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The Congress and The Senate: Legislating by Accident
The health care bill has passed the Congress and most of the world is assuming that it will pass through the Senate as well. The reconciled bill is much closer to the original House bill than to the Senate bill, so that assumption seems a bit premature. Though the Senate's 41 Republicans will definitely vote against it, the Democrats have to hope that the changes don't cause enough defections by so-called "Blue Dog" Democrats. Perhaps none of them are willing to risk the political damage at this point, but it's strange to see the U.S. media trumpeting that "the health care bill has passed" when there is still at least one legislative hurdle to go. The new story being told is that Obama and Pelosi have achieved history, that the bill is "a tremendous achievement", but beware: The media is always looking for a story to tell ... and the media knows how to get behind a winning side. That doesn't make their story this time any more believable; both the effort expended and the resulting bill are far from awe-inspiring. It is only by setting the bar extremely low that U.S. lawmakers can earn such accolades: Hell, just getting through a week without a Senator or Congressman getting outed as a pedophile or a philanderer (or both) counts as a tremendous achievement at this point. In truth, the Congress and the Senate are so politically moribund, it seems that inertia is the only thing keeping America going these days. This article was going to be called "The Special Olympics of Legislation" but that was too unfair to the athletes in the Special Olympics. They at least <i>try</i> to win whereas "trying" is not something either legislative body is at risk of being accused of. Nevertheless, it seems that no matter how poor the actual performance, simply spending time on a bill with the words "health care" in the title merits an achievement medal from the media. In troubled times, shouldn't we expect historic legislation once a month instead of once every quarter-century? The nation is besieged by a plethora of domestic problems, is involved in two major wars and is hemorrhaging money in all directions. Its vigilant press is there, however, to help it pat itself on the back for passing one piece of watered-down legislation every couple of years. The health care bill promises to improve the dismal---nay, criminally incompetent and often fatal---situation in American health care today. The bill will not even carry the U.S. to parity with the Switzerland, the nation that spends the next-most per person on health care in the first world. Instead of parity with Europe, the insurance companies will be <i>forced</i> to cover more people, but will be reimbursed handsomely for it. Future price increases are actually locked in rather than restricted, there is no wholesale negotiation on prescription drug prices for medicine purchased by the government and people are further forbidden to obtain their medicaments from outside of the U.S. Most European nations crossed that majestic threshold nearly a century ago: A marvel of progressive legislation and a "tremendous achievement" indeed. <h>Obama's Take (Finally)</h> After having relegated health care to the Congress and the Senate for over a year, Obama has finally taken to the road in the last few weeks to drum up support. He recently gave an inspiring relatively matter-of-fact speech trying to bring it on home (see <a href="http://www.whitehouse.gov/the-press-office/remarks-president-house-democratic-congress" source="White House" author="Barack Obama">Remarks by the President to the House Democratic Congress</a> for the full transcript). He started by addressing the massive disinformation campaign being waged by opponents, lamenting that the media is only too happy to treat the bill as yet another horse race instead of with the gravity the issue deserves. Instead of showing concern for the fate of millions of Americans, the media evinces instead <iq>an obsession with ďWhat will this mean for the Democratic Party? What will this mean for the Presidentís polls? How will this play out in November? Is this good or is this bad for the Democratic majority? What does it mean for those swing districts?</iq> He following up with a good point about taking <iq>a lot of friendly advice offered all across town [...] warning [...] of the horrendous impact [of] support[ing] this legislation.</iq> He noted how strange it would be for the Republicans to suddenly be so <iq>deeply concerned about their Democratic friends.</iq> With tongue firmly in cheek, he admitted that there was <iq>a possibility</iq> that his ideological opponents---not one of whom will vote for the bill---are giving advice meant to keep Democrats in office. He admitted freely that the bill is not perfect, that <iq>there are all kinds of things that many of you would like to see that isnít in this legislation.</iq> Here he's clearly talking to the Democrats who wanted a public option or who wanted single-payer health care (like Kucinich, to whom we'll return below). Here he's talking to those legislators who haven't been completely captured by the health care industry. He appeals to them by calling the bill a <iq>vast improvement over the status quo</iq> (which it technically is). The bill could have been a <i>lot better</i> and could have saved <i>even more money</i> but it would have had to be at least partially socialist.<fn> And that it is most decidedly not. As described in the blog post, <a href="http://robertreich.org/post/463440906" source="" author="Robert Reich">The Final Health Care Vote and What it Really Means</a>: <bq>So donít believe anyone who says Obamaís health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obamaís health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option.