THANK YOU!

jay rosen on bill moyers:

BILL MOYERS: One of the subjects not in the debate over health care reform is single-payer. And contrary to what many people think about it being a far left proposal, the polls show that it has substantial support among a large swath of the American people. Many of whom would not call themselves far left.

But Senator Baucus said, its not in the discussion because we’ve gone too far now to go back and consider single-payer. There it seems to me is a very good example of how a legitimate idea gets delegitimated in the debate between the powers that be.

JAY ROSEN: I think it’s a classic example of the real religion of the Washington press, which is savviness. And from a problem-solving point of view, we would certainly want to consider single-payer, because it’s an important option in a debate. But from a savvy point of view, the inside players know that single-payer is never going to be the answer. And they’re already factoring that into their political calculations about what’s likely to result.

Which in a way cuts off the debate that we need to have. And so, the inside players in Washington are able to kind of contain the debate by anticipating the outcome, and then talking about the things that are most likely within that set of assumptions. And this is a normal process in Washington that goes on all the time.

more from jay rosen, this time from an interview with glenn greenwald: Salon Radio: Jay Rosen on the media’s control of political debates

And that’s why I go, an earlier piece which also talked about in your column, about savviness being the kind of real ideology of Washington journalism — it’s not liberal or conservative or even power-worshipping. It’s savviness, it’s this notion that that might be a good argument, but that’s not what the committee is going to do, you know? And this kind of religion of – I call it a religion because it’s a faith – that if you’re savvy, that you are realistic, and again, you are vulnerable to irresponsible elites when you do that. You can cut yourself off from your naturally constituency which isn’t them, but an informed and engaged public.

background from jay rosen: Audience Atomization Overcome: Why the Internet Weakens the Authority of the Press

my bolds.

thanks

Blue Dogs aren’t unified on the public option, why assume they would be on single payer? And you get to 15 the same way you’re using the whip tool to get to 40.

Jan was on the Ed show last night. Looking for clip

Can’t find her yet. She was on towards the end of the show
http://www.msnbc.msn.com/id/30031533/

Who’s the “you” that’s going to do this work? Where’s the effort to whip Blue Dogs for single payer?

We’re whipping progressives to get to 40, not Blue Dogs. I wouldn’t waste my time sending progressives to whip Blue Dogs, they don’t give a shit what we think. But I’m willing to listen to how you plan to do this.

How do you plan to get them?

Not sure what you’re saying. That the vote will actually pass, and people are being naive to think that it won’t?

What’s the math that gets there? Still haven’t seen anyone try to do a vote count that gets to a hundred.

so progs vote single payer, lose and are expected to accept a shit pub opt? that could backfire no?

you’re asking me to be savvy and i’m asking you for the “debate we need to have” first.

i know it’s late in the game to be asking. but we’ve had a year and i didn’t wait until now to ask. there are a lot of reasons to think the po, as conceived in hr3200, will be a massive fail. maybe there are good responses to the issues that have been raised by single payer advocates (for example at pnhp), but i haven’t seen them (and i’ve been looking and asking).

why not start from the position of supporting hr 676 (Expanded and Improved Medicare for All Act) — with the understanding that there will be compromise? that way 1) we educate ourselves and each other about the issues as part of the process 2) start from a stronger negotiating position and 3) if we should end up with a public option compromise and if it should fail progressives have a chance to win the “i told you so” argument because you know the republicans will be saying something along the lines of “stupid democrats with their wasteful, expensive big gov program failure”

p.s. i have to step away from the computer for a bit but will be back at some point — just in case anyone responds and wonders where i went off to.

selise,

Great comment. It’s that reflexivity George Soros talks about, affecting and constraining and determining what’s possible, even though reflexivity is just ourselves predicting the future and arrogantly assuming that we’re right even though the future, when it finally arrives, frequently shows us that we were wrong after all. Black Swans and all of that. Here and here are two recent posts on reflexivity, one focused on health care.

There hasn’t been a concerted effort on most of the largest blogs on the left, but that’s more because it was generally declared to be impossible under a Chuck Todd “that is an idealistic view of this thing. Then you have the realistic view of how this town works” belief.

Much of the activism on the left in recent years has been with a view towards what was right, not what was “possible.” People protesting the Iraq war before the bombs started falling largely knew the president and Congress didn’t give a shit what they thought, but went out there anyway. Maybe now that Democrats are in power that calculation is different, but I think there’s still something to be said for encouraging people to get out to their representatives’ appearances and pushing for it.

You tell me how we get 15 Blue Dogs first. Then we can have that conversation.

Because we could also start whipping for world peace and maybe that could pass too, and that seems like it’s more important. Then we can compromise for paintball in Honduras.

I’m a single payer advocate. I’ve said how I think we get there. Mike Ross took those plans very seriously and the Blue Dogs had a melt down in order to defeat it.

How do we get 15 Blue Dogs on board for 676? (Which already has a very ambitious assumption behind it — that everybody else in the Democratic caucus votes for it.)

Maybe now that Democrats are in power that calculation is different

It just means the lobbyists give cash to the blue dogs instead of the GOP.

Progressive Caucus sold us out on the War Supplemental in June. “Whip Count: The Final Total, or How We Went from 0 to 32”.

They’re trying the same thing now.

How do they get the Blue Cross Dogs on board? As Vito Coreleone said “make them an offer they can’t refuse!” Time to take the gloves off and start to play rough.

I’m ready to go to work in a big way on my Blue Dog rep. His is not a safe seat so maybe he’ll realize he can’t afford to lose any support. If he wins the middle but loses the left, he still loses.

Do you think these meetings will end in violence.
http://www.dailykos.com/story/…..o-meetings
Apparently it could be headed that way.
Does the FBI monitor things like Twitter “iamthemob”?

It’s already happened. Let me go find the link.

http://www.huffingtonpost.com/…..53478.html

Citizen Hamsher:

But the point isn’t that Single payer will fail, the point is that it can be brought up and used to make a strong government option intelligable so that it becomes the fall back. While I would like to see as many votes for single payer as we ken get, it really doesn’t matter because the vote on single payer can be cover for a vote on a strong public option.

And to you and other FDLers who have been beatin’ on Obama for various administrative and political positions the administration has taken…let me propose that Obama is tryin to get the entire structure of American government, all three branches, to do their jobs. So when he takes a position already articulated to the courts by the fascist Bush administration he is sendin a message to the court to do their job and strike it down. Indeed, Obama is usin the same tactic on the Congress…instead of makin Clinton’s mistake on healthcare, Obama has told the legislature what he wans to accomplish in a bill and where he wants it to go but it is up to the Congress to put the damned thing together. It is my belief that as long as Obama’s approvals are at or near 60%, it is the courts and the Congress who will take the hits if the job doesn’t get done.

The system of checks and balances has not been allowed to work since 1981 and Obama knows that he hasta get all three branches workin’ or no lasting change is possible. I think we are beginnin’ to see the rise of new, strong progressive leadership in the Senate and this healthcare thing is NOT gunna be a creature of the Blue Dogs or Max Baucus.

Maybe Schakowsky got played for the fool. I don’t know much about her. Congress critters are not necessarily good strategists. I’m for single-payer–hell, in the abstract, I’m for socialized medicine. But that’s not do-able right now, so I’m for a robust public option, and I think this could bring us to single-payer. Lot’s of people don’t get that.

Citizen lilbelle:

There are wheels turnin within wheels here and now that the fascist Republicans have become irrelevant, the battle is where it should be, inside the Democratic caucus. We won’t know what is really gettin’ scrubbed out and what’s gunna stay for at least 3 weeks…maybe we start to see the outlines of things in the next 10 days.

I’m sure any number of Blue Dogs who held the E&C committee “hostage” (Mike Ross’s word, not mine) to cripple the public option’s capability to elide into single payer would be happy to instead vote for single payer on the floor of the House.

I would also like a pony. Or even a unicorn.

How about 60 in the Senate?

Voting for single payer, purely symbolically, will allow the Progressive Caucus and their allies to say to their supporters, “See, we tried.” Then they can vote for whatever thalidomide baby comes out of conference, with neither a robust public option nor any start date until 2013, with impunity.

