Editor: Mark Schone
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Healthcare Reform

Dear Mr. President: What are you thinking?

Stop dawdling on healthcare, forget about Snowe and Lieberman, and become the leader we voted for already
Salon

Dear Mr. Obama,

I hate to complain, and I certainly do not want to sound cranky. But time is awasting, so here goes: Nearly 70 million people voted for you because we supported your commitment to ending the war in Iraq, closing Gitmo and creating universal healthcare. Only a couple thousand of them were passionate about the whole bipartisanship thing, and based on my scientific research, exactly 38 believed that Olympia Snowe's vote on the healthcare reform bill would even make it bipartisan. Thirty-eight people! (And you should see them.) So now the other approximately 66,999,962 of us are left wondering, Why did you lose so much time courting her vote?

I mean no offense, but the belief that Snowe's vote made the bill bipartisan was delusional from the start. It was exactly the sort of thing my mother would have come up with -- and she was from Liverpool. I rest my case: Those of us with English parents faithfully attend special 12-step meetings to break through the uniquely English forms of denial. The vote of one extremely withholding woman -- and I say that without judgment -- never changed the nature of the bill, no matter how much you and your staff convinced yourselves it did. It is a Democratic bill -- a quintessentially Democratic bill, in that it's about trying to help those in need. It is about fairness, decency and the common good, the values most Americans were raised on. But you can't even mention those words and ideals these days without getting laughed at by the Republican leadership -- or, worse, tea-bagged.

A great pastor in New York City once said that if you wanted to get into heaven, you needed a letter of recommendation from the poor. Teddy Kennedy got his. So did Lincoln, FDR, Shirley Chisholm. And now it's up to you.

To get Ms. Snowe's mingy vote, you would have needed to include her little pet rock, the trigger option. But the trigger option was the emperor's new clothes. Perhaps a more precise way of saying this is that the trigger option was a figment, a dodge from greatness. My mother would have called it a "crock." My 20-year-old son, "Totally bogus."

I am not saying that continuing to waste our time -- while people die every day from lack of healthcare -- will keep you out of heaven, although you may get an inferior seat, possibly in the room serving only nursery snacks. How will you face Teddy if you muff this historic moment? Do you think he will share his eclairs with you? His brie?

It's OK that you wanted Ms. Snowe's vote so desperately, but the truth is that she was getting high on not giving it to you. She was getting a hit, like a junkie, from withholding. Believe me, I have dated men like her. She had a chance to participate in greatness, which does not happen all that often anymore in American politics, but the possibility is there now -- for you, for us, for our country.

A huge majority of people in America and specifically in Maine want the public option. For a few months there, she had the power to kill it. Dude, what was that about? Was it some form of Kabuki theater, wherein you knew she would never give you her vote, but you needed to pretend she might for another week? Was it a multilevel chess game that all the people who voted for you were too dumb to figure out? She didn't want decent medical care for the poor and middle class: She wanted power. She, like so many of us, is hungry for what she is not giving -- for generosity of spirit, the only thing that can fill us up. And yet, she chooses to withhold, this woman who happens to have great government healthcare. I bet she and her extended family never worry when they get sick, or even when they need psychiatric care. Not to mention dental, which just kills me to think about -- me and my family, with our terrible English teeth.

So we've lost two or three months to that business. And now we have Lieberman. In some ways, he's even worse, because of -- well, you know -- the voice.

We do not personally blame you for the fact that we have to listen to him. It's political life, on political life's terms. And maybe his therapist or rabbi will help staunch his latest episode of swerving sickness. But recently on "The Rachel Maddow Show," the great Jane Hamsher compared the healthcare debate to a beauty contest in which the contestants who feel ignored start stripping and said that, at some point, one of the directors will convince Lieberman to put his shirt back on. So I am wondering, why can't that be you? Why can't you do what Leon on "Curb Your Enthusiasm" keeps urging Larry to do? Take him the ruckus.

Use your most reliable parenting skills: Joe Lieberman is acting like a petulant, icky little kid -- I say that with love. Use those classic parental standbys, bribes and threats. Back-channel him. Try reverse psychiatry -- "Thank God you stepped in, Joe. Otherwise, we would have been responsible for all those slacker poor people. All those feverish babies and children. All those English expats, with their bad teeth." If that doesn't work, maybe you could just remind him of the famous story from 15 years ago, that family with a 5-year-old girl with leukemia who needed blood in massive quantities to stay alive. You remember: Everyone in her family except her older brother was tested and found to be incompatible. But the boy was afraid of having blood drawn in order to test it, and his parents respected him enough to let him come to the decision by himself.

