How the Democrats are screwing up healthcare reform

With major healthcare reform sputtering as the clock runs out on the current session on Capitol Hill, it's tempting to blame the Republicans for what appears, for now, to be the failure of the 111th Congress to deliver on 60-odd years of trying to get universal healthcare for Americans, the way every other (and we often assume lesser) Western power has managed to do. After all, Republicans (and some top Democrats) are being paid handsomely in the way of campaign cash from the major pharmaceutical, insurance and medical lobbies to stop any attempts to reform a system that is making them very, very rich. But blaming the GOP is too easy. The "Party of No" is doing exactly what it's supposed to do -- stopping reform any way it can, serving the well-to-do, and using whatever scare tactic and underhanded scheme to convince the easily duped that they really, really, do love the claim-denying, coverage-dropping, premium-raising insurance companies currently standing between them and their doctor. Democrats, on the other hand, are supposed to know better. The party of JFK, RFK and TeddyK, was supposed to be able to deliver once it finally got control of both houses of Congress. That's the meal we were sold in 2006, and well ... it's 2009, and the table's looking pretty damned empty (and not just on healthcare -- ditto on anything to do with investigating lawbreaking by the former administration.)
So why can't the Democrats get their act together and get health reform done? I'll give you five reasons.
1. Democrats don't know how to wield power. If there were 60 members of the Republican Senate caucus instead of 60 Democrats, Republicans held 59% of the House, and a Republican president wanted something done -- no matter how ridiculous -- would we even be having this conversation? One-word answer: Iraq. The fact is, even with sliding poll numbers, Americans still trust President Obama and Democrats far more than they do Republicans when it comes to healthcare. But you wouldn't know it from the media coverage, or from the way Democrats shape their own narrative. Democrats seem terrified of embracing the very progressive ideas Barack Obama got elected with: including the public option. The minute Republicans swipe at it as "government healthcare," the entire Democratic caucus, with a few exceptions, seems to shrink, measurably.
2. Harry Reid is a wuss. If Nancy Peolosi was running the Senate instead of the House, would a handful of "blue dog" Democrats be able to dominate and stymie the process as effectively as they have? To be sure, Pelosi has blue dog headaches of her own, but her leadership style seems heavier handed than Reid's, and in the game of herding cats that is politics, it also seems to be more effective than Reid's gentlemanly bargaining and begging. (Senate Democrats are so loath to play hardball, they have all-but abandoned the budget reconciliation option, giving the wee Republican minority the power to block any reforms -- think Republicans would have hesitated to use whatever parliamentary tool they could in order to do George W. Bush's bidding?)
3. Democrats have no message. The president has a message (at least I think he does...) Liberals have a message (universal care, public option, or else.) Moveon has a really poorly done message (something about a spiraling football.) The DNC has the tired Harry and Louise routine and a lot of warm, fuzzy talk about how this is "gonna get done" (nicely, but who the hell knows how.) And the blue dogs have a message, too ("the insurance companies won't let me.") But the party as a whole looks about as organized as a squirrel Olympics. They're all over the place, while the Republicans have been very effective at using variations on a simple theme that's designed to scare the hell out of people: "'government run' healthcare will destroy our democracy, outlaw your doctor, and kill your grandma." Would it kill my party to remind the public that the post office is the public option on mail delivery, and not only does it work out pretty well in getting you your mail every day, it hasn't yet killed off FedEx or UPS? ... or to put out a simple ad saying:
"In the healthcare debate, the Republican Party has taken the side of the insurance companies. The same companies who deny claims, drop coverage for the sick and elderly, and refuse to cover people with pre-existing conditions. The president wants health coverage for all Americans, at an affordable cost. Call your Senator or Congressman today, and ask them. Whose side are you on?"
4. Some Democrats are a lot like Republicans. Go through the CREW list of who got what from big pharma, big insurance, and the major medical interests, and there you'll find our friends the blue dogs, plus an ample share of the Democratic leadership. Some Democrats are in such hawk to the insurance-medical lobby, they might as well switch parties, and their decisions on reform, particularly the public option, are driven largely by insurance industry concerns, possibly dooming the public option. Some of them even admit it.
