Pearlstein Says Moderates Should Be Pushing More Reform, Not Less
The big political problem with health care, I think, is that on the one hand pushing for major cost-savings is a more “moderate” policy goal than is just expanding coverage. But on the other hand, pushing for less reform is also more “moderate” than pushing for more reform. But the nature of the current health care system in the United States is that you achieve more savings by pushing more reform; by becoming less moderate and more radical. Thus, as Steven Pearlstein writes in today’s Washington Post if the Blue Dogs are really concerned that the draft House legislation doesn’t do enough to control cost growth they ought to be pushing for more outside-the-box ideas, not just carping around the margins:
A better vehicle would be the new government-run insurance option that has become a political must-have for House leaders and President Obama. In return for dropping their opposition to such a “public option,” the Blue Dogs could have insisted that it not be structured as a fee-for-service plan along the lines of Medicare but rather offer services through a network of high-quality, lower-cost hospitals and clinics that use teams of salaried doctors to provide coordinated care, along the lines of the Mayo and Cleveland clinics that Obama is always touting. In a competitive market, the success of such a government-run plan would force other insurers to follow suit.
That’s a good idea! Pearlstein concludes:
The problem with the Blue Dogs is that they tend to confuse centrism with splitting the difference between the warring camps, or making policy by choosing one from Column A and one from Column B. The more effective centrists use their political leverage to create a Column C.
Maybe that’s the problem, or maybe the problem is that the Blue Dogs are busy raking in health care, financial services, and energy sector corporate cash. After all, in addition to difference-splitting or column-grabbing, one thing you can do with your pivotal position in a legislature is block reform in exchange for money from interested parties. You hear a lot about Blue Dogs coming from “conservative rural districts” but it’s not as if major financial services firms are wildly popular among rural conservative voters.
31 Responses to “Pearlstein Says Moderates Should Be Pushing More Reform, Not Less”
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July 24th, 2009 at 10:47 am
When conservative Democrats side with Republicans and right wing talking points and with concentrated business interests, maybe they’re not “confused”, or spineless, or timid, or any of those things — maybe we should on occasion stop assuming unintentional consequences and assuming they are working for the policies they prefer and against the ones they don’t and that their party ID’s as “Democrats” are useful in legislative and dishonest PR battles in this.
July 24th, 2009 at 10:54 am
They only “rake in cash” because government has an inordinate amount of control over regulations that intimately affect profits, and it benefits them to invest in lobbying rather than just making shit cheaper.
I will never understand how someone can cry about lobbying, and then suggest more government control.
July 24th, 2009 at 10:54 am
1) Why is it that Republicans toe the line and vote as a monolith whereas Blue Dog Democrats feel free to betray the Democrats of this country with impunity? No fear — not even the slightest anxiety.
2)As the Chinese say, kill one to terrorize 10,000. Time to make an example. Time to Make this betrayal PERSONALLY expensive for Ben Nelson.
July 24th, 2009 at 10:54 am
be careful with that image. Mr. Rodrique doesn’t like blogs using his stuff…
July 24th, 2009 at 10:56 am
For example, why is Nelson serving on ANY committees?
Why is his state getting a single dollar of federal funds?
Why is there not a recall movement gearing up in his state even as we speak?
July 24th, 2009 at 10:57 am
Is Nelson so clean that there is not the slightest cause for the Senate to impeach and remove him from office?
July 24th, 2009 at 10:58 am
“Through a network of high-quality, lower-cost hospitals and clinics that use teams of salaried doctors to provide coordinated care, along the lines of the Mayo and Cleveland clinics that Obama is always touting.”
It’s not that easy. How many such hospitals exist? Very few. Most of American mediicne is structured on fee-for-service; physicians are fiercely independent and work as contractors in private community hospitals. Changing this system will take a long, slow, arduous turning of the medical culture. This will take a while, and will likely involve at least one generation dying off. In the meantime, no such national network could exist, because there wouldn’t be enough hospitals to support it. Not only are there not enough such hospitals now, but there wouldn’t be enough physician buy-in even if you encouraged the formation of them through grants or tax breaks or something.
July 24th, 2009 at 10:59 am
We hit a critical dose of Teh Stupid awhile back. Our dumbo conservative class refuse to do simple math: unless we reform our health care delivery, we’ll continue to fall further behind the countries who have a rational health care system. We’re officially a Banana Republic: the venal legislators who only care about delivering wealth to their bosses have a veto on change.
July 24th, 2009 at 11:03 am
El Cid has stated it correctly. Conservative Democrats are democrats in name only. They are theoretically considered moderate on Social Issues, but their economic policies are the same as the Republicans. The problem for the U.S. is the disproportionate power of the rural states of the West and Great Plains areas in controlling political progress for the whole country. These low population states have two Senators each in the Senate. The likelihood of any of these Senators being ‘liberal’ on anything is almost nil.
