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Krugman: Health reform “looks good”

Paul Krugman on the health reform bill:

So what’s the reality of the proposed reform? Compared with the Platonic ideal of reform, Obamacare comes up short. If the votes were there, I would much prefer to see Medicare for all.

For a real piece of passable legislation, however, it looks very good. It wouldn’t transform our health care system; in fact, Americans whose jobs come with health coverage would see little effect. But it would make a huge difference to the less fortunate among us, even as it would do more to control costs than anything we’ve done before.

This is a reasonable, responsible plan. Don’t let anyone tell you otherwise.

Read the whole thing, as they say.

Lindsey Graham: If Obama defeats GOP obstructionism on health care, the GOP will obstruct even more!

Apparently President Obama and Congressional Republicans are interested in reforming the nation’s immigration system. Time for some bipartisan agreement! Well, yes and no:

(Lindsey) Graham, in a statement, said he had told Mr. Obama “in no uncertain terms” that the immigration debate “could come to a halt for the year” if the president moved to pass health care legislation by a method known as reconciliation, which requires a majority of 51 senators instead of 60 and would in practice require no Republican votes.

And Graham is one of the reasonable Republican senators, supposedly. But the GOP has apparently never heard of “you win some, you lose some.” They either win everything, or they shut down the system — even on areas where they disagree with Democrats. It’s a good way to attract votes, I suppose, but a damn poor way to actually get stuff done for the American people.

Will Bart Stupak kill the health reform bill over abortion?

Looks like it could happen:

A dozen House of Representatives Democrats opposed to abortion are willing to kill President Barack Obama’s healthcare reform plan unless it satisfies their demand for language barring the procedure, Representative Bart Stupak said on Thursday.

“Yes. We’re prepared to take responsibility,” Stupak said on ABC’s “Good Morning America” when asked if he and his 11 Democratic allies were willing to accept the consequences for bringing down healthcare reform over abortion.

“Let’s face it. I want to see healthcare. But we’re not going to bypass the principles of belief that we feel strongly about,” he said.

This, of course, is the corrosive and corrupting way that the abortion issue affects our politics and policy debates: Bart Stupak is so pro-life that he’s willing to kill a bill that will help millions of Americans stay alive and healthy. It’s infuriating.

At this point, Stupak’s position amounts to little more than grandstanding. Never mind that the Obama Administration is promising that federal money won’t be used to fund abortions; Stupak might think about Congress itself. Simply put, we’re a couple of decades into a rough-but-by-n0-means-complete consensus that federal money not be used to pay for abortions. Given that plenty of Democrats in Congress feel this way, it’s unlikely we’ll see a sudden rush of tax dollars to abortion clinics, no matter how strict the safeguards in the bill.

Stupak is playing defense against an improbable scenario, in other words. And he’s willing to kill the health reform bill over this fantasy. It’s dumb and irresponsible.

Ed Rendell: Make the Republicans filibuster on health reform

Yes. Make them take to the floor and hold it for a week or two. Or even a month. If they want to play Jimmy Stewart, let them really play Jimmy Stewart.

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Barack Obama is cerebral, cool and detached … from his own agenda

The past week has treated us to an onslaught of “Barack Obama: WHAT WENT WRONG?” stories and columns. This seems premature to me — the big items of his presidency are still in flux — but the combination of Scott Brown’s election, Obama’s falling poll numbers and his first anniversary in office make it an irresistable narrative.

Picking out three big items from the first year of his presidency, it’s easy to see a troubling pattern:

• THE STIMULUS: Barack Obama announced the broad parameters of the stimulus package … then let Harry Reid and Nancy Pelosi hash it out, making concessions to Republicans on taxes and the size of the bill in exchange for, well, almost nothing.

• THE HEALTH CARE BILL: Barack Obama announced the broad parameters of the bill, but made it clear that he wouldn’t absolutely go to bat for certain parts — like a public option — that he supposedly supported. He let Harry Reid and Nancy Pelosi hash it out and drag it out until the sheer amount of time had exhausted the public’s patience.

• CLOSING GITMO: Barack Obama announced he’d close Gitmo in a year — then broke the promise when he ran into opposition fro Congress, even getting rid of the official whose job it was to get Gitmo closed.

