Friday, December 18, 2009

"What you're seeing is the progressive backlash against the progressive backlash."

If it's bill killer stuff you want Fort McHenry is definitely not the site for you. (besides, Kos and most of HuffPo are filling that bill for ya, so go enjoy!).

But amidst all the strum and drang, to quote the oft-hated Rahm Emanuel (Loved in 2006, loathed in 2009) "What you're seeing is the progressive backlash against the progressive backlash."

True dat. He is a sampler platter of today's highlights.

Jacob Heilbrunn

Is Obama really such a wimp? Or is he dealing with the harsh reality of: 1) the legacy of the Bush era; and 2) a divided Democratic party that has, in many ways, betrayed him?

It's hard to imagine that this is the health care plan that Obama envisioned during the campaign. Nor did he want to have to send tens of thousands of troops to Afghanistan. But imagine the outcry had Obama begun to exit Afghanistan. He would have been the victim of a new stab-in-the-back legend on the right that might well have destroyed his presidency before it even had the chance to get off the ground. When it comes to health care, Congress will surely revisit it in coming years. Whether or not the bill contains a Medicare expansion, Obama is exactly right to say that it represents the biggest potential Democratic accomplishment since the establishment of Social Security. Little Joe Lieberman can pout and strut all he wants, but ultimately he'll be a mere footnote in the history of the bill.

The blunt fact is that Obama has been president for one measly year. Compared to the blunders that other presidents have committed early on, Obama is looking good. If the economy improves, he will look even better. So ignore the tedious and hypertrophied Obama bashers. And never forget that he is as as good and intelligent and decent a president as America will ever have. He still has a chance to become one of the greatest. Eight years from now, after Obama has successfully served two terms, that judgment may well look like a commonplace.


Joe Conason (from the end of a pretty positive profile of Howard Dean)

But the real crux of the argument between Dean and the bill's supporters is less about the details than over what this act means for the future of healthcare in America. For those who want the bill to pass despite its defects -- a position that I have come to share -- this is the moment when the nation decides that health insurance must be provided to every citizen, period. That tidal shift is why right-wing politicians and pundits are so ferociously opposed to this bill -- and why its passage would represent an important victory on the way to restoration of the American social contract.


Ezra Klein

The law for the law of unintended consequences is also an important reminder that this bill represents the beginning, rather than the end, of health-care reform. “I am not the first president to take up this cause,” Obama said back in September, “but I am determined to be the last.” He will not be the last, or even close to it.

But this bill is a start. It gives states the tools – new money, new regulations, new programs, new processes – to begin fixing the health-care system. Maybe just as importantly, it recognizes that, eventually, we’re going to have to fix the fix to the health-care system, too. Passing this flawed-but-important bill is, in part, a leap of faith. It is a bet that we, as a society, can solve our problems. It is an admission that we never get it totally right, but that that’s no excuse not to try. It is a decision to trust ourselves to do our best with what we know now, and apply the hard-won knowledge of experience when we know more later. It says so right in the legislation.

There are those who oppose this bill, and its aims, in its totality. I don’t agree with their opposition, but I respect it. Those who would let their disappointment with a small piece of the bill cancel out their support for the overarching effort are, however, making a far more serious mistake. Chances to take large steps forward on longstanding problems do not come often in American politics. This legislation is not perfect, but it can be moved in that direction. The same cannot be said for the status quo.


Jonathan Alter

There's another factor that liberals should consider: the fate of their non-health-care priorities. The plain political fact is that if this bill dies, it will cripple Obama's presidency. Certain impassioned progressives are this week saying, "So what? We don't work in the White House. His political fortunes aren't our concern."

But how about the dozens of other issues that are of concern to progressives? If health-care reform dies, the Democrats will be pummeled in 2010, just as they were in 1994 when Clinton's bill went down. Failure breeds failure. The 12 years that followed that shellacking were dark times for progressive ideas. Any liberal who wants to risk going back to that era should have his head examined.


Paul Krugman

A message to progressives: By all means, hang Senator Joe Lieberman in effigy. Declare that you’re disappointed in and/or disgusted with President Obama. Demand a change in Senate rules that, combined with the Republican strategy of total obstructionism, are in the process of making America ungovernable.

But meanwhile, pass the health care bill.