July 24th, 2009 at 11:10 am
There is a major problem with the assumptions in this post. Nelson and the blue dogs don’t give a shit about saving money, the deficit or for that matter the American people. Who is giving them the most cash to keep in power? That is who they will work for. There is no incentive for them to work for what is best for the country and every incentive for them to work for what is best for their biggest donors. All the other discussion is pedantry.
Why do we keep beating around the bush on this most obvious point?
July 24th, 2009 at 11:15 am
“You hear a lot about Blue Dogs coming from “conservative rural districts” but it’s not as if major financial services firms are wildly popular among rural conservative voters.”
Absolutely. I wish someone would point that out to the press, who just accept that being from a “rural district” means fighting for the interests of financial and insurance companies instead of being more moderate on issues such as abortion and guns.
July 24th, 2009 at 11:15 am
There are a lot of wealthy interests dependent on legislation being passed in the next few months.
Why does Obama not let it be known that he will VETO every bill Congress passes until it passes health care reform? Does anyone think the Republicans or Democrats could muster enough votes to override a veto?
That financial bailout should be looking kinda shaky as well.
50 percent of Americans live in miserable poverty. Why not give them a lot of company from the other 50 percent?
Nobody does Strategy any more. The Superrich 2 percent of the population have the power because they have much of the nation’s wealth and income. In my view, that mean they have a LOT to lose.
Don’t just fuck Ben Nelson — fuck his bosses.
July 24th, 2009 at 11:19 am
By this time in his Administration, George W Bush had passed a $2 TRILLION tax cut for the Superrich. Anybody remember the Blue Dog Democrats blocking that tax cut because it cost too much?
July 24th, 2009 at 11:37 am
So this is totally OT, but Matt used to make a regular feature of Jonah Golberg’s incessant stupidity and today he’s offered a real gem. It’s called “The Folly of Obamacare” and the premise is that if healthcare is a fundamental right, then any regulation of healthcare would be an abridgment of that fundamental right. And, says Goldberg, the government doesn’t abridge fundamental rights like freedom of speech, religion and assembly. Except of course, we do. All the time.
What is it like being his editor? Have they just thrown in the towel?
http://article.nationalreview.com/?q=Nzk1ZmQ0ZjhmYWZiNmViZWI0NzgyNWU1ZGU5Njg3OTQ=
July 24th, 2009 at 11:46 am
It’s really best to ignore professional idiots like perlstein. Anyone who assumes the honesty of these people isn’t worth listening to.
It’s obvious to every but faux, even-the-liberals what’s going on here.
July 24th, 2009 at 11:48 am
Mavis Beacon: He’s making a fairly bland “Positive rights versus negative rights” argument. He’s arguing on behalf of it in a slightly more fallacious way than usual, but it’s really nothing too shocking.
July 24th, 2009 at 11:50 am
Don, thats really what makes it mendacious and dishonest when people say “But he’s only been President 6 month!”. If a political neophyte said that, it would be almost cute. When someone who actually knows what they are doing says it, it’s just an outright lie.
If a PResident doesn’t get the big things done in the first 7 months, then it’s not going to get done. Everyone who is serious about politics knows that, as do most of the people making the ‘He’s only been President 6 months!’ argument.
July 24th, 2009 at 11:58 am
Anybody remember how ole Ben Nelson voted in 2001 on that $2 Trillion giveaway to the Rich?
http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=107&session=1&vote=00170
Anyone remembering the alleged Democrats joining him?
Max Baucus
John Breaux of Louisiana ( Could have used some of that money fixing those New Orleans levees, John. Course that don’t matter if you are living in Washington DC as a high paid lobbyist)
Carnahan of MO
Max Cleland of Georgia (Still didn’t help you, did it?)
Diane Feinstein (say it ain’t so!)
Johnson of South Dakota
Landrieu of Louisiana (Could also have used some money for those levees, Mary. By the way, where are the recovery funds to repair the consequences of your corruption coming from ?)
Lincoln of Arkansas
Zell Miller of Georgia (Another loyal Democrat –just look at the video of the 2004 Republican National Convention)
Torricelli of New Jersey (Another Moral Giant in the Democratic Caucus)
Anybody see any punishment falling onto the above sellouts?
July 24th, 2009 at 12:04 pm
Re soulite at 17: “If a PResident doesn’t get the big things done in the first 7 months, then it’s not going to get done. ”
———-
Well, maybe those people who chipped in $700 Million for Obama’s campaign don’t want Healthcare Reform to get done. Maybe they just want a few showy , token gestures.
On the other hand, that $23 Trillion financial bailout went through so fucking fast the angels blinked.
