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I don't think "toughness" is a very good way to evaluate presidents; I do think a public option bill is a good idea; and I'm surprised to see Democratic Senate leadership going so hard against the filibuster.

Here's what I didn't get to:

1) Gallup's presidential approval center is some good fun for poll geeks.

2) The limits of money in motivating employees.

3) The way we test new medicines is really nuts.

4) The reason the health-care bill doesn't do more on cost control is that politicians didn't want to do more on cost control because they didn't think their constituents would want more done on cost control.

5) I'll be on Countdown with Keith Olbermann at about 8:05 Eastern.

By Ezra Klein  |  March 10, 2010; 6:05 PM ET
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#4 Ezra links to Leonhardt. Leonhardt links to Ezra. Everyone gets hits. It's a beautiful thing.

Unfortunately Leonhardt is wrong. The main reason there aren't more cost controls is because of Obama's deals with industry. The low-hanging fruit, as I've said many times, is Medicare drug price negotiation and administered rates to providers (ideally converting the private insurance industry to glorified claims processors). That sounds like a heavy lift, but it's way easier than what MedPAC proposes to do, i.e. inserting itself between doctors and patients.

Posted by: bmull | March 10, 2010 7:33 PM | Report abuse

"The reason the health-care bill doesn't do more on cost control is that politicians didn't want to do more on cost control because they didn't think their constituents would want more done on cost control."

Mr. Klein,
I'm a huge fan - I read your posts almost religiously.
One thought - the reason "constitutents" don't want more done on cost control is that they have been made afraid of the bill by the far right and the conservative media echo chamber that tells them it's a bad bill - not that people are inherently against cost control. This is exactly why when people are polled about their opinions on "Obamacare" they say they are against it, yet when polled on specific parts of the bill, they are for it.

Posted by: david_anderson48 | March 10, 2010 7:44 PM | Report abuse

Ezra, I heard you say tonight on Countdown that Pelosi has never lost a vote, and i've heard that repeated recently. I may remember wrong, but didn't she lose the vote on the bailout bill the first time around?

Posted by: haniffe | March 10, 2010 8:18 PM | Report abuse


Instead of praising Ryan, please read this...

"The Ryan Budget's Radical Priorities
Provides Largest Tax Cuts in History for Wealthy, Raises Middle Class Taxes, Ends Guaranteed Medicare, Privatizes Social Security, Erodes Health Care"

And this chart from Krugman....

Posted by: Lomillialor | March 11, 2010 7:49 AM | Report abuse


Krugman's chart is certainly disturbing. If you care about effects on work effort and entrepreneurship, then having the tax take top out on the 80%-99% income quintile seems strange. I'm guessing a lot of it is taking away taxes on capital income, which as numerous commentators have noticed would create a strong incentive to label labor income as capital income. A good tax system should minimize the incentive for gaming it.

WRT #4,

I wish politicians would do what they think is right, even if constituents don't like it. There is a reason why we have representative democracy, not direct democracy.

No (or weak) cost control means our country eventually goes off of a fiscal cliff. In my view, that's a bigger problem that not getting re-elected.

Posted by: justin84 | March 11, 2010 9:31 AM | Report abuse

I'm no expert, but I do advise foreign drug and medical equipment producers. They have almost no interest in their home markets. The gold mine is the US, despite our product liability laws. Other countries limit health care costs. We don't, so they make the big bucks here and we (thereby) support research which benefits the whole world. Go figger..... It's a bit like our military budget. We provided security for the whole world - at least until our adventures in Iraq and Afghanistan - on our dime. We get a bigger say, but at what cost?

Posted by: RHouck | March 11, 2010 9:36 AM | Report abuse

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