Ronald Brownstein (took a bit of a cheap shot at the start of his article, which, even though I'm mad at the Bill Killers, wasn't cool)

Minorities don't seem to have much doubt about their investment in this debate. In November's Kaiser Family Foundation health care tracking poll, two-thirds of non-white Americans said that their family would be better off if health care reform passes. Though the evidence suggests that non-college whites could also receive a disproportionate share of the bill's spending (since they constitute more of the uninsured), they are dubious: just one-third of them believe they would be better off, a reflection of the mounting skepticism about government such blue-collar whites are expressing across the board. Yet the most skeptical group is the college-educated whites, the same constituency that has the most access to health insurance today: only about one-fourth of them expect to be better off under reform.

Against the backdrop of those attitudes, it's instructive to compare Dean's blithe disregard for the Senate bill to the more measured and sensible tone that Andy Stern, president of the Service Employees International Union, struck when he held a teleconference Thursday to discuss the debate. Stern recapitulated the concerns that many on the Left hold about the bill--the adequacy of the subsidies for the uninsured, the bite of the "Cadillac" tax on high-end insurance plans. But Stern also insisted: "We can't just focus on what we don't like--it's the largest expansion of coverage since Medicare, it's the largest expansion in Medicaid; with the bill it would make things way better than what our current system does, for our members at least."

Stern didn't commit to endorsing the final bill, but he pointedly refused to join Dean in urging the Senate to tear up its work. Stern can't surrender to the vanity of absolutism because he represents a predominantly lower-income and minority constituency with a tangible stake in the outcome of this epic legislative struggle--not only for themselves but for their relatives, neighbors and friends. For much of the constituency that Dean and the digital Left represent, by contrast, the health care debate may be largely an abstraction--just another round in their perpetual struggle to crush Republicans and ideologically cleanse the Democrats.


David Weigel (posted the same paragraph about Minority support for HCR, then followed up with this dark little warning):

A plugged-in Virginia Democratic strategist told me, after Creigh Deeds’s bumbling gubernatorial campaign came to an end, that there was a tide shift when Deeds appeared to say he would opt the state out of a public option if it passed the Senate. Black voters, especially, wanted health care to pass — it made it tougher to get them out to vote for Deeds when he said that.

MSNBC: President Obama (somewhat angry) Speech at Copenhagen (VIDEO)

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Andrew Sullivan: Reader Jokes...

Oh, this was friggin' hysterical:

Young Chuck moved to Texas and bought a donkey from a farmer for $100. The farmer agreed to deliver the donkey the next day. The next day the farmer drove up and said, 'Sorry Chuck, but I have some bad news, the donkey died.'

Chuck replied, 'Well, then just give me my money back.'

The farmer said, 'Can't do that. I went and spent it already.'

Chuck said, 'OK, then, just bring me the dead donkey.'

The farmer asked, 'What ya gonna do with a dead donkey?

Chuck said, 'I'm going to raffle him off.'

The farmer said 'You can't raffle off a dead donkey!'

Chuck said, 'Sure I can. Watch me. I just won't tell anybody he's dead.'

A month later, the farmer met up with Chuck and asked, 'What happened with that dead donkey?'

Chuck said, 'I raffled him off. I sold 500 tickets at two dollars apiece and made a profit of $898.00.'

The farmer said, 'Didn't anyone complain?'

Chuck said, 'Just the guy who won. So I gave him his two dollars back.'

Chuck now works for JP Morgan.

Stupid Blog Posts...Part 345

This morning Miles Mogulescu wrote a post for Huffington Post (rapidly becoming a joke in my eyes) entitled: Fire Robert Gibbs...Or At Least Make Him Apologize to Howard Dean.

Look, if Mogulescu wants to defend Howard Dean and rip on the White House's attack on Howard Dean, fine. I disagree with it. I'm not wild about the White House making a target of Howard Dean. (I'm also not sure, this isn't part of a larger strategy to mollify Conservative Democrats, but that's waaaay too Machevellian.)

But that's not what makes this a stupid blog post.

The Press Secretary is does not craft the White House's communications strategy. Robert Gibbs merely is the spokesman, the mouthpiece. The guy actually crafting the communications strategy...and thus telling Robert Gibbs to take a shot at Howard Dan Pfeffier, also known as the White House Communications Director. If Mogulescu wants to call for someone's firing (which is stupid it and of itself), he should be calling for Pfeffier's head, not Gibbs.

