Not sold: the netroots still fuming over healthcare

December 21, 2009 · Posted in Healthcare, Politics

President Barack Obama delivers a speech on health care to a joint session of Congress, Wednesday, Sept., 9, 2009, on Capitol Hill in Washington. (AP Photo/Pablo Martinez Monsivais)

The Florida netroots is still at odds over the Senate healthcare compromise, as are liberals across the country, with some saying pass the bill, because even if flawed, it will do some good, and others saying not only kill the bill, but good-bye to Team Obama. The disappointment with the president, whom most liberals had assumed was one of them (though there was ample evidence during the campaign that he was not, and is not, a liberal, in the classic, Ted Kennedy/Bernie Sanders sense — something both the left and the right clearly missed…) is palpable, including on Capitol Hill, where Russ Feingold is laying blame for the loss of the public option squarely on the White House. But something else seems to be sinking in on the left: the futility of fighting on. Already, the Vicky Kennedy card has been played, prominent thinkers like Paul Krugman have bowed to reality. This healthcare bill is all we’re going to get. Time to start dealing with it.

Meanwhile, before the 1 a.m. vote even takes place, the White House has dispatched its troops to sell the bill to a wary public, touting the bennies they say kick in sooner rather than later. Here’s the spin from the administration’s Nancy Ann DeParle, via the White House blog:

We learned today from the Congressional Budget Office that this bill will reduce the deficit by $132 billion over the first decade, and more than $1 trillion in the decade after that. That makes it the biggest deficit-reduction effort in over a decade. All while expanding coverage to 30 million more Americans.

But bringing down the deficit and expanding coverage are only part of what insurance reform will do. And today the Senate introduced a package of changes to their bill that will make critical progress in ensuring competition, providing affordable choices, and holding the insurance companies accountable. These improvements were bundled together in what’s called a manager’s amendment – and here are some of the highlights:

Penalizing insurers for unfair rate hikes. If insurers who arbitrarily jack up rates before the exchanges come online, they won’t be allowed to participate in them – they’ll miss the opportunity to compete for millions of new customers. That creates a strong incentive to keep premiums low before the exchanges are up and running in 2014.

Making sure your money goes toward care, not administrative costs. Insurers will be required to spend a greater portion of your premium on the care you receive, rather than administrative costs or salaries. And if they don’t, they’ll have to pay you a rebate.

Ending discrimination based on pre-existing conditions. Once the exchanges are open in 2014, insurance companies will no longer be able to deny you coverage because you have a pre-existing condition. In the meantime, the legislation immediately creates a high-risk pool where adults with pre-existing conditions can purchase affordable coverage. And for families with kids, the news is even better: insurers will immediately be prohibited from denying coverage to kids with pre-existing conditions. Period.

Protecting your access to care. Lifetime limits on benefits will be banned right away.

Annual limits will also be banned once the exchanges are up and running. The manager’s amendment ensures that in the meantime, the use of annual limits will be tightly restricted until we can do away with this unfair practice entirely.

More help for small business. The bill now includes additional help for small businesses. The health insurance tax credit for small businesses will now start in 2010, eligibility for the credit will be expanded, and small businesses will see improved purchasing power to make sure employees are getting good coverage at a good value.

Choice and competition. Insurers will now offer multi-state plans under the supervision of the Office of Personnel Management. That means more choice and more competition in your state.

Focusing on quality, not quantity. Health care providers will be reimbursed by Medicare for the quality of care, not just the quantity of tests and treatments. Shifting the way we reimburse for care is one of the most important things we can do to rein in spiraling health care costs – and it means a renewed focus on what’s best for the patient.

A Koskid meanwhile, does their own, pretty thorough overview of what’s hot and what’s not in the manager’s amendment, and concludes that it’s mostly bad, and the insurance industry’s pet mandate should be stripped out.

Meanwhile, on the Sunday shows, HoDo softened his stance from “kill bill” to “beat bill up a bit before it’s passed,” and David Axelrod offers the olive branch of saying HoDo isn’t insane. Can you feel the love?

It appears we’re nearing the end-game, folks, and the progressive side has lost this one pretty badly. The insurance companies, whose stock prices are at a 52-week high on the anticipation of 30 million new forced customers, has won. Liberals must now do a battlefield assessment, and figure out how to play it better next time. A good start would be not assuming that the POTUS is a liberal. This OpenLeft post from July of 2008 should be read and re-read:

In a post called the Immunity Hysteria, ardent Obama supporter Larry Lessig mocks Obama supporters who thought that Obama was a strong liberal:

You can’t read Obama’s books, watch how he behaved in the Illinois Senate, and watched how he voted in the US Senate, and believe he is a Bernie Sanders liberal. He is not now, and nor has ever been. That’s not to say there aren’t issues on which he takes a liberal position. It is to say that the mix of views he actually has and has had doesn’t map on a 1970s spectrum of liberals to conservative. He is not, for example, “against the market,” as so many on the left still make it sound like they are. He is for same-sex marriage. So if you’re upset with Obama because you see him shifting, you should actually be upset with yourself that you have been so careless in understanding the politics of this candidate.

The point there is that President Obama has long held views that could not possibly be considered liberal — he is an evangelical Christian who opposes gay marriage, he favors the FISA domestic spying regime and the Patriot Act, and while he intends to close Gitmo and end the wars in Iraq and Afghanistan, clearly he will do neither precipitously, or without explicit support from the generals. Sure, he has some liberal positions (on cap and trade, and on card check, for instance,) but it is by no means clear that any of these are issues he’d go all the way to the mat for, rather than eke out a compromise. Mr. Obama is, after all, a politician. And it is the rare politician who has the luxury of ideological rigidity. Ted Kennedy could stand fast because he was a Kennedy, was congenitally wealthy enough that he didn’t need the job, and because he was in Massachusetts, in a seat he could, and did, hold for life. Ditto Jay Rockefellar — he is a Rockefellar … and Bernie Sanders given where his is from (Nancy Pelosi is another pol blessed with both riches and a true-blue electorate.) So progressives start their battles for liberal reform from a deficit, and without a White House that feels beholden specifically to them. Meanwhile, that OpenLeft post also contained the following prescient warning:

As a liberal, I believe that if Obama comes in and implements a bunch of muddled centrist policies, proposing tax cuts to deal with poverty and an expanded military and entitlement reform along with a weird convoluted health care reform, he will fail because basic liberal ideas like accountability, oversight, and integrity in leadership will not be embedded into our institutions. The rich have left us with a massive bill in the form of an intractable trade deficit, national debt, and oil addiction, and someone’s going to pay it. If it’s the public instead of the people who ran up the country’s credit cards (take a look at the nation’s billionaires), it’s going to make a lot of people much angrier than they are right now.

UPDATE: Some on the left are getting the picture. Things like this are not going to happen in an election year. (And Obama will not risk a row with the military brass or an uproar among officers who are about to deploy to Afghanistan, over DADT. Trust me on that.)

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