One day he came to them and told them he was ready. They took him to the doctor, his blood was tested, and it was an almost exact match with his little sister. So the two of them were put on beds side by side in a hospital room, and the nurses withdrew blood from his arm, and let it flow into his sister's. He lay with his eyes closed, in silence for the entire procedure, until the doctor gripped his shoulder and asked how he was doing. The boy opened his eyes.

“How soon 'til I start to die?” he asked.

This kind of profound and innocent moral courage is the most attractive characteristic a person can display, especially a politician. It is time for you to come out vigorously and loudly for Harry Reid by getting your people in line. Reid has managed, with a lot of help from liberals and progressives and too much time lost, to whip most of the Senate Democrats behind what you campaigned for. Now it is time for you to roar. Ms. Snowe and Joe can still choose greatness, too: They have free will, and they may surprise us all. Or, hey, while we are at it, why not hit up George Voinovich? He is not running for reelection and is -- or should be -- rooting around for a legacy. Otherwise, people will scratch their heads while trying to remember who he was. "Oh, Voinovich? Wasn't he the guy up on Laurel who had to tent his house for termites?" He could go out a hero, by simply doing what public servants are supposed to do -- stand up for the people, for greatness, for compassion, fairness and the common good.

So again I ask you, do the right thing, and do it now. Shoot the moon, Boss: right between the eyes. 

Reid's sick numbers

He carried the healthcare bill through the Senate and may be paying the price for it

The bad news just keeps on coming for Harry Reid.

A new poll commission by the Progressive Change Campaign Committee--who seem to be everywhere lately--shows his approval numbers dipping further. Right now is, of course, a key policy moment during which Reid simultaneously looks weak to some for not keeping his coalition together and caving to Joe Lieberman, and yet looks to people on the other side of the spectrum like a Nancy Pelosi whipping boy who pushed through the Senate a giant socialized medicine reform bill. The poll was done nationally, not just in Nevada, and here are the findings:

Overall, 55 percent of respondents nationwide said weak. 36 said strong. Nine percent said "not sure." Reid does alright among Democrats--only 37 percent say he's weak, with 58 percent saying he's doing a good job. But he's getting creamed among independents by almost the opposite numbers. Only 34 percent of independents say Reid is a strong leader, while 58 percent say "weak."

Things are, if anything, worse for him in Nevada, where a majority of Democrats describe him as ineffective.

I have never been a fan of Reid's, I must confess. But this week I almost feel sorry for him. The health care reform battle was destined to be a tough fight for all Hill Democrats and the White House, but for Reid even moreso than Speaker Pelosi or President Obama. The president can speak and decide unilaterally. And although Pelosi cannot, she at least has more favorable chamber rules, a generally more ideological coherent majority, and basically the same size (59 percent of seats) majority. (Bigger, in fact, if you don't count Lieberbulwark and Bernie Sanders)

And thus it was always destined to be a grim outcome for Harry Reid as he carried this bill to passage. And now Harry's Carry is starting to look like political-electoral Hara-Kiri.

Senate healthcare bill: Time to kill it?

Is reform without public option worth it? Markos, Ezra Klein, Paul Krugman, Howard Dean and others weigh in
AP/Harry Hamburg
Sen. Joseph Lieberman, I-Conn. on Capitol Hill in Washington, Wednesday, Dec. 9, 2009.

Is the watered-down, no-public-option healthcare reform bill worth saving? Or should it be killed? That is the question on everyone's lips today.

By Twitter, Markos of Daily Kos let it be known where he and many progressives stand on the issue: "Insurance companies win. Time to kill this monstrosity coming out of the Senate."

That specific tweet, and the broad sentiment that underlies it, is generating quite a bit of response. The WaPo's Ezra Klein writes on his blog:

The core of this legislation is as it always was: $900 billion, give or take, so people who can't afford health-care insurance suddenly can. Insurance regulations paired with the individual mandate, so insurers can't discriminate against the sick and the healthy can't make insurance unaffordable by hanging back until the moment they need medical care. The construction of health insurance exchanges so the people currently left out of the employer-based market are better served, and the many who will join them as the employer system continues to erode will have somewhere to go.