“See, we tried” is the motto of the Progressive Caucus. But now there are documentarians and activists will to call them on their shit. Which is why they got shut down last week.

Talk to Duncan, he used to give them to Holden.

How do we exert our power? Or do you think the struggle for public opinion is a sideshow?

I guess I don’t think the fascist Republicans are irrelevant, even if I wish they were. And I do think we the people can still affect the shape of the legislation that will pass.

Am I wrong?

The fascist Republicans are certainly not irrelavent when they have their birther and bagger brigades out in force. They also have the corporate media solidly in their corner.

As long as Harry Reid is majority leader, fascist GOPs will be relevant.

Citizen Teddy Partridge:

Now I have not been known ta be a shrinkin’ violet or an incurable optimist but I would like to turn your fantasy into somethin a little closer to reality. How ’bout the Progressive Caucus uses the single payer vote as the foil and then uses the other bills to come out of committee as the more acceptable alternative. Remeber that the fascist Republicans have made themselves all but irrelevant in this entire debate now…the nut is gettin’ cracked in the Democratic caucus and the Blue Dogs can huff and puff and blow themselves up but they aren’t gunna write the finished product.

Unemployment goes to 15% by delaying this bill the GOP and Blue Dogs only risk increasing the need for it. Also there is always the chance that Swine Flu will be real bad this year if that happens we get Healthcare. We can take away things the GOP and Blue Dogs want you suggested the Farm Bill for example is that off the table now?
I think we should not settle for a bad deal on healthcare we want single payer we not no White House deal with the drug companies.
However if we lose Healthcare well No cash for Healthcare no Cash for war!

For the straight scoop on the TH in Tampa last night, WMNF, whose News Director and nightly anchor were there with sound equip, will have a story on it tonight starting at 6 ET. I have no idea when the segment will be aired within the hour long broadcast. Click on the “Listen Live” link at upper right.

Citizen BlueToe2:

The fascists and their tactics are gunna create all kinds of opportunities for Dems to cave in but ultimately they are irrelevant, it is still the Democrats and the administration who will write the bill.

Teddy I’m going to have that carved in stone somewhere.

Jane, have sent you info that my rep, Blue Dog Mike Thompson, voted for HR 3200 and was the only blue dog who did. When I called, his staffer said he sees a place for private sector; what I don’t know is what place that is; participant or dictator/controller. And I don’t know how I can find out. I’m supposed to be contacted by Thompson’s staff about how to reach out to my seniors/neuropathy network, but haven’t heard from them yet; have sent follow-up package to his primary district staffer after a lengthy talk. His Napa town hall meeting was disrupted but not horribly and MT and the other forum speakers did not lose their cool. See his web site for his June health care reform speech and his “most asked” questions and answers that was posted after Napa hall meeting.

Blessings,

Leadership combines the bills coming out of committee into one. And then there will be amendments. The Rules Committee decides which ones get to the floor, but it’s pretty much whatever the Speaker wants. The individual bills will not come up for a vote.

Assuming the scenario you describe happens, what would make the Blue Dogs vote for a public option plan after defeating a single payer bill. If I’ve just smoked Goliath why would I not smoke some pretender, seein’s how my chest is all puffed out an’ shit now?

Sadly, the progressives caved on cash for war, and unless people force them to hold the line, they’ll cave on this too.

We have to have enough Reps willing to stop the government completely in the House to get healthcare. We need enough progressives with Stones to stop the government.

The Blue Dogs did write the finished product. They got everything they asked for. You think that shit’s coming out of the bill?

We are trying to get them to hold the line outside of trying to get more of us to healthcare rallies I’m out of ideas.
Do you have something in mind?

Breaking News……
They just let Dodd and Conrad off.
What is it that Gomer Pyle says? Surprise! Surprise! Surprise!!!!!!! They let the crooks off. Amazing!!!!!!!!!!

Say, now that SEIU is getting involved, any chance they’d lend their support to or actively participate in whipping for 40 to take the pledge?

I have to admit I’m aligned with selise on the issue. We’re essentially being compelled to rally for something that none of us really wants in the first place, and for which there’s quite a bit of evidence that it won’t really solve the problems that brought this issue to the table after a decade and a half in exile.

I don’t want to speak for selise, but I end up asking myself, “Like it or not, I’m going to end up owning this public option thing if I throw my support behind it, and is it shaping up to be something I want to have to take ownership of?”

The condition is constantly presented as such that doing something is better than doing nothing, because purportedly nothing can be worse than what we have right now. I have a difficult time accepting that wisdom. To me that seems like the kind of Hobson’s choice we were all presented with regarding TARP (et al). The reality is that it’s entirely possible to do worse than what we’re suffering with today, and if we pre-negotiate away workable solutions that are politically difficult in favor of unworkable solutions that are politically possible; the failure of those things is going to get pinned firmly on us, and we’ll have to wear it like a scarlet “A”.

Admittedly I don’t have a plan, other than to hammer on precisely what we want and spend every last penny primary challenging the people who won’t get on board, even if that means unseating Republicans with other Republicans just to break the incumbency cycle.

Not to be flippant, but RL calls.

Jane asks: “How is Jan Schakowsky not playing everyone for a fool?” That sounds like the kind of question of which Bob Somerby would remark “We don’t know.” To this particular outsider, it seems like the kind of 11-dimensional chess that everybody’s playing all the time, for all I know there are side deals we don’t know about — and reconciliation is supposed to handle all other known problems, so why not this one? Maybe if there were a PNHP staffer at FDL, in addition to an HCAN staffer, you could get a better answer…

NOTE Personally, I prefer to reserve the phrase “single payer advocates” for mere citizens who are asking the questions at forums, doing civil disobedience, writing letters to the editor, holding rallies, writing letters to the editor, and even blogging — as opposed to political creatures in Washington. Not that there’s anything wrong with being a political creature in Washington, but I wouldn’t consider Schakowsky a “single payer advocate” by any stretch of the imagination.

Sad to say but the members of the Progressive Caucus need large donor contributions, just like everybody else. Power and its perks are addictive and expensive.

Exactly. They get credit for the meaningless vote and then we hear that the giveaway to insurance and pharma is “the best we could get – don’t let the perfect be the enemy of the good.”

Well said.

Rahm Goes Apeshit On Liberals in the Veal Pen
more Jane

You tell me how we get 15 Blue Dogs first. Then we can have that conversation.

This was the same line that was used to torpedo any move to impeach Bush and Cheney. If Congress had followed this same logic, Nixon would never have been looking at impeachment either, because the votes weren’t there when the investigation and hearings started.

What progressives are supposed to be about, at least in my estimation, is making our best case, and trying to use the force and reason of our arguments to move the debate. To accept the idea that where the votes are before there is any debate determines where we stand, then we have accepted defeat in advance. The public was open to single payer. It was the best idea out there. It still is. But to ditch it without a fight or even an effort, for some kind of nebulous public option, why should the public support something we aren’t willing to support ourselves? Why is it that we have so little faith that we can change the terms of debate? You ask where we can find 15 votes. I would ask isn’t that where Presidential leadership comes in? Do we not look to Obama and the Democrats for leadership precisely because we know that they really aren’t that much different from the Republicans? So just as Obama supposedly compromises his principles to agree with Republicans, we are supposed to compromise ours to agree with him? I would rather fight for single payer, a solution that works and spend my time educating the public about it. If we lose, we lose, but at least we stood for something that was worth standing for, not some half-assed public option that was tacked on to make the rubes feel better about being treated like rubes.

Damn, another well said.

Citizen torgo2009:

OK nice ta hear from ya…now back under the bridge and outta the sun before your last brain cell gets fried.

+1000.

It would be much easier to conclude that anything would be better than nothing if the public option advocates could show examples of the policies they advocate working, and in particular of health exchanges working. (I’m not hearing cries of joy from either MA or CA in that regard.)

So, if whatever is passed ends up forcing millions of us to buy junk insurance — since the insurance companies will chip away at the coverage, still having the fiduciary responsibility to make a profit, and the subsidies will be framed as welfare, and chipped away at, too — then millions of us are, indeed, going to be worse off. Which is where the detail on the success of Health Exchanges would really help, but there is none to be had. So it reduces to a trust issue, which would be fine if a lot of money, and health, even life weren’t involved. But they are.

