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health care summit

Health Care Summit: The “I told you so” post

Ok, I’ll admit that it didn’t work out precisely as I said in my scenario in a previous post, and the Republicans did much better than I expected, however the result was exactly what I claimed it would be. A refresher with added emphasis:

Obama gets his moment recorded by the TV cameras no less. And mournfully he pronounces the Republicans as obstructionists who refused to negotiate in good faith as the great and wonderful Democrats have offered to do. And because of that, it is with a heavy heart and reluctantly he is forced to agree with the Senate Majority Leader Harry Reid that reconciliation is the only route left open to them to do “what is right” for the American people.

When I wrote my quick review yesterday, Obama hadn’t yet spoken. In his 10 minute wrap up which went on for 20 minutes, he finally got to the purpose of the summit.

I’d like Republicans to do a little soul searching to find out if there are some things that you’d be willling to embrace that get to this core problem of 30 million people without health insurance, and dealing seriously with the pre-existing conditions issue. I don’t know frankly whether we can close that gap.

And if we can’t close that gap, then I suspect Mitch McConnell, Harry Reid, Nancy Pelosi and John Boehner are going to have a lot of arguments about procedures in Congress about moving forward.

Or: “Ok, Republicans, time to join the team and show some real movement or we’ll do what we have to do procedurally”. And that, of course, is reconciliation. Greg Sargent heard the same message. Referring to that quote he says:

Unless I’m misreading that, Obama is saying that unless Republicans support comprehensive reform as Obama and Dems have defined it — dealing with the problem of 30 million uninsured and, by extension, seriously tackling the preexisting condition problem — they will almost certainly move forward with reconciliation.

What’s more, Obama also essentially accused Republicans of approaching today’s summit in bad faith — after they had sat there with him for six hours. He said that even after the public option was taken off the table, Republicans continued to use the same “government takeover” slur.

“Even after the public option wasn’t available, we still hear the same rhetoric,” Obama said. “We have a concept of an exchange which previously has been an idea that was embraced by Republicans before I embraced it. Somehow, suddenly it became less of a good idea.”

This accusation, combined with his assertion that Republicans need to do some “soul-searching” on whether they wanted to join Dems in tackling reform as they have defined it, amount to an unmistakable vow to move forward without them.


That’s what it was all about. And anyone who watched or listened to the summit know the Democrats didn’t offer a single concession (they repeatedly refused to scrap the present bill and start over – something the Republicans asked for as a means of crafting a bi-partisan solution, a process in which they made it clear they’d be very happy to participate). There was no real attempt at negotiation – just a listing of purported agreements. But the implication is those agreements should be included in the existing comprehensive plan the Democrats had put forward and not the new bill the Republicans desired.

So it was 7 hours of window dressing to get to the point of claiming that lack of progress on the part of the Republicans (in a month to 6 weeks) would leave Democrats no choice but to move forward without them. The only way they can move forward without them is via reconciliation, since they no longer have the votes in the Senate to pass the bill via the appropriate means.

Bottom line: while Republicans showed well in the summit, it was indeed political theater staged to justify reconciliation. But because Republicans did much better than expected, the justification is much weaker than it would have been had Republicans mucked it up. As a result, I think the Democrats have essentially failed in accomplishing their primary goal – justifying reconciliation and gaining the approval of the American public to do so.


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Health Care Summit review

I’ve been watching and/or listening to the health care summit today and it became fairly obvious from the opening bell that there wasn’t going to be much of anything worthwhile or substantive accomplished – not that I’m surprised.   5 hours into it, it has been mostly the exchange of talking points.  Right now I’m forced to listen to Henry Waxman give his. He’s claiming his version of the bill is the best and the Republican’s version sucks. Pretty much the way it has gone all day (Republicans have mostly said they want to start over with a clean sheet).  Every one of the Democrats are appealing to emotion via tragic anecdotes.

Tom Coburn made the most important point – any reform has to reconnect purchase and price.  Until that’s done, we’re not going to get the value that reconnection would bring.

Then there have been the CBO wars (each side claiming their side is supported by the agency), with Rep. Paul Ryan pointing out that the problem with the CBO numbers is that it doesn’t account for the double counting and that throws the curve in an upward trajectory. Ryan also pointed out that Democrats removed the “doc fix” from the bill and plan on passing it separately, but that removed around $300 billion from the HCR bill which should be included in the cost.