</bq> The bill does not rock the American boat; it offers a small step toward what even the bloody Economist called "a moral obligation" and a scandalous social separation between the U.S. and the rest of the first world. The Economist, for God's sake, the last bastion of using the free market as a hammer for ever nail they can find. Obama practically quoted from the Economist article<fn> as he drove him his last appeal to members of the Congress (he's typically long-winded about it, but quite eloquent nonetheless<fn>). <bq>[...] I have to say that if you honestly believe in your heart of hearts, in your conscience, that this is not an improvement over the status quo; if despite all the information thatís out there that says that without serious reform efforts like this one peopleís premiums are going to double over the next five or 10 years, that folks are going to keep on getting letters from their insurance companies saying that their premium just went up 40 or 50 percent; if you think that somehow itís okay that we have millions of hardworking Americans who canít get health care and that itís all right, itís acceptable, in the wealthiest nation on Earth that there are children with chronic illnesses that canít get the care that they need -- if you think that the system is working for ordinary Americans rather than the insurance companies, then you should vote no on this bill. If you can honestly say that, then you shouldnít support it. Youíre here to represent your constituencies and if you think your constituencies honestly wouldnít be helped, you shouldnít vote for this. But if you agree that the system is not working for ordinary families, if youíve heard the same stories that Iíve heard everywhere, all across the country, then help us fix this system. Don't do it for me. Donít do it for Nancy Pelosi or Harry Reid. Do it for all those people out there who are struggling. Do it for them. Do it for people who are really scared right now through no fault of their own, whoíve played by the rules, whoíve done all the right things, and have suddenly found out that because of an accident, because of an ailment, theyíre about to lose their house; or they canít provide the help to their kids that they need; or theyíre a small business who up until now has always taken pride in providing care for their workers and it turns out that they just canít afford to do it anymore [...]</bq> <h>Some Good Guys</h> It is perhaps such an appeal that finally pulled the more reluctant---and progressive--- supporters on board, like Dennis Kucinich. Though he would have been much happier with single-payer or at least a public option (for which continued to lobby until the last minute) he can cling like a castaway to the fact that 32 million more Americans will be covered. In a discussion with Ralph Nader and Dennis Kucinich on <a href="http://www.democracynow.org/2010/3/18/dennis_kucinich_and_ralph_nader_a" source="Democracy Now!" author="">Healthcare, Politics and Reform</a>, Kucinich laid out his reasons for changing his vote at the last second. It was clearly not an easy decision for a lawmaker known for standing on his principles when all others abandon theirs: <bq>I know I have to make a decision, not on the bill as I would like to see it, but as it is. My criticism of the legislation has been well reported. I do not retract those criticisms. I incorporate them into this statement. They stand as legitimate and cautionary. I have doubts about the bill. I do not think it is a step toward anything Iíve supported in the past. This is not the bill I wanted to support, even as I continue efforts until the last minute to try to modify the bill. However, after careful discussions with President Obama, Speaker Pelosi, my wife Elizabeth and close friends, Iíve decided to cast a vote in favor of the legislation. If my vote is to be counted, let it count now for passage of the bill, hopefully in the direction of comprehensive healthcare reform.</bq> The article <a href="http://trueslant.com/scotthpayne/2010/03/17/dennis-kucinich-grand-machiavellian-political-wizard/" source="True Slant" author="Matt Taibbi">Dennis Kucinich: Grand Machiavellian Political Wizard</a> takes a different tack, congratulating Kucinich for using his fleeting popularity over the last week to deliver his message to a wider audience. He was able to <iq>get [single-payer and the public option] [...] greater coverage and airtime to a larger audience than they might have otherwise.</iq> That this is an eminently defensible point in the current climate reflects badly not on Taibbi, but rather on the political climate and the Congress. We expect so little from our multi-trillion dollar government that <iq>even discussing those issues in a broader forum is a fairly significant step in the right direction.</iq> Again, we come back to low expectations: The Congress continues their blatant, corrosive and gobsmacking corruption but are congratulated for having at least one halfway upstanding member. At least one person drew attention to the complete and utter lack of measures that will actually address the problem toward which nearly a trillion dollars will be spent in the decade starting in 2014. When asked how he was bribed<fn>, Kucinich responded that he wanted a public option---nothing for his state or himself---just a public option for all Americans. Though the Congressional Democrats desperately needed his vote and had vocally pledged support for a public option in the past, <iq>they still wouldnít budge on it</iq>. Truly progressive politics, regardless of how much cheaper or useful are anathema in America, as they have been for decades. Alan Grayson and Anthony Weiner are a couple of the other good guys who preferred a single-payer program and would have settled for a public option, but ended up voting for the current health care bill just to get <i>some</i> coverage for <i>a few more</i> Americans. They have all