July 24th, 2009 at 12:05 pm
it’s not as if major financial services firms are wildly popular among rural conservative voters
The tax structure and private health care system are being reformed to appease foreign creditors, not American conservatives, moderates, liberals, progressives or whatever. The administration and its bloggers are trying to make the pill of cost-cutting to pay off debt go down easier by covering it with notions such as “choice”, “freedom”, “competitiveness”, and “justice” in order for the masses to not join the dots that lead from an indebted and defunct empire to a new world order in which the US does not reign supreme.
Just like Argentina, Mexico, Russia, Thailand, etc. after their financial crises, you have no options. You are at the mercy of your creditors.
How does it feel?
July 24th, 2009 at 12:13 pm
Anonymous, I think you’re basically right that the underlying argument is about positive-negative rights. I just thought the whole thing is pretty rambling and unfocused and the part where he suggests that government doesn’t exercise control over our free speech rights is just plain stupid.
July 24th, 2009 at 12:16 pm
The private insurance companies don’t need a public option, but it seems they need the extra customers a reform plan would bring. Their share of national healthcare expenditures has shrunk steadily to 35%, their overpriced product is being dropped by employers, and the Medicare Advantage scam is played out.
In the absence of reform legislation, what prospects do they really have? That is probably why some reform plan, though perhaps without a public option at first, will eventually emerge.
July 24th, 2009 at 12:19 pm
The good news is: we longer have to talk about health care every goddamn day. Obama stated yesterday that he hopes a bill reaches his desk before the year is out. Or did he say before the sands of time run out. I can’t remember. Either way, so much for August.
What I want to know is: what has Ted Kennedy been doing the last 140 years? I thought he spent every waking moment of that time furtively working on a health care bill. You would think that “the Lion of Senate” would have wrapped up the details 70 years ago.
July 24th, 2009 at 12:20 pm
The Blue Dogs are of course a bunch of corporate whores. The relative conservatism of their districts gives them the room to be corporate whores, but it certainly doesn’t drive them to be so.
Still, the Blue Dogs should remember that it wasn’t the most liberal members of the Democratic caucus that lost their seats in the 1994 electoral debacle – it was the Dems from states and districts like theirs.
So, corporate whores or no, they might should get behind Obama’s healthcare reform, out of their own self-interest. If they lose their seats in Congress, they won’t have anything more to sell to the corporations they’re cozying up to.
July 24th, 2009 at 1:03 pm
Yeah right. The fact that we pay more per capita than any other country, and pay a much, much higher percentage of our GNP for health care has nothing to do with it.
It’s all evil foreign lenders, who, oddly don’t seem to want us to cut our military spending in order to pay them back.
July 24th, 2009 at 2:32 pm
It’s all evil foreign lenders, who, oddly don’t seem to want us to cut our military spending in order to pay them back.
I did not say foreign creditors were evil, just that they have set conditions for further loans to the US which you have no choice but to accept unless, of course, you choose a crash like Argentina’s.
Now that the US is about to lose its AAA rating (public debt is projected to be over 80% of GDP; rating agencies state that anything over 60% is incompatible with an AAA rating) the US must convince its creditors that is has a plan to improve its balance sheet.
How can Americans be so unaware that your sudden reforms are a sign of imperial weakness, not philosophical and democratic strength or a quest for social justice? I suppose because it is less painful than admitting to yourselves that you have sold your freedom and independence, not to mention your global hegemony, for imported junk, overpriced real estate, and wars of choice.
July 24th, 2009 at 4:44 pm
Lupita,
Considering that China has increased it’s holdings of US treasuries by 60% in the last 12 months, I doubt any threats they make about our spending habits are taken seriously. This is genuine domestic concern.
July 24th, 2009 at 5:48 pm
I doubt any threats they make about our spending habits are taken seriously.
Ah, hubris lurks its ugly head. Capital just naturally flows to contracting economies with no way to pay for entitlement programs with exploding costs two years down the road. Such financial innocence is touching. Well, just like any 3rd worlder, you will soon learn the difference between long and short term loans, vulture hedge funds, capital flight, currency depreciation, and the debt trap.
July 24th, 2009 at 5:56 pm
Re: I did not say foreign creditors were evil, just that they have set conditions for further loans to the US which you have no choice but to accept unless, of course, you choose a crash like Argentina’s.
Unlike Argentina the US can pull the whole international house of cards down and those creditors would be buried under tons of financial rubble. Any US leader worth his salt should remind the foreigner bankers of that inescapable fact of life. He could even have the guy with the nuclear “football” standing at hand to really concentrate the fools’ minds.
July 24th, 2009 at 9:31 pm
More hubris. The nuclear touch was great.
July 27th, 2009 at 11:04 pm
[...] increased coverage as they haggle over the numbers? The Blue Dogs are barking rather loudly about cost–particularly with regard to subsidies–but when you follow these complaints to their [...]