Republicans have argued for tort reform for medical malpractice. Democrats (Dick Durbin in particular) have argued against it. McCain used the Texas model to make the point for tort reform. Texas, which has instituted tort reform has seen malpractice premiums reduced by 27% and has had a net gain of 18,000 doctors – extrapolated nationally using direct savings (malpractice insurance premium cost) and indirect savings (reduction of the “defensive medicine” practiced by doctors) the amount saved could be in the $150 billion range.

Essentially each side is trying to support their point of view. If there’s any agreement it is that Medicare is full of fraud, out of control cost wise and needs to be fixed and that both sides want to fix the pre-existing systems.

As expected, President Obama sits quietly while the Democrats give their talking points and challenges Republicans as they deliver theirs.

Most amusingly, Joe Biden said this:

“I’m always reluctant after being here 37 years to tell people what the American people think. I think it requires a little bit of humility to be able to know what the American people think, and I don’t, I can’t swear I do. I know what I think. I think I know what they think. But I’m not sure what they think.

Then everyone, including Biden, spoke for “the American people”.

The one thing Obama said concerning reconciliation, in answer to a point made by John McCain, was that the “American people” really aren’t that interested in the process. Obviously he hasn’t seen the CNN/Gallup poll today which says they are interested and overwhelming reject it’s use.

Chris Dodd tells a story about a guy who privately put together a small business health care association in CT. Of course the point lost on him as he argues for the government to act is it was done privately.  Perhaps the government’s role ought to be enabling that. Rep. Joe Barton then made that point.

“Blinky” Pelosi is now wrapping it up with her usual attack on insurance companies and Republicans (except Tom Coburn for some reason) while still pitching the public option.  Yeah, negotiating at its finest.

The cable news networks covered most of the first part of the session but began bailing around 1pm, cutting in from time to time, but mostly going to discussion among their “experts”.

Bottom line – no bi-partisan attempt on either side to reach a compromise. And again, that’s fine.

After that, I think I’ll go watch some exciting curling.


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Is Senate Health Care Reform bill dead? And does Obama have a fallback plan? (Update)

It is looking more and more like the support for passing the pending Senate Democratic version of the health care bill just isn’t there – among Democrats. Deaths and recent resignations in the House, as well as pro-life Democrats, make getting the required number of votes to pass that legislation – unchanged as necessary – virtually impossible. Unless the House passes that legislation Democratic members of the Senate are saying the process is dead. Even Sen. Robert Byrd has gotten into the act addressing Democratic Senate colleagues by letter and warning against changing filibuster rules in order to advance their legislative priorities

That leaves us with today’s scheduled televised health care summit.  What’s its purpose?  My contention has been it’s a bit of political theater to convince the public that the Republicans are the problem (both generally and specifically).  But it also appears a bit of political reality is beginning to settle on the White House. The Wall Street Journal reports that Obama may introduce the idea of a vastly scaled back plan if he determines that the present plan isn’t going to make it. Given the difficulty outlined above of passing what is presently pending in Congress, this may be the result of the summit – a new and much smaller approach to passing something called “health care reform”. Says the WSJ:

It would do that by requiring insurance companies to allow people up to 26 years old to stay on their parents’ health plans, and by modestly expanding two federal-state health programs, Medicaid and the Children’s Health Insurance Program, one person said. The cost to the federal government would be about one-fourth the price tag for the broader effort, which the White House has said would cost about $950 billion over 10 years.

If, in fact, that’s the plan, then it is hardly what anyone would call “reform”. SCHIP (the Children’s Health Insurance Program) has already been expanded – it was one of the first bills Obama signed. Additionally, the expansion of Medicaid won’t please state who mostly pay for the program. Lastly, such a bill would do nothing to address the 800 pound gorilla in the room – what is necessary to bring costs in the federal programs (Medicare, Medicaid and SCHIP) under control. That is where the problem is to be found – not in private insurance. It also leaves those things the GOP and the right want where they our now – left out.

If that’s the result of today’s summit, it will be considered by all sides to be a failure. It will obviously be spun by the usual suspects in the administration as a rousing success. However, what has to be kept in mind is even this would have to pass through Congress and that’s not at all a sure thing anymore with the election of Scott Brown, breaking the filibuster proof majority formerly enjoyed by the Democrats.

