Health Care Reform–The Train is Ready to Leave the Station

Universal Health Care? Don't Be Silly! Image: oldamericancentury.org

Update 18 Mar, 12:50 p.m., PDT:  The U.S. House Rules Committee has just posted the text of H.R. 4872–Reconcilation Act of 2010.  http://bit.ly/aUWBUK #healthreform.

The very first post for Extreme Thinkover was to advocate for health care reform.  Although I have written dozens of posts since September 2008, my most frequent theme has been to make the needed, and yes, sweeping changes to the nation’s health care system that will establish access to medical care as a right and not a privilege available to only those who can afford to pay for it, that these reforms rectify an endemic injustice that mushroomed into a national health crisis of unprecedented historical proportions.

By July 2009, it had become evident that the Big Medicine, often led by the

The Sniffer. My Buddy to Detect Nuclear Radiation. Photo: Ajax

American Health   insurance Providers (AHIP), while publicly mouthing support for reform was, in fact, spending hundreds of millions of dollars and perhaps the most intense lobbying in U.S. history to kill reform once and for all.  They were gearing up to use what I labeled their “Nuclear Option”–to destroy the health care reform legislation in one large blast.  To accompany me on this journey, I invented The Sniffer.    The Sniffer has been constantly busy, doggedly pursuing every whiff of anti-reform nuclear odor, as Big Medicine worked and spent millions of our dollars paid for our care to try to deny us the very care we were paying for.    The Sniffer was “semper fi” in his work.  He helped reveal attempt after attempt to do in the legislation.  Big Medicine ratcheted up the pressure week after week as the President and the Democrats (with the exception of the shameful behavior of the “Blue Dog” Democrats, who on more than one occasion nearly succeeded in pushing the button), struggled through a barrage of anti-reform initiatives, advertising and lobbying, and the increasing pitch of outrage by such groups as the Tea Partiers.

Nuclear Option Button. Photo: Courtesy Getty Images

The Town Hall Meetings of August 2009 devolved into the summer of discontent and ended up as the month that will be remembered as the time when throwing political tantrums erupted onto the American political scene or else a new form of Primal Scream Therapy had become vogue.  It was difficult at times to distinguish which one was happening at the moment.  To be honest I experienced moments of angst and despair that this negative energy might provide the critical mass Big Medicine needed to construct its nuclear device.  One thing I was very certain of is that with the support of the congressional Republicans, if the legislation appeared to have the votes to pass, the Anti-Reform Mission Control would press the button.

Then something else arose out of the smoke and mirrors of the August tempest.  It began to lose steam.  In reality, the tantrums burned themselves out.  The American Public, being smarter and more insightful than given credit by  either many politicians, in particular the Republican Leadership, one Rep. John Boehner and Sen. Mitch McConnell (minority leaders in their respective houses), or the political consultants and pundits, soon tired of endless pictures and TV video of people, appearing to be adults in terms of their chronological age, acting like four-year olds who hadn’t gotten their way at the pet store because mom or dad refused to let them buy that cuddly little mastiff puppy.

In the midst of this din of obstructionism and protest being broadcast at a volume equivalent a Rolling Stones concert at Yankee Stadium, the House passed their version of the health reform bill.  I held my breath.  The Senate was still wrangling over the details.  In October 2009 I wrote:

America’s Health Insurance Plans pushed the button on their “nuclear option” bomb to blast health care reform into oblivion. The safety was released, the countdown went to zero, and “click!”

The device failed to detonate.  Through November and into the Holidays, the Senate sat paralyzed as Montana Democratic Senator, Max Baucus, employed a strategy to get his version out of committee.  He did, when Sen. Olympia Snowe (R-ME) finally broke and said she’d vote yes, but only to move to the floor of the Senate for a final vote.  It passed finally on December 24 on a strict party-line vote.

The Late Sen. Ted Kennedy with Pres. Obama. Photo: PBS.org

When Massachusetts held its special election to fill the seat left by Ted Kennedy (who had died months earlier from brain cancer), which had been filled by an appointee Democrat and the voters chose a Republican, the champagne bottles were uncorked by the Anti-Reformers.  The Democrats had lost their filibuster-proof majority and could no longer pass a bill over the heads of the Republican opposition.  The airwaves fairly sizzled with pundits announcing that without Kennedy to champion the cause it was over; health care reform was dead.