In the long view, it's a tiny, nit-picky error...but at the same time, we don't live in an age where we can afford nit-picky errors. If we're going to argue about Policy and Politics, we need to understand how they both work.

The Fireside chat for December 19, 2009

The President looks back to the bipartisan Patients Bill of Rights, a bill that was defeated in Congress at the hands of special interests and their supporters, and notes that health insurance reform covers the same ground and much more in terms of giving the consumers the upper hand over their insurance companies. He calls on the Senate to allow an up-or-down vote, and for those opposing reform to stop using parliamentary maneuvers to drag it out.

Thursday, December 17, 2009

If you want to get something...

Randi Rhodes talked to Sen. Tom Harkin (D-IA), and got the Senate Conferees. These are the dudes (and in this case, I mean that literally) who'll be in there with the House Delegation, creating the Conference Report for the final Senate Health Bill, aka the one last chance to make the HCR Bill better.

The conferees are pretty much who I'd expect: Harkin, who's on the Senate HELP Committee; Sen. Chris Dodd (D-CT), also on the HELP Committee, Max Baucus (D-MT), and of course Harry Reid (D-NV).

Overall, this is pretty good news in that three of the four are pro-Public Option in their thinking (though Max Baucus wanted to include it, but couldn't get a Chairman's Mark out of Committee with it).

Does this mean one more chance for the Public Option?

Uhhh, probably not.

Conference Reports, unfortunately, can be filibustered, so the more odious parts of the Senate Bill (aka, the stuff that makes it suck) are probably going to have to remain.

So, does that mean Nancy has to show up and and just take everything the Senate throws at them? Not necessarily.

If I'm Nancy Pelosi, there are a few main areas I'd concentrate on. Can't bring back the Public Option, bring back this stuff and she'll go a long way to easing the hurt in the House. They are:

  1. Improve the Subsidies for working families. These have gotten less generous as the Senate Debate has gone on. The more money, the better in this case.
  2. Improve the Timeline to get the good stuff out the door faster. One of the things delaying implementation of HCR until 2014 is deficit concerns. Moving the schedule up means increasing strains on spending. If the GOP is against this anyway, even with Spending limits, I don't see the need to acquiesce on making the bill deficit neutral in the near term. As long as its deficit neutral over the ten year period, the President keeps his promise. This is both good policy and good politics.
  3. Improve the cost controls. Ironically, the Medicare Commission (one of the controls) might get strengthened in the Senate Bill, and strengthed by Traitor Joe (it's what he was talking about when Al Franken smacked him down). But more is always welcome.
No big surprises. All pretty basic stuff.

Looking to the Aftermath...

At the minimum, President Obama needs some face time with the people he's pissed off. I think that means a sit down interview with Keith Olbermann. (Yes, I'm still pissed at him for last night, but that doesn't mean he doesn't have issues that should be addressed, so don't cut him off). Face time in the Oval Office with Howard Dean. And I think a town hall at Yearly Kos wouldn't be a bad idea either, and yeah Kos should moderate.

This isn't about changing minds, it's about airing out...and not in a nasty or "screamy" way. I think the President should let what I'll call the Angry Left (for shorthand's sake) get a chance to speak their mind (underline: speak).

It's the kind of thing that wouldn't have happened under Bush.

Think Progress: "at the end of the day when what emerges from the piranhas’ den is better than nothing..."

The philosophizing has started. Can't tell if that means we're nearer to the end of this intra-idelogical squabble.

Today, it's Matthew Yglesias (of the Center for American Progress):

The question is where does this analysis lead you. The smarter brand of rightwinger I know believes—or at least professes to believe—that the corrupt nature of the political process means that any effort to seriously remediate social problems through public action is doomed. Therefore, the best thing one can do politically is nothing. Or perhaps cut the minimum wage.

Another place it can lead you is the place where Kevin [Drum -- of Mother Jones] and I are. You complain about this stuff. And complain and complain and complain. And fight and fight and fight. And at the end of the day when what emerges from the piranhas’ den is better than nothing, you say yes and live to fight another day. I think if you read Andy Stern’s letter you’ll see that’s what he’s saying too.

