August is the Cruelest Month…for Healthcare Reform

In a few short months President Obama has turned public opinion from a solid majority in favor of healthcare reform into a divide public and perhaps a solid opposition. Americans who had a very dismal view of their own healthcare options suddenly seem very fond of them, according to one poll. We can quibble about which polls to believe and how much, but there is no doubt that confidence in reform has declined precipitously, along with confidence in the President and his party.

Why? Is it the Republicans, who haven't enough strength to block reform in either chamber? Is it the evil health insurance agencies (as Speaker Pelosi would have it), who, as the WSJ points out, have been very timid? Is it those pesky voters who show up at town hall meetings? Fellow short person Robert Reich says that Republicans won't defeat healthcare reform. He is surely right about that. If it goes down, it will be the Democrats and the people who done it in.

The main problem is that the reform effort so far has been a basket case. Let's look at what is in the basket.

The President has no plan. Nobody in these United States has a clear idea of what is being proposed. Never mind all the disinformation Republicans are supposedly generating. The President and Congressional Democrats keep saying contrary things about their own proposals. You get to keep your current plan, and you don't. Without a coherent proposal, it's hard for Democrats to go back home and defend the President.

The President can't decide what case to make for reform. Originally, it was all these poor people who were uninsured. Then it became a necessity to save the economy, the main argument up until very recently. Now it's a new one: health insurance security. These aren't necessarily exclusive, but the shifts in emphasis weaken the idea that reform is an imperative.

The President is making implausible promises. Can any healthcare package really extend health insurance and more treatments to a lot more people, put no limits anyone's choices, be not only revenue neutral but actually help bring down budget deficits, and all this without raising taxes for anyone making less than $250 grand a year? People are smart enough to see that the answer is no, and now that they are being forced to think about it, they figure that what goes and what stays might be very unpalatable.

The President isn't being honest about what he really wants. He wants a single payer, Canadian style healthcare system. He wants that because he is a liberal Democrat, and that is one of their congenital desires. It may be a good idea. But it is a means, and they see it as an end. It is clear that the President and a lot of powerful Democrats see the "public option" as only a way to get single payer down the road. But he won't say that in public now. He thinks that we won't buy it, and that the only way to get it is to sneak it in.

This is a another fine mess. It has eroded support for reform, and it is reviving the fortunes of the Republican Party. Two major state houses are in play this year, in Virginia and New Jersey. The Republican gubernatorial candidates lead in both by about 14 points. Short of a miracle, both state houses will go red.

In the generic Congressional polls, Rasmussen has the Republicans ahead by 5 points. Gallop has the Democrats ahead by 6. But this kind of poll, for whatever reasons, usually exaggerates the Democratic lead. Either way you cut it, this is a tremendous recovery for the GOP. I have no crystal ball. But just right now this looks like a disaster for the donkeys.

Comments

[A.I.]

I hate (well, at least dislike) it when you're right, but in this instance, I have to agree on a few points. Support for reform is wavering more than I would like and much of the blame is on the back of Democrats--including Obama.

In part, the problems Democrats face are inherent in the issue. Reform is complicated and politics isn't about the complex, it's about clear cut wrong and simple fixes. That is why insurance provider excesses and Republican--dare I use the word--obstructionism must be dominate Democratic themes during the August recess.

Obama and Democrats in general must zero in on a clear message--without a robust public option, private insurance providers will continue to run roughshod over individuals and the economy. It's time for political hardball. They must forget about bipartisanship on meaningful reform, it isn't happening. Republicans must be portrayed as blocking the noble efforts of Democrats because they are in the pocket of insurers and thus irrelevant to any meaningful discussion.

Personally, I'm thinking Max Baucus and Kent Conrad both need some religion and should be locked in a room with reverend Emanuel until they get it. Their waffling and preening is counterproductive. In fact, they are simply handing the insurance companies 40 some million new customers and saying the government will guarantee their ever-rising premiums are paid. And, the idea of health insurance coops is a joke. If the big privates don't eat the coops for breakfast, they'll damn well devour them by lunchtime. Then they will continue eating smaller, private competitors for dinner/supper.

A June poll showed over 70% approval for health care reform. My gut tells me that hasn't changed and that what current polls are showing is disgust and disappointment with Democrat's lack of resolve. That lack is seen as second thoughts which open the door to silly lines of attack like Obama wants to kill old people and babies, stifle individual freedom and break America. In short, Democrats inability to use the power they have is creating a vacuum the Republicans are more than willing to fill.

