The Fruits of Compromise
The typical “blogger” thing to do is criticize Democrats for being too willing to compromise on substance without tangible gains, but this looks like tangible gains to me:
A new coalition this morning is launching $12 million in TV ads to support President Obama’s health-reform plan, in the opening wave of a planned tens of millions of dollars this fall. The new group, funded largely by PhRMA, is called Americans for Stable Quality Care. It includes some odd bedfellows: the American Medical Association, FamiliesUSA, the Federation of American Hospitals, PhRMA and SEIU. [...]
The group’s campaign is likely to mean that White House supporters keep the upper hand on the airwaves. PhRMA’s participation is key, because the group has promised to kick in as much as $150 million for advertising and grass-roots activity to help pass the president’s plan. But the new group could provoke complaints from the left. The debut ad is mean to shore up support among the conservative House Blue Dog Democrats, and to target swing senators. So it’s airing in Alaska, Arkansas, Colorado, Indiana, Louisiana, Maine, Montana, Nebraska, Nevada, North Dakota, South Dakota and Virginia. The first buy is expected to run for two weeks, with a weekly spend of around $3 million.
The fact of the matter is that the country is likely to pay a price for moving in the direction of health reform that gets buy-in from these kind of interest groups. But that’s a price relative to a theoretical universe in which it’s possible to pass a better plan with PhRMA spending hundreds of millions in negative ads rather than kicking in money to help finance pro-reform ads. In the real world of politics, this looks to me like dealmaking that’s paying off.
49 Responses to “The Fruits of Compromise”
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August 13th, 2009 at 2:14 pm
You are a tool of the oppressor, Yglesias!
August 13th, 2009 at 2:23 pm
Ideological purity is far more important that actually achieving anything!
August 13th, 2009 at 2:25 pm
how friggin naive do you have to be to swallow this BS?
we haven’t even began to understand the price pharma will extract. you can be certain that once they get what they want – a bill that locks the government in to certain parameters while only committing them to “goals” of some sort – that they will use their discretion to go in directions that will produce howls of outrage, but nothing more.
obama is selling everyone out. folks had better wake up and stop being deluded about some masterful, multilevel chess game he is playing.
he is what he appears to be: a slick, principle-free politician who will lie and cheat when it suits him.
August 13th, 2009 at 2:28 pm
frankie, you sound about half as paranoid as the death panel crowd, which is still pretty damn paranoid. Relax, no one with a brain thinks Obama is a genius chess player. Politics is the art of the possible etc.
August 13th, 2009 at 2:29 pm
That’s MattY – the partisan hack, trying to get us to swallow another sellout. Anybody remember Obama telling us he’d negotiate lower Rx prices and have it televised on C-Span?
August 13th, 2009 at 2:30 pm
Please. Pharma is the lesser evil by far when it comes to healthcare costs, but spends a hell of a lot more on lobbying than the insurers. It’s very smart of Obama to take them out of the equation so he can train his fire on AHIP.
August 13th, 2009 at 2:31 pm
what he is going to accomplish is this: mandates for everyone else, profits for the health care industry.
this is turning into a replay of bush’s medicare debacle, the only difference is that obama is being a bit slicker about selling it. he’s awkwardly dancing around the fact that he’s selling us out, while bush simply barreled forward, unconcerned about the fact that everyone knew he was selling us out.
at the end of the day, we’ll get a bunch of toothless, unenforceable regulations that supposedly protect us – while they still will allow them to charge us any price they want – how about finally being free from pre-existing condition restrictions only to find that you’ll have to pay 20 grand a year in order to get that insurance! – and the corporations will get an entire nation of customers who are mandated by law to purchase their overpriced products.
what a deal!!!
August 13th, 2009 at 2:33 pm
Obama wants to sell your baby to the pharmaceutical industry!!!
August 13th, 2009 at 2:33 pm
Ideological purity is far more important that actually achieving anything!
It makes you feel good because are smarter than everyone else and more “hardcore.”
But if Obama does pass something decent in part it will because of the the few, the brave, the Pure heroically pushing from the Left, as much as I hate to admit it.
August 13th, 2009 at 2:36 pm
I have to agree with your view regarding compromise. Too often, dogmatic thinking and lack of compromise prevents any successes from being made. However, could Obama really achieve anything without compromise? It’s not likely with the lobbying power of groups that stand to lose from changes to the system. Thus, this is likely the only realistic option despite the cries of foul from those with idealistic visions.
