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Meet ObamaCare

1. "For months I've been reporting in The Huffington Post that President Obama made a backroom deal last summer with the for-profit hospital lobby that he would make sure there would be no national public option in the final health reform legislation," Miles Mogulescu wrote this week." "I've been increasingly frustrated that except for an initial story last August in the New York Times, no major media outlet has picked up this important story and investigated further.

"Hopefully, that's changing. On Monday, Ed Shultz interviewed New York Times Washington reporter David Kirkpatrick on his MSNBC TV show, and Kirkpatrick confirmed the existence of the deal."

Memo to progressives: Feel like a bunch of chumps, yet? If not, read on.

2. "Politico's Ben Smith yesterday suggested that one important aspect of Rahm Emanuel's health care strategy - to ignore the demands of progressives on the ground that they would fall into line at the end no matter what - has been vindicated," the estimable Glenn Greenwald writes.

"For almost a full year, scores of progressive House members vowed - publicly and unequivocally - that they would never support a health care bill without a robust public option. They collectively accepted hundreds of thousands of dollars based on this pledge. Up until a few weeks ago, many progressive opinion leaders - such as Moulitsas, Howard Dean, Keith Olbermann and many others - were insisting that the Senate bill was worse than the status quo and should be defeated. But now? All of those progressives House members are doing exactly what they swore they would never do - vote for a health care bill with no public option - and virtually every progressive opinion leader is not only now supportive of the bill, but vehemently so. In other words, exactly what Rahm said would happen - ignore the progressives, we don't need to give them anything because they'll get into line - is exactly what happened."

3. "Ever since Thomas Frank published his book What's the Matter With Kansas? Democrats have sought a political strategy to match the GOP's," David Sirota writes. "The health care bill proves they've found one.

"Whereas Frank highlighted Republicans' sleight-of-hand success portraying millionaire tax cuts as gifts to the working class, Democrats are now preposterously selling giveaways to insurance and pharmaceutical executives as a middle-class agenda. Same formula, same fat-cat beneficiaries, same bleating sheeple herded to the slaughterhouse. The only difference is the Rube Goldberg contraption that Democrats are using to tend the flock."

4. "Here's a phrase you can expect to hear a lot in the next few days: 'According to the CBO,'" Ruth Marcus writes. "The CBO is the Congressional Budget Office, the official scorekeeper of the costs of proposed legislation. Rarely has a CBO report been more anxiously awaited than the analysis released Thursday of the proposed changes to the Senate health care reform bill. Democrats are delighted with the bottom-line analysis that the measure would save $138 billion over the next 10 years, and as much as $1.2 trillion in the second 10 years - all this while expanding coverage to 32 million people who would otherwise be uninsured.

"So Democrats will be pointing to this preliminary CBO score as if it is engraved on stone tablets. Republicans will profess their respect for the CBO and proceed to argue that its estimates should not be taken too seriously in this instance. What I'm about to say may come as a surprise, but I think the Republican argument is closer to the correct one. To crow, as did House Speaker Nancy Pelosi, that the package is 'a triumph for the American people in terms of deficit reduction' is premature at best, delusional at worst."

5. The Obama administration wanted a partisan fight. It was the only way to rally Democrats and their constituents to support a bill most of them hate. By making the issue partisan, the administration has framed it as "us vs. the Republicans. Which side are you on?"

Likewise, Obama's faux anger over Jim DeMint's comment months ago that health care could be his Waterloo worked to his advantage; now it's Obama saying his presidency is on the line.

July: "White House Plans to Use DeMint's 'Waterloo' Quote to Rally the Troops."

Now: "President Obama's pitch: Fate of presidency on the line."

6. Obama's approach to health care has not been unlike the community organizing approach of Saul Alinsky: don't tell people what they should think is important and what they need, let them determine the agenda for you, the leader. In this case, Obama let Congress determine what a consensus could built around and let them fight it out until stepping in at the end. The problem? Congress isn't his constituency, the American people are. From community organizer to congressional organizer.

7. Obama at the health care summit:" No, no, no. And this is an example of where we've got to get our facts straight."

This was the main point of disagreement at the summit - whether premiums will go up or down, sort of important - and Obama scolded Lamar Alexander for not being as close a reader of the legislation as he. Well, guess what?


Obama did, however, incorporate the wackiest notion to come up at the summit into his proposal. When Tom Coburn (R-Oklahoma) whined and pleaded for sending undercover agents into hospitals to weed out Medicaid fraud, I thought the summit would be deemed a success for the way the president let the nutballs expose themselves. Guess not.


"The bipartisan health care meeting on February 25th offered something you rarely see in Washington: an open, honest, productive discussion between the political parties."

- The White House

8. "David Nexon had a big problem. An early version of national health care legislation contained a $40 billion tax aimed squarely at members of the medical device trade association he represents," the Tribune reports.

"Nexon, a former adviser to the late Massachusetts Sen. Ted Kennedy, went to work. He marshaled 14 people like himself - lobbyists who were once congressional aides, many of them from staffs of congressional leaders or committees that had a hand in crafting the health care overhaul.

"When Senate Democrats unveiled their bill in mid-November, Nexon's handiwork was evident. The tax on device-makers was still large - $20 billion - but only half what it might have been without the efforts of Nexon and his fellow lobbyists.

"Nexon's team is an illustration of how deeply the health care industry has embedded itself on Capitol Hill, using former aides of lawmakers and ex-lawmakers themselves.

"An analysis of public documents by Northwestern University's Medill News Service in partnership with the Tribune Newspapers Washington Bureau and the Center for Responsive Politics found a revolving door between Capitol Hill staffers and lobbying jobs for companies with a stake in health care legislation."

9. From AP: "A look at some of the concessions lawmakers and interest groups won in the latest version of the Senate's health care overhaul bill."

10. "Senator John McCain memorably called the 2003 energy bill the 'no-lobbyist-left-behind' act," the Economist writes. "But the Centre for Responsive Politics, a non-partisan think-tank, expects that the amount spent on formal federal lobbying by the health and health-insurance industries (some $425m in the first nine months of 2009 alone) will break all records. And this is just a fraction of the two sectors' total spend on television advertising and other efforts to influence the debate.

"The fact that health reform is likely to pass in spite of this wall of money does not mean that Congress is impervious to the power of special interests. Much of the spending was designed to shape the bill, not to defeat the reform altogether."

11. "The bills are largely a sideways move," Dr. David Himmelstein, a co-founder of Physicians for a National Health Program says. "They will have very little impact on resolving or stabilizing the health care system. They improve things for some people and make things worse for some people.

"For example, some poor patients or near-poor patients would benefit from federal subsidies for private insurance or by getting Medicaid, which they're presently not eligible for. That would be an improvement.

"However, patients who remain uninsured - and there will be at least 17 million of them - would probably see the resources available to them dwindle, because the bill takes part of its funding out of the hides of safety-net hospitals. Part of the proposed Medicare savings is derived from decreasing the funding for hospitals that care for a lot of poor, uninsured patients. So, for the remaining uninsured, the safety net would be even more threadbare than it is now.

"Another example of an adverse impact: young people who have private coverage today would have to pay higher premiums because of the limits on premium differentials on age.

"Almost no one would see an improvement before 2013 if the House version is passed, or 2014 if the Senate version passes. One thing is certain: the bills would entrench the insurance industry and pharmaceutical industry even further in their control of the health care system."

You're being played, America.


Comments welcome.


Posted on March 19, 2010

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