And since we’re going to be waiting ’til 2013 anyhow, why all the rush and the desperation?

If you want examples of today’s Dems taking a bad situation, making it no better, and at least arguably making it worse, then take a look at executive power issues.

Citizen SouthernDragon:

“…what would make the BlueDogs vote for a public option plan after defeating a single payer bill.”

Answer: The whip and prospects of primary opponents and re-election. The single payer beat down is their “victory” against the boogyman while the public option bill becomes the “savior” of the healthcare industry.

Come on Brother Dragonman, this shit ain’t nuclear physixx fer Christ’s sake!

Napa paper, which endorsed John McCain, came down pretty hard on the disruptors but didn’t make the link to national organizations, the RNC, and healthcare lobbyists. Perhaps a letter-to-the-editor would open their eyes?

wonder what Sen. Bernie Sanders would recommend to your question.

just got the following from his office

Senator Sanders Unfiltered
August 10, 2009 12:00 PM

Sen. Bernie Sanders will soon begin a weekly series of web-isodes on various topics with Robert Greenwald’s Brave New Films. This program will be available on http://www.sanders.senate.gov on Monday, Aug. 10 and regularly on Thursdays thereafter.

You can submit your own video question on twitvid.com by uploading your video and using the #sanders tag.

You can share this video with friends on Twitter, Facebook or elsewhere by using the “Share” button in the upper righthand corner of this page.

The video was a nice teaser.

If the majority of the public is for single payer and the Running Dogs manage to smoke it, if I were one of that person’s constituents there’s no way in hell I’d vote for him/her no matter what they did with a public option.

If a citizen can’t push for good public policies without being an analyst of the personalities, lobbyists, histories, 1000-page legislation that keeps getting rewritten, probabilities, et al., it’s no wonder we have such a quiescent populace. I’m not a savvy player. I can’t tell you how to “get the Blue Dogs on board” or play the political insider in any other way.

I respect the work you do here, so I respect your decision to work for this “public option”. But the efforts to denigrate those who continue to work for something better than the very, very small little box to which the big smart people are restricting public discussion is ultimately counterproductive. And irritating as hell. And I think I can win any duel where piety is the weapon if you want to argue who and how many people get helped under various scenarios. Playing with the insiders is a necessary role in reform, but so is fighting for what the majority of the citizens of a democracy want.

Of course, I’ll keep up the world peace demonstrations, too.

Southern Dragon:

What progressives are supposed to be about, at least in my estimation, is making our best case, and trying to use the force and reason of our arguments to move the debate.

If you (the generic you, not you personally) think that Medicare For All is like farm subsidies* or something, then you will probably think that “moving the debate” is useless, and then you’ll demand the arithmetic, and be worried that the issue won’t be raised again in 15 years.

If you think that Medicare For All is more like women’s suffrage, or civil rights, then “moving the debate” is absolutely essential, and you’ll believe that the issue will be raised again and again until victory is won.

I’m in the latter camp, obviously.

NOTE * This is not to say that food is not a justice issue, it absolutely is, but for the purposes of this comment I’m taking it as the paradigm for a horrific piece of sausage making.

I’d like to say that my opinion on this is in no way intended to be a judgement or criticism of Jane’s vociferous advocacy of getting us all involved in the process, and working tirelessly to create ways that facilitate that involvement. Something for which I’m endlessly thankful. Her perseverance gave me a voice I didn’t have before.

Simply an expression that it’s very difficult for me to go all-or-nothing on this horse when from the grandstands it looks like two guys in a costume standing in a line of thoroughbreds.

Personally, I hope Sanders does an old-fashioned bring-in-the-cots filibuster for S703. That will at least make it easier to do the right thing after the health exchanges go down in flames.

Here is the list of Blue Dogs:

Altmire, Jason (PA-04)
Arcuri, Mike (NY-24)
Baca, Joe (CA-43)
Barrow, John (GA-12)
Berry, Marion (AR-01)
Bishop, Sanford (GA-02)
Boren, Dan (OK-02)
Boswell, Leonard (IA-03)
Boyd, Allen (FL-02)
Bright, Bobby (AL-02)
Cardoza, Dennis (CA-18)
Carney, Christopher (PA-10)
Chandler, Ben (KY-06)
Childers, Travis (MS-01)
Cooper, Jim (TN-05)
Costa, Jim (CA-20)
Cuellar, Henry (TX-28)
Dahlkemper, Kathy (PA-03)
Davis, Lincoln (TN-04)
Donnelly, Joe (IN-02)
Ellsworth, Brad (IN-08)
Giffords, Gabrielle (AZ-08)
Gordon, Bart (TN-06)
Griffith, Parker (AL-05)
Harman, Jane (CA-36)
Herseth Sandlin, Stephanie (SD)
Hill, Baron (IN-09)
Holden, Tim (PA-17)
Kratovil, Jr., Frank (MD-01)
McIntyre, Mike (NC-07)
Marshall, Jim (GA-03)
Matheson, Jim (UT-02)
Melancon, Charlie (LA-03)
Michaud, Mike (ME-02)
Minnick, Walt (ID-01)
Mitchell, Harry (AZ-05)
Moore, Dennis (KS-03)
Murphy, Patrick (PA-08)
Nye, Glenn (VA-02)
Peterson, Collin (MN-07)
Pomeroy, Earl (ND)
Ross, Mike (AR-04)
Salazar, John (CO-03)
Sanchez, Loretta (CA-47)
Schiff, Adam (CA-29)
Scott, David (GA-13)
Shuler, Heath (NC-11)
Space, Zack (OH-18)
Tanner, John (TN-08)
Taylor, Gene (MS-04)
Thompson, Mike (CA-01)
Wilson, Charles (OH-06)

Voting No in Education and Labor:

Jared Polis (D-CO-02)
Dina Titus (D-NV-03)
Jason Altmire (D-PA-04)

Voting No in Ways and Means

Ron Kind (D-WI-03)
Earl Pomeroy (D-ND-AL)
John Tanner (D-TN-08).

Voting No in Energy and Commerce

Boucher
Stupak
Matheson
Melancon
Barrow

So who is left that has not declared opposition to the public option?

Are there any Blue Dogs who voted the bill out of their committees?

Don’t just take Blue Dogs and a unified group and count them as a block. They can be as wiggly with their caucus as the Progressive Caucus folks are.

I don’t think there is hope that there are 15 who might support single-payer, but I don’t discourage single-payer advocates within their districts from whipping them to see if some might come over.

And I think that using the single-payer vote as test vote for the public option would tell you whether you have 40 progressives who will fight for a public option.

Mike Ross my brag that the Blue Dogs held it hostage, but that was only in Energy and Commerce and he only had to whip less than 10 votes to do it.

Ross is crowing to his healthcare industry owners.

I wasn’t the original poster but I see Hugh saying that we should take on the single payer debate, taking full advantage of the opportunity we have. I view the struggle for single payer as important as any of the examples you name. As for farm subsidies I support them for family farmers, not agribusiness.

I didn’t take it as such.

Let’s hope that some of the dogs are doing political kabuki too, so they too can say “See, we tried” to their supporters. I don’t know…

I know, I was just thinking others might have taken it as such. I don’t have a very soft touch to the things I say sometimes, and worse I have a hard time noticing in advance when I’ve committed such a sin. Something to do with frontal-lobe deficiencies caused by my unmedicated ADHD.

Aye, and there’s the rub! Without publicly financed campaigns it’s nothing more than a circle jerk.

Then fuck the bill and let it die. No bill is better than a half-assed piece of shit that merely perpetuates the status quo for all intents and purposes. Let things get so bad that the Blud Dogs, Republicans and the Rhame Emanuels of the world are running for their lives. As Claudius said “let all the poisons come out.”

“let it die” and Rahms Blue Dogs will go down the tubes too

hope you are right

“we should take on the single payer debate, taking full advantage of the opportunity we have.”

Exactly.

