Sign of the times: Barack Obama puts his signature to the health reform bill at the White House, the pursuit of which consumed most of his first 15 months as president
Coinciding with the first hint of Washington’s spring cherry blossom, Monday morning found the White House in a playful mood. “I thought we were supposed to be idiots,” said a senior official just a few hours after the historic passage of Barack Obama’s signature health reform bill. “Now all of a sudden we are geniuses?”
As Republicans have been doing their best to demonstrate all week, Washington is not a very bipartisan town nowadays. But it could be described as bipolar. One minute the president is ushering in a new age of progressive politics. The next he is a failed hope-monger who lacks the spine to finish the job.
In his latest incarnation, Mr Obama is a strategic maestro who had foreseen the past triumphant week, which was by far the best of his presidency. The truth is a little more prosaic. It is easy to forget but until late January, when Democrats were knocked sideways by the surprise defeat of their Senate candidate in Massachusetts, healthcare reform was on a comfortable trajectory to enactment. It had already been passed by both houses of Congress and they were expected to thrash out a unified product some time in February.
Then the bombshell hit. Most Washington insiders saw the loss of Edward Kennedy’s seat as a disaster for the president because it crystallised how far opinion had turned against him. It also deprived his party of its controlling super-majority in the Senate. Republicans were already unified against any big Obama initiatives. Now they could filibuster whatever he threw at them.
But a small number saw the Massachusetts defeat as a timely jolt for a party that looked to be sleepwalking towards a Bill Clinton-style disaster at the midterm elections in November. They may have been right. After a few days of panic, the White House emerged with a game plan and a new sense of resolve. “This was the cold shower that President Obama needed,” said a senior outside adviser. “It forced him to raise his game.”
More is known about Mr Obama today than a few weeks ago. As was the case during his campaign, he can drift for long patches. Then something happens – Hillary Clinton crowns herself the inevitable winner in the primaries, or Benjamin Netanyahu, Israeli prime minister, insults the administration once too often – and a more purposeful Mr Obama emerges.
The Massachusetts defeat was such a moment. It turned him from America’s lecturer-in-chief, who had even his most ardent supporters nodding off mid-paragraph, into the robust campaigner who could electrify his troops. Having allowed Congress to manage the healthcare bill for its first nine months, Mr Obama in early February finally took day-to-day control.
He led from behind the scenes, holding decisive strategy sessions with Nancy Pelosi, Speaker of the House of Representatives, and Harry Reid, Senate leader. He has also made more use of his cabinet, including Kathleen Sebelius, health secretary. And he led in public, flying to carefully located town hall events in districts represented by wavering Democrats. By showing spine, Mr Obama made it easier for Democrats in marginal seats to show spine as well.
At his rousing pep talk to Democrats on Capitol Hill before last weekend’s vote, Mr Obama appealed to what may have originally motivated lawmakers to enter politics. “Every once in a while, you have a chance to vindicate all those best hopes you had about yourself,” he said. “This is one of those times where you can honestly say to yourself, doggone it, this is exactly why I came here.”
So what happens next? Three consequences are apparent. First, Mr Obama seems to be getting better at governing. That bodes well for his ability to push through other reforms, including the re-regulation of Wall Street, the next item on his list. Given what the past week has done for his approval ratings, which have shot up, he might also prove an asset for Democrats on the campaign trail in November. They will need him.
“The lesson from the last few weeks is that President Obama should not delegate too much of the initiative to Congress,” says Simon Rosenberg, head of NDN, formerly the New Democrat Network, a Washington think-tank. “If he leads from the front good things are more likely to happen.”
Second, success at home helps abroad. It may have been a coincidence but it seemed fitting that Mr Obama on Wednesday pulled off his most tangible foreign policy success yet – reaching the new Strategic Arms Reduction Treaty with Russia to make deep cuts in the countries’ nuclear arsenals – the day after he signed healthcare reform into law.
Likewise, the evening he signed healthcare, he showed relish, and invested a certain amount of thought, in fashioning a humiliation for Mr Netanyahu. It was a rare glimpse of him behaving as an alpha male in response to someone who had treated him as a pushover, most recently in a speech in Washington on Monday, by openly mocking Mr Obama’s desire for a settlements freeze in Jerusalem.
