problem-solving, and become involved with our own personal agendas. The major future challenges for health care provision will be an aging and increasingly obese society.
Improving case-management, provider-practioner collaborations and allowing nurses to perform more procedures will be necessary to curtail costs. Tort-reform will need to be more reasonable, not encouraging "defensive medicine," over/under utilization, and developing a system where providers and payers manage to reduce errors. Across state-line purchasing, in addition, will introduce greater competition and drive costs down.
The Health Care Bill is overwhelming, mmoreover, and might benefit from being broken down into packaged items.
MCOs, i.e., HMOs focusing on primary, continuous, comprehensive, chronic care
manages costs through prevention. HMOs pursue a preventative, rather than "reactive" approach to medicine.
I believe this has been Obama's message, and I applaud Micchelle's efforts towards
the key aspect of adolecent obesity education.
With a more healthy and active youth and mid-life population in the work-force, our CMS government programs can be funded. More people will be self-insured and productive in the work-force.

Posted by: solid3 | February 26, 2010 1:17 PM | Report abuse

Rhetoric, Philosophy, Politics = not important, not decisive.

No, only the single real issue will matter to the swing voters in the middle: costs.

The fun complexities of all the politics and such is ultimately a trap for all us more mentally able types. It's over-thinking it.

That's entertaining, but it's also fooling yourself.

The challenge is to weigh reality more accurately.

http://findingourdream.blogspot.com/2010/02/eric-cantor-fingers-key-sticking-point.html

Posted by: HalHorvath | February 26, 2010 1:26 PM | Report abuse

SO instead of your doctor saying if you can take a treatment the bill will decide but its made so you cant get approved. Also everyone will receive an ID card for your health care and they have full access to your finances and personal information. The main reason for this to be rushed and passed is "HIGHER TAXES" for us to pay. The bill will decide who will not be excepted, who gets treatment, who will pay for it and last who will have it( but its mandatory ). And it cost us 2 trillion.

Posted by: viciouzchi | February 26, 2010 1:31 PM | Report abuse

Your analysis here is SPOT-ON.

At this point, there NO real objections to the *substance* of the Senate bill (as would be modified by the President's suggestions). So, instead, the Republicans have to frame in exaggerated, scary terms what the bill actually does - otherwise they have nothing to latch on to that they can criticize.

So, they characterize as the $750 per year "free rider" excise income tax on those without health insurance as "an assault on freedom that is unconstitutional because, for the first time in history, the U.S. government would require someone to purchase a product."

Also, they characterize a pretty darn benign consumer-protection idea - that there should be ONE nationwide definition of "health insurance" - as "government take-over of 17% of the economy."

As if we have "government take-over of the food supply" because we have national standards for food safety.

Give me a break.

Posted by: sumipatel1985 | February 26, 2010 1:31 PM | Report abuse

DEMOCRATS: - this Smells like Pelosi / Obama

- the people that gave $50 Billion to the UAW for killing GM
- The people that were funding ACORN after being caught registering Dead People and ILLEGALS
- The Top outside visitor to the White House - the SEUI Union leeches

- Payoffs ... in Health Care - Louisiana, Florida - Nebraska

Payoffs are how OBAMA got his house -
- Pelosi's father was the Mob Boss of Baltimore ($50 Million - kickbacks on garbage collection / construction)

OBAMA and Insurance Company Fraud - They planned the rate hikes ... votes get mad;
- push for OBAMACARE
- Insurance Companies get millions of new "customers"

Democrats get kickbacks and Insurance Companies get richer

Posted by: highkey11 | February 26, 2010 1:32 PM | Report abuse

MOONBEAM:

- Find out which Insurance Execs were at the White House
- Where has RAHM been lately? Meeting with insurance execs

**THIS is a SCAM

INSURANCE Companies Raise Rates
- Mad voters push for ObamaCare Socialism
- Million of new "Customers" are on the Insurance Companies books and they get rich
- Democrats are promised kickbacks

TAXPAYERS pay for the whole Democrat kickback boondoogle


The Kickback Democrat Playbook is Obvious -

Standard Democrat Operating Procedure - DSOP

Posted by: highkey11 | February 26, 2010 1:32 PM | Report abuse

A point on compitition across state lines. The insurance industry is controlled by less than a handfull of very large companies. These companies offer different policies in different states based on different regulations and local market conditions. If the government did "allow" someone in California to buy a policy from say South Dakota what makes you think any insurance company would?