How do “public option” supporters expect a plan that will cover at best 4% of the under 65 population without a physician network expect it to turn into single payer when Medicare hasn’t with 45 million enrolled after 40 years?

How do “public option” supporters expect to pass a “robust” public option when even the President has not made it central to his proposal?

How do “public option” supporters expect the “public option” to turn into single payer when millions more Americans will have been mandated to purchase private for-profit insurance while less than 4% of the under 65 population, at best, will have been enrolled into the public option?

How do public option supporters rationalize supporting a public option that was supposed to streamline SCHIP and Medicaid, start out with 123 million enrolled, be the only plan for which the taxpayer subsidies could be utilized, use Medicare reimbursement rates AND a built in physician network with what, from the start, was negotiated down to something that isn’t viable?

Absolutely. Let the progressives vote for the spo, it will go down in flames. But then let them vote against the monstrous piece of crap that will be proposed. It is true that no bill is better than a bad one.

The upside? Maybe Obama may finally realize that it is not hope that is audacious, but solid leadership that leads to action. He needs to step up to the plate and lead or get the hell out of the way and be a one termer.

Time to wipe the stardust from the eyeballs and realize that there is one hell of a difference between a canny trial lawyer and a lawyer who writes appellate briefs, and that community organizing experience has little or nothing to do with being a leader like FDR, JFK or LBJ, for all their respective faults. These guys were men who took their politics and obligations seriously. I really can’t say the same for our waffling on damn near everything prez.

Have we really come to the point that sewer rats like Rahm and Baucus impose their agenda on the rest of us?

I mean, my point is single payer advocates don’t see a viable plan here that leads to single payer. Or, even the near 2/3’s of Americans enrolled in government financed health coverage that the original Medicare Plus option provided for. So maybe Medicare for All can’t pass, but then neither can anything close to Medicare Plus. The big error for progressives and liberal Democrats was to let single payer be excluded from the table at the outset. Because unlike the public option, Medicare for All has been a growing movement for at least the last 20 years with tens of thousands of doctors and nurses behind it. The public option doesn’t have a movement. Most people, even those who support it, can’t define it.

If you (the generic you, not you personally) think that Medicare For All is like farm subsidies* or something, then you will probably think that “moving the debate” is useless, and then you’ll demand the arithmetic, and be worried that the issue won’t be raised again in 15 years.

If you think that Medicare For All is more like women’s suffrage, or civil rights, then “moving the debate” is absolutely essential, and you’ll believe that the issue will be raised again and again until victory is won.

Exactly.

How do HR676 supporters get the entire conservative Democratic caucus to enact HR676?

THIS WAY

The following petition tells Mike Ross of the Blue dogs get HR676 enacted into law OR we boycott his friends at Tyson Foods. We refuse to buy Tyson chicken and other Tyson Food products until HR676 gets enacted into law. We get to Mike Ross through his campaign contributor and a company in his state of Arkansas. Oh and when you sign the petition, email goes out right away to Ross and Tyson Foods.

http://bit.ly/single_payer_ross

Read our blog http://blog.democratz.org

That’s because it doesn’t have a definition. It’s a floating construct in the debate. Medicare is a firm entity, and expanding its enrollment is a clear goal. The problem with the public option is that we can only describe what we’d like it to be, not what it is.

Exactly x 1

I wish I could hear “I support single payer” without the “but…”.

If we all support it, why cant take it to the street, literally.

Excellent discourse, all. Can I ask the question in a slightly different way?: Who here believes H.R. 3200 as drafted is going to be an improvement on the status quo from the perspective of the average American? I ask because it’s not obvious to me that it will be, and I would like to hear from any smart folks who think otherwise.

That’s not such a bad idea.

Attack the Blue Dogs through their corporate owners.

The HR 676 floor vote is a distraction from where single-payer efforts need to be focused: on keeping the state ERISA waiver amendment alive and building on its existing bipartisan support — from progressives who want single payer and conservatives defending “states’ rights.”

Jane asked the other day how the ERISA waiver amendment (aka the Kucinich amendment) would garner votes, and I responded regarding the bipartisan strategy, which is the actual plan, as articulated in a meeting about the amendment that I attended in Washington last week. It’s still a long shot, but far less so than the HR 676 Hail Mary gambit.

As masslib nicely lays out, anyone who believes that even the strongest public option currently on offer will eventually transition to single payer has no standing to lecture anyone about pipe dreams. It’s a lottery ticket. With the Kucinich amendment, we’ll have bought two lottery tickets and doubled our meager chances.

Whatever happens, true single payer is not going to emerge without mass mobilization on a civil-rights or anti-Vietnam war scale. A majority of Americans want Medicare for All, but power concedes nothing to “opinion,” only to resistance.

The problem with the public option is that we can only describe what we’d like it to be, not what it is.

Well, you’ve got those principals. But they turn out to be a little vague. Like “… available on Day One.” Of course, nobody said Day One of what year; I’ve actually got a link somewhere of a commenter saying, well, of course that meant Day One of 2013. No irony at all. And then there’s the whole bait and switch thing.

I agree completely. Obama and the Democrats have played this very badly and lived up (down?) to the caricatures of themselves as ineffectual strategists and mobilizers of even those inclined to support them. The reasoning they have offered for taking single payer off the table is ludicrous. The votes aren’t there? Were the votes there in the beginning for Medicare or the Voting Rights Act in 1965. Am I mistaken or didn’t LBJ have to do a significant amount of arm twisting to get those bills passed? We need a “uniquely American solution”? Don’t we already have one – that’s a world of suck? If we were starting from scratch we would go with single payer? If’s hard to imagine a better time and set of circumstances for starting over from scratch than what we have now.

The saga of this entire process is emblematic of why I did not support Obama’s candidacy and am no longer a registered Democrat. The ill-considered emphasis on bi-partisanship, the empowerment of a small group of legislators representing less than 3% of a not-so-diverse segment of the population and that is (surprise, surprise) heavily dependent on the campaign donations tit of the medical/health industry, etc. etc.

Instead of advocating for Medicare for all, an easily understandable policy that has been shown by evidence to be effective in accomplishing the stated goals of health care reform and that builds on a program that has the allegiance of even many who are opposed to the current legislative plans (and by the way is as American as apple pie; well, it has been since 1965 at least), the ObamaDems are producing a convoluted Rube Goldberg contraption that is easily misrepresented and doubtful to work as intended.

So excuse me if I can’t get worked up over how to get 15 corporate whore ConservaDems to vote for this ugly piece of shit. That ain’t the point.

I love it.

crickets on the it’ll be better part. i actually think it’ll be much worse than what we have now, with people mandated to buy “health” insurance. the industry will make out like bandits and the people will keep dying.

Yeppers. In the last two hours I’ve come to see this as a Disaster Capitalism move.

hmmm, now that you mention it…..

i knew the bailout was disaster capitalism. i haven’t been thinking of the insurance industry bailout as disaster capitalism too, but the genie’s out of the bottle now. thanks, that makes it a lot clearer.

the global warming bill took the enforcement teeth out of the epa, which makes that bill much worse than what we had, as far as i’m concerned. the health care “reform” bill is well on its way heading in the same direction.

i just went to that thread you linked to.

disgusting idea to let them have nais for health care. that would put small farmers with any kind of animals out of business. no way. i was at the hearings here in texas. even the cattle ranchers don’t want it. almost no one wanted it. if we think our health is important, we need to do everything we can to support the small farmers.

some of the other ideas were significantly better: don’t give them money for war/stimulus money.

as always, i’m with you 100% re health care reform.

1) Obviously there were the votes to impeach Nixon, that’s why he resigned
2) You are acting like I made the decision to take single payer of the table. I didn’t. It would’ve been my preference.
3) We’re making the best of the situation at hand, which factors in that the President is opposed to single payer, and we have slightly less power than he does.

Maybe Obama will bring up single payer? I think that would be a great idea.

We’re essentially being compelled to rally for something that none of us really wants in the first place,

76% of the country supports a public plan. Who’s “we?”

That’s true. But once their number falls by about 20 of so; when health care come up again, their attitude may be very different.

“76% of the country supports a public plan”…

Surely that’s a little tendentious, given the lack of informed consent to the public plan actually on offer?

