From a conversation I had with a friend; feel free to chime in:
Regarding health care, I see what you mean about the rope-a-dope but I am not sure if that was their deliberate strategy, rather than necessity. With their huge Congressional majority and Obamania still lingering from the election, I think Obama expected to pass the health bill in a few months, and with a public option (what he campaigned on). He expected to get some GOP on board and celebrate a bipartisan reform. But they were shortsighted to not anticipate the tea party grassroots opposition. And they made the tactical blunder of letting the process be Congress-driven and not responding to the sometimes ridiculous attacks from the right. In short, Obama was too much of an "elitist Washingtonian" last summer, and lost the initiative. The public tired of the "sausage making" deals and such, and instead turned their attention to the inflammatory sound bites from the tea baggers (dealth panels, socialism, etc.). There was a failure to communicate. I can pretty much guarantee that Scott Brown wouldn't have won if Obama didn't mess up so badly last summer. I really think that Obama expected his grassroots army to respond to and defeat the tea baggers. But they have been working 24-7 since early 2008; how much can you ask of these exhausted volunteers amidst a recession? They are his adoring fans and patriots, but not robots. And he didn't give them much inspiration and leadership to keep them going. I think that turned a lot of them off, and Dem turnout in November may suffer (we already saw some early signs with 3 significant GOP election victories besides Massachussetts).
So then Obama had to spend all fall and winter to repair the damage, and figure out how to pass the bill with parliamentary tricks and policy compromises. Then I guess he went into rope-a-dope mode, or war of attrition mode. He used his bully pulpit a lot since the State of the Union, and scheduled all those health care discussions that were mostly media spectacles. It was a good move that he finally published his own version of the health bill in January, but that should have come out last June. Give the nation (and Congress) a roadmap and a vision. He is the president! And he should have been more decisive about abortion funding, public option, taxing union Cadillac plans, and other funding. We kept hearing so many versions and explanations with or without all those components, and Obama was so vague and wavering, that we just got turned off and tuned out. In this case, there was too much communication. Don't say anything until you're ready and you have a finalized plan. I know things change constantly in Washington, but don't confuse the public. I am sure they witheld 90% of the health care negotiations from us anyway, but the portion that were were exposed to wasn't persuasive enough it seems. You're not going to please everyone and have to compromise somewhere, but stop listening to the pollsters and consultants. Pick the best plan you can at the time, and stick with it - that's what made George Bush successful (until it did him in).
So Obama snatched defeat from the jaws of victory, and then recovered to snatch victory back. It is a noteworthy, historic accomplishment for his administration, but at what cost? Over the last year, he definitely lost his election mojo, and the GOP is emboldened. Many Dems will get voted out in Nov., and the public is as angry as ever with Washington. He disappointed (or even enraged) parts of his loyal Dem base like the unions, the pro-choice camp http://www.upi.com/Top_News/US/2010/03/21/Abortion-rights-groups-criticize-Obama/UPI-76141269215815/, and the more liberal wing who still believe that single-payer is the only way and for-profit healthcare is unsustainable (maybe more now than ever!). In fact, who in America is going to rejoice over this bill apart from politicians and the poor/sick who directly benefit from the legislation? It's kind of sad that the only celebrations going on for healthcare reform are inside the Beltway (I exaggerate but you know what I mean). The polls are mixed, but I think it's safe to say that 40-50% of America is not only opposed to the bill, but outraged about it (but maybe those people hated Obama and his agenda from the start anyway?). I wonder how many Obama supporters and undecideds became opponents due to the healthcare effort though. Those who support the bill are maybe just relieved that the debacle is over. Like Kucinich, they'll take the bill, but wish there was more meat in it. I know it's a first step that Obama and future leaders can build on, like the civil rights effort. But for me and many liberals, I think after millions spent on PR, all the man-hours wasted, and a year of Washington wrangling, there should be more to show for it.