The president’s revenge the following evening was perhaps rendered with the swagger of a man who had a few hours before enacted a reform that eluded all his Democratic predecessors. Then again, maybe not. “I think it’s safe to say that Obama really, really dislikes Netanyahu,” says an unpaid White House foreign policy adviser. In a calculated snub, the Israeli prime minister was ushered into the White House for a meeting with no photographers to record it. After 90 minutes of unfriendly discussion, he was left to stew in the Roosevelt room with his advisers while Mr Obama went and ate supper alone (his family was in New York). They then resumed their meeting.
It may sound trivial. But by the standards of diplomacy, particularly those of US-Israeli diplomacy, Mr Obama’s behaviour was rude. It was read as such in Israel – with quite a lot of Israelis approving, according to the country’s media.
More generally, Mr Obama’s success with healthcare at home ought to increase respect for him abroad. Leaders of 12 countries, from the UK’s Gordon Brown to the king of Saudi Arabia, rang to congratulate him this week.
“The critique of Obama has always been that he is ‘soft’,” says David Rothkopf, formerly a senior official in the Clinton administration. “As Joe Biden predicted would happen, everyone has been testing Obama – the Russians, the Chinese, the Republicans, Democratic senators, Hamid Karzai, Netanyahu, you name it. Gradually they are finding out that he can sometimes show mettle. Obama is genuinely evolving as a president.”
The third consequence, and in some respects cause, of Mr Obama’s healthcare victory is the at least temporary capture of the Republican party by its radical wing. At a dinner in Washington this week, Newt Gingrich, the former Speaker and likely 2012 presidential candidate, described Mr Obama’s bill as the biggest threat to the “American way of life since the 1850s” when the country was heading for civil war.
Others, perhaps only sketchily aware of Adolf Hitler’s career, which is not remembered for efforts to extend healthcare to the uninsured, continue to toss around words such as “Gestapo” and “fascist”. John Boehner, the House Republican leader, saw the passage of what by normal standards should be seen as a centrist bill as “Armageddon”. Meanwhile, according to a Harris poll this week, 24 per cent of Republicans think Mr Obama “may be the anti-Christ”.
The Republicans will probably re gain their balance. But the apoplexy of recent days suggests they could take time to graduate from the anger and denial stages of loss. It also suggests they will continue trying to block most of Mr Obama’s initiatives. As one of his advisers says: “With enemies like these, who needs friends?”
Democrats could still face big losses in November. And Mr Obama has few tools with which to reduce joblessness rapidly – still the electorate’s overriding concern. Likewise, he may fail to persuade voters it was worth devoting most of his first 15 months to healthcare, particularly since its benefits will only slowly become apparent.
But whatever happens in the midterms, he now understands how presidencies have their highs and their lows. Perhaps that realisation among friends and foes alike will temper the mood swings as his term goes on.
“People will wake up one morning and realise that the healthcare bill hasn’t brought socialism to America,” says David Gergen, adviser to four former presidents. “And Democrats will wake up to realise we have not magically solved all our healthcare problems. People should calm down a little. There has been a tendency to exaggerate recently.”
THERE were times when last Sunday’s great G.O.P. health care implosion threatened to bring the thrill back to reality television. On ABC’s “This Week,” a frothing and filibustering Karl Rove all but lost it in a debate with the Obama strategist David Plouffe. A few hours later, the perennially copper-faced Republican leader John Boehner revved up his “Hell no, you can’t!” incantation in the House chamber — instant fodder for a new viral video remixing his rap with will.i.am’s “Yes, we can!” classic from the campaign. Boehner, having previously likened the health care bill to Armageddon, was now so apoplectic you had to wonder if he had just discovered one of its more obscure revenue-generating provisions, a tax on indoor tanning salons.
But the laughs evaporated soon enough. There’s nothing entertaining about watching goons hurl venomous slurs at congressmen like the civil rights hero John Lewis and the openly gay Barney Frank. And as the week dragged on, and reports of death threats and vandalism stretched from Arizona to Kansas to upstate New York, the F.B.I. and the local police had to get into the act to protect members of Congress and their families.
How curious that a mob fond of likening President Obama to Hitler knows so little about history that it doesn’t recognize its own small-scale mimicry of Kristallnacht. The weapon of choice for vigilante violence at Congressional offices has been a brick hurled through a window. So far.