It’ll be interesting to see how this summit turns out today. Reviewing the list of those invited, I don’t expect much in the way of compromise or bi-partisanship. And that’s fine with me.

UPDATE: Gallup weighs in with a poll about the health care summit and the mood of the public:

Americans are skeptical that lawmakers will agree on a new healthcare bill at Thursday’s bipartisan health care summit in Washington, D.C. If an agreement is not reached, Americans by a 49% to 42% margin oppose rather than favor Congress passing a health care bill similar to the one proposed by President Obama and Democrats in the House and Senate. By a larger 52% to 39% margin, Americans also oppose the Democrats in the Senate using a reconciliation procedure to avoid a possible Republican filibuster and pass a bill by a simple majority vote.

I agree the skepticism is warranted. 49% of independents oppose passage with 24% strongly opposing it in that poll (only 8% strongly favor it). Also note the overwhelming margin concerning the use of reconciliation. Again, looking at independents, 53% oppose it with 25% strongly opposing it (only 9% strongly favor it). I believe that could be deemed “fair warning” to Democrats.


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The Coming “Health Care Summit” Ambush

Maybe I’m just  being a bit paranoid about this upcoming televised “health care summit” that President Obama has decided is suddenly so necessary.  Maybe it’s that I see politics in every move this guy makes.  This summit just isn’t what it seems and, at least to me, that seems apparent.  What it is however is the perfect opportunity for Obama to play at statesman, provide himself an opportunity to keep a campaign promise and finally make – for once and for all – the GOP the bad guys in all of this.

Here’s the scenario I envision:

Fresh off his televised performance at the GOP retreat in Baltimore a few weeks ago, which received rave reviews from the usual media suspects, the administration hit upon an idea. TV is and always has been the prefect medium for Barack Obama. And the format at the retreat was perfect for him – it allowed him to lecture, cajole and demonize without any real opposition. Why not do that again on an even bigger scale and for some big stakes? Why not do it on health care?

What has been a problem for the Democrats? The public doesn’t like their health care bill. And their continued attempts to pass it have only cause the public to like it even less. But Democrats know that this is the only window of opportunity they’re likely to have and it is closing rapidly. So how do they get the public on their side and get this bill passed? The easiest way is a distraction and a bit of blame shifting. Good TV. The fact that Obama has made it clear that he has no intention of seeing the present and pending Senate bill scrapped should be sounding warning bells among the GOP. This isn’t about compromise. This isn’t about “bi-partisanship”. This is about a justification for passing health care via reconcilliation by showing the Republicans as the “party of ‘no’”.

Think about it. Who controls the format and tone of the the “summit”? Certainly not the GOP (and when they did they still came off looking pretty lame). So let’s say Obama says to the Democrats “what is it you want?” And they claim the “public option” (or whatever). Obama says it’s probably not going to happen. They act disappointed (but don’t forget they have 2200 pages of health care legislation already to be passed). Obama then asks the Republicans, “what do you want”. And they lay it all out – tort reform, drop the mandates, insurance across state lines, etc. And he say, “OK, we will put all that in the bill. Now will you support it?”

Heh … it’s the perfect question, because like any good lawyer, he already knows the answer. The answer is “no”. They’ve already made it clear they can’t support the Senate version of the bill – that’s the bill to be passed. And if they say yes, they may as well resign from office because the backlash will be such that they’d wish they had.

Obama gets his moment recorded by the TV cameras no less. And mournfully he pronounces the Republicans as obstructionists who refused to negotiate in good faith as the great and wonderful Democrats have offered to do. And because of that, it is with a heavy heart and reluctantly he is forced to agree with the Senate Majority Leader Harry Reid that reconciliation is the only route left open to them to do “what is right” for the American people.

Just hide and watch – I’m giving 3 to 1 odds I’m right. Don’t believe it? Read this and tell me it doesn’t indicate the scenario I’ve suggested.


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The Purpose Of The Health Care Summit?

Any number of people, myself included, have warned that the upcoming health care summit isn’t something the GOP really wants to involve itself in because it is a setup for something else. There’s something fishy about it. Other say those advising against it are paranoid and that the event provides Republicans with a great venue for making it clear they have always had plans and ideas concerning reforming health care.

I think it is becoming increasingly obvious the skeptics are most likely right. A very closed process – in which the GOP was excluded and closed-door meetings and backroom deals were common – is now suddenly open? And televised? It makes no sense except as a move to set up another move.