But the place where I think it can’t lead you is the place where I think a lot of the people on the left want to go. That’s a place where you’re so shocked and horrified by the corruption of the system that you think that if you can persuade two or three left-wing senators to say “no” that suddenly a better legislative product emerges. If you think that’s going to happen, you should spend some time reading Glenn Greenwald posts about how screwed up Washington is.

When even Paul Krugman is saying pass the damn thing...

Paul Krugman has been one of the...well, better critics of the Administration. I've spent my days wincing at some of his commentary. I've spend my mornings growling at what he said, even with an occasional "what the @#$%, Paul??"...

...but in the end, I still read him. (The man's a !@#$%ing PhD and Nobel Prize winner in Economics, for pity's sake. I read Galbraith because of him. I might read Keynes because of him.)

If I have to put a finger on how I feel about him is, he's an incredibly smart man with very a literate temper. I can feel the frustration oozing off the page at times. (A not-so-veiled "Oh my God, you really don't get it" tone that I often hear from Professors -- you hear that, Dad?).

I think his Math is impeccable, and the predictions connected to them are unusually on the mark, at least in the neighborhood. (So far, he was wrong that the Stimulus wasn't big enough to turn around the economy, but right that it was small enough lead to a jobless recovery.) I don't think he gives as much acknowledgment to Political realities as he should (see: frustration), but he will acknowledge when he's made a mistake.

And I also love his acknowledgment of the "shit sandwich" concept (no, he doesn't use those exact words, but you'll get what I mean), of which the Senate Health Care Bill is one:

Health care and Iraq

Steve Benen is right: for the most part the debate among progressives about whether the final product on health reform is worth supporting has been edifying. Serious people are making serious arguments, in a way that puts conservatives, who have offered nothing but smears and lies, very much to shame.

That said, some of the arguments here annoy me — in particular the line I’ve been hearing from some quarters that progressives who say we should hold our noses and pass the flawed Senate bill are just like the “liberal hawks” who supported the Iraq war.

No, they aren’t. And I don’t say that just because, as it happens, I stuck my neck way out in opposing Iraq, and was more or less the only columnist with a spot in a major newspaper to say outright that the Bush administration was misleading us into war.

Look, I don’t know for sure what motivated the liberal hawks; you’ll have to ask them. Some, I hope, were genuinely naive: despite all the signs that we were being sold a bill of goods, they just couldn’t believe that an American president would start a war on false pretenses. Others, I suspect, were being careerists, aligning themselves with where the power seemed to lie; sad to say, their career calculations were justified, since to this day you’re generally not considered “serious” on national security unless you were wrong about the war.

What’s going on with health care is very different. Those who grudgingly say “pass the thing” — a camp I have reluctantly joined — aren’t naive: by and large they’re wonks who have looked at the legislation quite carefully, understand both its virtues and its flaws, and have decided that it’s a lot better than nothing. And there isn’t much careerism involved: if you’re a progressive pundit or wonk, the risks of alienating the people to your left are at least a match for the risks of alienating people to your right.

Now, the pass-the-thing people could be wrong. Maybe hopes of improving the new health care system over time, the way Social Security has been improved, will prove to have been fantasies; or maybe rejecting this bill and trying again, a strategy that has failed many times in the past, would work this time. But it’s a carefully thought-out, honest position. And arriving at that position has, in my case at least, required a lot of agonized soul-searching.

And maybe I’m being unfair, but I don’t seem to see the same degree of soul-searching on the other side. Too much of what I read seems to come from people who haven’t really faced up to what it will mean for progressive hopes — not to mention America’s uninsured — if health care reform crashes and burns, yet again.

This is a moment of truth; it’s not a time for cheap shots or name-calling.

Nate: Answers to the 20 Questions...

Nate Silver posted 20 Questions for Bill Killers yesterday, and actually got some cogent responses from Markos Moulitsas (DK) at Daily Kos and Jon Walker (JW) at FireDogLake (two of my least favorite Liberal sites, BTW), but still they stepped up and answered.

Didn't answer particularly well, in my opinion (for reasons that will be made clear later). Didn't answer clearly at times, but they answered. And there does seem to be a desire in this intra-Liberal split to keep things civil in some parts.

Nate put up a very good (but very long) posting at his website. Since I don't feel like crashing my site, I'll just link to it. And I can already see a response to Nate's responses coming in short order.