The real purpose behind this change is to minimize or eliminate various state regulations and regulating bodies that set various requirements and prices. This allows insurance companies to offer homogenized policies across the U.S. whose price only varies by local market conditions. What it will mean is that policy holders in California might (and that's a very weak might) pay slightly less for insurance while people in South Dakota pay a lot more.

This idea does not really introduce competition because there is no competition to be had. There is no magical way that people in an expensive area can by a cheap policy offered in cheap area and have an insurance company pay local rates and make money. Best case is that the insurance company would pay the rates applied to South Dakota to practitioners in California and the patient would be responsible for the rest. Insurance companies can already accomplish this by raising deductibles.

Posted by: elkiii_2008 | February 26, 2010 2:04 PM | Report abuse

highkey11,

Nutty posts like yours do nothing to solve the problem. In fact, they compound the problem.

Posted by: pathfinder12 | February 26, 2010 2:12 PM | Report abuse

Let me say it more clearly:

There is only one predominate issue that most voters and most swing voters do actually care about -- net costs compared to their own tight or underwater personal finances.

And this is key to several things.
(see link I offered above)

Posted by: HalHorvath | February 26, 2010 2:49 PM | Report abuse

Dude, yes. I'm often amused and perplexed by the contradictory behavior and positions on the right, and I've written about it in my own blog, but you've expressed it more concisely than I could.

Posted by: MercuryChaos | February 26, 2010 3:36 PM | Report abuse

Even if the rhetoric seems a bit lofty for Ezra's taste, there's no questioning that rewriting the rules for one sixth of the economy should give pause. Ignoring the real history of government social contract costs with new manipulated estimates is naive at best, or more likely, dishonest. Act smug and self righteous if you insist Ezra, but Democrats will pay dearly for this over-reach.

Posted by: ecrutle | February 26, 2010 3:58 PM | Report abuse

THERE IS HUGE DIFFERENCE BETWEEN GOVERNMENT MANDATING WHEN IT IS A BENEFIT GIVEN BY MEDICARE LIKE THE PRESCRIPTION DRUG BENEFIT AND MANDATING WHEN YOU ARE OBLIGATED TO BUY INSURANCE AND YOU CAN ONLY CHOSE A GOVERNMENT APPROVED PLAN. THE PRESCRIPTION DRUG BENEFIT IS OPTIONAL AND SENIORS CAN CHOSE NOT TO PAY FOR IT. SO YOUR COMPARISON DOESN'T HOLD WATER.

Posted by: greenfld | February 26, 2010 4:10 PM | Report abuse

I think you're giving too much credit to Eric Cantor, who appears to be pathologically incapable of doing anything but spout talking points. It hardly matters whether he is on the floor of Congress, at a press conference or a guest on a talk show, interrupt the flow of his one track mind, and he appears completely flummoxed, like a trained dog with a new master, who doesn't necessarily follow the same protocol as the last. The man simply cannot have a give and take conversation to save his life. That's not a philosophical difference, it's a problem with his wiring.

Posted by: Koko3 | February 26, 2010 4:20 PM | Report abuse

What I find amusingly missing from the "don't want the government making me buy or controlling my insurance" crowd is that government already makes you buy one form of insurance -- auto liability insurance. The government also sets the minimum standards, and restricts or bans certain objectionable insurance practices.

Yet, not a word of protest over this "government mandate."

This "debate" isn't about the government imposing a financial obligation on anyone. Its about power -- who's got it, who hasn't and who wants to control it.