What would that other move be? Well first, consider the fact that the president and Democrats are unwilling to even consider scrapping the present Senate version of the bill and start over. If that doesn’t raise red flags everywhere, I’m not sure what would. Why, if the idea of the summit is to discuss everyone’s plans and ideas for health care reform, wouldn’t a clean slate be necessary?

Quite simply because that’s not the real purpose of the summit. The purpose of the summit is to justify reconciliation. There, I’ve said it. What Democrats need is cover to do what they feel they need to do in order to pass the Senate bill intact and then have the Senate use the reconciliation process which only requires a simple majority to fix certain parts of the bill to the House’s liking.

But publicly that’s a highly unpopular idea. That doesn’t change the fact that it is the only way Democrats can do this. So they need a demon. They need “obstructionists”. They need “the party of ‘no’” to be as uncooperative as they can make them and have that on public display.

Republicans seem to have at least an inkling of this. They know, or at least are pretty sure, that the Democrats have already agreed among themselves to use the reconciliation process. The latest member of the GOP to point to this was Senate Republican Whip Jon Kyl of Arizona. Appearing on CNN’s “State of the Union,” he questioned the sincerity of Democrats and the president concerning this planned summit. In this case I think his political instincts are good. I think the GOP should hold out for some major concessions prior to any such meeting.

However all of that, one of the advantages of the invitation – given the desired outcome – is it becomes a win-win for Democrats even if Republicans don’t show up, at least by their calculation. They want a “party of ‘no’” and not showing up would demonstrate that even more handily than showing up would. Politically it is a very smart move.

The GOP needs to be ready to handle that sort of negative publicity when it comes as it most assuredly will. They need to point out what the real purpose of the summit was, that there was no desire on the part of Democrats to negotiate (given their pre-summit stance) or actually include Republican ideas and that Republicans simply chose not to participate in a sham designed to make them look uncooperative and justify the use of an unpopular procedure.

Not an easy roe to hoe, is it? Politically, the move by Obama and the Democrats is brilliant. The question is, will it actually bear the fruit that he and the Democratic leadership hope it will? While all of that political theater may work exactly as they wish, Nancy Pelosi may not have the votes necessary to pass the Senate bill.

That could end up being the final irony – the bill fails in the House because of the reelection concerns of members in marginal districts and a Democratic distrust of their colleagues in the Senate.


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What Bi-Partisanship Really Means

Especially in cases like this. Mark Knoller nails it:

When a sitting president calls for bipartisanship by the opposition – he really means surrender. And if they block his proposals, its “obstinacy” and not political views they hold as strongly as he holds his.

Bingo. Spot on. So why, again, are the Republicans agreeing to this televised “bi-partisan” health care summit?

“At this late date, it is hard to see how bipartisanship is going to occur,” said Ron Pollack, the executive director of the healthcare reform activism group Families USA. “Quite frankly, I don’t understand how this dialogue is going to move the process forward other than by demonstrating that the opposition only cares to derail reform.”

Liberals see the summit as a chance for Obama to be seen responding directly to Republican critiques and for him to critique their ideas. “It isn’t going to change the prospects of passing reform,” said Richard Kirsh, national campaign manager of Healthcare for America Now, a union-affiliated activism organization. “It’ll be one more chance for people maybe to understand that Republicans have no ideas to actually solve the healthcare crisis.”

That last line is it’s purpose and, if it is anything like the performance at the Republican retreat, that will be the outcome. With the president saying he won’t reset the process or trash the present version of the bill, it should be obvious that this isn’t really about bi-partisanship or any desire to include the GOP or its ideas. It is a plan to embarrass them publicly and gain political points.

House Republicans are fresh from an encounter with the president at their retreat in Baltimore last month, where he garnered rave reviews for his performance taking questions from GOP lawmakers on live television.

“It may be that the president came off looking pretty good during the Republican retreat and maybe they think there is a political gain to be had from this. My side needs to plan very carefully for this,” said Rep. Michael Burgess (R-Texas). “It’s a press event, not a policy event.”

Of course it is. So again, why has the GOP agreed to participate?

And, of course, the irony is that a process which has been entirely closed to the public, after a campaign promise of transparency, is now suddenly thrown open to the cameras? Yeah, no reason to be suspicious about that, is there?

The Republicans: Oz’s scarecrow of politics.


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