Because the question isn’t really what those polled believe, but what those who are being asked to rally know, right?

Fun thought:

1. Give the Republicans the opportunity to vote against Medicare on the floor, with a full debate, instead of just in committee. That should deal with the “Medicare is not a government program” crowd (or at least the fraction of them that are not beyond help).

2. Then when Medicare For All gets its up or down vote, at least the stage is properly set.

Well, the NOW NOW NOW part was straight out of disaster capitalism.

Now the deadline for passage is Thanksgiving. I thought it was earlier, but maybe I missed the memo.

Hi Masslib,

I’ve wondered about these myself? Perhaps Jason Rosenbaum and HCAN can answer these questions? If not perhaps they’d change their lobbying strategy and start working for Medicare for All?

Perhaps George Soros would even support this change in direction, since he is really good at recognizing when a strategy isn’t working, and so has to be replaced quickly by another strategy? If the President and Rahm were as nimble as George is in changing trading strategies when that’s necessary, they would have started pushing Medicare for All three months ago. -:)

We’re making the best of the situation at hand.

Well, so are single payer advocates.

“Medicare for all with a strong private option” is the slogan we evolved (with “strong private option” in the fine print, of course). Look, anybody that wants to pay 30 cents on every one of their dollars to the insurance companies is perfectly free to go on doing do*, especially for the cosmetic surgery they so desperately need….

* Really? No, not really.

I think our President is taking his community organizing experience as a model for working with Congress and the lobbyists. He thinks that they are the community whose organization he has to facilitate to forge “consensus.” He forgets that he was elected to facilitate the renewal of America, and that part of getting that renewal is to put in place a policy framework that brings America back from the brink of plutocracy.

JFC, Lambert. You are a broken record.
The truth you will not face is something like this: We want to go back to the Moon so we can practice for and support a Mars mission. But you want to bypass all practical considerations and send a maned mission straight to Jupiter. Now.

Single-Payer, which I support, has exactly zero support in the Executive branch, a dribble of support in the Legislature, and absolutely, positively ZERO dollars in advocacy. OTOH, the Public Option folks have at least one arrow in the quiver – OBAMA said he supports it, and it is there that we have the only leverage in a health care fight.

…unless you have hundreds of millions of Single-Payer advocacy dollars lined up and are keeping it dark from the rest of us.

I largely agree with this, except for the last point about not being able to define the public option. One conception of the PO was defined well by Jacob Hacker in his original work. And if that PO was in HR 3200 right now, I think the gap between PO progressives and medicare for All progressives would be much smaller. But, in fact, the problem with many PO supporters is that they’ve swallowed whole all the changes introduced by a House concerned about the future of the health insurance industry. And so, they have voluntarily abandoned their original and relatively clear conception of the PO, in favor of a growing nebulosity of concept, which they evidently believe will still be just as effective in mobilizing progressive support, because, above all, they believe, everyone wants a bill; any bill at all.

I believe this too. This is not 1994. Progressives won’t let a Democratic President refuse to bring up Health Care Reform again if it fails this year. If reform is not passed now, next year the problems surrounding health care will be even more acute; and the year after that they will be unbearable.

Great. I’ll sign that.

Right. I’ve discussed the vagueness of the public option in a number of places. Here’s one.

Health care reform as it is being presented to us today is deformed. The federal government must become the single payer in order to provide all Americans with a sustainable,equitable and comprehensive plan. Without it, Big Brother insurance companies will continue to bully us with higher premiums, higher deductibles and arbitrary rescissions. This bill has been perverted by compromises and is no longer a force for improving Americans’ lives. As such it should be euthanized.

Here’s a thought experiment….

When Social Security was brought in in ‘36, it excluded agricultural workers and domestics. They weren’t added till ‘55. (The strong 1955 version would not have passed in ‘36 because those domestics and agricultural workers were disproportionately black and Latino, and the Dixecrats had veto power within the FDR coalition)

In the intervening 19 years a large number — but not the optimum number — of people grew old, but not in poverty, due to the passage of the bill. Death benefits got paid, and survivor’s benefits got paid, but not to everyone who needed them. Some misery and suffering was averted, but not as much as could have been.

But the ‘36 bill was a bad bill on its face. A racist bill.

You’re a legislator in ‘36. The SS bill that became law comes up for your vote. Do you vote it up or down?

That is a very interesting thought experiment.

ralphbon,

I don’t see why “The HR 676 floor vote is a distraction from where single-payer efforts need to be focused . . .” even assuming that we ought to be focused on the Kucinich Amedment.” It seems to me that the two things need to be done sequentially. The HR 676 floor vote will get people on the record as Medicare for All supporters, and then they are set up to vote favorably on saving the Kucinich Amendment.

I have one concern about that Amendment btw. I don’t think it provides for any tax exemptions for taxpayers whose taxes are being raised to fund the national reform. I think that if States opt out of that in order to adopt a single payer plan, their taxpayers should be exempt from the national tax, so the State can tax them to fund its single payer program.

Finally, if a bad bill like HR 3200, or the even worse alternatives coming out of the Senate, were passed, such a result would be much more palatable to me if State-level Medicare for All plans were sanctioned in the bill. The possibility of state level Medicare for All in many of the States is really much preferable to a weak public option across the country from teh standpoint of evolution to national Medicare for All.

And going bankrupt.

Everyone who is sitting still for Obama’s decision to take it off the table is joining in that decision at some level, Jane. And while it’s true that the President has a great deal more power than we have, he doesn’t have the power to compel us to support his efforts to arrive at a bad bill. Whether we do that or not is our choice.

This week, various MSM columns have indicated that the President needs to mobilize people who supported him during the campaign in order to get health care reform passed. And, sure enough, we’ve seen requests for support from the President via e-mail, from HCAN, and from other movement organizations.

Well, since he evidently thought that we could get along without Medicare for All; it seems clear that many of us will decide that he can just get along without our support for the bad bill he is closing in on.

The difference between what you’ve been saying and what many of us have been reflecting is not a difference in practicality or in realism. It is a difference in value judgments. We see the kind of bill Obama will most likely support emerging from conflicts in the Senate and the House, and between the two Houses; and we think that what is emerging stinks, will lead to nothing better, and may indeed reduce the intensity of efforts at reform over the next four years. You see the same things happening and you evidently evaluate the emerging result as better than waiting till next year for reform. That’s a difference in value judgments, not in what we think is happening.

Finally, in addition to this difference in value judgments about what is emerging, some of us at least are really angry at Obama’s power move against single payer. Since the inauguration we have seen Obama marginalize progressive views in many areas, and enact policies that are either pretty corporatist in character, or pretty authoritarian in their implications.

It’s quite true that our political reactions should not be motivated by anger alone, but, more importantly, by what the consequences of our acts are likely to be. But failing to support Obama in this situation may bring home to him that progressives have other things they can do apart from supporting every arbitrary judgment about what’s feasible that he and his team arrive at, especially when the issue involved is one that many of us have been intensely concerned about for a generation or more. He needs to know that for the sake of his continuing relations with the progressive movement, and he needs to learn that he will not solve the great problems of American Society without giving due consideration to solutions we favor, and that includes not unilaterally deciding to take off the table alterantives that have the support of many millions of people.

That 76% includes the 58% whose first choice is Medicare for All, so pure public option supporters ampount to only 18% at best, and it’s a good bet that many of those have the PO confused with Medicare for All.

It is. But where’s the precise analogy?

The HR 676 floor vote is purely symbolic, it can’t win, the publicity it will draw to single payer is less than people think, and most House supporters of single payer have already gone on the record as such by co-sponsoring the bill. If that floor vote vanished in a wink, it wouldn’t make a bit of difference to the complexion of the 2009 legislation.

When Kucinich originally got his amendment passed in Education and Labor, I heard talk of Pelosi agreeing to have it brought to a free-standing floor vote if it was stripped out of the reconciled HR 3200. Because of the hoopla over the symbolic HR 676 vote, I’ve since heard no mention of or insistence for preserving a separate vote on the ERISA waiver. That’s what I mean by distraction. Big time.