That's all policy. And as I spent yesterday arguing, it has a tendency to overshadow the lives in the balance. You can choose your estimate. The Institute of Medicine's methodology says 22,000 people died in 2006 because they didn't have health-care coverage. A recent Harvard study found the number nearer to 45,000. Since we talk about the costs of health-care reform over a 10-year period, may as well talk about the lives saved that way, too. And we're looking, easily, at more than a hundred thousand lives, to say nothing of the people who will be spared bankruptcy, chronic pain, unnecessary impairment, unnecessary caretaking, bereavement, loss of wages, painful surgeries, and so on.

A lot of progressives woke up this morning feeling like they lost. They didn't. The public option and its compromised iterations were a battle that came to seem like a war. But they weren't the war. The bill itself was. When liberals talked about the dream of universal health-care insurance 10, 20 and 30 years ago, they talked about the plight of the uninsured, not the necessity of a limited public option in competition with private insurers.

Salon reached out to others with strong opinions on this issue, and we will be updating this post as reactions come in, so stay tuned.

In contrast to Klein, Stephanie Taylor, co-founder of Progressive Change Campaign Committee, told us:

The "Joe Lieberman Senate Bill" is ugly. Democrats stand on the verge of ushering in a world of nearly unregulated mandates, in which we're all forced by the state to hand over our money to failed private monopolies, with no cost control in return. Without a public option and no hope of expanding Medicare coverage, this bill is not worth supporting.

We got to this point due to a complete failure of leadership by President Obama--who chose to negotiate with out-of-touch senators instead of rallying their own constituents against them. It's also a failure of leadership by Harry Reid, who failed to exert any leverage over Joe Lieberman--by threatening to take away his committee chairmanship or use reconciliation to make his vote irrelevant.

When Democratic leaders refuse to fight, they can't then ask progressives to cave with them. The Progressive Change Campaign Committee is continuing to fight for the best health care bill possible, and we're intent on holding Democrats' feet to the fire. But we need to think very seriously about whether there will be a moment when it is clear that the bill does more harm than good--we need to be prepared to kill the bill.

Part of being a great negotiator is being able to walk away.

 Jonathan Cohn, author of Sick and writer for the New Republic, more closely echoed Klein's view:

Is health care reform without a public option still worth passing? Unequivocally, unambiguously yes.

The case for is simple and straightforward: 30 million additional people, maybe more, will have health insurance. Many more who have insurance will see their coverage become more stable. The ability of insurers to exclude people based on pre-existing conditions will diminish significantly, if not disappear. And that's on top of a host of delivery reforms which should, in combination, help make medical care less expensive over time. The bill could be much better, for sure, but to argue that it's worse than nothing you have to make the case that nothing will somehow lead to more progress in some reasonable frame of time.

I don't see that. Failure to pass health reform won't lead to a progressive revival or resurgence. It will cripple the Democrats, hand the Republicans more political power, and likely to send health care reform into hibernation for another ten to twenty years. It's theoretically possible we could get a better reform at that point. But the historical trend is in the opposite direction. Every new effort is a less ambition version of the old one. Meantime, millions of more people would suffer.

Pass this bill now. Improve it later. That's the way we do things in America, for better or for worse.

Paul Starr, c0-founder of the American Prospect and no liberal he, seems to be squarely in the Klein/Cohn camp:

The moment of decision on health-care reform is arriving for progressives in Congress. Some of them have insisted they will refuse to vote for any bill without a public option, and that is now the only bill that has any chance of passing. If they hold to their position, the most significant social reform on behalf of low-income Americans in 40 years will go down to defeat.

It should hardly be surprising that we have come to this point. The requirement for 60 votes in the Senate to pass ordinary legislation was always going to empower the most conservative members of the Democratic caucus or the few moderate Republicans who might support a bill. For a while this past week, it seemed as though a provision to allow 55- to 64 year-olds to buy in to Medicare might provide an acceptable alternative to the public option and secure the 60th vote for the bill. But when both Joe Lieberman and Olympia Snowe said they wouldn't support a Medicare buy-in, that hope dissolved.

None of this, however, affects the central provisions of the legislation, which would extend health coverage to an estimated 33 million of the uninsured, raise standards of protection for millions whose coverage is limited, eliminate some of the most hated abuses of the insurance industry, and create a new system of insurance exchanges that would enable people who buy policies individually or through small groups to get new choices and better prices for coverage....

Strategists will argue about whether it ever made sense to include a public option in the bill, ...[b]ut the attention lavished on the public option meant that pressure from the left did not come to bear on other provisions of the legislation such as the slow timetable for implementation (under the Senate bill, most of the extension of coverage would not occur until 2014). The danger now is that some liberals in Congress may not be able to shift gears and vote for something they earlier pledged to oppose. Some of the Democratic base may also become demoralized about reform because it lacks a provision they were mistakenly told was essential.

