Wednesday, January 27, 2010

Congress slows down on health care

Congressional leaders are taking health care legislation off the fast track as rank-and-file Democrats, wary of unhappy midterm election voters, look to President Barack Obama for guidance in his State of the Union address. House and Senate leaders said Tuesday they need time to determine the best way forward on health care in the wake of last week's special election loss in Massachusetts, which cost Democrats their filibuster-proof Senate majority.

Obama is not expected to offer a specific prescription in Wednesday night's speech, but Democrats want to hear him renew his commitment to the health care overhaul he's spent the past year promoting as his top domestic priority. It is now badly adrift, and lawmakers want to stop talking about the divisive topic and move on to jobs and the economy, the issues they say preoccupy their constituents.

"The president effectively will hit the reset button (Wednesday) night, after which we'll have a matter of weeks, not months to get this right," said Rep. Anthony Weiner, D-N.Y. "We're reaching the point where our momentum is clearly stopped already," Weiner said. "If we're going to do this, I think we have to do this soon."

Not so, according to Senate Majority Leader Harry Reid, D-Nev. "We're going to find out how to proceed," Reid told reporters Tuesday. "But there is no rush."

The House and Senate separately passed 10-year, nearly $1 trillion bills last year to remake the nation's medical system with new requirements for nearly everyone to carry health insurance and new regulations on insurers' practices. Negotiators were in the final stages of reconciling the differences between the two measures before last week's GOP upset in the race for the Senate seat long held by the late Edward M. Kennedy. Democrats acknowledge that opposition to the health care remake in Washington helped spark the Massachusetts revolution.

Democrats now have four options for moving forward, said House Majority Leader Steny Hoyer: no bill; a scaled-back measure designed to attract some Republican support; the House passing the Senate bill; or the House passing the Senate bill, with both chambers making changes to bridge their differences.

House Speaker Nancy Pelosi has ruled out passing the Senate bill with no changes, and no Democrats are publicly advocating abandoning the effort altogether, though Rep. Stephanie Herseth Sandlin of South Dakota, a leader of conservative House Democrats, said some conservative Democrats would prefer to do just that.

The option attracting the most attention is for the House to pass the Senate bill with changes. Rep. Jim Clyburn of South Carolina, the No. 3 Democrat, told reporters Tuesday he thinks the House could do so if lawmakers get rid of provisions like special Medicaid deals for Louisiana and Nebraska and dial back a tax on high-cost insurance plans opposed by labor unions.

But two centrist senators threw up a roadblock to the approach, because it would require using a special budget-related procedure to go around Republican opponents in the Senate, a calculated risk sure to inflame critics on the political right. Sens. Evan Bayh, D-Ind., and Blanche Lincoln, D-Ark., who both face re-election this year in Republican-leaning states, said they would oppose taking that step.

The strategy requires only 51 votes to advance, but Senate leaders may not be able to round up the support. Even if they do, final action could stretch into late next month or beyond. And a number of Democrats sounded Tuesday like health care was the last thing they wanted to be dealing with. "If someone's losing their house, lost their job, the last thing they care about is their next door neighbor's health care," said Rep. Shelley Berkley, D-Nev. "Health care isn't the No. 1 issue on their minds. If it's not the No. 1 issue on my constituents' minds, it's not the No. 1 issue on my mind."


Obamacare: CNN Poll Shows Only 38% Support

I’ve long said that the magic number to kill Obamacare was %35. But with the election in Massachusetts, I think %38 will do. From the story:
Only three in ten Americans say they want Congress to pass legislation similar to the health care reform bills that have already been approved by the House and Senate, according to a new national poll. A CNN/Opinion Research Corporation survey also indicates that nearly half the public, 48 percent, would like federal lawmakers to start work on an entirely new bill, and 21 percent feel Congress should stop working an any bills that would change the country’s health care system.

Devastating. What a debacle. Why? Because they made the same stupid blunder as Hillary Clinton did in 1993. Unbelievable.

For the good of the country, it is time for President Obama, Speaker Pelosi, and Leader Reid to pull the plug on this monstrosity and start anew with a more targeted reform. Or, they can tear the country apart–and destroy their own political fortunes–by forging arrogantly ahead in total disregard of public opinion. Politically, I’d rather they did the latter. But too many people need help, so I am rooting that they finally gain wisdom and pursue the former course.