That's why the neo-con GOP does not like going toe-to-toe with their opponents, both internally (e.g., moderate GOP members) and externally (the Democrats). Once they have to face their opposite number and actually go past the sound bite talking points, their logical inconsistencies, philosophical hypocrisies and political posturing are exposed.

I'm a former traditional GOP member (now independent) that has been pushed out of my party, marginalized and excluded because I pointed out the illogic of party policies. In my old GOP, party posturing and electioneering stopped at some point. The neo-con, religious right dominated modern GOP prioritizes politics over everything else.

Pity.

Posted by: Parziale | February 26, 2010 4:30 PM | Report abuse

-our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!

Posted by: cmt138 | February 26, 2010 10:20 AM

-our president appears to have more interest in this POWER PLAY than true health care reform .....this mess the democrats should be scraped and start again ....this time they should consider real health care reform !!

Posted by: cmt138 | February 26, 2010 10:24 AM

*****

Gee, @cmt138!

Cut-and-paste very much? How else do you get two posts precisely the same punctuation, spacing, word structure and text layout?

Hey, did Rush, Sean and/or Glenn send you the text to post? Or, did the GOP PR department?

Posted by: Parziale | February 26, 2010 4:39 PM | Report abuse

The Republican choir was well rehearsed and the performance was worthy of rotten eggs and smelly tomatoes. And they even brought their timekeeper to balance the time spent by each side so that the conversation was not monopolized. It was a sickening event. Cantor and Boehner were as good as bookends, each with a copy of the more than 2000 page bill to use as their prop, to have open to favorite phrases, none of which they quoted, and they admirably looked the part of fools of the week. John McCain rambled and rambled like a politician on the stump, fighting for his fat paycheck of more than $176,000 a year, for which he spends less than half a year in DC. I watched some recaps of the meeting and did not see a Republican discussing an idea of their own, only carping "kill this bill", "start over", and all of the other worn out phrases they were taught. This legislation is needed, but the meeting proved that no new input will come from the Republicans, they will only try to support the status quo for their special interest cronies, and the Democrats must take this one to the end by themselves.

Posted by: ronjeske | February 26, 2010 4:42 PM | Report abuse

Hopefully, the President of the United States will not have to suffer through another philosphical discussion on health care with the Dems or GOP. Let's just get something done for the millions of people with no insurance, how about we suspend Congress' insurance until they do it right!

Posted by: scottsandy02 | February 26, 2010 5:14 PM | Report abuse

Ezra, Ezra, you miss the point totally. In a democracy, the will of the people prevails. There is a maximum of individual liberty and a minimum of government intrusion ino individual lives. Just the reverse is the current perception.

The people are speaking loudly and clearly:
1. there is out of control spending (+or-
$100 trillion in debt and unfunded
welfare programs) on a 3 to 1 vote,
2. there is a lack of trust in the federal
government on a 3 to 1 basis (less
government not more is desired), and
3. there is rising frustration with a
bankrupt Medicare system and a desire
for reform NOT more spending with a
slight majority saying yea. (So
Congress covers all legal and defacto
illegal foreigners in the country to
raise our trust??)

The taxpayers are NOT into philosophical discussions. These are gut factual, personal reactions in the midst of the worst unemployment/under employment (20%) since the great depression. Economists are suggesting it will be 10 years before we get back to 2006-7 levels of economic activity. Very practical positions to take by those who pay ALL the bills from my perspective.

Posted by: PRRWRITER | February 26, 2010 5:47 PM | Report abuse

Oh, yes, it's hypocrisy on the part of the Republicans. Pure and simple.

Posted by: gsross | February 26, 2010 6:00 PM | Report abuse

Absolutely right on, Brother Klein! Your grasp of what is actually happening is little short of prophetic. I would add only that the word "philosophic" comes from two Greek words for "love" and "wisdom." There is no question who loved and expounded wisdom in the summit, yesterday, and it was not a Republican -- no, not one. All any thinking person saw (including our Philosopher in Chief) coming from Republicans was obstructionism by any other name. I wouldn't even honor their obviously hypocritical performance as cynical, in that the early Greek Cynic Philosophers made a point of living a natural life, free of the false values of the prudential ethic (e.g., doing only what seems acceptable, rather than what is right). As for me and my North Carolina house, give me our state motto: "Esse Quam Videri" (To be, rather than to seem). The Republicans around yesterday's table of opportunity "seemed" all over the place! Bah! Humbug!