Frequent Salon contributor Ed Kilgore, ever the stragetist who can see the whole board, doesn't so much take a side as lay out five options progressives have in front of them:

...the fact remains that there are only 58 reasonably assured votes for cloture on the recently negotiated Team of Ten "deal" for health care reform. Assuming Ben Nelson can be brought aboard without highly divisive concessions on the abortion issue, that still leaves one vote to be secured from a universe of just three senators: Lieberman, Snowe and Collins. So what are the options left to the White House and the Democratic congressional leadership?

(1) Forget about Lieberman and go after Snowe and/or Collins. It would obviously be satisfying to most Democrats to deny Joe Lieberman the opportunity to be King of the Senate and Arbiter of Health Reform, or more to the point, the chance to screw up or kill the legislation down the road....

(2) Give Lieberman what he wants and then fix the legislation later. The key argument here is that the very items Lieberman is objecting to--an option for some younger Americans to buy into Medicare, and any sort of public option--are budget savers which could without question be added later (say, next year) via the budget reconciliation route, which only requires 50 votes....

(3) Threaten Lieberman with loss of his seniority unless he votes for cloture. Without question, it was a major mistake for the Democratic Caucus to allow Lieberman to maintain his seniority after the 2008 elections without an ironclad pledge that he would support the Caucus on all procedural votes, including cloture votes....

(4) Reframe the bill to use reconciliation. This is the strategy many progressives have been urging all along, for the obvious reason that it gets rid of the need for more than 50 Senate votes and also would make it vastly easier to craft a Senate bill that's close enough to the House bill to avoid friction in a House-Senate conference....

(5) Go back to the drawing board. Before resorting to any of the above unsavory options, health reform supporters will undoubtedly make some effort to devise yet another compromise that can obtain that 60th vote without losing existing supporters....

Maybe I'm missing something, but these seem to be the options at present, and none of them are particularly good. We may be once again at a crucial juncture where progressives--and most of all, the President--simply have to decide what percentage of a loaf is acceptable.

According to Greg Sargent, former DNC chair Howard Dean reportedly says kill it:

In a blow to the bill grinding through the Senate, Howard Dean bluntly called for the bill to be killed in a pre-recorded interview set to air later this afternoon, denouncing it as “the collapse of health care reform in the United States Senate,” the reporter who conducted the interview tells me.

Dean said the removal of the Medicare buy-in made the bill not worth supporting, and urged Dem leaders to start over with the process of reconciliation in the interview, which is set to air at 5:50 PM today on Vermont Public Radio, political reporter Bob Kinzel confirms to me.

The gauntlet from Dean — whose voice on health care is well respsected among liberals — will energize those on the left who are mobilizing against the bill, and make it tougher for liberals to embrace the emerging proposal. In an excerpt Kinzel gave me, Dean says: "This is essentially the collapse of health care reform in the United States Senate. Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill.”

The incomparable Paul Krugman says swallow hard and grudgingly, but pass it:

 

Ugh. It grates terribly to have the health care bill seriously weakened out of pure spite — and that’s clearly what’s happening, as Joe Lieberman demands the withdrawal of a feature he himself was advocating just three months ago.

Paul Starr — a veteran of the Clinton attempt — says that we should just pass the thing and try to fix it later. I guess I grudgingly agree — unless Lieberman demands further changes, gutting the bill. And I have a sick feeling that he’ll do just that.

But no more. On the next big challenge, financial reform, I say do it right or not at all. And we really need to talk about changing the way the Senate works; at this rate we’re well on our way to becoming a failed state.

Going Rahmbo

Progressive group runs ad attacking the White House chief of staff in his own backyard Video

The gloves are off!

Continuing a theme for the day of backyard Illinois politics, the Progressive Change Campaign Committee -- which brought us the "Connecticut for Lieberman" ad -- is running a new ad in White House Chief of Staff Rahm Emanuel's backyard that more or less drops the public option gantlet down on Rahmbo. 

The ad has a limited buy, but you can be sure a lot of folks will be watching it on YouTube and it should get ample play on the cable networks tonight. HuffPo's Sam Stein, who reminds us that Emanuel didn't take kindly to this sort of stuff back in August, has more.

Biden: Lieberman wrong on healthcare

VP warns that failure to pass reform now will stall process for a generation

Vice President Joe Biden says Connecticut Sen. Joe Lieberman is wrong to opposed a health care compromise in the Senate that would allow Americans as young as 55 to buy into the Medicare program.