Instead the Opposition made a fatal strategic error in their plan of destruction.  The Republicans failed to have at the ready a full-blown alternative bill to introduce as the savior of health care to fill the vacuum.  Their “start over with a clean sheet of paper” backfired, because no one in America believed it was possible, including those who opposed reform.  The tide shifted.

House Health Care Reform Bill. Photo: Jesse Blumenthal.

After the Health Care Summit in which President Obama invited members of both houses and parties to participate, the Republicans during the televised seven hours long event had nothing to offer. They repeatedly sniped at the bills that had passed and the fact they were over 2700 pages long , copies of which they had sitting on their tables as a prop making an impressive stack.  The pundits also got it wrong.  The Republicans spoke with a carefully rehearsed unified voice, but rather than its intended affect to present to the people a solid wall of principled objection, they showed a solid wall of obstructionism–and with nothing behind it to present to the public.  They had been determined to cause the failure of this bill and Obama’s presidency.  They failed on both accounts.  The President and the Democrats came out energized.

As I write this post, three days from now, the House of Representatives will vote on the final version of the bill.  The Senate then will vote, as well.  The Republicans are desperate to stop it, but only have an expensive nuclear dud left in their arsenal.  AHIP and Big Medicine are still spending millions to thwart it.  This last ditch effort is failing on both fronts.  If they have something up their sleeves, a secret device they can detonate and kill the process, now is the time they must use it.  That they apparently are losing ground, and that they appear to have been outflanked by both Pres. Obama and the Democratic leadership in both houses seems to be the evidence they have no nuclear option left to use.

Short of a secret weapon unleashed, the bills will pass and health care reform will begin to move, like a freight train beginning to roll, almost imperceptibly at first, but with an inexorable increase in velocity rumbling down the track, creating in its path an new era for Americans and their health and medical needs.

Photo: Cape Care, MassCare

Professor Obama: The Presidential School of Bipartisan Education.

You may have thought the summit President Obama presided over today was all about health care reform.  It wasn’t.  Health Care Reform was the topic, but the subject was a six-plus hour seminar in front of a national audience on how to  be bipartisan led by the professor-in-chief, Barack Obama, J.D.   The pundits and bloggers, well, like, me are pounding away at their computers trying to wring every bit of meaning and nuance from the day’s-long exchange.

Health Care Reform was the topic, but the subject was a six-plus hour seminar in front of a national audience on how to  be bipartisan led by the professor-in-chief, Barack Obama, J.D.

Let’s get one thing out of the way.  How do I grade the debate on health care reform?  I give the Democrats a C, and that’s generous.  Their acting like they are close to the Republicans in the substance of the bill was stretching credulity nearly to the breaking point.  But I give the Republicans a D- and that is because they went out of their way to avoid any semblance comprehension what the summit was really about.  Just a whole day of props and talking points without as much as a single original thought.

Sorry, Mitch, John, Lamar and Eric, starting over isn’t an option.  It wasn’t about how many minutes each side gets to speak, Mitch (that has to be one of the most sophomoric gaffs of your career). You know as well as I do that it is empty rhetoric.  It’s impossible to start with a clean sheet.  The sheets in the health care debate are not paper.  They are hospital bed sheets and have over a half a century of political grime ground into them.  There are no clean sheets.  You can’t rewind history.  The perpetuation and dissemination of ideas follows the one-way arrow of time.  Health care reform does not exist in a bubble undisturbed by the flow of reality in the present environment of human medical needs.

Republicans: It’s time for you to step out of the way and let we Americans have access to medical care that meets our needs, covers us without regard for preexisting conditions, and sets the stage for a era of wellness through preventing those medical conditions that can be prevented.  Your ideas won’t work because your plan has an inherent stinginess to it that is, well, just incomprehensible in a nation  that thrives on being generous.

Republicans: Your ideas won’t work because your plan has an inherent stinginess to it that is, well, just incomprehensible in a nation  that thrives on being generous.

Now, on to the real subject of the summit today.  Prof. Obama led the seminar in bipartisanship.  Neither political party really figured that out, however.  They have over the past year (two? three? twenty?) been overwhelmed by the drumbeat of talking points drilling themselves so deeply into the daily consciousness of our congressional representatives, that it appears almost as if they have lost the capacity to speak in any other manner or with any independence of thought.

