Obama’s healthcare deal to pass with a squeak….

One thing is obvious this St Patrick’s Day: very few people in Washington are thinking about Ireland, north or south. Obama’s healthcare bill is the only thing people are talking about. The general perception (ie from both left and right is that Obama has been strangely passive. Past Presidents have be active in writing law and then offering it to Congress to rip up, or disagree with. In this case, President Obama has delegated much of the initial drafting to Congress. The bill before them now has striped out a lot of the more controversial provisions, like the possibility of state funded abortions. But it has annoyed some Democrats that their leadership in Congress has agreed to abandon a public option (meaning all government will flow into the expensive private system) or an expansion of Medicare. Jane Hamsher:

The Senate bill isn’t a “starter home,” it’s a sink hole. It needs to die so something else can take its place. It doesn’t matter whether people are on the right or the left — once they understand the con job that’s about to be foist upon them, they agree.

That might be the sensible thing to do. Except, that US politics seems to be even more locked down than our own little regional affair in Stormont.

If and when Congress clears healthcare out of its inbox, the mid term elections will dominate the minds of the mainstream press and the US’s vast army of voluble bloggers. Yep, just over a year after the Obama ‘audacity of change’ election, the Democrats in the House (along with a third of the Senate, and a collection of Mayoral and gubernatorial contests now face a ‘throw the bums out’ election (in a poll released by NBC last night, 50% of US voters said they would vote out their congressman) in November.

Back in 1993, when Bill (and Hillary) Clinton tried and failed to get medicare reform through Congress had a trust rating of 70%. Now, according to the NBC poll (PDF copy), it is down to 17%.

The vicious culture wars that has slowly asserted its grip on US politics (and which once Obama promised he would bring to an end) seems to have trashed the bipartisanship that once allowed the US federal government to actually pass some law. Although getting a majority in the House works, it is not good enough to pass a bill in the Senate. When the Democrats lost Ted Kennedy’s old Massachusetts seat to Scott Brown, they definitively lost their filibuster-proofing.

In Washington, it seems, it is the game that counts, not the policy. A few weeks back (before he declared himself a candidate in the Democratic primary in California, Mickey Kaus argued that:

For months, both GOP and Fox hosts have been talking about socialized medicine and death panels and vicious Medicare cuts and the government coming between you and your doctor, etc. If Democrats pass the bill and none of this happens, Republican opponents will be more than defeated. They’ll be discredited.

But as PoliticsDaily notes:

Where the quandary comes in for Democrats is that the [NBC] survey found 67 percent of Republican respondents said they were very interested in the November elections compared to 46 percent of Democrats.

Moral appears low amongst Democrats on Capitol Hill. Some suggest that’s a lot to do with the Obama White House’s aloofness from their team in Congress. They cite poor engagement both with Congress and their external support base. The conventional wisdom, from bloggers to mainstream media insiders, at this moment is that it is the Dems are going to get caned in November. The degree to which they lose seats will depend on whether they can bed in their change and begin selling it.

The buzz now is that despite huge pressure being applied by a very targeted ad campaign at wavering Democrat congressmen, the party is confident of passing the bill. Confident even though the word goes the bill may only pass by one vote. Why? Because although they can pass it with more than one vote, they won’t because voting yes to health care for these guys is almost instant death in November’s mid term elections.

So one will get to take the poison chalice, whilst the other four (it’s rumoured) get to run with the opposition herd.

We should get a result by midnight Eastern Time on Saturday night.

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  • Decent piece. Nice summary.

    Err (an ambiguous err-ing, too):

    Moral appears low amongst Democrats on Capitol Hill.

    I thought the current Democrat moral problem was centred on Albany, NY.

    As for Lá ‘le Pádraig, the NY Times gave you an editorial (mainly about the US being a land of immigrants, with a strong nod at the new Chieftains’ album). Wha’ more d’ ya wan’, bud? Huh?

  • Kevsterino

    Mick,
    I don’t believe we will have a good estimate on the mid-terms until about August or so.

    Well outside the Washington beltway, here in the midwest, Republicans are crowing they have Obama on the run and Democrats are perturbed Obama hasn’t pressed ahead with his program. Once a bill is signed, we’ll see how the polls look then.

    Enjoy your day.

  • IRIA

    Jane Hamsher is an outlier. The Democrats should/will lose seats in the mid term election b/c they won so many seats in 06 & 08 from the GOP. It’s natural. The question is: how many will they lose? It’ll come down to turn out, and right now the GOP base is fired up and the Dems are not. However, when(if) Health care passes, the Dem base will finally have something to get excited about.