Biden says, however, that such posturing for leverage on major legislation as it moves toward a vote is not unusual. Lieberman is an independent whose support is seen as crucial for the Democrats.

The vice president also said a failure to approve a health care overhaul by the end of this congressional session would "kick back for a generation" attempts to reform the system.

Biden spoke Tuesday MSNBC's "Morning Joe."

Connecticut Democrat blasts Lieberman

Rep. John Larson, the fourth-ranking House Democrat, says he hopes Lieberman will come around in the end

WASHINGTON -- One of Joe Lieberman's colleagues in the Connecticut delegation doesn't think very highly of the way the "independent Democrat" has been mucking up healthcare reform legislation.

"Joe Lieberman has always been a person of conscience, and I take him at his word when he says he is opposed -- but the ball seems to move," Rep. John Larson, D-Conn., the chairman of the House Democratic Caucus, told a handful of reporters outside House Speaker Nancy Pelosi's office Monday afternoon.

Lieberman, of course, announced late Sunday that no matter how much support the idea of a Medicare buy-in might have garnered from other Senate moderates, he's not interested in playing along. Never mind that he supported a very similar plan only a few months ago.)

House Democrats have, generally, been pretty irritated by the Senate's inability to move forward even with a version of legislation well to the right of the bill the House has already passed. "The caucus is frustrated in general with the Senate that was bringing this health bill up in June and here we are Christmas, and they're still laboring over the package," Larson said. "Any time, whether it's Joe Lieberman or [Nebraska Sen.] Ben Nelson or someone who is critical to obtaining 60 votes -- or whether it's the Gang of Four or the Gang of Six, you name it, whatever gang is operating at the time -- the thing is, any one of them, or a collection of them, can hold up the process. And I think that's extraordinarily frustrating for our caucus."

But Lieberman, who endorsed John McCain last year over President Obama and escaped without much retribution, presents a special case. "It's certainly beyond frustration," Larson said. "In terms of the concern over an issue that's critical to the nation and President Obama, as Social Security was to FDR and Medicare was to Lyndon Johnson -- that's why people are beyond frustrated." Asked what other Connecticut Democrats could to about Lieberman, Larson laughed. "Pray," he said.

Still, hope springs eternal in the hearts of high-ranking House Democrats. "In the final analysis, I think most senators are going to be hard-pressed to stop healthcare from having a vote," Larson said. "It does go back to 'Mr. Smith goes to Washington.' The general public has a sense that you may disagree on policy, but certainly people are entitled to a vote in the Senate on healthcare... This is too big of an issue, too big of a historic moment, to say that a bill can't be voted on."

Whether Lieberman shares Larson's sense of the importance of the issue, of course, remains to be seen.

Obama gives himself B+

One wonders who would give the president similar marks to those he gives himself

So Barack Obama, asked by pal Oprah Winfrey to issue himself a first-year grade as president, gave himself a B+. I'm a college professor and he's a former one, but we all know that a B+ indicates a solidly above average, if imperfect, performance. (Although with rampant campus grade inflation, a B+ isn't as far above average as it used to be.)

Passage of health care reform would boost his grade to an A-, he said. Until Americans get back to work, he said, "I can't give myself the grade I'd like."

One wonders who would issue Obama the same grade. Liberals would almost certainly mark him down for his long-awaited, hemmed-and-hawed over decision to send 34K more troops into Afghanistan, for being less than vigilant about the public option, and for being too cozy with Goldman Sach and other Wall Street types. Not sure if our own Glenn Greenwald is going to pipe up, but I'm guessing Glenn would issue a grade somewhere south of B+. Likewise for Jane Hamsher or Matt Taibbi or other leading left lights too numerous to list here.

Then there are the conservative, and well, fugettaboutit. Looks like they already found their way to the Daily News link provided above, and over to the right column where they ask readers to issue their own grades. As of this writing, 53 percent of these non-scientific, self-selected respondents issued Obama an "F."

African-Americans? I suppose if the tug of identity politics is as strong we suspect, there are plenty who would give Obama a B+ or higher. As the president's poll numbers continue to steadily slide lower, you have to believe African-Americans are standing fast with Obama as the core of his approval number.

The point is, very few Americans would probably give Obama a B+. And even if that were the average year-end grade, the distribution would probably be very bimodal. Whatever the case, as the president admits, he's gonna need to hit the books a little harder on jobs in the next 11 months than he did in the first 11 months if he hopes to limit the electoral damage congressional and other down-ballot Democrats suffer come November.

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