Why Obamacare Is Doomed -- The Hollywood Version

Whereas the Obamans want us to have less health care, the movie “Extraordinary Measures” wants us to have more medicine, more cures

Here’s a paradox of liberalism: Hollywood hurts the Obama health care plan more than it helps. Hurts it a lot more. But how could that be, one might ask, when everyone knows that studio moguls, as well as actors and writers, are solidly “blue” in their politics--and in their campaign contributions? The answer is this: Yes, Hollywoodites think liberal, but when it comes to making movies, they think a bit more conservatively. More precisely, they think in terms of what real people will want to see, and that pushes in a center-right direction, which is where the country is.

Oh sure, they might give a few thousand dollars to chic liberal Democrats every couple of years, but when it comes to spending tens of millions on a movie--in hopes of making a lot more than that in return--they are a good deal more, well, conservative. A case in point is the new film, “Extraordinary Measures,” starring Brendan Fraser and Harrison Ford. The movie is an out-and-out tribute to science, family values, and, yes, entrepreneurial capitalism. Obamacare, with its emphasis on bureaucratic rationing and government control, is nowhere to be seen.

If the Obamans had stopped to think about the implications of such a movie being made in 2010--released by CBS Films, no less--they would have realized that their fundamental approach to healthcare is wrongheaded, at odds with the way that Americans think about health issues. Whereas the Obamans want us to have less health care, “Extraordinary Measures” wants us to have more medicine, more cures.

“Measures” tells the mostly true story of John Crowley, a business executive whose two children were diagnosed with Pompe Disease, a degenerative neuromuscular disease that paralyzes, then kills, its victims, usually before their 10th birthday. In other words, it is a horrible disease, fully worthy of a massive effort to cure it; “I wish we had a drug to treat Pompe,” one character says early on--“but we don’t.” And so the issue of health insurance, while important, is not as important as the issue of cures. If there’s no cure for Pompe Disease, children die a painful death--and an expensive death, involving lots of time in hospitals, lots of expensive therapy equipment. But if here is a cure, the children can grow up to become productive citizens.

As for John Crowley, he did something truly daring and capitalistically heroic--right out of an Ayn Rand novel. Starting with $100,000 of his own money, he quit his job and started a company to make the cure for Pompe and so save his children. And it worked--let’s hear it for capitalism and freedom. Fictional composites aside, this is basically a true story, as recorded by a Wall Street Journal reporter, Geeta Anand, in her 2006 book, "The Cure: How a Father Raised $100 Million--And Bucked the Medical Establishment--In a Quest to Save His Children."

And so yes, it’s an inspiring story of family love and duty--although, of course, Hollywood has made many movies in the past out of similar stories. “Magnificent Obsession,” about a man who goes to medical school to restore the sight of the woman he loves, has been made and remade--although, to be sure, most medical dramas coming out of Hollywood go to TV, where for half a century, dramas ranging from “Dr. Kildare” to “Marcus Welby” to “ER” to “House” have emphasized heroic doctors, practicing heroic medicine. Indeed, the currently running “House,” about a crazy-brilliant doctor who breaks all the rules in his determination to cure his patients, is rated as the most popular television show in the world.

So if people love medical drama, focusing on cures, then Hollywood loves medical drama, focusing on cures. Show business is, after all, a business.

But politics is a business, too, and so one would think that politicians would know what they are doing. But maybe not. Obamacare, like Clintoncare before it, is bureaucratic and boring. And that’s on a good day. Last August, The Nation’s Chris Hayes, a liberal-leftist supporter of Obama, perfectly described what the Obamans had done to the health care issue:
In its health care messaging, the White House has taken an issue more intimate and immediate than perhaps any other in a voter’s life and transformed it into an abstract, technical argument about long-term actuarial projections. It’s a peculiar kind of reverse political alchemy: transforming gold into lead.

Turning gold into lead--not at all what Hollywood is about. If there’s one thing Hollywood prides itself on, it’s getting bottoms into seats, and eyeballs onto screens. And if that takes drama and excitement, so be it: The show must go on.