The thing about having some form of deal is that it provides the option for future dialog. The parties involved have previous agreements from which to build future agreements and amendments. This is very powerful for ongoing change.
August 13th, 2009 at 2:36 pm
I’ll be generous. I’ll give it one week before Fox runs a report on how ASQC is actually run by crypto-communists, funded by PhRMA, an organisation known to have strong links with far-leftist George Soros. What ASQC hasn’t told you is that when they call for “cutting red tape”, they mean for it to be sown into red communist flags, for flying outside the forced euthanasia clinics.
As I said, give it one week.
August 13th, 2009 at 2:36 pm
For a lot of people, reform isn’t worthwhile unless it inflicts sufficient pain on pharma and the insurance companies. Paul Begala has a good piece out today about what people like frankie d and kafka would have thought of Social Security as originally enacted.
There are some of us whose lives may be literally saved by what can be gotten now. Let’s take it and improve the system in the future as it becomes possible. It’s hard to believe we’ll be better off in 10 years if we’re still working from square 1.
August 13th, 2009 at 2:37 pm
“no one with a brain thinks Obama is a genius chess player. ”
BS. every obama apologist always tries to argue that we really cannot judge his current actions because he is playing strategically, that he is really setting his opponents up for a future move where he will actually come forth with his truly progressive plan.
it’s always been a crock and it’s becoming more obvious each day.
the art of the possible?
yea, the possible benefits he’ll get when he runs for re-election and artfully spends all of that big pharma money on campaign ads. if you never demand anything you will never get it. i’d think that any idiot would understand the kind of power the president actually has, if they’ve been paying attention at all, the last 8 years.
ask bush about what is and is not possible…
August 13th, 2009 at 2:38 pm
Though I’m laughing at MY’s straw man in the first sentence of the post, I totally agree with him.
The whole game here was to split Insurance and Pharma. If we win, we will have won by doing that.
If there was a purely grassroots way to win this, I’d choose that. But my observation is that the grassroots are *not* fully engaged on this issue. When I go to events, they’re thinly attended. It’s a hard issue to fully grasp; it doesn’t have the immediate outrage factor of a war. If there was a million-man-march about this in DC, I’d say, screw PhRMA. But I haven’t seen one yet.
In short, if you want to complain, please direct your complaints at the grassroots left.
August 13th, 2009 at 2:40 pm
FACT: Health care reform wouldn’t have gotten out of a single committee if industry was hammering it with a massive negative campaign.
If a handful of lunatics with a bullhorn at a town hall meeting can damp down support for reform, what do you think would happen if the really powerful interests decided to take their gloves off?
Until progressives find away the get around that sad reality, the only way to pass any sort of reform is to keep the medical industrial complex more or less on board.
If PhRMA follows through on its $150 million ad campaign promise, it really could make the difference between a bill that covers 95+% of the public and no bill at all. It’s awful, but it’s the reality of American democracy right now.
Come up with an idea to fix the underlying problem before you brand Obama a sellout who’s giving into industry because he’s some kind of shill who doesn’t care about the American public.
August 13th, 2009 at 2:42 pm
I guess in my theoretical universe, tangible gains are based in the policy produced, not in some high-priced commercial airing to fellow DC’ers on late night C-Span?
In my made-up universe, Obama was a former community organizer, a smart guy who knew the Constitution and political movements, and one who could keep his cool until the most opportune moment. Then he’d unleash his populist streak, calling out those who seek to negotiate based on petty political dealings, rather than exchanging policy important to constituencies. He’d be Bush reversed, a guy who didn’t care about polls.
So I guess I’m left wondering, was there any possible theoretical universe where reform had a chance *and* those with most a stake in the current screwed up system weren’t the key beneficiaries in the new one? Creating a captive market for these industries is not a good thing. That’s why the public option is so important to people … it plants a seed for later reform, where none would be possible otherwise.
Obama constantly marketed himself as a youngish guy, not yet corrupted by Washington. I guess I bought into that and didn’t expect he’d support a Medicare Part D thing.
August 13th, 2009 at 2:42 pm
In the real world of politics, this looks to me like dealmaking that’s paying off.
That’s when you know you have become a very serious person in DC: you read about an incredibly corrupt and secret agreement behind closed doors between the executive branch and lobbyists, about a very important law, and you think it is how that is supposed to work in the “real world of politics”.