    It is likely that the “wave” that many confident GOP strategists are envisioning in November has broken too soon.

  • LabourNIman

    The health care bill is a major disappointment for those who voted for Obama. In fact, I’d go as far to say it’s such a big waste that it could have came from stormont.

    Poor leadership and tact like this will make Obama a one term President.

  • Hold on, hold on: as I recall the Dem support on the health vote has got mixed up with topic A.

    Topic A? a+b+o+r+t+i+o+n. Got it?

    Sorry: in a rush. Finally got the barman’s attention.

    Back to the main business of today.

  • What sort of country has the USA become, without trying to be to offensive, it must have some of the stupidest people in the world living there. Especially amongst those who belong to the tea party crowd, who have allowed themselves to be totally manipulated by the Republican corporate right

    I cannot think of another land, in which people would view with hostility a health care programe which is free at the point of need. Something which bar the USA, almost the entire first world now takes for granted and sees as a necessity in any civilised society.

  • I ment to add whilst our political elite in the UK and Ireland are a corrupt bunch, the US political stables needs burning down if the progress of this bill is anything to go by. Those democratic party senators and congressmen, etc, who have stonewalled the progress of this bill should; and must be hounded out of office as by this act they have clearly demonstrated they are first and foremost the creatures of corprate America.

  • Dread Cthulhu

    MR: “I thought the current Democrat moral problem was centred on Albany, NY.”

    That is a matter of perspective, specifically how close you are to Albany, NY or some other cesspool of Democratic moral difficulties (as opposed to the other sort). Chicago usually holds the depth and stench record, particularly the First Ward, which was famously described as stinking like a whore-house at low tide.

    IRIA: “Jane Hamsher is an outlier. The Democrats should/will lose seats in the mid term election b/c they won so many seats in 06 & 08 from the GOP. It’s natural. The question is: how many will they lose? It’ll come down to turn out, and right now the GOP base is fired up and the Dems are not. However, when(if) Health care passes, the Dem base will finally have something to get excited about. ”

    There is a world of difference between the normal deflation of a majority in off-years, ala 2006, and the implosion of majorities, as occurred in the nineties. The real question is what will happen between now and then — the economy will be key, with predictions of prolonged near 10% unemployment. That said, the stench rising off of Congress right now doesn’t help the Dems in a couple dimensions, starting with their inability to manage their majority.

    Mickhall: “What sort of country has the USA become, without trying to be to offensive, it must have some of the stupidest people in the world living there. Especially amongst those who belong to the tea party crowd, who have allowed themselves to be totally manipulated by the Republican corporate right”

    So many misrepresentations in two run-on sentences… Much in the fashion that when someone say “with all due respect” you can expect something insulting, when someone says “without trying to be offensive,” you can pretty much guarantee the next phrase is going to be just that.

    Firstly, the fact that they don’t agree with your politics doesn’t make them stupid. You also are neglecting the tendency for the press to seek out the worst examples out of the crowd to present as the mainstays of the mass. Lastly, mayhap they dislike the notion of another government-run entity, seeing as the Post Office, the IRS and the DMV have been such stunning successes.

    Mickhall: “I cannot think of another land, in which people would view with hostility a health care programe which is free at the point of need. Something which bar the USA, almost the entire first world now takes for granted and sees as a necessity in any civilised society. ”

    First of all, it may be free at the point of service, but it surely isn’t free. The NATO subsidy has permitted a certain amount of experimentation into soft socialism in certain quarters, with monies that would have otherwise gone into defense going into social spending.

    Secondly, the problem of rapidly escalating costs comes, at least in part, from the warping of health insurance (a financial device meant to cushion the blow of a catestrophic event) into a cost shifting device that divorces the consumer from the supplier. Health insurance for the masses are something of an unintended consequence of Europe’s inability to stand up to the little Austrian corporal and FDR’s wage freeze, as much as anything else.

