Ooh, that Obama! (With thanks to E. J. Dionne Jr. and Ian Welsh)

Is it really much consolation to the president to be linkable to this pack of born-and-bred nitwits and liars?

"For Obama, there is no escaping health care. He needs to engage in an aggressive new defense that acknowledges problems in the individual market. . . . But he also has to grapple with the wider causes of discontent. . . . He can survive his enemies. He needs to win back the citizens who were once his friends."

-- E. J. Dionne Jr., in his WaPo column today,
"Obama needs his friends back"

"When you are dealing with bad people, you must assume bad faith; bad behavior. You must plan for it. . . . [Obama] thinks you can make deals with these people, and make sure everyone wins. You can't. These people are the most successful parasites ever produced by our nasty form of sociopathic capitalism. . . . [T]his failure is the inevitable product of how Obamacare was designed."

-- Ian Welsh, in his blogpost "The Obamacare Fiasco"

by Ken

A couple of memories from recent presidents:

First there was Bill Clinton --

who all through his troubles over Monica and the blue dress watched his dedicated supporters crawl out farther and farther on that precarious limb until he had to admit he had been fooling them. Of course there never should have been any such to-do over such a matter, but Clinton compounded the misery immeasurably by stonewalling, leaving all those poor souls who had dedicated themselves to weathering the storm swamped by it -- and, to abandon the metaphor before it engulfs us all, feeling totally stupid and totally betrayed.

Now a whole bunch of his who allowed ourselves to hope for the best with the ACA, hoping against hope that -- as I put it several times -- it would do more good than harm -- learn that President Obama either had no idea what was in his lobbyist-written health-care fake-reform package, or else plowed ahead despite what he knew. (If I had to guess, it would be "a little of each.")

Then there was George W. Bush --

a man whose entire career was a series of escalating managerial disasters, but who nevertheless kept rising higher on the corporate ladder. Is it any wonder that he seems never to have known that he was a blithering incompetent? To all outward appearances, he was a business genius.

Now as we ask ourselves how President Obama could have presided over an administration this abysmally clueless about, well, everything, the obvious place to look is to his past, and we see that he has always listened to people who either didn't know what they were talking about or were intentionally using him as a dupe. And yet . . . and yet here he was, barely out of his teens, and elected president of the United States. That means all those people he listened to all that time must have been pretty smart, right?

I've been stewing about this --

trying to figure out what to say. Fortunately, I find that a couple of pretty smart fellows have trod this ground, and while their takes aren't identical, there's broad enough agreement to make what both have to say pretty persuasive.

(1) E. J. Dionne Jr.

This is from E.J.'s Washington Post column today, "Obama needs his friends back" (lots of links onsite):

In situations of this sort, there is always a search for an instant repair. "Fix the Web site" is the most obvious, and it's certainly necessary. But a tech problem has been compounded by the reality of health-care reform itself. The small but highly visible individual-insurance market was volatile before Obamacare. It's hardly surprising that some who are in it are angry when plans are canceled and premiums rise.

The very purpose of insurance reform is to create a broad market in which the less healthy will be able to get coverage at affordable prices. This made a certain amount of cost-shifting inevitable, a truth captured succinctly by the New Republic's Jonathan Cohn, one of the nation's premier health policy writers: "You can't fix health insurance without changing health insurance."

But the president's promise that Americans would be able to keep their policies downplayed this risk, and it now haunts him. A Republican opposition that never wanted Obamacare to work -- "an organized constituency for failure," in former Treasury secretary Larry Summers's phrase -- jumped on Obama's words even as GOP politicians disrupted the law at the state level.

This means there will be no quick fix. Obama faces a longer slog, and he has to ask where he can begin his political recovery.

A detailed comparison of two Pew surveys -- one conducted in December that found Obama with a 55 percent approval rating (with 39 percent disapproving) and the more recent survey with the 12-point approval deficit -- shows that, while he has lost support across the board, he has taken a big hit among two classic swing groups, white Catholics and political independents.

Conservative independents who didn't much like him before like him even less now. But most striking are the president's severe losses with two groups of independents: those who call themselves liberal and those who lean toward the Democrats. In principle, both should be open to reconciliation with the president. Many in their ranks may be turned off not only by the health-care plan's failures but also by the controversy over National Security Agency surveillance and possibly the battle this year over intervention in Syria.