I agree with Jane that co-ops need to be snuffed abornin’. Beyond that, like you, I’m unconvinced that a national public option as weak as that on offer in HR 3200 is worth doing anyway because it creates a foot in the door. The kind of public option that Howard Dean continues to dishonestly claim is in the offing — Medicare-like and available to all — is dead. Robust is dead.

The urgent reforms about which bagofhoneybunchesofhealthcare writes his predictable four diaries a day hinge almost entirely on insurance reform, not a public option. This may be sacrilege, but it may be worth calling the reform of 2009 Phase I, passing those reforms (no more preexisting condition denials, no more recission, in exchange for mandates) and immediately launching into a newly energized push for a public plan as Phase II, with Medicare for Allers playing bad cop to the Medicare-like Public Option Available to Allers as the “pragmatists.”

That 76% includes the 58% whose first choice is Medicare for All, so pure public option supporters ampount to only 18% at best, and it’s a good bet that many of those have the PO confused with Medicare for All.

Amen. And even for the unconfused, how many would have said yes if the question had made clear that the public option almost certainly would not be available to them personally under 2009 Obamacare legislation?

I would assume that enacting a bad bill that could be broadened and otherwise incrementally improved in coming years may be preferable to enacting nothing now and having no platform for future improvement.

1) Obviously there were the votes to impeach Nixon, that’s why he resigned
2) You are acting like I made the decision to take single payer of the table. I didn’t. It would’ve been my preference.
3) We’re making the best of the situation at hand, which factors in that the President is opposed to single payer, and we have slightly less power than he does.

76% of the country supports a public plan. Who’s “we?”

I don’t think I’m acting like you made the decision to take single-payer off the table at all. I don’t blame you for it, nor criticize your tireless work in refining the means for turning online activism into political results. It’s highly commendable and the learning process has been truly awesome to witness.

My point was simply that we –as in the people who are being asked to exchange a sure-thing solution for something that has a high probability of being a red herring–, or perhaps I, have a hard time personally getting in line to support something that doesn’t look like it has much chance to solve our problems, and then be hamstrung with its failure when it comes home to roost.

The fact that it’s not entirely clear that the public option is fundamentally better than doing nothing, depending on how it shapes up, is utterly terrifying to me.

Good. I intend to be a broken record, so I’m glad you noticed.

If you want to get a message across, “repeat, repeat, repeat” is the only way. That’s lesson of the blogosphere c 2003 before it stratified into what it is today.

Last I checked, women’s suffrage, civil rights, stuff like that, weren’t achieved by savvy well-funded insiders.

* * *

On your other point:

OTOH, the Public Option folks have at least one arrow in the quiver – OBAMA said he supports it, and it is there that we have the only leverage in a health care fight.

A rather weak reed, if you ask me, even if we knew that the so-called “public option” were Hacker’s Medicare for All (as Dean keeps dishonestly claiming), the order-of-magnitude smaller House version, or some third thing we don’t know about yet that’s going to emerge from “Conference.”

And then, of course…. Remember Obama filibustering on FISA, back in August? No?

Joining the debate late.

Look, the trouble with the Public Option, particularly as it’s come to be embodied now through the congressional sausage-factory, is that it isn’t that good. It’s certainly not the original concept and it’s not clear that it will be perceived as a success if it passes.

It’s not clear to me that it’s all that much better than the further dilutions that are more than likely going to be the final resulting bill. Sure co-ops are a miserable idea, but so is a public option that won’t take effect for four years, that will serve what, 5% of the people (overwhelmingly the indigent, in all likelihood), that will follow the private insurers instead of pressuring them. If that analysis is true, why do we want to own it, which we will do if it is called public option. The truth is, I would settle for an imperfect insurance exchange and end to pre-existing condition discrimination about as readily as I would for this foot-in-the-door (finger in the door?) public option at this point.

I don’t call either one “nothing” – I call them the best we can do at this point.

Have any you ever had the experience of being in the leadership of a union during a strike in tough times? I have, back in the early (pre-PATCO) days of the Reagan administration. You rally the troops, organize pickets, dispel a constant drumbeat of rumors spread by both honestly scared people and people actively trying to sabotage you. At some point, if you’re lucky, and don’t get totally smashed, a tentative agreement is reached that is better than what you started out with but nowhere near what you and your strongest supporters had hoped (and yes, promised) to achieve. You then have to face the question of whether you advocate for pushing further (and risk coming away with nothing or worse) or advocate passage of the imperfect agreement, hopefully making clear that it’s not what you hoped for, inadequate, but leaving you able to fight another day. In doing the latter, it’s inevitable that you will have to walk back some of your own prior rhetoric, making you an easy target for those who honestly (your former strongest supporters) or dishonestly want to find fault with you.

The Public Option had two strategic flaws – although it could garner more political support than Single-Payer could it couldn’t garner enough:

1. The Private Insurance Companies WERE NOT FOOLED. They no more wanted a slow death than a fast one and were able in the end to buy enough Congress-critters and gin up enough scared people to mount angry mobs. (Oh, and by the way, when we were on strike back in the eighties, it was well known that a little company money was getting into the hands of the union’s opponents among the rank-and-file of the work force).

2. The Public Option could not answer the cost concerns as well as the Single-Payer could. This fed the fears of its opponents as well. For all the tee-heeing at the “stupid” tea-baggers who didn’t know that Medicare was a government program, I believe that those who honestly had the same questions saw a huge and not-properly funded increase in government-provided Health Insurance leading to a dilution in what they already had. They may not have grasped the details, but they got the essentials.

The Public Option was fundamentally a strategy for getting, eventually, to a single-payer-like system, and it’s time, or will soon be time, to say it didn’t work. I have no problem with those who continue to agitate for Single Payer and keep that hope alive. What we have to come to realize is that both they and the Public Option supporters are fighting the same fight, with the same enemies, and this beating each other up is a side show.

Which brings us to the subject of Barack Obama and the seemingly endless attempt to determine, once and for all, if he’s one of us or our enemy. IMHO, it utterly misses the point. I can rightly complain and wish that he was more willing to spend his political capital on this fight, but what I can’t say with certainty is that we would be winning this battle if he had. We can’t know that. Given the war chest of the industry, the totally compromised nature of the Democratic Congressional leadership, the miserable lazy media willing to spin these tea-bag events as totally honest outpourings of real public sentiment make it clear that the battle terrain was difficult at best. I neither know nor care what’s in the guy’s heart. I side with neither the “Obama Fan Base” willing to invest my hopes in him with all my heart and soul nor their converse, those who believe he could have, with one flick of his wrist, turned that fan base against the real enemy and marched us on to victory. Both are wrong.

This is where we are. We have no choice but to Live with it.

That’s not the analogy. My concern, at least, is that the Dem bill is going to make things worse, not that it’s a bad bill (though it is a bad bill). And people who want to forcefully that the Dem bill going to be better need to come up with some examples of success so that there’s someething else going on here than “trust us.”

And then, of course, the administration just has to put the boot in by claiming the process is open and transparent. Look, can’t we at least get a “Honey, I’ve changed?” out of these guys?

* * *

In a way, this mirrors some discussion on the markets. People who think that the problem is liquidity tend to frame the problem as confidence; once the animal spirits revive, money will flow again. People who think that the problem is solvency tend to think the problem is trust; the institutions need to be reformed before it’s safe to do business again.

So, confidence v. trust is another kind of value judgment, as you say. It’s almost like the public option folks are acting in confidence mode — “We can deliver on something that’s sure to be better.” However, it’s natural for those to whom legislation is not a counter in a game to lose trust when they’re censored and excluded — exactly for advocating the policy that everybody admits is the best. There are actions that could be taken to restore trust, of course, but so far as I can tell, those things are not being taken. (Ian Welsh had an interesting post on this topic.) Albert O. Hirschman has done interesting work in this area.

If pre-existing condition discrimation is prohibited or even substantially reduced, that will be a good thing.

It will, of course, without the economies of Single-Payer, have budgetary crises down the road, which will then be the opportunity for you and other Single-Payer advocates to make that case.