Still, I feel a need to put up some of Nate's highlights:

One of the fundamental rules of political forecasting is never say never -- miracles, or at least things that seem like miracles beforehand -- can happen occasionally. But it would probably take a miracle to get any sort of marginally robust public option into the bill. At least 2-4 senators have stipulated outright that they'd vote to filibuster such an effort, have been saying so for months, progressives have no obvious leverage over them. Blanche Lincoln will not be unhappy if liberals block the bill; she'll be thrilled that she doesn't have to make a no-win vote and can blame Bernie Sanders or Roland Burris or the SEIU for her troubles. I don't know how many times you can bang your head against the wall before this sinks in. It's not like liberals haven't tried everything in the playbook to get a public option into the bill; they've been both dogged and creative in their pursuit of one. It hasn't worked.


I don't like the insurance companies either; I'd gladly get rid of them and replace them with single payer. But the industry's profits are low: only about 3.3%.

And the evidence that the insurance industry would benefit from this bill on balance -- on either a marginal or an aggregate basis -- is almost completely lacking. Jon's point that "insurance stocks have gone up dramatically with each day of bad news for the public option" [emphasis mine] is absolutely correct -- I have observed this as well. But my question is how insurance company profits would respond to a public-option-less bill versus the status quo.


I don't know how people can still be arguing that the individual mandate isn't necessary. If you don't have a mandate but require insurers to cover people with pre-existing conditions, you get extreme adverse selection and possibly even a death spiral.

Indeed, this why it's so hard to do incremental health care reform. If you want to cover people with pre-existing conditions, you need an individual mandate or everyone will be furious that their premiums have gone up. But if you have an individual mandate, you had better have subsidies to help poor people to afford the coverage.


The notion that only Blue Dog seats are endangered is flat wrong. There's almost no way that Democrats will end up with more votes for a public option at any point in the near future -- keep in mind that the House passed its bill, which had only a mediocre public option, by just about the bare minimum of votes.


There's also the idea, which Jon has advanced, of using the reconciliation process for some parts of the bill but not for others. It's a creative idea, but I don't see how it works, since it's not like you can keep this a secret from people. If you plan to pass certain provisions under reconciliation so as to circumvent Ben Nelson, it seems to me nearly certain that Ben Nelson would counter-circumvent you by filibustering the parts of the bill that you attempted to pass under regular order. So you'd still end up with half a loaf -- although maybe a different half than you might have otherwise.

Now, I certainly do think the Democrats would have some chance of passing portions of the bill under reconciliation in 2011; in that case you wouldn't have this transparent bait-and-switch with the moderates and could claim that you'd received a new mandate from the public.


For starters, you're going to lose any senator who is already looking for an excuse to vote against health care reform -- meaning Lincoln, Lieberman, Nelson, Landrieu. You're going to lose a couple of process hawks -- Byrd, probably Conrad, probably Bayh, maybe Feingold. There are far short of 50 enthusiastic votes for the public option -- there are closer to about 43, and that includes a couple of the process hawks. The odds of getting to 50 votes under reconciliation would seem to be about 60/40 at best.


The point is, at this point I don't think they've been directing their focus in ways that optimize the progressive-ness of the health care bill. But, as both Markos and Jon imply, that might not be the point. Rather, progressives are fighting a sort of proxy war over the public option -- as a way to exert their influence and authority. This is where I've always parted ways with the strategy -- I think health care is too important an issue to use as a demonstration of one's authority. What might be better? Financial reform would be one answer. But obviously, the cat is way out of the bag now on the public option and people have become vested in their positions.

Let me state for the record, even though I'm a Liberal, I can't stand Markos Moulitsas. I feel he lets his ego run amok at times. I think his positions are based in his belief in the superiority of his political wisdom, which of course I think he vastly overrates. I think he's a reason to fast foward through Countdown with Keith Olbermann.

That being said, you can't knock what he's accomplished, with DailyKos or anything else (he is a Veteran, after all). I feel much the same way about FiredogLake in general.

I've never read anything of Jon Walker's (at least I don't remember reading anything of Jon Walker's). That's not a swipe at him, it's on me. I certainly may have, but I don't personally recall his byline.