No less curious is how disproportionate this red-hot anger is to its proximate cause. The historic Obama-Pelosi health care victory is a big deal, all right, so much so it doesn’t need Joe Biden’s adjective to hype it. But the bill does not erect a huge New Deal-Great Society-style government program. In lieu of a public option, it delivers 32 million newly insured Americans to private insurers. As no less a conservative authority than The Wall Street Journal editorial page observed last week, the bill’s prototype is the health care legislation Mitt Romney signed into law in Massachusetts. It contains what used to be considered Republican ideas.
Yet it’s this bill that inspired G.O.P. congressmen on the House floor to egg on disruptive protesters even as they were being evicted from the gallery by the Capitol Police last Sunday. It’s this bill that prompted a congressman to shout “baby killer” at Bart Stupak, a staunch anti-abortion Democrat. It’s this bill that drove a demonstrator to spit on Emanuel Cleaver, a black representative from Missouri. And it’s this “middle-of-the-road” bill, as Obama accurately calls it, that has incited an unglued firestorm of homicidal rhetoric, from “Kill the bill!” to Sarah Palin’s cry for her followers to “reload.” At least four of the House members hit with death threats or vandalism are among the 20 political targets Palin marks with rifle crosshairs on a map on her Facebook page.
When Social Security was passed by Congress in 1935 and Medicare in 1965, there was indeed heated opposition. As Dana Milbank wrote in The Washington Post, Alf Landon built his catastrophic 1936 presidential campaign on a call for repealing Social Security. (Democrats can only pray that the G.O.P. will “go for it” again in 2010, as Obama goaded them on Thursday, and keep demanding repeal of a bill that by September will shower benefits on the elderly and children alike.) When L.B.J. scored his Medicare coup, there were the inevitable cries of “socialism” along with ultimately empty rumblings of a boycott from the American Medical Association.
But there was nothing like this. To find a prototype for the overheated reaction to the health care bill, you have to look a year before Medicare, to the Civil Rights Act of 1964. Both laws passed by similar majorities in Congress; the Civil Rights Act received even more votes in the Senate (73) than Medicare (70). But it was only the civil rights bill that made some Americans run off the rails. That’s because it was the one that signaled an inexorable and immutable change in the very identity of America, not just its governance.
The apocalyptic predictions then, like those about health care now, were all framed in constitutional pieties, of course. Barry Goldwater, running for president in ’64, drew on the counsel of two young legal allies, William Rehnquist and Robert Bork, to characterize the bill as a “threat to the very essence of our basic system” and a “usurpation” of states’ rights that “would force you to admit drunks, a known murderer or an insane person into your place of business.” Richard Russell, the segregationist Democratic senator from Georgia, said the bill “would destroy the free enterprise system.” David Lawrence, a widely syndicated conservative columnist, bemoaned the establishment of “a federal dictatorship.” Meanwhile, three civil rights workers were murdered in Philadelphia, Miss.
That a tsunami of anger is gathering today is illogical, given that what the right calls “Obamacare” is less provocative than either the Civil Rights Act of 1964 or Medicare, an epic entitlement that actually did precipitate a government takeover of a sizable chunk of American health care. But the explanation is plain: the health care bill is not the main source of this anger and never has been. It’s merely a handy excuse. The real source of the over-the-top rage of 2010 is the same kind of national existential reordering that roiled America in 1964.
In fact, the current surge of anger — and the accompanying rise in right-wing extremism — predates the entire health care debate. The first signs were the shrieks of “traitor” and “off with his head” at Palin rallies as Obama’s election became more likely in October 2008. Those passions have spiraled ever since — from Gov. Rick Perry’s kowtowing to secessionists at a Tea Party rally in Texas to the gratuitous brandishing of assault weapons at Obama health care rallies last summer to “You lie!” piercing the president’s address to Congress last fall like an ominous shot.
If Obama’s first legislative priority had been immigration or financial reform or climate change, we would have seen the same trajectory. The conjunction of a black president and a female speaker of the House — topped off by a wise Latina on the Supreme Court and a powerful gay Congressional committee chairman — would sow fears of disenfranchisement among a dwindling and threatened minority in the country no matter what policies were in play. It’s not happenstance that Frank, Lewis and Cleaver — none of them major Democratic players in the health care push — received a major share of last weekend’s abuse. When you hear demonstrators chant the slogan “Take our country back!,” these are the people they want to take the country back from.