Obama's drop with Hispanics was close to the national average, but significant: His approval fell from 75 percent after the election to 60 percent now. Frustration over the slow economy and the stalling of immigration reform probably play a role.

And Obama's losses were also steep among white blue-collar women -- those without college degrees. As with Hispanics, they have reason to be dissatisfied with the economy and to hold a sense that Washington has defaulted in dealing with basic working-class and middle-class economic challenges.

The president's one advantage is that Republicans seem to be in even worse shape than he is. Democrats outnumbered Republicans in the Pew survey by 32 percent to 24 percent. And a Gallup poll released Tuesday showed Congress with an approval rating of 9 percent, the lowest in the 39 years Gallup has asked the question.

For Obama, there is no escaping health care. He needs to engage in an aggressive new defense that acknowledges problems in the individual market. He should be open to transitional patches but only if they do not undercut the overall reform effort. And he must take on Republicans over how high the cost of dismantling Obamacare would be to the large swath of Americans who will benefit from it -- or already do.

But he also has to grapple with the wider causes of discontent, from the surveillance program to gridlock on immigration reform to the strained economic circumstances of many who have supported him in the past. He can survive his enemies. He needs to win back the citizens who were once his friends.

(2) Ian Welsh

This is from Ian's latest blogpost, "The Obamacare Fiasco":

Obama told people they could keep their policies, but that decision was never his to make, it was up to insurance companies. Since there is no robust public option, Obama does not have any significant leverage over the insurance companies, there is nothing he can do to them, so why shouldn't they do what is in their best interest?

Please don't say something like "because that would hurt people" because I'd laugh so hard I might rupture something. Insurance companies are run by evil people as a class, and they make their money, not by providing care but by denying it. The more care they deny, the more money they make. One of my friends once designed medical "interest free" loans for people who needed life-saving operations. Sounds like a deal, doesn't it? Of course, that's zero interest on list price, not on what the insurance company was paying. The company was making a hundred to two hundred percent profit per policy. Nice business to be in, if you have no soul.

When you are dealing with bad people, you must assume bad faith; bad behavior. You must plan for it. The best option was always Medicare-for-all (and I was told by at least one House staffer that they could pass it if they really wanted to and were willing to go nuclear.) The problem with Obama has always been this sickening need to be one of the boys. He appears to genuinely like and genuinely admire the people who have "made it" in this society-- people like Jamie Dimon and the people who run insurance and drug companies. He thinks you can make deals with these people, and make sure everyone wins.

You can't. These people are the most successful parasites ever produced by our nasty form of sociopathic capitalism. You can only give them what they want or you can rip them from the body politic, so they stop sucking the blood from the host they're killing.

So the insurance companies have bitten the hand that fed them. Obama gave them everything they wanted and made sure nothing of importance they didn't want (like a public option) was in the bill. Now they're chomping and chewing, destroying what remains of his presidency.

He has reaped as he sowed.

This is going to get worse. As Corrente has repeatedly pointed out, the provider networks on the low cost plans are extremely thin. People are going to find out that they're only covered in theory, that there is no hospital that treats their type of cancer anywhere near them, for example. They're going to find out that they're paying for coverage they cannot, in effect, use, for any number of reasons. Drug costs will continue to rise, as well, since Obama carefully made sure all methods of reducing them were made illegal.

Obamacare was, and is, a subsidy. A way of keeping the insurance companies going; of keeping the current healthcare system going. The good, gold-plated private insurance plans, unless you're an executive, are pretty much gone. As such everyone had to be forced to buy a shitty private insurance plan. It will definitely help some people, some people will win, but many people will lose.

I will point out, for what feels like the millionth time, that simply putting everyone on Medicare would have been less expensive per person and produced better outcomes. Even a robust public option would have given Obama leverage, because the insurance companies would have been scared everyone would migrate over to it, and so would have needed to treat people well.

But this… this is the worst of all worlds, and that is how it was designed to be.

It's unclear to me how much of this is corruption (rest assured, Obama, like Clinton, will make tens of millions miraculously quickly on leaving office) and how much is some pathological need to be one of the boys, but I am clear that this failure is the inevitable product of how Obamacare was designed.

Me, well, I've started watching old X-Files episodes, from an Amazon Gold Box special on the complete magillah, and I'm relieved to find once again that if you grant them their nutty premise of extraterrestrials being out there, they're ripping good entertainment. And the levels of paranoia and insanity seem rather more controlled than in the news that's coming our way.

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