Imagine we learn tomorrow that Baucus has a secret deal with the health insurance lobby making sure they won’t have to sacrifice more than 80 billion, and probably don’t really have to sacrifice anything, or Baucus filibusters the bill. But they will pay for ads! Would you say it is a triumph of smart dealmaking too?
August 13th, 2009 at 2:43 pm
“Stable-quality care”??? If that’s the best we can do, then I say “NEIGH”!
August 13th, 2009 at 2:45 pm
Focus on results.
August 13th, 2009 at 2:47 pm
Remember when Obama promised to televise health reform negociations on CSPAN? Why can he renege on that promise but not ‘Afghanistan-Good-War’?
August 13th, 2009 at 2:54 pm
Save this one. If the final product is a total piece of crap this will come back to haunt MY.
August 13th, 2009 at 3:00 pm
“Obama wants to sell your baby to the pharmaceutical industry!!!”
It is a well known fact that baby juice makes medicine tastier.
August 13th, 2009 at 3:06 pm
The final bill will almost undoubtedly be a piece of crap from the perspective of “What’s the best policy?”
But if it eliminates the worst insurance abuses and boosts coverages by tens of millions of Americans it still will be an enormous success.
If we can get to a point where 95% of Americans are covered, it will cement the idea that health care is basically a right, which will make future attempts at reform easier.
The problem today is that you have to fight a rearguard defense against people who flat out hate the idea that those dark skinned lazy folks will get coverage, and that medicine would be affordable if it were only restricted to “respectable” folks.
Make it a universal idea that “yeah, fine, everyone should be able to get medical care,” and it’s much easier to push reforms to squeeze out waste and improve quality of care. See what’s happening in Massachusetts now, where they’re looking at reforming fee for service medicine.
August 13th, 2009 at 3:06 pm
This is absurd on many levels: it totally undermines Obama’s claim that government can control health care costs, it’s exactly the same deal BushCo made with Pharma to get his Medicare drug plan passed, and finally, it’s a road map for all the other health care interests showing the way to roll Obama.
August 13th, 2009 at 3:07 pm
In my view anything short of a complete socialization of our health care system is a failure. That said, there are various degrees to which the health care bill will be a failure. Some of the proposed reforms to private insurance would be quite a breakthrough. If we can manage to cover some, but not all, of the poor and underinsured it will be silly and tragic but it will also save a lot of people from illness and death.
But the fact is that allowing for-profit health care to exist is going to cause preventable illness and death.
August 13th, 2009 at 3:16 pm
” he is what he appears to be: a slick, principle-free politician who will lie and cheat when it suits him. ”
I agree. Everyone that gets as far as Obama is. Why care, that does not matter at all for the outcome.
August 13th, 2009 at 3:26 pm
At least we got something. It may be a godo deal or not, but at least we got something. I agree with you on this:
August 13th, 2009 at 3:31 pm
So, are we just giving up on the increased-efficiency thing? We’ll get, like the rest of the industrialized world, universal coverage, but we’ll be paying 3x as much as them instead of 2x?
August 13th, 2009 at 3:39 pm
The actual objection of the ultras is not a compromise plan, but to the passage of a plan. Any conceivable health care bill that passes, they would bitch about and call Obama a sellout, simply because they don’t want to make the health care system better for people – they want to use dissatisfaction with the health care system as a spur to the revolution, and there goes Obama, keeping the contradictions from heightening.
August 13th, 2009 at 3:39 pm
“So, are we just giving up on the increased-efficiency thing? We’ll get, like the rest of the industrialized world, universal coverage, but we’ll be paying 3x as much as them instead of 2x?”
How do you fight for increased efficiency when half the country basically views any attempt to rein in costs as some sort of dastardly scheme to redistribute health care from hard working white folks to lazy minorities?
Universal or near universal coverage is a necessary prerequisite to create the political will to improve efficiency, but it’s not going to happen in the same bill.
August 13th, 2009 at 3:44 pm
Honestly, if Obama was going to go this route, he should’ve gone all the way.
Sell out totally to Pharma. Promise to add tens of billions of dollars to their profit margin. In exchange, they earmark a couple billion for pushing for a single payer bill. Use that to crush the insurance industry. Then in a decade or so other politicians could turn on pharma and roll back all the giveaways.