vowed to fight on, to get follow-up bills passed that will "repair" the bill that has passed. Though Grayson has over 70 members of Congress on board for his public option bill, he has an uphill battle. For an example, take a look at the following video of Anthony Weiner<fn> being forced to listen to purely fictitious---and thoroughly discredited---memos being read into the record. <media src="http://www.dailykostv.com/flv/player.swf" caption="Weiner tears apart GOPer who read hoax memo on House floor" href="http://www.dailykos.com/tv/w/002617/" author="" source="DailyKosTV" align="center" class="frame" args="config=http://www.dailykostv.com/w/002617/vxml.php?448"> This is how Congress wastes our time and money and takes 15 months to pass legislation. <h>Hold Your Nose and Vote</h> Not a single House Republican voted for the bill and none are likely to vote for it in the Senate. But the progressives aren't happy either. Ralph Nader, who doesn't have a political office, can afford to be more stridently against it. He's also playing his role perfectly, pushing so-called progressives further left in order to get more benefits for long-suffering Americans. In the interview with Kucinich on Democracy Now! linked above, he described the final bill: <bq>And letís say there are more people covered, right? Well, theyíre being forced to buy junk insurance policies. Thereís no regulation of insurance prices. Thereís no regulation of the antitrust laws on this. Everything went down that Dennis was fighting for. Thereís no regulation that prevents the insurance companies from taking this papier-m‚chť bill and lighting a fire to it and making a mockery of it. Thereís no shift of power. Thereís no facility to create a national consumer health organization, which we proposed and the Democrats ignored years ago, in order to give people a voice so they can have their own non-profit consumer lobby on Washington.</bq> Nader isn't budging, but neither should he. He can continue to fight for an ideal and guilt the sausage-makers into passing something useful, despite themselves. Others are trying to find the silver lining, sometimes desperately. Once again, it seems that it's lesser-evil time again in a country that seems dead-set against letting the masses have any nice things. The article <a href="http://trueslant.com/matttaibbi/2010/03/16/reconciling-reconciliation/" source="True Slant" author="Matt Taibbi">Reconciling Reconciliation</a> provides some supporting argumentation for the "swallow the bitter pill" rationale: <bq>I hate this bill and have since the beginning ó to me it seems like a radical and dangerous step to start forcing people to become customers of a seriously overpriced, inefficient product, thereby removing the last incentive for an already antitrust-exempted, horrifically-performing industry to improve itself in any way. [...] But Iím beginning to come around to the idea that if we do pass this thing, sooner or later Congress is going to get around to complaining about subsidizing the profits of WellPoint and Aetna and all the rest of them.</bq> <img attachment="tr100319.gif" align="left" class="frame">In the end, the primary problem with the current health care bill is that it does not "provide" insurance but rather forces private insurance companies to sell insurance to more people. More people will not become magically insured, but more people will not be denied should they apply for health insurance and be able to come up with the scratch to pay for it. Cartoonist Ted Rall sums it up nicely with this Obamaman cartoon (shown at left). When confronted with an uninsured person, Obamaman says <iq>Meet my assistant, Mr. Insure. I'm giving him your credit card. Congrats---you're <b>insured</b>!!!</iq> <a href="http://robertreich.org/post/459007965/a-worried-postscript-to-the-house-health-care-bill" source="" author="Robert Reich">Worried Postscript to the House Health Care Bill</a> adds other problems that will have to be fixed in legislation before the full bill goes into effect in 2014. <bq>[T]he pending House bill (that will go to the Senate for a ďreconcilationĒ vote) does not repeal the antitrust exemption for health insurers, nor does it contain a public insurance option. It thereby will allow health insurers to continue to consolidate into even larger entities, gain as much market power as they can, and charge ever higher prices. Yet Americans will be required to buy health insurance from them.</bq> His concerns about the antitrust exemption are well-founded, as the fact that it remains in effect belies many of the sunny promises Obama is making right now. <h>So What Is In The Bill?</h> There is a tremendous amount of misinformation out there, for the most part viewing the legislation as far more progressive than it actually is. People are calling it universal health care, they're calling it a giveaway, that the poor will stop working in order get on the Obama free-ride. The bill doesn't affect the poor at all, really: They already have Medicaid. <a href="http://www.slate.com/id/2248030/pagenum/all/#p2" source="Slate" author="Timothy Noah">Health Reform 3.0</a> has a decent summary of the detaills. For the most part, it looks like the final version (called the "reconciliation bill" in the article) will be less progressive than the original bill passed by the House, but more progressive than the one passed by the Senate. On the plus side, the doughnut hole in the Medicare prescription drug plan will be closed, Medicaid doctors compensation will be raised, the projected deficit reduction over doing nothing will be $138 billion and 32 million more people will be given the chance to purchase health care. Though the article states that these people <iq>would become newly insured under the House-passed bill</iq>, it is more accurate to say that they would become "newly <b>insurable</b>" with a relative handful of those