They can’t. Demographics are avatars of a change bigger than any bill contemplated by Obama or Congress. The week before the health care vote, The Times reported that births to Asian, black and Hispanic women accounted for 48 percent of all births in America in the 12 months ending in July 2008. By 2012, the next presidential election year, non-Hispanic white births will be in the minority. The Tea Party movement is virtually all white. The Republicans haven’t had a single African-American in the Senate or the House since 2003 and have had only three in total since 1935. Their anxieties about a rapidly changing America are well-grounded.
If Congressional Republicans want to maintain a politburo-like homogeneity in opposition to the Democrats, that’s their right. If they want to replay the petulant Gingrich government shutdown of 1995 by boycotting hearings and, as John McCain has vowed, refusing to cooperate on any legislation, that’s their right too (and a political gift to the Democrats). But they can’t emulate the 1995 G.O.P. by remaining silent as mass hysteria, some of it encompassing armed militias, runs amok in their own precincts. We know the end of that story. And they can’t pretend that we’re talking about “isolated incidents” or a “fringe” utterly divorced from the G.O.P. A Quinnipiac poll last week found that 74 percent of Tea Party members identify themselves as Republicans or Republican-leaning independents, while only 16 percent are aligned with Democrats.
After the Civil Rights Act of 1964 was passed, some responsible leaders in both parties spoke out to try to put a lid on the resistance and violence. The arch-segregationist Russell of Georgia, concerned about what might happen in his own backyard, declared flatly that the law is “now on the books.” Yet no Republican or conservative leader of stature has taken on Palin, Perry, Boehner or any of the others who have been stoking these fires for a good 17 months now. Last week McCain even endorsed Palin’s “reload” rhetoric.
Are these politicians so frightened of offending anyone in the Tea Party-Glenn Beck base that they would rather fall silent than call out its extremist elements and their enablers? Seemingly so, and if G.O.P. leaders of all stripes, from Romney to Mitch McConnell to Olympia Snowe to Lindsey Graham, are afraid of these forces, that’s the strongest possible indicator that the rest of us have reason to fear them too.
Issues of the New Health Care Law, Many Single Payer Would Have Cured!
http://www.currentwire.com
Issues of the New Health Care Law, Many Single Payer Would Have Cured!
In Sickness and In Health Department of You Can’t Buff a Turd
Sat, 03/27/2010 - 6:03am — libbyliberal
This is a preliminary list of issues relating to the new health care law. Please add, correct or comment. (I began to overlap my researched characteristics so I ended up clumping all the sources at the end. Forgive the slapdashery!)
Lack of Real Cost Control
o Windfall for pharmaceutical giants - govt. can’t negotiate drug prices or import drugs, gives name brand drug makers 12 years of monopoly.
o No govt. bulk discount negotiating opportunity
o No cost controls
o Can charge three times more based on age plus more for certain conditions
o Double charge employees who fail “wellness” programs because of diabetes, high blood press., high cholesterol, or other medical conditions.
o As plans grow more expensive workers taxed and will have to switch to poorer, skeletal plans
o Anti-trust exemption for companies
o Hundreds of thousands of bankruptcies each year
o Companies can cherry-pick healthier, less costly enrollees
o There is no standard benefits package as frame of reference
Weak Enforcement
o No meaningful restrictions on claims denials
o Permitting insurers to sell policies “across state lines”, exempting patient protections passed in other states. Will set up in least regul. states.
o Insurers may continue to rescind policies, drop coverage, for “fraud or intentional misrepresentation”—the main pretext used
o There is no standard benefits package to use as frame of reference to aid monitoring
Individual Mandate Burden
o Massive expansion of IRS or government coercion on taxpayers
o Billions of dollars of new customers to insurance companies that have been price gouging already and denying adequate care
o Demands younger, healthier customers who might have suspended health care for economic reasons sign up or be penalized
Restrictions on Abortion and other Women’s Rights
o Takes away abortion coverage of millions of Americans. Women mandated to buy into insurance plan that may not provide them w/ a legal medical procedure! Law imposes bizarre requirement on enrollees who buy coverage through exchanges to write two monthly checks (one for an abortion care rider and one for all other health care). Even employers will have to write two separate checks for requesting abortion rider.
o A new executive order from the President for the votes of anti-abortion Democrats, reinforces and extends safeguards to states and entities who withhold access to abortions according to the Hyde Amendment, affirms that there be no federal funding for abortions (establishing double standard for women in terms of access in America, rich vs. poor). Catholic bishops and extremist abortion rights opponents know that it will greatly restrict of access to safe abortions, one of the most common medical procedures for women.