If you were to make a checklist of political positions, I'd probably agree with 98% of what these guys want and believe in (the one area of disagreement is probably Afghanistan).

Where we really diverge is in the area of is tactics, and the results they produce. I'm willing to sacrifice some of my agenda to get something done. They're not. Fine, a split on that area can actually be quite healthy.

But I also believe in fixing the damn problem at the end of the day (for those of you who remember the movie Disclosure). I believe that Liberal solutions are always preferable...but they're not an absolute. If a Conservative idea fix the damn problem, fine. I'm not so tied to ideology that I believe we're the only ones with good ideas in this Country. Despite what Kos and Walker think, not all of our ideas have worked in the past.

I also feel (as Nate suggested) that this is more about getting a pound of flesh fro the Republicans more than it is fixing said damn problem.

We just went through eight years of a rotten President, who thought that Government ended and began with the Executive Branch. Bush has become an epithet. A symbol of all that is wrong and evil in the country. In fact, you saw the President's Afghanistan speech being denigrated by calling it "Bushian".

But now, when cornered, my fellow Progressives want Obama to act like Bush.

Steamrolling was bad...when it was against us. Now that we need something, it's okay to steamroll Republicans.

I thought Obama was going to behave differently (he has). I thought we wanted him to behave differently.

So much for that.

Wednesday, December 16, 2009

Keith's Low Point (VIDEO)

This was, without a doubt, the most ill-informed Special Comment Keith's ever delivered.

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There's a lot of reason to be pissed, but to argue against the Individual Mandate is insane. Worse, its demonstrably bad policy.

And yes, the argument that I make is from a person that Keith has had on his show multiple times. Yet, when it came to making his argument, instead of bringing on people that'd push back against his notion, Keith cleared the deck for his Special Comment by bringing on only Bill Killers -- with the possible exception of Anthony Weiner.

Where were Keith regulars? Where was Jonathan Alter? Where was Senator Sherrod Brown (D-OH), or Ron Wyden (D-OR). I'll grant you that Jay Rockefeller (D-WV) was on MSNBC earlier in the day, so Keith wouldn't want to step all over that interview. But he's had Erza Klein on, he's had Jonathan Cohn on. Both of them would have told Keith to his face, that he's out of his freaking mind.

Instead we had all Bill Killers.

And if there is a Primary Challenger to this President, as Keith cavalierly suggested, not a few people are going to suggest race is involved. (Yes, even for white does happen).

You're trying to tell me that a (white) President going into re-election with whispers of a sex scandal hanging over his head doesn't deserve a Primary Challenge, yet a (black) President who couldn't move an intractable Congress deserves one.

'In spite of all!'

Erza recommended reading this paragraph in regards to HCR. I'd figured I'd save y'all the trouble and quote it directly:

Politics is a strong and slow boring of hard boards. It takes both passion and perspective. Certainly all historical experience confirms the truth--that man would not have attained the possible unless time and again he had reached out for the impossible. But to do that a man must be a leader, and not only a leader but a hero as well, in a very sober sense of the word. And even those who are neither leaders nor heroes must arm themselves with that steadfastness of heart which can brave even the crumbling of all hopes. This is necessary right now, or else men will not be able to attain even that which is possible today. Only he has the calling for politics who is sure that he shall not crumble when the world from his point of view is too stupid or too base for what he wants to offer. Only he who in the face of all this can say 'In spite of all!' has the calling for politics.

Top Ten Benefits coming out of HCR

This is from John Podesta, following up on Ezra Klein's post.

Sorry fellow Progressives, more grown folk's business:

All of us are anxious to see the final language from the Senate. And a final bill must ensure that the subsidies provided are sufficient to make insurance truly affordable for working families. But based on what we know, here are my top ten reasons for why progressives should support the Senate passing the bill:

1. Largest Expansion Of Coverage Since Medicare’s Creation: Thirty-one million previously uninsured Americans will have insurance.

2. Low/Middle Income Americans Will Not Go Without Coverage: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill’s provisions will ensure that working class Americans will no longer go without basic health care coverage.

3. Insurance Companies Will Never Be Able to Drop or Deny You Coverage Because You Are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can’t rescind coverage or impose lifetime or annual limits on care. Significantly, the bill also ends insurer discrimination against women — who currently pay as much as 48% more for coverage than men — and gives them access preventive services with no cost sharing.