I heard some commentary on Friday that the "winner" in the health care fight will actually be the loser, politically speaking. Now that the Dems have prevailed, health care costs will still inevitably rise in the coming years until all the bill's measures kick in by 2014 (and even then the average American won't see drastic cost savings). So the GOP will say, "See we told you! The bill is costing us $1T AND your premiums are still going up!" But if the GOP won and killed healthcare reform, the Dems could say in November: "We tried to help middle class families but the GOP just blocked everything, so we're stuck with the broken status quo and you can't afford health care." What is the GOP counter for that? Contrary to some predictions, I doubt the GOP would try to repeal the bill. It's political suicide and the Dems could play the sympathy card: "Little Sally has leukemia and she was able to get life-saving coverage through the Obama reforms. But now the GOP wants to take it away and let her die!" The Dems had to pass something though, but maybe they painted themselves into a corner. They pass reform, and the conservative backlash will haunt them for several elections. They scrap reform, and the whole country loses faith in them as ineffective leaders. It's enough to make you long for the days of monarchy.
This bill is a healthcare coverage expansion and a respectable reform of health insurance practices. Both those steps are admirable and necessary, but unfortunately they failed to address price negotiation and reimportation for drugs, pay-for-outcome instead of pay-for-service, and other factors that strongly contribute to our bloated healthcare costs. But considering the state of Congress and lobbying today, maybe it's the most the public could reasonably hope for, which is sad.
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In the end, do you guys really feel that this "reform" will actually save both the federal government and regular privately insured citizens money? Will illegal immigrants (who do use emergency services) continue to provide a justifiable reason for hospitals to charge inflated rates on services/products which in turn raise overall premiums?
I feel like I have more questions than answers ... fail.
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Yes the bill does create more questions than answers, and only time will tell. Plus it's hard since history is not a controlled experiment; we can only speculate on the bill's true benefits, since we will never know how America could have been without the bill or with a different/better bill. But the social scientists will be able to mine the data and tell us something down the road.
I just wonder how many private citizens without insurance will actually get covered, or just elect to pay the small fines, which can be much less than insurance premiums anyway. And although the cost burdens to the states won't kick in until 2013 or so (the Feds will fit the bill for expanded Medicaid and higher reimbursements in the meantime), I wonder how near-bankrupt states will be able to handle all the new beneficiaries. Plus, will we train enough doctors, nurses, etc. to handle the increased demand (especially when the Baby Boomer health professionals are retiring)?
Here's a healthcare discussion on KQED today: http://www.kqed.org/epArchive/
I haven't listened to it all yet, but it looks to be an informative program.
The bill covers more needy Americans, but doesn't address the quality of healthcare gap. Yes the poor and sick will now get subsidies and protections so they can get Medicaid and won't be turned away by private insurance. But the plans that they are on are fairly terrible. Yes it's better than paying out of pocket with no insurance, but the copays are high, and many doctors won't treat Medicaid patients now because the gov't reimbursements are too low (shame on those doctors though). The "working poor" who do get crappy health coverage from their employers (Walmart for example) have high copay, bad coverage plans. I am not sure if the bill addresses insurers refusing to cover certain procedures? And of course on the other hand, the rich continue to enjoy their Cadillac plans, and wastefully consume a lot of healthcare resources because they can. Obama scaled back his taxing of those such plans to get the necessary Democrat votes.
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the one thing that is perfectly clear about this healthcare bill is the fact that both sides of the political spectrum didn't like it. obama made all kinds of concessions-no public option, reinforcing the hyde amendment, etc. for the right's vote, but made NO concessions to the progressives. when this healthcare reform process started, rahm emanuel made some comment somewhere that obama won't have to worry about the progressives. they'll vote on whatever you give them. what will happen? they'll cause a dem. loss on the bill and they'll be thrown out on the next election cycle. that, and they'll be responsible for the ruination of the obama presidency.
obama has shown his true colors in this process. he's down with the neoliberal policies of the past several presidents. he plays a liberal so thoughtless liberals will like his brand. but, in reality, he's a corporatist like the others. -----------
I have to agree with that. How much slack can liberals give him? We don't have infinite patience and loyalty. What is the point of running for president on a change agenda when you act 70-90% like your predecessors, for better or worse? Of course he's an improvement over Bush (but that would apply to anyone but Palin), though call me naive for disapproving of the disconnect between his campaign and presidential rhetoric.