Posted by: ladlai1 | February 26, 2010 6:16 PM | Report abuse

Ezrawhich is very much lacking in this President.

Posted by: mrtro | February 26, 2010 6:19 PM | Report abuse

Ezra, if this Obamacare is so good for the citizens of our country, why is there no mandate that Congress, their staff, the Administration and their staff and all federal government workers will be covered by this plan vs the plans they now have? That would show commitment and leadership which is missing in this President. Let's get serious, this is a Democrat power play of the socialist kind. Oh if we could bring back the great Democrats of the past to work with Republicans we could get something done.

Posted by: mrtro | February 26, 2010 6:43 PM | Report abuse

"Oh if we could bring back the great Democrats of the past to work with Republicans we could get something done."

I hereby nominate Paul Wellstone and Ted Kennedy.

Posted by: Patrick_M | February 26, 2010 6:57 PM | Report abuse

The proposal is to have a program like the one that covers the 41 Worthless Republicans and their counterparts in the Senate. GET IT???

Posted by: rpmcestmoicoxnet | February 26, 2010 11:20 PM | Report abuse

This is one of Mr Klein's better columns even though I have big philosophical differences with him, usually. Here he gets to the kernel of the issue as he sees it, and ends it with a great, accurate observation. Unfortunately, there is one massive error: politics isn't detached from philosophy, politics IS a branch OF philosophy. The issue is how consistently an individual adheres to his/her principles...and on what they are based--always morality, but which morality.

Posted by: wpcharowhas | February 26, 2010 11:32 PM | Report abuse

I hope everyone was watching the summit yesterday because anyone that did has to know what is going on. If you couldn't tell the Republicans are just obstructing because they are like spoiled children who didn't get what they wanted, then you are blind. They do not know how to comport themselves as the minority party.

They came to the table reluctantly because they couldn't figure out how to boycott it without seeming to be petulant. They came armed however with all kinds of political props and talking points to stave any kind of healthy debate or progression. I thought President Obama was particularly succinct when he told John McCain they were no longer campaigning, the election was over. Touche Mr. President.

Posted by: MaggiePi | February 27, 2010 12:26 AM | Report abuse

Klein Is Fine! :-)

Posted by: OICUR2 | February 27, 2010 4:19 AM | Report abuse

Ezra,

States rights versus Federal solutions is the basic philosophical difference.

When Republicans feel threatened they lean libertarian, and take it a step further toward individual rights.

When Democrats feel threatened they consider total government takeover.

Perhaps the solution lies in argument where the solution is taken out of governments hands and given to bipartisan commission similar to what our President recently did with the deficit.

I enjoy reading your column Ezra!

Posted by: pparris | February 27, 2010 9:03 AM | Report abuse

Ezra, the only reason there is no healthcare reform getting done is very simple, and it has nothing to do with Republicans. The fact is the Democrat Party has been taken over by a gang that is so far to the LEFT and so eager to create new expensive over-arching big government programs that even the moderates in their own party KNOW how bad their reform ideas are. If that was not the case, they could have passed some kind of sensible legislation months ago WITHOUT the Republicans. Though if their plans had been sensible and modest they would no doubt have garnered some Republican votes. THAT'S IT, EZRA. So your continual pathetic attempts to paint Republicans as nasty people trying to undermine Obama just because they don't like him are just beginning to look silly. The American people get it. Sadly, you don't.

Posted by: lisaaitken | February 27, 2010 9:26 AM | Report abuse

Does anyone writing here work for an insurance company? If not, how can you buy into the perennial argument that "they fleece the public and make obscene profits"? That they "must be put under the thumb of our eternally vigilant (?)government nabobs?"