The only constant being change, I still have hope. There are glimmers of a Democratic spine developing. Meanwhile, I wouldn't count on that New Jersey Governor's chair just yet KB. The history of polling races there tends to be voters, Lucy; office, football and Republicans, Charlie Brown. So, we shall see.

[Christine]

I'm a nurse and in my opinion single payer is the only fair option. Currently Medicare does not interfere with patient care like the HMOs. Why continue having Wall Street and CEOs stand between you and your doctor? I challenge you to watch Sicko(no matter how you feel about Michael Moore) and Bill Moyers Journal on PBS (he interviewed a former Cigna VP who quit his job after witnessing a healthcare expedition in VA where doctors and dentists gave free care in animal stalls to thousands of patients who were denied care). A superpower like the United States cannot even take care of it's own citizens because of corporate greed. Pathetic!
I dont trust the Republicans or Democrats. What this country has turned into is a Corporatocracy! Lobbyists have ruined this country. Profits before people. I believe in freedom of the individual and I dont think enough is done to protect small business owners but there are times when the government needs to step up to the plate and protect the public welfare as stated in the US Constition. How would you like it if the fire and police departments were privatized...."Oops sorry can't help you - you didn't pay your fee." How about privatizing the school system..." "Sorry you dont qualify for an education - you've been denied".

Will the United States shirk it's duty to it's citizens like all of those doctors do who sit on the boards of insurance companies and make decisions to deny care after they have taken a Hippocratic oath TO DO NO HARM!

[Liberty Belle]

I find it interesting that every Democrat but one voted against Sen. Colburn's amendment to the healthcare bill that would have required the senators to also be covered by the same healthcare they plan to impose on the rest of us. And the only Republican senator who voted against it did so because he was voting against EVERYTHING in the healthccare bill.

[FascistSocialist]

Ken you still haven't answered questions about your opinions on health care in multiple other threads on your own blog. So I guess I'll just repost them in this thread.

[Masshole]

Currently there are many people who take a risk and opt out of health insurance. The industry is trying to increase the pool of underinsured people and take away our freedom to choose by forcing everyone to buy insurance just so they can increase profits while providing the same substandard care. Wake up America take to the streets and rise up against the rampant corporate greed in this country it's time for Main Street to take a bite out of Wall Street!

[FascistSocialist]

Ken, I would suggest you take a quick glance at this opinion piece from Krugman:
http://www.nytimes.com/2009/07/31/opinion/31krugman.html

I am inclined to agree that government is the only reason that health care works at all in this country.

Medicare rates go up at about 50% the rate of private insurance premiums. Neither are sustainable, but private insurance costs are doubling every 9-10 years. The system is broken and headed for cataclysmic failure and arguments like the one you are making here are not useful, and are in fact harmful as they detract from the question of 'How?' and bring us back to the question of should we, to which we know the answer already: we must.

---------------

Health care is a vital function of a society, like transportation, education, security, communication. Most of these services are either provided for by government or heavily influenced by government policies.

What government does seem to do best is guide innovation with incentives and protect individuals from other individuals (aka consumer protection). I would agree that they are not typically the best implementer of goods and services. Using market incentives to shape services, and using regulation for consumer protection is what the government is often good at and that is the vast majority of what health care reform entails.

And, you didn't read the Krugman post or respond to it. That the only reason anyone has any semblance of good health insurance in this country is because of government regulation and intervention in the health care markets.

Also, since you seem to think that no government entity can possibly provide a better service at a better rate than private industry, how do you explain away the disparities in the rising costs of Medicare reimbursement and private insurance premium rates? (I would also remind you, apart from costs, that 100% of people over 65 are covered, while private insurance has an abysmal rate of coverage for people under age 65)

-----------

Also, another post I made days ago that was never responded to by you or miranda:

http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html

Health care is currently rationed and will always be rationed. We'll never pay for a 50 trillion dollar treatment, for example, but were someone to have 50 trillion dollars personally, they might purchase that treatment to save their own life. Right now the rationing is based on how much money/insurance you have.

Well, when everyone has health insurance and we have a finite amount of resources we would do well to define where the cut off is for various treatments. As explained in this particular article, a treatment that saves a 90 year old for 1 year and equally saves a 9 year old for 50 years should not be treated equally. In this sense we have to define our value on life at different ages since we MUST put value on human life given the nature of paying for health with finite resources. Right now we have no system to do it, poor people die, wealthy live. That's not palatable for anyone with any semblance of a conscience.