Bush favored the neocons, business elites, and Christian conservatives, and lost the support of the fiscal conservatives and independents, many of whom then voted for Obama. If Obama and Rahm keep taking the progressives for granted, they may not jump ship and vote GOP, but they will tune out or support an alternative agenda, like how the Tea Party movement spawned from the feeling that GOP politicians weren't conservative enough. If you claim to be a coalition builder and bipartisan leader, and then fail at it (whether your fault or not), it will only serve to hinder cooperation and moderation. The angry groups who felt shut out of the coalition will turn more extreme and polarized, as we have seen on the right at least. That's the sad irony of governing from the middle. Some say that it's better if everyone is a little unhappy instead of one group gaining favor at the expense of the rest. But if everyone is unhappy, of course they're going to blame you and each other, and that doesn't bode well for future political cooperation.
Bush favored the neocons, business elites, and Christian conservatives, and lost the support of the fiscal conservatives and independents, many of whom then voted for Obama. If Obama and Rahm keep taking the progressives for granted, they may not jump ship and vote GOP, but they will tune out or support an alternative agenda, like how the Tea Party movement spawned from the feeling that GOP politicians weren't conservative enough. If you claim to be a coalition builder and bipartisan leader, and then fail at it (whether your fault or not), it will only serve to hinder cooperation and moderation. The angry groups who felt shut out of the coalition will turn more extreme and polarized, as we have seen on the right at least. That's the sad irony of governing from the middle. Some say that it's better if everyone is a little unhappy instead of one group gaining favor at the expense of the rest. But if everyone is unhappy, of course they're going to blame you and each other, and that doesn't bode well for future political cooperation.
So what are liberals to do? When the GOP was in power, they used 9/11 to silence dissent and twist arms, so the Dems in Congress just had to approve everything (even invading Iraq) or risk being labeled as unpatriotic during the next election cycle. What was the good of that anyway, since the Dems lost Congress and the High Court too? But now that the Dems are in charge, how are they holding the GOP's feet to the coals and using their numerical advantage? It's almost like David is bullying Goliath here; the GOP just doesn't want to let Obama and the Dems get credit for anything positive. And if the GOP isn't blocking progress, then the "centrist Dems" are. I use quotation marks because they aren't centrists really, but wed to specific religious, regional, or corporate agendas that conflict with progressives. So Obama and the Dems can't pass anything until they water it down to the point of triviality. So forget about bringing up anything to do with tax hikes, abortion, climate change, or expansion of government. I just hope that during the next GOP dynasty, the Dems are just as obstructionist. Government will be paralyzed, and the cynical public will tire of both parties and remake the political landscape into something more constructive and rational.
FYI, I just re-registered as an independent voter, after 12 years as a disgruntled Democrat. If only I didn't live in CA, then I would really be a swing vote.------------
We all know the legislation is far from perfect. But a move (in this case, a big move) in the right direction is a big deal. Yes, corporations and insurers will continue to profit, but the next steps - maybe in the next twenty years (hopefully sooner) - may be to take the profit motive away from health insurers (making them non-profits) and/or moving to single-payer by expanding Medicare.
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I would rather have this bill than the status quo (even though it doesn't affect me, but helps some needy people), but I just worry about the future that you mention. If this bill doesn't show clear, measurable healthcare improvement for the public and our national debt gets under control, the GOP will attack health reform as ineffective and wasteful, making it harder to move towards single-payer. In other words, this was their one big chance in a generation to cram in as many improvements as they could, and they didn't deliver much (in terms of cost controls and quality of care). On the other hand, if the bill is successful, then future administrations will have an easier time building on it. Time will tell I suppose. But you can bet that in the meantime, the insurance companies will be strategizing how to defeat any future reforms and do what they can to show America that these new regulations on their industry are bad.
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