My daughter is an attorney for the industry and she says profits from health insurers, industry-wide, is between 3.4 - 3.7%. Now, with that much fleecing going on, maybe you still truly believe we should shackle them even more. Better yet, put them completely out of business and replace their 100's of thousands of employees with government hacks?

Anyone who would buy into that foolishness , of course, is condemned to reap the whirlwind ruination of our entire system. Remember, when one domino falls against another, it's not long before the whole thing comes tumbling down.

Incidentally, have a single one of you ever worked for a poor man or woman? How about you Ezra: I hear the Grand Dame of newspapers is bleeding red ink and has been for quite some time.

Perhaps if there were some equitable balance in the opinions of the staff, more people would read it.

Good luck tho! Your writing style is superb, but sadly, you lack the comparable substance of the 'other' side. My best to you.

Posted by: snoocks2 | February 27, 2010 10:27 AM | Report abuse

I expect the newest buzz-word we'll hear ad nauseum from the GOP in every public mention of health care reform to be: DEEP PHILOSOPHICAL DIFFERENCES.

I watched the summit from beginning to end and found it extremely enlightening. I thought the legislators on both sides had substantive points and arguments to make, but as one GOP legislator after another spoke, once again we were subjected to certain phrases and buzz-words - 'scrap this and start over; this massive 4000 page bill (point to stack of documents prominently displayed); trying to jam this through; the AMERICAN PEOPLE don't want . . .'

Clearly they had all agreed that each of them would repeat this boring song and dance at least once during their remarks. The time spent repeating these buzz-words would have been better spent saying something substantial.

To be fair, most of them did go on to say something that helped me understand their approach and ideas, which, as many posts here suggest, were not really 'deep and philosophical,' but just ordinary GOP ideas.

Reading follow-up analysis and news reports, I note another pair of GOP buzz-words, these describing our President: 'arrogant, condescending.' Really? I thought the President's behavior was the model of a good facilitator/participant in the discussion. Could it be that some people don't cotton to his being in a position of authority because of certain prejudices?

Anyway, we can expect to hear the buzz-words 'arrogant and condescending' and especially, 'deep philosophical differences' often on the talk show circuit and campaign trail. If they say it often enough perhaps people will believe it to be self-evident truth. Operant conditioning as campaign strategy.

Posted by: PeggyB1 | February 27, 2010 11:20 AM | Report abuse

Ezra, a perceptive media analyst (that's a fancy term for a newspaper columnist in this day and age) usually forgoes all of the background junk he/she had to use to give justifiable (?) credence to his or her article. Yours is a work of art....as political as the rest of the folk you talk about in your analysis (babble babble). I guess you are telling me our philosophical President demonstrated his openess to what he heard....but has a nasty habit of not showing it in his looks if it is not going his way. ..I guess you are telling me, after reading your entire article....with all of its references, is that everybody down on the Potomac is a political animal...I side with the GOP on this issue really out of fear of the President's philosophical basis for his administration. Cheney may be right, inasmuch as an increasing number of us..even those who voted for him...are finding that without clear purpose....without clear direction...an almost total disliking of his "advisers" and a growing lack of trust in the man...we had best use our best weapon, which is politics, Ezra, unless you have something better for us. (..you may, if you wish, simply tell me to substitute Demoncrat wherever GOP appears in what you wrote.)

Posted by: connyankee1 | February 27, 2010 1:10 PM | Report abuse

Philosophical differences? That is pretty hard to see since the Democrats have only one philosophical position: "Get along to go along". They have no philosophy, either moral or political. For that matter, the Republicans only have one philosophical position:"Hey, whoever pays for our campaigns to keep us in office, we will represent you". Come to think of it, that is the Democrats second philosophical principle.

Gad, Socrates and Aristotle must be spinning in their graves.