[Erik]

KB:
You have made one of the most cogent conservative arguments against any meaningful health care reform. But I think you are wrong. What we are seeing is the Democrats getting used to their majority statues. It takes awhile to construct congressional majorities. Furthermore, this isn't 1994, I would hazard to guess that the Democratic majority is more ideologically cohesive this time around. Also, the GOP astroturfing is more transparent than in '94 or '00 (remember those rent a mobs during the recount?)
Take Care,
Erik
PS Do you take requests from the audience? How about some posts about South Dakota Politics? I'm in the Carolinas and appreciate your blogging about your part of the US. I always learn something....

[FascistSocialist]

"Fellow short person Robert Reich says that Republicans won't defeat healthcare reform. He is surely right about that."

You are taking his article's title out of context and using it against his very argument. His argument is that the Democrats and the people are strong enough to overcome these absolutely false, disingenuous displays by republican backed anti-health care groups. But, based on the polling you're displaying here it appears the Republicans might be beating back the people successfully.

He's contending that health care reform will NOT fail, if it does fail I'm 100% certain he would squarely place the blame on the backs of Republicans.

Republicans Vs. The People

Are they hopping for congratulations if they win?

[FascistSocialist]

Also, Ken, shame on you for linking to a video with choppy bits of video taken completely out of context.

For shame, sir.

If one of your students cited that video and website as an academic source and the basis for their thesis in a paper, I would hope you would chew them out and give them back their paper to re-do.

I won't even dignify that pathetic hackjob video with a response.

[Reggie Greene / The Logistician]

As a practical matter, this country lacks the ability to address healthcare (and for that matter ANY problem), in a focused, direct, and coordinated fashion. It is also incapable of really planning much of anything of real value, at least not at this point in time. That type of activity does not fit within our governance model.

What you see here is an example of what happens when ANY entity is run by committee. We've known that as a society for a long time.

Our governance model is a “herding cats” governance model, where we let people and the entities they form have the freedom to do most of what they consider to be in their best interests, and we hope that it will also be in society's best interests.

Sometimes that works for us, and other times it doesn't. It will never yield consistency in approach, effort, and results. For us to think so is delusional in nature.

We (as a nation) lack the ability to rally around anything, unless it is perceived as an imminent threat to virtually all of us, and that's not going to happen often. And so we become self-absorbed in thinking about our own personal, close to home minutiae.

There are some positive and negative ramifications associated with ANY alternate approach we might pursue, and the yelling and screaming will always be loud and raucous.

As George Will often says, there is the "inertia" which is Washington. There is also the "inertia" which is the U.S. and its constituent parts.

Although this approach has served us well for most of the last 110 years, from a theoretical perspective, one has to wonder how long we can govern ourselves using the "herding cats” governance model, in light of our increase in size and complexity of our citizens.

If the US were run like a business, then every single day, its management team would assess whether its goals are being attained, bust their butts to achieve those goals, ensure that it was getting the maximum value and productivity out of those working for it, and make on the dime changes to most effectively and efficiently reach those goals. In other words, be nimble.

This country is not nimble, and can not be.

I’m not advocating a particular change, either left or right; just the recognition that EVERY governance model has its limitations, and this one is no different. However, for us to think that we can continue to use it and not have negative periods and poor, inappropriate responses to problems, is not reasonable. A country needs to know its limitations.

[KB]

A.I.: let me know when your gut is finished polling. Congress and the White House clearly think that public opinion has shifted against them on healthcare. You keep talking about recalcitrant Dems as if they just needed a little starch, when in fact they are doing what they constituents elected them to do. And, as I pointed out, they aren't getting effective leadership from the White House.

Christine: Medicare is going into the red very soon, and will add a net drain to the economy. If you want medicare for all Americans, you might want to show how you are going to fix that.

FS: I didn't respond to Krugman because one always knows in advance what he is going to say: government good, private sector bad. I haven't been arguing against heathcare reform or against any particular healthcare reform proposal. I have been criticizing the reform process, and pointing out the problems that make it so difficult.

In brief, I think that the American healthcare system is not in crisis and that arguing so makes the problem more difficult to solve with practical legislation. The biggest problem cited--the uninsured--is a serious but marginal problem. Most of the uninsured are so only briefly. Many are young people who don't think they need health insurance. Some are illegal aliens. The bigger problem in the long run is that an aging population and a rapidly advancing technology base are becoming unaffordable.