The problem is not that President Obama seems cerebral, cool and detached. It’s that he seems cerebral, cool and detached … from his own agenda. We’ve seen him give speeches, on occasion, but we haven’t seen him roll up his sleeves and fight for his own administration’s efforts. Perhaps this is all going on behind the scenes, but we as a public need to see some more of it.

With rare exception, it seems he’s not willing to work with Congress so much as he’s ready to defer to Congress. And there’s no item that’s not negotiable, it seems. Maybe this is pragmatic. But a year into his presidency, it’s more difficult than it has ever been to say what line in the sand Barack Obama won’t cross, what he definitively stands for. He’s one-quarter of the way into the only four years he’s guaranteed to hold the White House; it’s time to stop being a blank slate upon whom the voters can project their dreams and time to deliberately make a few people angry.

Scott Brown, health reform and the filibuster

Should health reform die just because Dems now “only” have 59 votes? My take in this week’s Scripps Howard column:

The Village Voice headline said it best: “Scott Brown Wins Mass. Race, Giving GOP 41-59 Majority in the Senate.” Democrats actually have an 18-vote majority in the Senate, but the Republicans have just enough votes to ensure that Democrats are unable to enact their agenda. If you’re opposed to the health-reform bill, that probably makes you happy.

It was not always this way. The filibuster is mentioned nowhere in the Constitution; it was created by the Senate itself to govern proceedings. For most of American history, though, the technique was used rarely — and when used, senators were actually required to get on the floor and hold it, Jimmy Stewart-style, until they could speak no longer. Only in recent years has it become standard operating procedure to use the threat of a filibuster to obstruct business. And the threat is all that’s needed. When is the last time you saw a haggard senator reading from phone books for 15 hours straight in a desperate attempt to keep a bill from coming to a vote?

Hypocrisy, unfortunately, taints all discussion of ending the filibuster. When Democrats were in the minority, they loved the technique. Now they hate it. Republicans who used to cry about the need for “up-or-down votes” now claim the filibuster’s necessity as a tool of checks and balances to keep government from overreaching.

But there are plenty of checks and balances in the legislative process. And the Supreme Court is always ready to hear a constitutional challenge. The supermajority requirement isn’t a check or a balance; it’s a roadblock that ensures no serious business can ever be done. The filibuster — which holds Americans hostage to the wishes of a minority of senators who represent a minority of voters — is unfair and undemocratic.

Health care reform and the poor: Why we may never get universal coverage

Start writing the health reform obituaries:

“I would advise that we try to move quickly to coalesce around those elements of the package that people agree on,” Mr. Obama said in an interview on ABC News, notably leaving near-universal insurance coverage off his list of core goals.

But some lawmakers in both parties began calling for a scaled-back bill that could be adopted quickly with bipartisan support, and Mr. Obama seemed to suggest that if he could not pass an ambitious health care bill, he would be willing to settle for what he could get. In the interview with ABC, he cited two specific goals: cracking down on insurance industry practices that hurt consumers and reining in health costs.

The poor, of course, get left behind by this turn of events. People who have insurance already will be helped by the reforms that are now apparently coming, and that shouldn’t be a surprise: People who already have insurance are the people who vote. As David Leonhardt noted earlier this week:

Something like 90 percent of voters already have insurance. Many imagine that they will never lose it. Many people even believe they don’t pay for their insurance, because the money comes out of their paycheck before they see it. (They do pay in lost income.) Polls also show that Americans are more aware of our medical system’s strengths than its weaknesses (like needlessly high error rates). As for Medicare being on course to break the bank — voters rarely get excited about future fiscal problems.

So health reform was probably destined to inspire more fear than hope.

All of this means that efforts at universal health care are destined to help the people least likely to pay it back in terms of electoral support. It has always been thus, and probably always will be. Which means that universal coverage will always be tossed by the wayside when the political battles get a little rough. The reforms we do get will always be for people who benefit the politicians — which is why we got the Medicare drug benefit and why we’ll get efforts to rein in costs. The greater good might be served by helping the poor through universal coverage, but the political cost-to-benefit ratio will probably never make sense to Congress.