    Mickhall: “I ment to add whilst our political elite in the UK and Ireland are a corrupt bunch, the US political stables needs burning down if the progress of this bill is anything to go by. Those democratic party senators and congressmen, etc, who have stonewalled the progress of this bill should; and must be hounded out of office as by this act they have clearly demonstrated they are first and foremost the creatures of corprate America. ”

    The Dems have been so feckless as to show the sausages being made. They had the votes to pass whatever they wanted, so long as they could all agree — a filibuster-proof Senate and enough of a House majority that whatever their greasy little hearts wanted was theirs for the taking. The GOP, the Tea-Parties — everything else should have been irrelevant. The Dems, metaphorically speaking, screwed the pooch on the steps of Capitol Hill at high noon for the television news cameras and have been doing so for the better part of a year. They made such a mess that the state of Massachusetts elected a Republican to “the Kennedy seat.” As for running the “Blue Dogs” out of office, you’re more than likely to end up with a GOP office-holder as a result than a more liberal Dem — the two parties may look monolithic to an outsider, but there are regional fractures to those monoliths — a NYC Dem has little in common with, say, one from NorCal or Alabama. The Dems also have to contend with ethnic fault-lines in their alliances, with the Hispanic Caucus threatening “no” votes over the lack of availability of subsidized access to illegal immigrants and the Black Caucus which opposes it for the lack of a “public option.”

  • “Much in the fashion that when someone say “with all due respect” you can expect something insulting”

    Exactly, it is called irony, which is, ‘with respect’ something you yanks don’t seem to get. Lighten up old friend.

    Is it really such a crime that monies which might have been poured down a sewer of open ending defence spending, instead went into healthcare, etc?

    No matter how much over here, those in the pay of multi national health care providers have tried to tilt it in their masters favour, few Europeans, whether of the left, centre, or right politically, consider the sick as consumers, but sensibly, as we all understand we will find ourselves some time in this position, regard them as people in need.

    If you look at the spiralling private health care costs in the US, in comparison with the national insurance/taxation based european systems, then our system wins hands down.

    It is a no brainer if you add in the 40 million citizens of the riches nation in the world who have no health care cover, which is something which in my eyes shames every single citizen of the USA.

    And that is not me being ironic.

  • Comrade Stalin

    Dread, can you explain to slow learners such as me why the “NATO subsidy” is the cause of the cost of US healthcare being substantially higher (in GDP terms – which includes public and private spending) than anywhere else ?

    Can you explain how the NATO subsidy is anything to do with the successful operation of public health insurance in those well-known North Atlantic nations such as South Korea, Singapore and Japan ?

    Why does the NATO subsidy mean that ex Eastern Bloc states in many cases have better health statistics than the USA ? The US infant mortality rate is about the same as that in Croatia, a country that’s just been through a major decades-long civil war, and Belarus, a country fundamentally crippled by decades of Soviet repression and subsequent dictatorship. If I was an American I’d be embarassed.

  • Mack

    Mick –

    I’m not sure they have absolutely no health cover (i.e. health care available if they get sick), rather they have no health insurance. AFAIK, they’ll get treatment if they get sick & also a bill they won’t be able to pay and then they’ll be forced into bankruptcy / financial destitution. But I may be mistaken, especially for chronic long term illnesses, it just maybe that many won’t get treatment..

    It’s a big issue for workers loosing their jobs. There’s no risk equalisation (as in Ireland) so insurers are pretty ruthless about accepting members into new schemes (even when it’s just the details that change – moving from an group scheme into an individual scheme and back can be nigh on impossible if your health circumstances change).

  • Mack
  • Greenflag

    mack,

    ‘it just maybe that many won’t get treatment..’

    Even if the present very much watered down reforms take place some 180,000 Americans will die because of non access and inadequate medical treatment over the next decade .

    Those who have no health insurance also have an 8 times greater chance of dying while undergoing ’emergency’ treatment than those who have health insurance .

    The entire system as Obama says is unsustainable . From consuming 5% of American GDP in the late 1960’s to almost 20% now it’s clear that left to their own devices (just like the bankers and insurance and hedge fund gangsters) the health care sector will continue to feed off the body of the american economy until there’s not a cent left for anything else . When the military industrial complex costs are added on to the medical care extortionists then the USA will have nothing left to offer the world except vacant parking lots , burned out former industrial zones and trashed fast food outlets .

    Obama has decided to try to save his Presidency and his party for the upcoming elections rather than ‘fix’ health care or do the decent thing . The GOP have never wanted to do the decent thing or fix health care . They know that the powerful Insurance lobby and Corporate Pharmaceutical interests will and have fought tooth and nail to protect every dollar of profit regardless of the impact on healthcare for Americans .

    It’s not democracy it’s financial oligarcy and plutocracy plain and simple.

    All that Obama can claim is that the door to having health care for all americans has been opened a little . This after all represents the first serious atttempt at reform since the last failed effort by Hilary Clinton in 1994 -16 years ago.

    With almost 20% unemployment and probably little possibility of any major improvement over the next 5 to 10 years in that figure many tens of millions will have no access to health care services unless they crowd into the emergency treatment centres or decide to choose to die or go into bankruptcy .