How to fix that? I am not sure I know, but the best way would probably be to make tax credits/vouchers available to all to pay for basic medical insurance, and let the insurance industry compete for that. Persons who want more coverage for more expensive and perhaps less cost effective could purchase it on their own. But no one is taking an honest look at the problems because decades old agendas (on the left and right) get in the way.

Or at least no one facing reelection. You point out some of the difficulties. Should we publicly fund the "saves a 90 year old for one year" expensive treatment? Probably not. But is anyone in Congress or at the White House talking squarely about that question?

As for the film clip, it is propaganda to be sure. But are the quotes taken out of context? It is not enough to say that, you have to show that, in the context, the quotes don't mean what they clearly seem to mean. Is it false that Obama is on record as favoring a single payer plan? No. Is it false that Obama and Barney Frank see "the public option" as a way to get single payer, without having to openly argue for the latter now? I think so. Again, maybe single payer is a good idea. But it is a bad idea to sneak it in under the table.

Erik: as I said above, I am not arguing against healthcare reform, I am criticizing the process and trying to point out the problems that aren't being squarely addressed. I think you are wrong that the current Democratic disarray is merely a result of "getting used to majority status." It is a result of the problems they are trying to solve and the more or less incoherent way they are trying to solve them. It is also a result of the extraordinary deficit spending that the administration is sponsoring. People are getting worried, as well they should be. The sudden reversal of the Republican parties hitherto dismal standings is real. Whether it will last, I don't know. But the Democrats would do well not to hide behind wishful thinking about that.

R.G.: you provide a thoughtful reflection on the difficulties of solving problems in a democratic republic. No government operates with the efficiency of a good business, but I think we can demand better government than we are getting.

[Reaganite Republican]

These shameful episodes of the DNC calling Obamacare protesters paid shills -even running TV ads to slander them- and Nancy Pelosi seeing imaginary Swastikas should make clear to anyone still giving Obama the benefit-of-the-doubt just what these far-left elitists think of your opinion.

Note that whenever Obama, Emanuel, or Gibbs are asked about why polls show SO many people oppose their misguided Cap-n-Trade and Obamacare proposals, they ALWAYS segue-right-into "we need to educate the public...".

LOL- save your breath guys, Constitutionally-aware patriots don't take lectures from Marxists.

http://reaganiterepublicanresistance.blogspot.com

[FascistSocialist]

Reaganite Republican - lmao

[Mike Licht]

Obama's gonna kill Grandma?

See:

http://notionscapital.wordpress.com/2009/08/07/obama-wants-to-kill-your-grandma/

[Anwar]

Are you seicahrng Are you seicahrng for a cure for cancer?Google: Tesla Rife RF Therapy Cancer Such devices can be purchased now or built. It's just one more example of how corporations have infiltrated the health care system, and replaced curing people with ways to keep them sick and make more money by perpetuating their illness and keep them addicted to pills.See integrity research institute (dot) org for more info on RF bioelectric treatment.Check out my channel and freeenergynow (dot) net

[Gullickson]

And become a naiton of socialist dwarfism enablers? Never!That is to say, the reaction of the lunatic right to this legislation is truly disturbing. And I don't think the Democrats have done enough to bring the message to the people. I'm actually encountering people who will benefit from this bill citing this as a good example of why it's a good thing we got Scott Brown in there, to stop this kind of totalitarian, big government taking over our lives thing.And the MSM isn't doing anything. The coverage is all about the venom and the anger and the distrust, not the facts.

[Paulo]

First off, tehres First off, tehres no such thing as Obama Care. Secondly, Obama initiated the debate and set the parameters for reform and congress produced several bills that are being debated now. If you'd only turn off Fox News and open your mind and ears and stop being so paranoid about your imaginary stock portfolio of pharma companies, and think about how we are going to reform the broken system that Nixon ushered in, we'd be much better off!!

[Lisa]

Rich, we're looking for a PATTERN here. Ok, so I asked for one epaxmle I think the Cantor incident is highly suspect. He's a Jewish congressman amdidst the HCR fallout in Virginia. It's not so far fetched to think it was a bigot, or that it may have been a warning on how to vote. (Note: He says it happened Monday night, i.e., before the vote.) Dan, I'm not claiming brilliance or anything of the sort. I just think it's weird for someone to post an exact copy of somone else's comment, without adding anything himself.