Thursday, December 17, 2009

Bismarck Didn’t Really Say That. About Sausages, I Mean.


by Doug Kahn

Wow! This is a really great fight! I haven’t felt so totally alive since I was hating on Richard Nixon.

Right now it looks really, really bad, but I'm going to play the role of Pollyanna here and say it's going to be okay. And I don't mean that the bill that gets Lieberman's vote (which will necessarily be a totally useless kiss-up to the insurance industry) is going to make life better for Americans, and we'll improve it later, and so on and so forth. I just saw Tom Harkin and Ron Wyden on MSNBC saying how much good that bill would do, and I'm convinced they're faking it. What I mean is that the bill that goes to conference will never be seen again; they're going to disappear it.

Is it your belief that they've really caved? I'm saying they've decided to make nice so they get the 60 votes on something, anything, then rewrite it in committee until it's a victory for Chuck Schumer, Tom Harkin, Ron Wyden, Jay Rockefeller and the rest of the relatively progressive voices. Don't y'all get why the insurance industry has been going all out to prevent 60 votes on even a sack of garbage? It’s because they know what can happen when it gets to conference. It's totally out of corporate control at that point, because the conferees are the action-oriented people in both chambers. And they're people who aren't all about getting attention and being windbags. They're all about something else: ordering people around and winning. Being in charge. I think we can relax a little now, because they seem to be confident they've got the 60 votes.

The Senate will pass something, and it doesn't really matter what it is. That's the weird part of this whole mess. The House/Senate conference committee can change everything. It used to be that a final bill couldn't contain anything new, it had to be made up of parts of the Senate and House bills. In recent years, though, that's changed. Things can come out of conference that never went in. I believe that's the equivalent of (if you remember this) the military base closing commission, whose decisions couldn't be modified, only voted up or down. The non-functioning nature of the Senate has made this kind of thing necessary.

So it'll depend upon who is on the conference committee. I've always thought that the crucial thing would be Chuck Schumer going into conference. I know he's not liked around the blogosphere (I've read a lot of postings) but he wants to get something done, wants to be majority leader, and seems to be keeping his peace. I can only hope he's waiting for conference, where he'll be meeting with the real power brokers. The people who'll be in that room will be the ones with real juice, people who don't give a flying fuck what Ben Nelson and Joe Lieberman think or say.

Most Senators are people who love attention, need attention, and who aren't good at writing or passing legislation. They’re a flock of strutting popinjays whose careers are based on talking a good game. They're just doing what they know. They get attention by being contrary, by whining eloquently, and their incessant blathering seems to have unhinged a lot of usually reliable online people. I think the gruesome spectacle in the Senate has left some people frazzled unnecessarily. For instance, I wish someone would look in on Chris Bowers and see if everything is okay. I gather that some group of moral enforcers is giving the guy a lot of shit. Get off his case, already! From what I can tell, he does what I expect myself to do, but seldom achieve: keep working away, never stopping, not giving up.

There are also Senators who love to be in charge, need to be in charge. Chuck Schumer is that kind of guy. He can't wait to get in a room and dominate. If a bill gets 60 votes (I think it probably will), they go to conference with the House, and Chuck gets his turn. I think the bill that comes out will be very different. And whatever comes out of conference can't be amended. Then, you either have an up or down majority vote in the Senate, or an attempted filibuster. Which would fail, if anyone were stupid enough to actually attempt it. The current talk of filibustering is just talk, it's what they do, talk until we're absolutely nauseated. (I am, anyway.)

What about starting over again, and using reconciliation?

I still wish they'd do reconciliation, but don't think there's much of a chance. This is a power struggle between Harry Reid and Chuck Schumer, and if it goes to reconciliation, that means Harry has failed. It might still happen, though. If they pushed through a real public option in reconciliation (and they could, the rules allow budget-affecting measures to be passed by majority vote in 'reconciliation'; and the public option would certainly affect the budget, the CBO says so; the savings would be huge) then they get the hard part out of the way on a majority vote.

Then there are other essential pieces of reform which would be political suicide to oppose if they were in stand-alone bills, for example:
1. Revocation of the anti-trust exemption
2. No pre-existing conditions
3. No lifetime caps, no yearly caps, no caps at all (For god's sake, what the hell good is insurance if it doesn't insure against disaster?)
4. Reasonable community rating (Do you think anyone will vote against people 47-65, the segment that controls the wealth of the country?)
5. Allowing importation of drugs from Canada and elsewhere

But I think this will end soon, with a bill going into conference. This thing is rolling, it has a momentum all its own. They're acting as though they'll do just about anything to get to the conference, so I'm assuming they actually will. I don't care how many Vermonters say that progressives should vote no in the Senate, it ain't going to happen.