getting help through subsidies. On the minus side, there is no public option, the system is not single-payer, the mindless tying of employment to health insurance still stands, there are only very vague guarantees of subsidies for those who cannot afford the new opportunity (with the punishment for not purchasing insurance standing at 2.5% of your income or $695, whichever is higher). Cost controls are also pretty much non-existent, which makes the president's guarantee of protection from future price-gouging somewhat suspect. The stupid Cadillac tax is still in there as a means to raise money, but it's been drastically reduced and replaced with a tax on families earning more than $250,000 (amazingly with little to no resistance from the defenders of "average Americans"). The article <a href="http://www.csmonitor.com/Money/Donald-Marron/2010/0322/New-healthcare-bill-pros-and-cons-It-expands-benefits-now-cuts-them-later" source="Christian Science Monitor" author="Donald Marron">New healthcare bill pros and cons: It expands benefits now, cuts them later</a> has more information, culled directly from the <a href="http://www.cbo.gov/ftpdocs/113xx/doc11379/Manager'sAmendmenttoReconciliationProposal.pdf" source="" author="">CBO's Analysis of the Bill</a> (PDF). When subsidies are considered with nearly equal weight as spending---as the CBO recently started doing---then the picture of the health care bill looked like this: <bq>[...] the reconciliation package increases the federal commitment to health care over the next decade (e.g., by rolling back the excise tax on expensive insurance plans thatís in the Senate bill) but then brings it down in the future (e.g., by ramping up the excise tax beyond the ten year window).</bq> <h>So What's Next?</h> As detailed above, the Republicans are completely and entirely against this bill whereas more progressive Democrats are hoping to pass this version and keep working to fix it in future versions. They may be hoping for too much, as their more center-right colleagues are wiping their brows and proclaiming that they can now coast along on their laurels<fn> and won't have to pass anything significant for the next dozen years. That only a shadow of a health care bill could be passed is in no small part due to the fact that Americans are trained from birth to not give a shit about the poor. To in fact think of the poor as lazy good-for-nothings that seek to profit from the sweat of our brows and the strength of our backs---where "our" is a very flexible concept including oneself, one's family and everyone one knows, but no other poor people. And this dastardly situation all came about because of an insidious socialism with which we were burdened by the delusional Roosevelt-besotted populace of early 20th-century America. Because many voters actually have health insurance---either through employers or through Medicare---their attitude is, as Stephen Colbert would say, "I've got mine, Jack". However, as detailed in <a href="http://uggabugga.blogspot.com/2010/03/if-not-this-year-maybe-next-or-year.html" source="Uggabugga" author="Quiddity">If not this year, maybe the next, or the year after that</a>: <bq>Most big employers plan to shift a larger share of health-care costs to their workers next year, according to a survey released Thursday. Many say they may charge more to cover spouses, tighten eligibility standards for their health plans and dispense financial rewards or penalties based on the results of certain lab tests. At some companies, overweight employees could be excluded from the most desirable plans.</bq> Once this happens, expect the "get government outta my life" crowd to do an abrupt about-face as the health care issue suddenly becomes very much about them. Self-interest is the best way of moving forward progressive legislation. But for now the Republicans are screaming repeal and slavering at the prospect of riding back to power on a wave of public indignation in November. All the usual suspects (<a href="http://www.nytimes.com/2010/03/22/opinion/22krugman.html">Newt Gingrich</a>, for one) are saying all the usual noxious things that betray how they see politics where they should instead see people. At least the stumblebums managed to careen drunkenly in a halfway useful direction for once, instead of just spending half a trillion on some new jet planes. <a href="" source="" author="James Kunstler">The Party of Cruelty</a> put it quite nicely: <bq>At least this once a workable majority in the government has stood up to the forces of cruelty and injustice, and whatever else happens to us in the course of this long emergency, it will be a good thing if the party of fairness and justice identifies its adversaries for what they are: not "partners in governing," or any such academical-therapeutic bullshit, but enemies of every generous impulse in the national character.</bq> <hr> <ft>That's a sarcastic swipe at those who deem anything beyond kill-or-be-killed as socialism. Also those who conflate Marxism, Stalinism, Nazism and socialism can take a long walk off a short pier.</ft> <ft>The author managed to snag a copy of the economist in a cool <a href="http://www.bagels.ch/">Bagel Shop</a> in Winterthur over the weekend. The article is not available online without a subscription.</ft> <ft>This author should perhaps be a bit careful throwing around the epithet "long-winded".</ft> <ft>Such quasi-legal bribery is increasingly common, as we saw during the passage of the initial Senate bill where a handful of Senators got massive kickbacks written into the health care bill in exchange for their vote.</ft> <ft>A fluke of districting put this author into Gregory Meeks's district instead of Weiner's when he lived in New York City. Since it's a matter of two city blocks, I vote for Meeks---who's pretty tepid overall---but pretend I'm electing Weiner.</ft> <ft>To mix methaphors flagrantly.</ft>