4. Lowers Premiums For Families: The Senate bill could lower premiums for the overall population by 8.4%. For the subsidized population, premiums would decrease even more dramatically. According to the CBO, “the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law.”

5. Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.

6. Insurers Can’t Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer sell subprime policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.

7. Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill’s state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.

8. Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that affected 3.4 seniors enrolled in Medicare Part D in 2008.

9. Reduces The Deficit: Not only would the bill expand coverage to 30 million Americans without adding to the nation debt, it would also reduce the deficit by up to $409 billion over 10 years.

10. Reduces National Health Spending: A CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years – with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019.

Ezra Klein explains the Individual Mandate...

Ezra Klein wrote a brilliant post today, pushing back on one of my fellow progressive's more popular claims: that the Senate Health Care Reform would be okay if they just got rid of the individual mandate.

One of the many things that drew me to Barack Obama during the 2008 Campaign was his opposition to an individual mandate. (Hilliary if you remember, supported one). All that meant to me was that Heidi was gonna be made to buy Health Insurance, and I wasn't down with that.

Now, I've since learned...since watching the Health Care debate is that then-Senator Obama was wrong about the Individual Mandate, and so was I:

Erza, thus, presents the reasons:

The importance of the individual mandate

Markos Moulitsas explains his opposition to the Senate bill, and says it all comes down to the individual mandate. "Strip out the mandate," he says, "and the rest of the bill is palatable. It's not reform, but it's progress in the right direction. And you can still go back and tinker with it at a later time."

I'm sympathetic to his thinking. This was, of course, Barack Obama's position during the 2008 campaign, and it led toarguably the most bitter policy dispute in the race. But after winning the presidency, the Obama administration flipped on it, and they were right to do so. Here's why.

Pick your favorite system. Socialized medicine in Britain. Single-payer in Canada. Multi-payer with a government floor in France. Private plans with heavy public regulation in Sweden, Germany and elsewhere. None of these plans are "voluntary." In some, there's an individual mandate forcing you to pay premiums to insurance companies. In some, there's a system of taxation forcing you to pay premiums to the government. In all of them, at least so far as I know, participation is required except in very limited and uncommon circumstances. And there's a reason for that: No universal system can work without it.

Holding the price of insurance equal, insurance is gamble on both sides. From the insurer's perspective, it's a better deal to insure people who won't need to use their insurance. From the customer's perspective, it's precisely the reverse.

Right now, the insurer sets the rules. It collects background information on applicants and then varies the price and availability of insurance to discriminate against those who are likely to use it. Health-care reform is going to render those practices illegal. An insurer will have to offer insurance at the same price to a diabetic and a triathlete.

But if you remove the individual mandate, you're caught in the reverse of our current problem: The triathlete doesn't buy insurance. Fine, you might say. Let the insurer get gamed. They deserve it.

The insurers, however, are not the ones who will be gamed. The sick are. Imagine the triathlete's expected medical cost for a year is $200 and the diabetic's cost is $20,000. And imagine we have three more people who are normal risks, and their expected cost in $6,000. If they all purchase coverage, the cost of insurance is $7,640. Let the triathlete walk away and the cost is $9,500. Now, one of the younger folks at normal cost just can't afford that. He drops out. Now the average cost is $10,600. This prices out the diabetic, so now she's uninsured. Or maybe it prices out the next normal-cost person, so costs jump to $13,000.

This is called an insurance death spiral. If the people who think they're healthy now decide to wait until they need insurance to purchase it, the cost increases, which means the next healthiest group leaves, which jacks up costs again, and so forth.

Kill the individual mandate and you're probably killing the bill, too. The mandate is what keeps average premium costs low, because it keeps healthy people in the insurance pool. It's why costs have dropped in Massachusetts, not jumped. It's why every other country with a universal health-care system -- be it public or private -- uses either a mandate or the tax code. It's why the Obama administration flip-flopped.

But maybe you're willing to ditch universality. Add some subsidies, leave the mandate, and it's a step forward, right? At least until the project is consumed by an insurance death spiral? And Congress will surely do something to stop that, right? Well, maybe.