These are politicians, not reformers

We have a situation in which there’s no bankable constituency for real policy reform, partially because the argument is too complex to make in public. So it's all about sound bites and who wins over whom. I conclude it has to come out of committee as a win over the insurance companies and Joe Lieberman, for three reasons:

1. Otherwise you don't get a majority in the House or the Senate.
2. If it's defeated with unanimous no votes from the Republicans in both chambers, it has to be obvious to all that they're siding with the insurance companies over the little guy.
3. Then, the Ben Nelsons and Landrieus are forced to get off the fence. Politically, they have no way to explain giving money to Pharma or AHIP.

The proposal with 55+ Medicare last week; didn’t that make it obvious that policy logic and principle are both out the window? It's all about political goodies now, it's about which side (them or us) gets the win. They're not focused on 'improving' the policy in the bill, just making sure the provisions that make the headlines are simple, obvious wins for the average American. If they don't do it that way, what do they have to say when the negative campaigns crank up next year over the mandate, the drug give-away, the weak-ass reforms?

Don't get me wrong; we're not really done until we finally, someday, get single-payer. But aren't you taking this a little more personally now? Tell me you don't have a personal score to settle with Joe Lieberman, even at the same time that you're aware this should be all about the public good and helping other human beings. Believe me, there are more than 51 Democratic Senators who really feel that way about Joe, and they're going to act on that feeling.

I don't know what the bill will say when it comes out of committee. But it'll do a few things like this:

1. Restrict the insurance company practices enough that they'll have to resort to new, really atrocious, inhuman tactics if they want to increase profits and gain a competitive advantage. They have to do these things; it's impossible for them to avoid, because it's their job as corporate 'persons'. They can't be good citizens of society, there's just no mechanism or incentive for that, except good public relations. The public relations battle is over, and they lost. They're never going to be the good guys, these insurance companies. They must compete, they have to be more diabolically and creatively ruthless than ever before, and get their stock price up more than the other guy. The point here is that the conferees will want to guarantee that politically the insurance companies will have more negatives when they fight the next battle.

2. Have enough progressive goodies to make all of us feel better. Seriously. That 55+ Medicare thing was absolute genius, even though it was kind of beside the point of the public option, and wasn't about defeating the insurance companies. I'm not saying that'll be back in there; but there'll be some stuff that makes us feel warm and fuzzy. Maybe raising MedicAid eligibility to 150% of poverty level, but probably not, because that would cost so much. Very likely it'll guarantee that some very large number of people (it has to be millions) can buy into the same coverage that Senators and Representatives have. The kind of thing that makes the average person’s head nod ‘yes’.

3. It will be written so that the Congressional Budget Office analysis ends up saying it saves more than $100 billion during the next ten years. No less; it has to be over $100 billion, because of how that sounds. This is guaranteed.

4. It will be written in such a way that it can be paraphrased thusly:
Memo to Lieberman and Nelson: Drop Dead.

When it goes into conference, that’s the time for all of us to make noise. When it comes out of the conference committee, the corporate last stand is a filibuster that must fail. That's the time for all of us to bring the heat.

On the other hand, I could be wrong. Maybe Trix really are for rabbits.

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At 6:54 PM, Anonymous Anonymous said...

Yeah, sure you are right. They're willing to screw us in public, but somehow they'll find their morals behind closed doors.

You're dreaming, dude ...

At 8:05 PM, Blogger Mike said...

This is the best (and most encouraging) thing I've read about HCR in a while. Schumer is one of my Senators; I don't always agree with him, but I think I can trust him (in the sense that he'll behave in a way that's fairly predictable). And I think you're right about him wanting to really put his mark on this issue and use it to make his image more than a loudmouth who never met a camera he didn't like. It will all turn on who gets put on the conference committee.

At 8:51 PM, Blogger Doug Kahn said...

Sarcasm is not a rational argument, anonymous, it's a logical fallacy. I want you to do some homework and figure out which one it is. And I'm not 'dude'. The name is Doug Kahn.

At 5:06 AM, Anonymous Lee said...

Best fucking piece on hc I've read.

At 7:23 AM, Blogger muldoon said...

Thanks for the encouraging post. If the Dems were to pass a POS health care reform bill, they would be handing the Republicans pure political gold.

All Repubs have to do is say, "We knew the Democrats were going to screw you over in favor of the pharmaceutical and insurance industries, and that's why we fought so hard to prevent this from happening." And just that quick, the Party of No transforms itself into the Party for the Protection of the American People.

Those Dems who've been around long enough to remember what it was like to be in the minority party, surely have no desire to end up there again. And that goes for the Blue Dogs as well.

The choice is pretty elementary (even for the Ben Nelsons): Pass a good health care reform bill, probably get reelected, and remain in power. Or, pass a POS bill that pleases your corporate sponsors, probably get reelected, and become insignificant.


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