o Gender rating—practice in which insurance companies charge women more for their premiums than men for identical coverage. Obama’s health care reform bill would only partially remedy this. Once the exchanges are up and running (after 2014), companies will be banned from setting different premiums based on gender unless company has more than 100 employees. For these larger groups not until 2017 will it be stopped.
o On average, women under 55 charged premiums up to 48 percent higher than those for men of the same age –maternity coverage excluded.
o Today’s law revives federal funding for an abstinence-only-until-marriage program that Congress correctly allowed to expire in 2008. The ACLU has long opposed abstinence-only programs on the grounds that they censor vital health information, promote gender stereotypes, discriminate against gays and lesbians and sometimes use federal dollars to promote one religious perspective. (ACLU article)
o The bill permits age-rating, the practice of imposing higher premiums on older people. This practice has a disproportionate impact on women, whose incomes and savings are lower due to a lifetime of systematic wage discrimination.
Immigration Discrimination and On Others Uncovered
o Undocumented immigrants would not be allowed to buy insurance on the new exchanges, even if they are willing to pay the full cost of the insurance with their own money.
o The bill imposes harsh restrictions on the ability of immigrants to access health care, imposing a 5-year waiting period on permanent, legal residents before they are eligible for assistance such as Medicaid, and prohibiting undocumented workers even to use their own money to purchase health insurance through an exchange.
o The bill covers only 32 million of the 47 million uninsured in this country,
o Right now there are 45,000 premature deaths of American citizens each year due to inadequate or no health care.
o By 2019 there will be 23 million without coverage, averaging 23,000 premature deaths each year.
Medical Industrial Complex Lobbying Statistics (Paul Street article)
o The health sector poured a remarkable $178,252,901 into congressional and presidential campaigns between the beginning of the 2008 election cycle and the summer of 2009. The insurance industry invested $52,739,320. Obama received more than $19 million from the health sector for the 2008 election cycle – a new record. The prolific author and former New York Times reporter Chris Hedges reports that “the five largest private health insurers and their trade group, America’s Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world’s biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of 2009.”
Pro-Medicare for All Statistics (Paul Street article)
o 69 percent of Americans think it is the responsibility of the federal government to provide health coverage to all US citizens (Gallup,2006).
o 59 percent of Americans support a single-payer health insurance system (CBS/New York Times poll, January 2009).
o 59 percent of doctors back a single-payer system (Annals of Internal Medicine, April 2008).
o In a remarkable CBS-New York Times poll conducted late Sept.2009, 65 percent of more than 1,000 Americans randomly surveyed by CBS and Times responded affirmatively to following question: “Would you favor or oppose the government offering everyone a government-administered health insurance plan – something like the Medicare coverage that people 65 and over get – that would compete with private health insurance plans?”
Scherman scolded by fellow Elk Grove City Council members
LOCAL ELK GROVE NEWS 03.24.10
During the Wednesday, March 24, 2010 Elk Grove City Council meeting Mayor Sophia Scherman was dressed down by fellow council members for her willingness to roll over for Republican Congress member Dan Lungren and not lobby for federal funds for local projects
Although the discussion of the health care bill has focused mostly on the benefits to individuals and employers, the law also will carry a considerable impact for the health care industry itself. Pharmaceutical companies, hospitals and makers of devices will be subject to new rules and billions of dollars in fees; while health insurance will operate under tighter regulations under one national standard, rather than the inadequate state-to-state hodge-podge that currently exists.
Perhaps the greatest incentive for future cost control is that the government and insurance companies both have a stake in keeping costs under control in order for it to be feasible to continue subsidizing people’s coverage.
According to White House Health Reform Director, Nancy Ann Deparle, the following is a list of insurance reforms that will curb the worst insurance industry practices and strengthen consumer protections:
* This year, this bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.
* This year, discrimination based on salary will be outlawed. New group health plans will be prohibited from establishing any eligibility rules for health care coverage that discriminate in favor of higher-wage employees.
* Beginning this fiscal year, this bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance companies.
* Starting January 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services. Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services. Any insurers who don’t meet those thresholds will be required to provide rebates to their policyholders.
* Starting in 2011, this bill helps states require insurance companies to submit justification for requested premium increases. Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance exchanges.
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