Scott Brown, Martha Coakley and the Massachusetts Senate race: What it means

Scott Brown - no, seriously! - back in the 1980s.

Scott Brown - no, seriously! - back in the 1980s.

Who knows if Republican Scott Brown can actually pull off an upset win to claim Ted Kennedy’s old Senate seat? At the very least, he’s going to make it very uncomfortable for Democrat Martha Coakley — and if he wins, he’s going to make it a lot harder to pass health care reform.

For a lot of Republicans and timid Democrats the moral of the story here is one of overreach: If President Obama hadn’t tried to do so much so soon, he wouldn’t be risking this backlash. Better to go slow on big-ticket issues like health reform. But I don’t buy it. It’s an analysis that overlooks Martha Coakley’s ample deficiencies as a candidate, for one thing, and a whole bunch of other minor irritations that are specific to Massachusetts politics.

And it ignores one other thing: politics goes in cycles. Republicans never win forever, nor do Democrats. Probably the best thing that our elected officials can do is to do the things they think are right in a quick and timely fashion instead of forever gaming out the electoral consequences. You don’t want to go so quick that you don’t conduct a good process. But once you’ve decided on a course of action — and we’ve known health reform was coming from the moment Obama was elected — it’s also unwise to allow yourself to be unduly slowed. You’ll only have the power for so long. You might as well use it.

Health care bill passes the Senate

I find that health reform is something about which I don’t have much, if anything, original to say. That’s probably a damaging admission for any Aspiring Pundit, but it’s true. That said, I’m heartened to see that the Senate passed its version of the health reform bill last night. And while I suspect the bill is far from perfect, I also believe it goes a long way toward the goal of ensuring wider access to health care than currently exists.

A conservative friend Tweeted last night that “Dems have no clue what populist hell they’ve just unleashed in this nation,” as though we didn’t just live through the Summer of Death Panel Obamahitler Screaming. And Atrios might be right that the compromises involved in getting the bill to 60 votes will make it so noxious to voters that Democrats will take a major hit.

But I suspect that Paul Krugman is right. He blogs about President Obama:

But on health care, I don’t see how he could have gotten much more. How could he have made Joe Lieberman less, um, Liebermanish? And I have to say that much as I disagree with Ben Nelson about many things, he has seemed refreshingly honest, at least in the final stages, about what he will and won’t accept. Meanwhile the fact is that Republicans have formed a solid bloc of opposition to Obama’s ability to do, well, anything.

Some of my commenters have argued that even with this bill Democrats may well lose seats next year — possibly even more than they would have without it. Definitely on the first point; on the second, I don’t think people realize just how damaging it would be if Obama didn’t get any major reforms passed. But in any case, that misses the point. The reason to pass reform, even inadequate reform, now isn’t to gain seats next year; it is to pass reform, which will do vast good, during the window that’s available. If it doesn’t pass now, it will probably be many nears before the next chance.

Right. We vote people in to do certain things, but often they don’t do things because doing things might make it harder for them to retain power. But what’s the point of helping them retain power if they won’t use it to do those certain things? The Democrats will likely lose seats in 2010 — that was probably going to happen anyway, given the history of midterm elections. As somebody who cares more about health reform than the electoral prospects of Democrats, I’m willing to sacrifice some of the latter to get a bit of the former. Otherwise, what’s politics for?

Pass the health care reform bill

Paul Krugman is wise today. In fact, I have nothing to add:

At its core, the bill would do two things. First, it would prohibit discrimination by insurance companies on the basis of medical condition or history: Americans could no longer be denied health insurance because of a pre-existing condition, or have their insurance canceled when they get sick. Second, the bill would provide substantial financial aid to those who don’t get insurance through their employers, as well as tax breaks for small employers that do provide insurance.

All of this would be paid for in large part with the first serious effort ever to rein in rising health care costs.

The result would be a huge increase in the availability and affordability of health insurance, with more than 30 million Americans gaining coverage, and premiums for lower-income and lower-middle-income Americans falling dramatically. That’s an immense change from where we were just a few years ago: remember, not long ago the Bush administration and its allies in Congress successfully blocked even a modest expansion of health care for children.