In saying that the Democratic bill is likely a net small positive, I am not arguing for portraying it as a great success but as a partial victory. It is important to portray it as honestly as possible, which is where you William Lloyd Garrisons come in. But I think you step one step too far if you exaggerate its flaws into “worse than nothing.”

Great comment, sTiVo. First I’ve known this was your personal history. Thanks!

* * *
Also, what you said here:

For all the tee-heeing at the “stupid” tea-baggers who didn’t know that Medicare was a government program, I believe that those who honestly had the same questions saw a huge and not-properly funded increase in government-provided Health Insurance leading to a dilution in what they already had. They may not have grasped the details, but they got the essentials.

Awhile back, I was very early in on posting the Taibbi article on Goldman Sachs as vampire squid, and I got a huge spike in SiteMeter when the link went viral. And from who? Not the left at all. No progressives. Nada. Libertarians and the right. And the problem is…. That Goldman Sachs really does have huge influence over the government, and that the continuities between this administration and the last on finance are far greater than the differences.

That’s could end up being a huge problem for Democrats, which might not be a bad thing. And as you say:

They may not have grasped the details, but they got the essentials.

In this case, the essentials being that the banksters are scr*wing them over royally, and the Dems are doing very little about it, and in some ways are actually helping. (If you think the health care thing is bad, wait ’til we start talking about the Fed).

In danger, opportunity…

So why not just pass a law against “pre-existing condition discrimation”? And throw in rescission? And do both in 2010 (if we’re not already?)

Surely we don’t need to put the Health Exchanges and all the rest of the 1000 pages in place to do that? Why not just take the net positive and forget the rest? Especially when that’s the only way we can really be sure that the net is positive?

Because this is where we are. Coming away with nothing is worse than coming away with something, even if we have a mess to clean up later.

The insurance exchanges will have lots of devils in the details, but some people who don’t now have insurance will be able to get it. And how do you prevent pre-existing condition discrimination without some mechanism for getting insurance to such people?

There’s no “even if” here. The mess is guaranteed.

And nobody can explain how it nets out, because “being forced to buy junk insurance” and “some people will be able to get insurance” could very well be the same thing in practice — and the longer we get no detail, and the more start date (2013) for actual, testable implementation is put off, and the longer we get no examples at all of success, the more the likelihood of net loss grows, because if the public option folks could bring forth examples of success that net out positive they would have done so by now. Meanwhile, the closest example we have to look at is MA, and that’s not looking too good, and there’s no proof it will scale. And so we get the screaming and demands for fealty, because the real case can’t be made.

* * *

As far as: “how do you prevent pre-existing condition discrimination without some mechanism for getting insurance to such people”… Since I want to get the insurance companies out of the system, not reinforce their role in it, I haven’t looked into that. Doubtless the research has been done by somebody in DC or academe. Really, though, 1000 pages and what? A trillion dollars to fix the pre-existing condition problem? On the face of it, that makes no sense. The mountains labor and produce that mouse?

Wouldn’t a truly incrementalist approach be looking for a way to separate the few things that can be shown to be net positives now from the cruft?

Wouldn’t a truly incrementalist approach be looking for a way to separate the few things that can be shown to be net positives now from the cruft?

From your lips to Congress’s ears. If someone up there brings that up as an alternative, I’ll listen. But I’m not holding my breath.

You’re still talking about what should be done. That train has left the station. In a couple of weeks you’ll be talking about what should have been done. And that’s okay.

My point of view is about where we go from here.

In regard to

They may not have grasped the details, but they got the essentials

you have correctly gotten my meaning.

Sure, if this were an area where incrementalism would work. See Kip Sullivan’s latest post on why it won’t.

That might work, if there’s no public option in the bill. But if there is, the opposition will just say that we’ve already had reform and now we have to wait to 2013 – 2015 too see if it will work.

Whether the floor vote on HR 676 makes a difference or not depends at least in part on how big a deal we make of it. We need to keep pushing for Medicare for All.

where we go from here.

we move to the civil disobedience phase.

We can never be certain that if Obama had done something different it would have worked better. But we can never be certain about very much when we talk about the future or what might have happened if we had done something else. Nevertheless, we have to talk about these things, because we do predict the future and we do try to learn from the past. In learning from the past, all we can do is to do our best to analyze our experience and draw conclusions about what might have been done differently. Here and here are two posts about Obama’s mistakes and what he ought to do now, i.e. living with where we are now.

I think that’s right, but consider, if a bill were passed prohibiting rescissions and denials of coverage due to pre-existing conditions, that would be something I could reluctantly support it. If it included an exchange without a public option I could support that, because a well-executed exchange could be of marginal help to some people. However, I couldn’t support such a bill if it left insurance companies free to set high rates or raise rates on people they had come to regard as poor risks. After all, the power to set high rates is, for most people, is the power to deny or rescind coverage. In addition, Mandates along with the subsidies they will entail, will create enormous costs for such a “reform.”

On the other hand, if such a bill contained a weak public option of the sort in HR 3200, I think that bill would not be a net positive, because it would freeze further reform for years by allowing opponents to claim that we all had to wait to see if the PO worked before attempting anything more. If there were no public option however, the continuing cost inflation we will see in the next few years can be immediately attacked with new reform proposals.

Exactly. Then we’re free to begin working for Medicare for All immediately.

I don’t see the problem. Prohibit discrimination based on pre-existing conditions, set up an agency to receive calls from the public about violations. In case of violations, send in the FBI, and put the violators into Federal prisons.

In a couple of weeks? Did I miss the memo? I thought Obama kicked the deadline back to Thanksgiving.

It’s also important to say what should be done in real time as the shit’s going into the sausage. The Cassandras on Iraq and the finance meltdown are looking pretty good right now.

So I guess it’s a question of whether having hopped on the train, or noting that those who hopped on the train are headed for the washout is more important, I guess. A value judgment, as letsgetitdone said above.

Well, they will be forced to buy it. I just hope people understand the trade-offs the Dems are making. Who is to pay for the end of discriminatory practices? Well, obviously, the new market of people who have to buy the Exchange insurance. That’s not taking it to the insurance companies. I agree with Lambert. Why add people to the system before reforming it? Well, obviously, because the insurers would not have agreed with it if they were not given a far larger market to cover the costs, and tax subsidies to boot. Growing this behemoth health finance industry is not actually a plus, imo.

On the other hand, if such a bill contained a weak public option of the sort in HR 3200, I think that bill would not be a net positive, because it would freeze further reform for years by allowing opponents to claim that we all had to wait to see if the PO worked before attempting anything more. If there were no public option however, the continuing cost inflation we will see in the next few years can be immediately attacked with new reform proposals.

I think we are in agreement. The goal is to pass something that improves the health insurance situation for Americans, not just to pass something that calls itself the “Public Option”. The definition of “Public Option” is way too elastic here, everything from Jacob Hacker’s original idea (I’m all over that if we could get it, but of course, we can’t) to the still-thinning gruel we are now left with. In that regard, given the dilutions that have already been and may still continue to be applied to the Public Option concept, I reluctantly conclude that a weak bill without something called “Public Option” may be better than a weak bill tagged with the “Public Option” tag.

I mean no disrespect to the people who formulated and pushed the idea of the “Public Option”. I myself was at one time committed to this concept. When I now say that it was flawed strategy, I say so with the full acceptance that I too once embraced that flawed strategy. My assessment is hindsight. The point is not to prove I’m smarter than other people, though, it’s about advancing the discussion, so I don’t care. But the devil is in the details and the details kept getting worse and so I have reached my conclusion.

Like Yossarian says: That’s some catch:

As the remarks by critics of “Bait and switch” quoted above suggest, some “political yes buts” have a superficial understanding of how social change happens. They think it happens quickly or not at all, and they think it begins and ends in Congress.

This view of social change is often expressed in the mantra quoted above, “Single payer is not within the realm of possibility this term.” The implication is that if single-payer advocates cannot demonstrate that they have at least 51 percent of the votes lined up, they should retreat to the sidelines and watch the “political yes buts” do their thing. It implies that social change must occur within a single session of Congress rather than over the course of many sessions. It implies that movements for social change should, in the event that they do not have a majority vote locked up at the beginning of any given session of Congress, put their campaign in moth balls and forgo the opportunity to educate the public and build their movement through lobbying, testimony, rallies and all the other tools associated with campaigns to move bills in Congress.