One might think that at one of those posh L.A. fundraisers, some Tinseltown type would have taken Obama aside and said, “Look, your whole campaign is about ‘hope.’ Hollywood movies are about hope; 98 percent of the time, the picture ends happily. So enough with the bureaucrats and the ‘death panels’--give the folks some reason to hope! Talk about cures! A cure for breast cancer. A cure for Alzheimer’s. For Parkinson’s. A cure for spinal cord injuries and paralysis--that would play with families of war veterans. Pick one of those; trust me, it’ll play well in Peoria, especially if we get Michael J. Fox involved. And then, once you have the trust and confidence of the folks, you can pile on with the rationers and price controls!” In other words, the mogul might have said, turn Obamacare into a movie with a happy ending--not a sorry and scary show starring Kafka-esque bureaucrats.

But if anything like that conversation occurred, the Obamans didn’t listen. Like the Clintonites two decades ago, they charged ahead with a health care plan that bombed.

Now as it happens, “Extraordinary Measures” has received mostly weak critical reviews, and is not doing particular well at the box office. Perhaps the disease, Pompe, is too obscure. Perhaps, as noted, TV has absorbed the huge market for “true med” stories. So there might not ever be a sequel to “Measures.” But here’s a safe bet: No matter how much they might love Obama, Hollywood execs will never greenlight “Obamacare: The Movie.”


The Obamacare War is Over

In the days since the Massachusetts vote, liberal columnists and bloggers urge Democrats to fight one last battle to save Obamacare. In his Friday column, economist Paul Krugman writes in the New York Times that House Democrats must recognize their “moment of truth.” He implores them to vote for the Senate healthcare bill and “do the right thing.”

47 health policy experts endorsed this position, writing an open letter to the President. In The New Republic, Prof. Harold Pollack of the University of Chicago, one of the letter signers, notes that: “we are so close to enacting a historic reform.”

Former Democratic speechwriter Michael Cohen, writing in the New York Daily News, implores Democrats to act now. He recognizes that they will need to “swallow their pride and vote for the health-care bill that passed the Senate without much change” but suggests it’s all worth it.

These arguments have been echoed across the blogosphere.

As I noted last Tuesday, there are still options on paper to pass Obamacare this year. The most plausible one: to get the House to drop conference negotiations with the Senate, and simply pass the Senate bill. Krugman, Pollock, and Cohen all endorse this approach. It seems that the White House is at least flirting with a variant of the idea. The reality, however, is that the war is over. Obamacare was lost the moment that the Democrats managed to lose even Massachusetts.

Democrats are still in a state of shock. They shouldn’t be. They spent 2009 crafting bad legislation.

The White House’s determination to swiftly pass health reform, and to pass it along partisan lines, meant that all meaningful policies were abandoned in the process. Health reform was supposed to be about reducing premiums for working Americans; every CBO estimate has suggested that premiums would in fact rise with the proposed legislation. President Obama has spoken time and again about the need to “bend the curve of rising health costs.” The White House half-heartedly embraced ideas that would rein in rising health costs, and then quietly negotiated away these provisions in the different drafts before Congress. Even a federal agency estimated that costs would increase under Obamacare. The promises of greater competition? By the time the Senate finally got around to passing its bill, the national health insurance exchange (modeled after the health benefits enjoyed by members of Congress) was whittled down to 50 unworkable state exchanges.

It should never have gotten to this point. The surprise wasn’t that the people of Massachusetts rejected this problematic legislation – it’s that the White House didn’t put the brakes on the process earlier.

In the coming days, we can expect Democrats to do little. They will blame others for their loss in Massachusetts; they will scheme about the possibility of passing some legislation this year; they will fantasize about a shift in public opinion. Ultimately, the White House will need to make a decision. Either they abandon all efforts or they reach across the aisle.

In 2009, the President worked with Democrats in order to craft popular and needed legislation to reform American healthcare. By this January, he couldn’t even persuade the people of Massachusetts as to the value of his efforts – in a state where registered Democrats outnumber Republicans 3.5 to 1, in a state that he himself won by more than 26% just over a year ago. In other words, while working with his allies, he didn’t achieve anything close to success.

A bipartisan effort, however, won’t give him everything he wants, but it may give him some sensible legislation. On Wednesday, when he delivers his State of the Union address, we’ll get a first taste of the post-January 19 presidency. Will he be feisty but irrelevant? Or will we enter into a period of post-partisanship, as he’s promised before?


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