Posted by: RedRat | February 27, 2010 1:17 PM | Report abuse

Aside to PeggyB1.....were we both watching and listening to the same President in action at his politically called meeting of the minds on Thursday. Yes, he speaks well if he can grab most of the "airtime", but he can also come across as the most arrogant person in the company! His snide comments to McClain were uncalled for...he should learn to respect his elders, especially to one who has a pretty good track record with the American people...and let's not start tossing BS at each other about the GOP or the Democrats..I dislike childish retorts.
I heard it all, too, and I didn't hear much. It simply was 5?6? hours of the same old same old for obvious political reasons. But I tell you, if we get into this 51 vote nonsense, they all should be tossed out on their duffs ( with no medical coverage for sore butts). I am already hearing "ohhh, well, the GOP used recon for COBRA, tax reductions for the rich, blah blah blah. None of these actions really resulted in an impact on the country that the medical insurance reform bill will produce on practically every facet of our individual and governmental lives.....and I would like the Democrats to drop their perfectly staged horror stories of individuals who suffered at the hands of insurance companies....including the President...I am actually tired of hearing the problems one of his family members had regarding coverage...even while in the hospital. You know, Mr. President, I guess you were a big boy just like me....see that thing on the table next to the bed...it is called a telephone.....and you are a lawyer...somebody in the family could have done something, so knock it off.
The summit simply was a sham.

Posted by: connyankee1 | February 27, 2010 1:29 PM | Report abuse

Core Republican principles were nowhere to be found during 43's administration when Congress greatly accelerated the demise of this country, lining its own pockets in the process. Now when Republicans open their mouths one tends to cup ears, mumbling la la la la la la la.

Republicans had their chance and blew it. That's still the bottom line, despite their beloved smarmy marketing attempts to persuade the majority of Americans otherwise.

Posted by: Kelly14 | February 27, 2010 3:27 PM | Report abuse

When are we going to recognize what health insurance truly is. It is a ponzi scheme. How else do you explain the insurance premium hikes proposed for CA. Blue Shield is making billions of dollars in profits and yet the need more money to deny health care to the CA public subscribing to their insurance.
Forget about the party of No.
We need reform in the health insurance business and the business of health care. Now.

Posted by: willsCA | February 27, 2010 4:52 PM | Report abuse

Listening to some of the comments here it makes me wonder how many people truly understand how health care works in this country. First some ground work. Health care is one of those few industries that is simultaneously labor intensive and highly skilled. In addition it has various mechanisms in place to limit supply. This combination results in high prices and substantial pricing power and very little opportunity to control prices using the standard methods of productivity and efficiency gains.

Any kind of reform must either reduce prices to reduce costs or reduce demand to reduce costs. The market has already chosen to reduce demand to control costs. This occurs as higher premiums and less coverage. Given that there is no competition, this includes insurance companies as there are only two or three large ones that dominate the market. This is why the Republican plan to open insurance markets to competition is unlikely to work. It presumes that the dominant companies want to compete. They don't. Small companies might but the only cost advantage they have is in pay structures for their employees. Large companies have gotten pretty efficient from that standpoint so overhead, unless you reduce profits, is pretty similar. In addition, small companies do not have as much negotiating power as large ones so their costs likely will be higher.

These stark choices. Without a major revamp in the delivery system insurance will be forced to cover fewer and fewer people at higher and higher costs. Reforms like insurance exchanges or tax breaks/credits, allowing policies to be purchased across state lines (is Aetna really going to allow some one in CA to purchase a policy offered in South Dakota? Who in South Dakota is really going to sell a policy in CA which has costs 35% higher than South Dakota?) does not resolve the underlying issue. Government is the only entity with the authority to control pricing. But someone somewhere is going to have whacking on profits or income.

To believe that we can somehow pay less for care without the health care industry making less money is just dumb. As I stated in the beginning, health care is not an industry that can be made more productive or efficient to reduce costs. The typical market based mechanisms simply do not work. If they did, we wouldn't be having this conversation.

Posted by: elkiii_2008 | February 28, 2010 4:07 PM | Report abuse

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