5. Like a first-time film director, the Obama administration appears to have lost control of the set, the script, the actors and the extras. With healthcare, as with the stimulus bill, Democrats appear to be frantically running amok, trying to find places to stuff cherished ideas from the '80s that they weren't able to get done because they didn't have the White House, or which died during the 90s because of Bill Clinton's personal chaos. And now that they do have the whole government, theoretically, and having kowtowed to George W. Bush for eight years, Hill Dems have discovered that they want to be the first branch of government after all. The fact that the Congressional circus, rather than the cool discipline of the Obama administration, is the prevailing narrative is a sign that Team Obama has dropped a very major ball. If the president wants to salvage healthcare reform, he needs to grab the reins, state in detail of what ideas he wants to see in a plan (consumer protections? fine. public option? Great! employer mandates? whatever. man, just tell us what you want!...) Then, Obama needs to determine the message, impose some discipline, and put that wild donkey of his in check. In fact, with Democrats and Republicans mercifully heading out of town, August is just the time to do it.
Cross-posted at The Reid Report.


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Comments
Case in point - Senator Arlen Spector. The man was a Republican for fifty years, and now since Pennsylvania has become a "blue" state, he switches over to Democrat. Our system of government is being undermined by the corporations and lobbyists, and I don't know if Obama has the will or the power to change this repugnant state of affairs.
RATED
- rated & believing it will happen!
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Regarding the health care policy reform fight, the endless election campaign season is a big part of the problem. We elect a president for four year terms, but the DC political warfare culture reality is that he/she has but one -- the initial year -- to accomplish anything substantive, because the legislatively distracting mid-term elections campaign season draws nigh thereupon, and close on the heals of that comes the ever-lengthening acute phase ramp-up for the presidential re-election campaign. Now, either the incumbent gets re-elected, whereupon he/she is increasingly viewed as a "lame duck" who must quickly (i.e., in a year or less) "spend" what little "political capital" remains, or, alternatively, a new President comes in. Back to square One. Lather, rinse, repeat.
Consequently, we have the problematic rush to get large-scale "reform" passed during year one -- with the tactically expedient opposition pushback to delay it long enough to effectively kill it.
So, we really just get presidential policy leadership potential for only one year out of four. But, we pay for all four.
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The Dems need tit for tat responses to each salvo the industry funded naysayers launch. When Republicans say "government bureaucrats between you and your doctor" the Dems need to counter, loudly, with "corporate bureaucrats between you and your doctor." And so on.
At the moment, we are on track for reform too diluted to bear the name. And delays are killing us.
I think I need a margarita.
So - if your point is that the dems are not doing that -- well then that is a totally other story all together and -- like most politicians - I recommend they get their behinds to a few film festivals and see how the real guys work - and steal the show!
folks, politicians work for themselves, just like you. in the usa, that means they keep the corporations happy ahead of the voters.
you want a better result? get a better system. but that's too hard for you, so just go on complaining. democracy? you don't even know you haven't got it.
[relevant provisions of the bill in my blog post]
...What will be the bureaucratic FTE necessarily devoted to determining compliance with the myriad foregoing provisions? How many childhood immunizations, annual checkups, MRIs, arthroscopic surgeries, splints, and rounds of chemo and radiation would these FTE otherwise pay for?
See my current blog post update.
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I used the filmmaker example because I'm in post production on a documentary, and the metaphor was just handy :) While there are a lot of first timers who do great work, before they get there they obviously direct smaller films. But I have been on sets, as I'm sure you have, where a young helmer doesn't yet have the sea legs to juggle all the egos and more experienced people around them. Not a dis to filmmakers at all. In fact, love them!
Thanks for the comment, and would love to read your articles! Email me a link or two if you get a chance!
Best
Joy
My favorite conversation on health care as of late, was on the John Stewart show. Stewart trapped a FOX news commentator into raving about the incredible health care that vets get through VA hospitals. It was a perfect lead in for Stewart to contradict him with his stance against gov't run health care for all. The guy was speechless, looked foolish, and it was golden.
great post as always