August 13th, 2009 at 3:45 pm
I can’t speak for anyone else, but all I ever expected of Obama was that he was inspiring enough to move the center of public opinion a few degrees to the left, and savvy enough to cut deals with the power brokers in DC that would provide incremental, but meaningful, progress on the most important issues.
I’m not giving up yet, but the last couple of weeks have been worrisome on both counts.
What concerns me from the Left right now is not the disappointment people are feeling about the quality of the compromises that are being struck, which I share to a great extent, but the attitude that Democrats shouldn’t be cutting deals with people like PhRMA at all.
There’s a Naderite undercurrent to some of the netroots criticism of Obama, Pelosi, and Co… a sense that we’d be better off telling the Blue Dogs and Republicans to fuck off, writing awesomely progressive bills, watching them all go down in flames amidst a massive corporate-funded right-wing scorched earth opposition to reform, and then going to the voters in 2010 and asking them to give us an even larger majority.
That way lies disaster.
August 13th, 2009 at 3:57 pm
I don’t mind buying off Big Pharma (or the AMA) if it led to to insurance companies being left out in the cold.
Even if that meant “Medicare Part D for all!”, it would be an improvement over the Baucus/Obama plan guaranteeing UnitedHealth and its peers a captive market by mandating everyone buy private health insurance or else face legal consequences (the public option will cover, at most, 10 million people).
August 13th, 2009 at 3:57 pm
A lot of people with insurance can just barely afford it now, and they are terrified that these sorts of compromises will cost them more in health premiums and/or taxes. All they have been seeing is huge cost increases for years, and they want to know what will be done about that. That’s the problem with the discussion so far–there is no talk of making things less expensive for the majority of people who already have some sort of coverage. Yes, in an ideal world they would like everyone to be covered, and they would love to have coverage if they lose their jobs, but not if it will tip their own family into bankruptcy. To sell health reform the Dems need to come up with the messages for how everyone will benefit now, not just the currently uninsured or those with insurance at some future date. There needs to be a more immediate benefit.
August 13th, 2009 at 3:58 pm
@32: yes, agreed, but I’m not worried yet.
The basic fact is, people like to gripe. Griping is always going to be there, as background noise. But I don’t yet detect the kind of pervasive disconnection from the whole process that produced the 2000 debacle.
August 13th, 2009 at 4:12 pm
Ted, I agree for the most part. However, I’m hearing a few echoes of 2000 in the content of the griping.
August 13th, 2009 at 4:15 pm
The only thing we can be sure of now is that disinformation is being spread so wide and so deep that we can’t be sure of anything. I’m just going to trust Obama til something is passed.
August 13th, 2009 at 4:20 pm
With Pharma, the AMA, and (so we heard at one point) the insurance industry behind the current reform, where is the opposition coming from? Is it strictly ideological? Who is bankrolling the opposition and putting pressure on the right-wing establishment to kill this? There’s got to be someone (besides the Republican Party) that thinks they’ll lose if this thing goes through.
Someone above asked why the grassroots on the left is not agitated to get behind reform, while the grassroots on the right is agitated to stop it. I believe the answer is very simple.
While the current reform proposals may represent an improvement over the current situation, there’s really nothing in there to get excited about. Yea! Incremental and very complicated new regulations on health insurers! We want an aggregated risk pool and we want it now!
So there’s really no one left to back this thing except for corporate interests. I believe that if Obama had started with a simple proposal–expand Medicare until it covers everyone and use the power of the Federal Government to control prices–then you’d see a huge and excited grassroots effort to back him up.
The business interests would hate it and would pull out all the stops to kill it. On the other hand, no one can convince me that that’s not what’s happening now. Could the opposition really be any worse? Medicare for all is a simple message, much harder to lie about and much easier to get excited about. The right is fighting against a single-payer system anyway, even though that’s not even on the table.
Of course this all assumes that Obama actually wanted single-payer in the first place, and I see no reason to believe that is true.
August 13th, 2009 at 4:26 pm
The drug companies have good reason to cooperate. While providers and insurers can make money dealing only with the wealthiest 50% + medicare, the drug companies need a broad market to make mountains of money.
August 13th, 2009 at 4:28 pm
Children, I hate to spoil the left-bashing party but it’s not about ideological purity or disappointment about not sticking it to The Man. It’s about whether the bill that emerges will actually work i.e. significantly increase access at a sustainable cost. We’ll see, but the signs are not very favorable.