Prof. Obama conducted a very well run seminar in what can easily be described as a highly-charged setting.  The representatives of the two parties, both Senators and Congressional Representatives have been sniping at each other, saying  some of the most outrageous things ever entered into the Congressional Register, attacking with a ferocity just shy of out and out fisticuffs.  It’s a good thing the debates in the wells of both Houses are not near windows.  The amount of acrimonious bile spewed at each other could have led to the defenestration of any number of the members in the tradition of the Bohemians in Prague, first in the 1400s and again in the 1600s.

It’s a good thing the debates in the wells of both Houses are not near windows.  The amount of acrimonious bile spewed at each other could have led to the defenestration of any number of the members in the tradition of the Bohemians in Prague, first in the 1400s and again in the 1600s.

But neither side got it.  At least neither side wanted to be the first to admit that they got it.  As soon as they walked out of Blair House and across the street back to the Capitol, the auditory hallucinations of hyperpartisanship appear to have kicked in like throwing the main breaker on a mental trash compactor.

Regarding health care reform, the lack of substance was arguably all that could be expected.  Regarding reestablishing a beneficial and productive dialogue between the two parties, it was right there for all America to see.  The professor, behaving at his presidential best, conducted an exercise in statesmanship.  The comments, although, at times impassioned, were respectful and under the watchful eye of the Professor-in-Chief. The two sides were able to carry on a debate that did not devolve into shouting or irrational charge and counter-charges.  The summit was a demonstration of political civility on the TV screens or computer monitors for all America to see.

So, now we will see how the introduction of statesmanship into this debate will be able to work its way through the consciousness of both our elected leaders and the American people.  Will it grow over time; were seeds planted that will germinate and change the landscape of the national political scene?

Health care reform, just a few weeks ago declared dead on arrival after the Massachusetts election, has survived.  Is it healthy?  That remains to be seen.  But the recovery of  reform is proceeding in ways that could be best compared to an intensive rehabilitation program.

He left no doubt that his skills as President of the United States have grown and matured in ways that give great encouragement to his supporters and equal concern to his opponents.

The summit today, however, was historical for what it may have saved for American politics, more than the result of the final disposition of health care reform.

Professor-in-Chief Obama is undoubtedly exhausted after today’s intensive experience and exercise in democracy.  But one thing is certain.  He left no doubt that his skills as President of the United States have grown and matured in ways that give great encouragement to his supporters and equal concern to his opponents.  I have said on several occasions that America would have to get used to a very smart president.  Today, we just saw one reason why.

Quinnipiac Poll: What the Republicans Failed to Mention About Health Care Reform

A Sniffer Report: The Quinnipiac House Health Care Bill PollThe Sniffer: Always on the Job to Sniff Out Anti-Healthcare Reform Radiation

During the Senate debate on the Health Care Reform Legislation,  the Patient Protection and Affordable Care Act, a number of Republican senators referred to a op-ed piece by David Broder, Washington Post columnist, titled, “A Budget-buster in the making.”  In his column, Mr Broder quotes from a survey poll conducted by Quinnipiac University released on November 19, 2009.  Mr Broder, focusing on just one question, states:

It read: “President Obama has pledged that health insurance reform will not add to our federal budget deficit over the next decade. Do you think that President Obama will be able to keep his promise or do you think that any health care plan that Congress passes and President Obama signs will add to the federal budget deficit?”

The answer: Less than one-fifth of the voters — 19 percent of the sample — think he will keep his word. Nine of 10 Republicans and eight of 10 independents said that whatever passes will add to the torrent of red ink. By a margin of four to three, even Democrats agreed this is likely.

That fear contributed directly to the fact that, by a 16-point margin, the majority in this poll said they oppose the legislation moving through Congress.

Hmm, is that so, Mr Broder?  Well, I just happened to read the complete news release from the researchers at Qunnipiac, including all those boring tables and numbers, and I came away with a completely different conclusion.

In Mr. Broder’s defense, he cites the opening statement of the report correctly:

Three-quarters of American voters – 74 percent – like President Barack Obama as a person, but only 47 percent like most of his policies, and voters disapprove 51 – 35 percent of the health care overhaul passed by the House of Representatives which he has endorsed, according to a Quinnipiac University national poll released today.