In short, it implies an absurd Catch-22. To get the “political yes buts” to join them, single-payer advocates must show proof of having a majority of Congress on their side; but to get a majority of Congress on their side, the single-payer movement must build and wage a campaign relentlessly over many years in the face of active discouragement from the “yes buts” – and without pestering Congress with ideas unfairly characterized as utopian.

It’s the best there is!

I agree with both of your posts.

The only possible area of disagreement (possible because I’m not sure what you are saying) is whether we need to blow up this bill or grit our teeth, accept it for what it is, learn from our mistakes, and try to force the Dems to acknowledge it’s half a loaf and get to work on a better bill one or two years out.

My vote is for the latter plan.

By the way, by “learn from our mistakes” I mean primarily starting from the premise that for-profit health insurance is a contradiction in terms and contains a built in conflict of interest that cannot be resolved or papered over. They have a fiduciary duty to their shareholders and a duty to their premium-payers to provide insurance, and the second duty inevitably gets short shrift. Public Option tried to fudge this issue (”if you like your insurance, you can keep it”) and it didn’t work. Hey, I might like my insurance but I don’t like the way it seems to be cut back a little each year and it’s not guaranteed I can keep it anyway.

The problem is it isn’t half a loaf. What the Dems are doing will grow the private, for-profit health finance market, so trying to improve upon this later will require going against a more entrenched industry.

+1000 sTiVo, for being a mensch. I don’t know if you’ve ever noticed this ;-), but in the heat of battle there are times I find it hard to drop the sword…

* * *

That said, best way to force them to acknowledge anything is to make them suffer the maximum amount of pain (lesson from Atrios) and blowing it up is that. Whether that’s a net gain or loss is a close question, but I think we’re agreed that the gain, at least, is small….

No, you didn’t miss the memo. I did. :-( Three more months of fun. Oh joy.

My overall assessment remains the same, though.

Nor in mine. I don’t think we should support a bill that makes insurance mandatory without something like Hacker’s original public option. The combination of a bailout for the industry and a very weak public option is not an improvment and is just more “lemon socialism.”

I think that gain or loss depends on details. If we could get an end to rescissions and discrimination on the basis pre-existing conditions, and the status quo on everything else, that would be a positive first step. Since that wouldn’t cost the budget anything, how could the Blue Dogs vote against it without exposing themselves? Then when costs continue to accelerate because the private system is incapable of disciplining itself, we can come back next year with single payer. And I mean next year, make ‘em vote against Medicare for All in an election year. For a Democratic representative or Senator that’s suicide, and it might be suicide for some of the Republicans too.

I think we’re pretty close, but with respect to your statement:

The only possible area of disagreement (possible because I’m not sure what you are saying) is whether we need to blow up this bill or grit our teeth, accept it for what it is, learn from our mistakes, and try to force the Dems to acknowledge it’s half a loaf and get to work on a better bill one or two years out.

My vote is for the latter plan

I’m not sure what to do yet. I’d blow up HR 3200 because I think it’s public option provision will hurt our efforts for years to come; but I wouldn’t blow up a bill that provided for an end to rescissions and discrimination based on pre-existing conditions. Nor would I blow one up that had a strong public option like Hacker’s original proposal. Anything in between I’d want to blow up right now,

let me propose that Obama is tryin to get the entire structure of American government, all three branches, to do their jobs. So when he takes a position already articulated to the courts by the fascist Bush administration he is sendin a message to the court to do their job and strike it down. Indeed, Obama is usin the same tactic on the Congress…instead of makin Clinton’s mistake on healthcare, Obama has told the legislature what he wans to accomplish in a bill and where he wants it to go but it is up to the Congress to put the damned thing together. It is my belief that as long as Obama’s approvals are at or near 60%, it is the courts and the Congress who will take the hits if the job doesn’t get done.

That’s a proposition worth a debate of two. Let’s get Bmaz and EW in on it as well as Jane and all of us firepups.

You tell me how we get 15 Blue Dogs first. Then we can have that conversation.

this is EXACTLY the church of the savvy as jay rosen has described it (maybe even the central dogma, although i don’t remember if jay has ever used that term).

and it means our conversation on healthcare is limited to exclude the questions and issues single payer advocates have raised about even the PUBLIC OPTION (let alone single payer) — both the policy and politics — because single payer advocates don’t currently have the votes for their preferred policy objective.

three years ago, in the progressive blogosphere, single payer was firmly at center of the circle of progressive consensus. and now we’re fighting just to get it back into the circle of legitimate debate. it wasn’t the grass roots that decided single payer universal healthcare should be thrown into the circle of deviance — that was the church of savvy (comments like “extremist” and “single payer or die” are indications of where — circle of deviance or cicle of legitimate debate — one places the issue and/or the person).

as a result, people who really know the subject matter — people like steffie woolhandler and david himmelstein (elizabeth warren’s coauthors on the medical bankruptcy studies!) or kip sullivan or drsteveb and many others — have been completely ignored, as though they don’t even exist, although they have long been writing and continue to write about the issue. we’re actually ignoring our best experts in favor of neoliberal talking points. yikes!

no one thinks you took single payer off the dem leadership’s table. firstly, i don’t think it was ever really there — the work was to get it there. but more importantly the only table you have control over is your own. and that’s the only table i’ve asked you to put single payer on (and then only because you were taking up the issue).

pre-compromise on aug 13, 2008 — almost one year ago.

confirmed feb 1, 2009

Playing with the insiders is a necessary role in reform, but so is fighting for what the majority of the citizens of a democracy want.

imo this is a really important statement. thanks.

It’s that reflexivity George Soros talks about, affecting and constraining and determining what’s possible, even though reflexivity is just ourselves predicting the future and arrogantly assuming that we’re right even though the future, when it finally arrives, frequently shows us that we were wrong after all.

agree completely.

p.s. have been reading and enjoying your diaries on the subject.

all great questions and would be a part of the conversation i’ve been asking po advocates for.

p.s. completely agree with your later statement:

The big error for progressives and liberal Democrats was to let single payer be excluded from the table at the outset. Because unlike the public option, Medicare for All has been a growing movement for at least the last 20 years with tens of thousands of doctors and nurses behind it. The public option doesn’t have a movement. Most people, even those who support it, can’t define it.

JFC, Lambert. You are a broken record.

i’m sure the people who answer the phones at our representative’s offices think the very same thing about us. doesn’t mean we stfu though.

more importantly what we are doing here is what jay rosen calls overcoming audience atomization.

Now we can see why blogging and the Net matter so greatly in political journalism. In the age of mass media, the press was able to define the sphere of legitimate debate with relative ease because the people on the receiving end were atomized— meaning they were connected “up” to Big Media but not across to each other. But today one of the biggest factors changing our world is the falling cost for like-minded people to locate each other, share information, trade impressions and realize their number. Among the first things they may do is establish that the “sphere of legitimate debate” as defined by journalists doesn’t match up with their own definition.

If we could get an end to rescissions and discrimination on the basis pre-existing conditions

that’s what we had in MA prior to our 2006 reform with its mandates and exchange (which was supposed to control costs – ha!).

p.s. another amen for your earlier comment:

That 76% includes the 58% whose first choice is Medicare for All, so pure public option supporters ampount to only 18% at best, and it’s a good bet that many of those have the PO confused with Medicare for All.

selise, I’m with you completely on this. Keep it up. We need to take this back, or if this year’s effort fails we need to learn the right lesson, and that lesson is that to win you have to fight on the right battleground and that battle ground was “Medicare for All,” not “public option.”

Right. All we can is to out HR 676 on our table and get it into the Town Halls. If enough of us do that and we can get some CBO scoring; maybe we can start to make something happen.

Thanks. You know another great example of more reflexivity is the current re-inflation of the financial system and the stock market. It’s all based on everyone’s expectation that the Government won’t take over the banks. But what happens when a new wave of foreclosures hits and we’re again brought face-to-face with those toxic assets? The new reflexive bubble will burst.