Kill the individual mandate and you make it easy for Congress to let the country backslide to its current condition. In a world with an individual mandate, insurance has to be affordable. If it's not, there's a huge political backlash. That gives Congress a direct incentive to focus on cost. Remove the individual mandate and ... eh. If insurance isn't affordable, people simply go uninsured. It's exactly what happens now. Same incentives, or lack thereof, to make the system better.

In his post, Markos says the bill lacks "mechanisms to control costs." I'd disagree with that, pointing to the bundling, MedPAC, the excise tax, the possibilities of a competitive insurance market, and more. The bill doesn't do enough, but it does more than anything we have ever done before. But put that aside for a moment. As Atul Gawande argues, there's no Big Bang of cost control. The public option wouldn't have done it, and nor would Medicare buy-in. It's a process. And this bill, in large part through the individual mandate, creates that process.

The key to cost control is a politics that forces Congress to make the hard decisions that lead to cost control. Right now, the ranks of the uninsured grow, the cost of insurance rises, and Congress can pretty much ignore the whole thing. The individual mandate controls average premium costs, but more than that, it is the political mechanism for cost control. Kill it, and you've killed our best hope of making the next reform better than this one.

Nate: 20 Questions for Bill Killers...

Wow. Nate's just as pissed as I my fellow progressives.

1. Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?

2. Would a bill that contained $50 billion in additional subsidies for people making less than 250% of poverty be acceptable?

3. Where is the evidence that the plan, as constructed, would substantially increase insurance industry profit margins, particularly when it is funded in part via a tax on insurers?

4. Why are some of the same people who are criticizing the bill's lack of cost control also criticizing the inclusion of the excise tax, which is one of the few cost control mechanisms to have survived the process?

5. Why are some of the same people who are criticizing the bill's lack of cost control also criticizing the inclusion of the individual mandate, which is key to controlling premiums in the individual market?

6. Would concerns about the political downside to the individual mandate in fact substantially be altered if a public plan were included among the choices? Might not the Republican talking point become: "forcing you to buy government-run insurance?"

7. Roughly how many people would in fact meet ALL of the following criteria: (i) in the individual insurance market, and not eligible for Medicaid or Medicare; (ii) consider the insurance to be a bad deal, even after substantial government subsidies; (iii) are not knowingly gaming the system by waiting to buy insurance until they become sick; (iv) are not exempt from the individual mandate penalty because of low income status or other exemptions carved out by the bill?

8. How many years is it likely to be before Democrats again have (i) at least as many non-Blue Dog seats in the Congress as they do now, and (ii) a President in the White House who would not veto an ambitious health care bill?

9. If the idea is to wait for a complete meltdown of the health care system, how likely is it that our country will respond to such a crisis in a rational fashion? How have we tended to respond to such crises in the past?

10. Where is the evidence that the public option is particularly important to base voters and/or swing voters (rather than activists), as compared with other aspects of health care reform?

11. Would base voters be less likely to turn out in 2010 if no health care plan is passed at all, rather than a reasonable plan without a public option?

12. What is the approximate likelihood that a plan passed through reconciliation would be better, on balance, from a policy perspective, than a bill passed through regular order but without a public option?

13. What is the likely extent of political fallout that might result from an attempt to use the reconciliation process?

14. How certain is it that a plan passed through reconciliation would in fact receive 51 votes (when some Democrats would might have objections to the use of the process)?

15. Are there any compromises or concessions not having to do with the provision of publicly-run health programs that could still be achieved through progressive pressure?

16. What are the chances that improvements can be made around the margins of the plan -- possibly including a public option -- between 2011 and the bill's implementation in 2014?

17. What are the potential upsides and downsides to using the 2010 midterms as a referendum on the public option, with the goal of achieving a 'mandate' for a public option that could be inserted via reconciliation?

18. Was the public option ever an attainable near-term political goal?

19. How many of the arguments that you might be making against the bill would you still be making if a public option were included (but in fact have little to do with the public option)?

20. How many of the arguments that you might be making against the bill are being made out of anger, frustration, or a desire to ring Joe Lieberman by his scruffy, no-good, backstabbing neck?

Empty Rhetoric...

Michael Moore and Rep. Rosa DeLauro (D-CT) both call for Joe Lieberman's recall.

One problem...

Memo to Michael Moore and any other frustrated lefties out there: There is no such thing as a Congressional recall. So until 2012, we're all stuck with Joe.