    The land of the free and the home of the brave -my arse . The land of the gutless , the home of the scared and a paradise for greed.

    At least Obama tried . But too many of his own Democrats belong to the gutless and paid off plutocrats of corporate America and in particular to Corporate Insurance /Big Pharm America .

  • Mack

    Greenflag –

    I don’t disagree with your general thrust, so suspect it may be a little extreme –

    http://gregmankiw.blogspot.com/2009/07/should-we-envy-european-healthcare.html

  • Greenflag

    ‘Preston and Hu show that this more aggressive detection and treatment were apparently effective in producing a better bottom line since death rates from breast and prostate cancer declined during the past 20 [years] ‘

    Preston and Hu may need to do some more research at leas tre the breast cancer findings . I haven’t got the info to hand right now but I believe that the aggressive treatment of ‘suspected’ breast cancer -lumps etc through overuse of radiation treatment is now believed to be causative of cancer in many cases were the treatment should not have been proscribed . The bottom line i.e the profit motif’ for the hospital being of course more important than the ‘patients’ well being .

    If my above comment in 12 appear extreme it’s because it’s not . Those seeking to defend the current health care system in the USA are like that little Dutch boy of legend who stuck his finger in the dyke to save his village except that in the current American debate those who are trying to stick their fingers in the dyke
    a) don’t have any fingers left and
    b) when they are eventually submerged by the rising waters there will be no lifebelts .

  • Kevsterino

    you mean “prescribed” not “proscribed”, don’t you, GF?

  • Greenflag

    I do I do I do Kevs .Thanks and well spotted . I’m not meself today at all at all . That morning after she cat littered in the mouth feeling after excessive food, booze and mirth . Still once a year it’s a tonic 😉 That feckin pretentious Brit Patrick has to have his due 😉

  • I really do not understand why Obama did not take the private health industry on with a system like the NHS. It would have created many new jobs, disciplined the multi nationals corporations and exposed those democrats who are in the pockets of the private health care and insurance corporation.

    Can a US president pass a law without a democratic vote in congress,etc, if not he should have made this a ‘do or die’ issue, gone out to the country in much the same way he did before he was elected brought the whole pressure of his office to bear on the democratic sellouts to such an extent they did not know what day it is.

    As things stand now, he will rub along the bottom, much as Clinton did, without a lasting legacy. Almost every US voter understands health care is the big issue of the day, one way or another [surly?] There is so many pegs which a president could hang his campaign on when trying to reform the current system,

    Fairness
    Jobs
    21 century health care for all, not just a tiny majority.
    Good employers would have the extra burden of health insurance lifted from their accounts.
    Time US came into 21st century
    Use the recession, example of bankers to expose the insurance and private health care multinationals.
    Training on the job of tens of thousands of new healthcare professionals
    Construction jobs to build new healthcare infrastructure
    New jobs for companies which will service national health care.
    An alternative to the private system will force the current health care providers to reduce their prices.

    The list is bloody endless, all are pluses, as those who wish to stay with the private sector can do so, although in truth in the long run only the very wealthy will do so.

  • Greenflag

    mickhall ,

    ‘and exposed those democrats who are in the pockets of the private health care and insurance corporation.’

    Probably more than half the Democratic Senators and Congressmen not to mention all of the Republicans in the Senate and Congress . I read the private health care lobby had 2,000 lobbyists camped out in Washington DC during these debates and they’ll be there until after the vote . even after the vote the Insurance industry will continue to fight for every profit dollar it can regardless of the health interests of the American people .

    Obama made the mistake of trying to reach out and compromise with the industry and it’s plutocratic appointees in the Senate and Congress . I haven’t yet decided whether that was from a longer term perspective a serious mistake or not . In the short term it may appear to be -longer term the americans will learn the hard way that the Insurance companies will find new ways to gouge ‘profit’ from the system as long as they are allowed to exist .

    Those who have in health care in the USA want to hold onto to what they have . They don’t want any alternative to the private system . They know they would lose .

    As for their ‘customers’ i.e the american people -well as long as they or their employers pay the premiums that will deliver sufficient profit to the insurers thats all they care about . That’s the system . As for those who can’t afford it . Tough . Early grave or just f**k off .

    It will probably take a ‘revolution’ of the violent or mass protest kind for the USA to get anything like even the NHS . Those opposed to such reform have wealth , privilige and corporate power on their side as always .

    Obama may succeed in opening the door to universal health care just enough to get a foot in .