Voters disapprove 53 – 41percent of President Obama’s handling of health care.

Perhaps, though, Mr. Broder only read those two paragraphs, because just two paragraphs later is this statement:

Voters favor 57 – 35 percent giving people the option of being covered by a government- run health insurance plan, the “public option.” Independent voters approve 55 – 39 percent. The overall approval is down from 61 – 34 percent in an October 8 survey by the independent Quinnipiac (KWIN-uh-pe-ack) University. And they oppose two proposals to modify it:

* Allowing states to opt out of the public option is a bad idea, voters say 49 – 43 percent;

* Voters also oppose 47 – 38 percent the “trigger,” where the public option kicks in only if private insurance does not cover enough people.

Mr. Broder, as well as the distinguished Senators from the Republican Caucus, conveniently forgot to mention these results.  And some others, very important others, but we’ll get to those in a moment.

How should we parse these responses?  First of all, as an experienced researcher myself, the question is not very well written.  Not because of the content; it is a perfectly legitimate question to ask.  But the setup is too complex, and it borders on being a leading question.  It also should have been split into two questions:

  1. Do you think that President Obama will be able to keep his promise,
  2. Do you think that any health care plan that Congress passes and President Obama signs will add to the federal budget deficit?

Because of the way the question is phrased, we do not know to which of the two issues the respondent is answering.  Technically, the question should have been thrown out and the results not reported.

This assessment is strengthened in light of the next set of results.  In contrast to the results of the first question, the voters show considerable support for components of the health care reform.  By a margin of 55-37 percent, voters support the public option.  They oppose letting states opt out by 49-43 percent, and they oppose the “trigger” option by 47-38 percent.

Now, I don’t know about you, but these three items are among the most important in the entire health care reform legislation.  Couldn’t one, with some degree of confidence, say that from these results the American public generally supports key elements of the bills going through Congress?

That depends.  When asked if the respondents supported the House version of the bill, the split was 51-35 percent oppose, but 14 percent gave no answer.  The strongest opposition was expressed by whites, over 55 years of age, making more than $100,000, and describing themselves as conservative, and born again Christian evangelicals.   The strongest support came from African-Americans, in the 18-34 year old age range, with incomes less than $50,000 per year, describing themselves as liberal. (No data for Black religious preference was listed.)

As for President Obama’s support of the House bill, the attitude of most Americans toward him appears not to be much affected.  The category “no difference” runs consistently in the 40-50 percent range, with the obvious exception of those who identify themselves as Republican.  Since the percent of people who look favorably upon the president for his support of the House bill averages roughly 30 percent, adding it  to those whose attitude has not changed, we can’t draw too many conclusions, because the ones claiming no difference may be overall positive or negative.

The respondents, however, contradict themselves.  The next four questions all have to do with core concepts of health care legislation: the public option, states having the authority to opt out of the federal plan, the passage of a “trigger” provision that would  activate under a set of conditions where not enough people were covered by an established date, and whether or not Congress should pass the legislation this year.  On all four items, the responses are solidly positive.

But one issue they do not contradict themselves is their opinion of the Republicans and their behavior regarding the health care reform legislation.

While this survey has bad news for the President, the news for Republicans is worse:

Voters say 45 – 36 percent, including 40 – 37 percent among independents, that Obama is better able to handle health care than congressional Republicans. In October, it was 47 – 31 percent in the President’s favor.

Voters also say 59 – 29 percent that Republicans are not making a good faith effort to work with Obama and the Democrats on health care.

As one might expect, neither Mr. Broder nor the Republicans, reading the same industry-supplied script they’ve been parroting for months, mentioned anything about this part of the survey.  In the spirit of fairness, the voters aren’t all that favorably disposed to the Democrats either, but  out of Pres. Obama (45-36% over the GOP), Democrats (36-55%) and Republicans (31-58%) , the GOP  comes out dead last.

The quest for universal health care continues, strongly braving the winds of opposition blowing at hurricane strength.  The storm may increase, but the gale will not deter us.  All storms blow themselves out.  America will have universal health care.  A new blessing of Liberty will be enshrined in the Great American Experiment.