August 13th, 2009 at 4:35 pm
Corporate medical care providers do not like the idea at all. They make enormous amounts of money selling unnecessary medical care. Obama is essentially saying he wants to eliminate 35-40% of their business. It’s probably even more drastic than that. The elements of the medical care community least likely to be padding their bills with useless servces are small private practice GPs without ties to a larger corporate organ. There could be a lot of very large health care companies looking at reform that tries to eliminate over half their business.
August 13th, 2009 at 4:42 pm
LaFollette,
While I understand the desire of certain Democrats to champion progress, no matter how incremental, the details of the compromises are important to dissect – and we just don’t know all of that information yet. What I find amusing is your sarcasm about purists on the Left. The only way a decent bill gets written is if progressives hold the White House and leadership’s proverbial feet to the fire. If you think the failure of health care reform will lead to a massive voter swing backward to the corporate policies of the Bush years, you really haven’t been paying attention. Most people know their pain and economic insecurities were caused by Republican greed and stupidity. The Right is discredited and will continue to be so for several election cycles. The real disaster lies in the unwillingness of the Democratic Party to primary the traitors in its ranks – with a full onslaught of advertising and visits from the President in 2010. Until we get such a strategy, we’ll just have to content ourselves with the scraps the corporate lackeys toss us and dream of third party insurgencies that change the world. Health care reform for Obama is all about re-election, which is why we’ll get a deal. I’m just skeptical we’ll see a bill that helps the poor and unfortunate more than the moneyed elites.
August 13th, 2009 at 4:57 pm
The speaker Pelosi called us “nazis”.
President Obama moved further : he wanted people to shut up.
“I want them [the critics] to get out of the way so we can clean up the mess.”
He accused opposition of being “manufactured” (while He was sending message to his folks to mobilise !).
When the Far Left protested Bush and rallied to maintain Saddam Hussein power, the liberal medias saw there only “everyone from grandmothers and students to veterans and mothers pushing strollers”.
It is forbidden to oppose Caesar whose wishes are paramount. But just one year ago, the Democratic slogan was : it is “a patriotic duty”. Obama is now the White House, so it is prohibited to oppose under penalty of campaigns of insults and slander.
The propaganda campaign emanating from the White House is an abject lowness. The Presidency has even set up a line for denouncements by e-mail : you can now indeed report any “fishy” behaviours to flag@whitehouse.gov – The infallible Caesar is monitoring the people through Big Brother ! He uses all the powers of the State to silent opponents and crush them.
As a community organizer in Chicago, Obama was a specialist in turmoil that manipulates and radicalizes envy, hatred, victimarian paranoia (a method brilliantly analyzed by the writer Tom Wolfe in Radical Chic and Mau-Mauing the Flak Catchers). Even physical pressure, aggression and threats.
The United States of Obama and Yglesias do not give citizenship to protesters and opposition. There is the superiority of Omniscients on us the poor mortals, us the ignorant populace, who has only the right to remain silent, and the duty to shut up.
The Caesarean State knows everything. The State and its Leader may speak : I do not want to see a head, others are a rabble, a mob of “nazis with swastikas”.” What an unprecedented audacity in this new “democracy” !
Obama drops in the polls. The majority rejects the health plan. Its economic policy, inefficient and expensive, is challenged because of over-indebtedness.
The mirage dissipates, except in the eyes of misted media (pathetically obsequious), which protect by lying, concealment and censorship. An uncontrolled rage has gripped the Power apparatus, frustrated not see “only one head” : panic !
The omnipotent Caesar, divinized by the media and the Left has managed to alienate a majority of the electorate. “Plus dure sera la chute.” We’re not there yet, but it cracks widen in the artificial building of Obama.
August 13th, 2009 at 5:32 pm
All hail the United States of Caesar and Yglesias!
August 13th, 2009 at 5:37 pm
Boy, that DHS report wasn’t kidding, was it.
August 13th, 2009 at 8:37 pm
of course there’s always the option of starting a real insurgency.
August 13th, 2009 at 9:49 pm
Hey maybe pharma can come up with a pill for the AMA to euthanize granny
.
August 13th, 2009 at 10:56 pm
I do, sadly, agree with Mr. Ed @18 that “Americans for stable-quality care” is a regrettable name. I can already hear Michelle Malkin pointing out that the American Veterinarian Association hasn’t endorsed our plan.
August 14th, 2009 at 12:28 pm
[...] Matt Yglesias touts this as “the fruits of compromise.” Yglesias blogs for Center for American [...]