Salvaged or Savaged?
by Charles Lemos, Fri Feb 26, 2010 at 03:58:20 AM EST
As I noted earlier I didn't have the chance to watch most of the seven and a half hour long Blair House Healthcare Summit. Given this, I'm going to defer to those who did. A review of opinion follows below the fold.
To an extent, I've been distracted by events in my native Colombia where Alvaro Uribe's re-election bid hangs by a thread and seems likely to be sunk by the Constitutional Court. Come August 7th, Colombia will have a new President and that brings me unending joy. Colombia's highest court will uphold the rule of law by tossing the Presidential referendum on technical grounds - campaign finance laws were broken and Uribe's supporters (it is important to note that Uribe was not directly involved in the re-election bid) violated, perhaps unintentionally but violated nonetheless, a number of other election laws. While I would have preferred the Court to uphold the constitutionality of term limits instead of sidestepping the issue, I expect the Court to firmly declare that elections in Colombia cannot be bought by the highest bidders.
It's not often that one gets to see two political systems debate such core issues, and somewhat overlapping ones at that (there is also a healthcare debate ongoing), so intensely, closely and simultaneously. Colombia is often termed a "failing" state. I've never bought into that view even as I am fully aware of the serious socio-economic disparities we face and of the grave security threat that such inequality breeds. Though I concede the fragility of the Colombian state, it has been remarkable to witness the growing resolve of Colombians of all walks of life coming together to break the dark cycles of the past half century. And while Colombian democracy has its own pervasive imperfections, it is increasingly vibrant and mature. To turn back Uribe is no small feat.
The US too faces serious socio-economic problems, of a different sort and scope no doubt, but it is the political intractability that should give us the most concern. I've taken the President to task this past fortnight for not being assertive enough in his leadership nor partisan enough in his politics but I think if we could replace Barack Obama say with an FDR or an LBJ, we would still face a political stalemate. The problem, ultimately, isn't the President. I may not agree with him on every single issue or his approach at times but I know he means well and I believe him sincere in his efforts to reach a governing consensus on pressing national issues.
Achieving that governing consensus, however, may be a hopeless task. The bitter reality is the United States is in danger of becoming a failing state because one party has become so radicalized in its ideology and in its approach to the game of politics that almost any issue becomes so intensely partisan that any compromise is effectively impossible to reach. As long as the GOP views governance as a zero-sum game, the national interest will suffer. Theirs is a scorched America politics. In their unyielding zeal, they are willing to see the nation falter and the American people suffer for what matters to the GOP leadership is serving the interests of an increasingly narrow economic elite.
That the GOP serves the economic interests of an elite few should be more plainly evident but it is to the detriment of the nation that we on the left have not been able to effectively expose them for the oligarchs that they are and the oligarchy that they foster. What are the consequences of Reaganite ideology is a question that we do not often broach but all we need to do is to look at the distribution of wealth and its trend to see that what Reagan wrought was a vast redistribution of wealth upwards for a precious few in an unrelenting war on the American middle classes.
As of 2007, the top 1 percent of US households owned 34.6 percent of all privately held wealth, and the next 19 percent (the managerial, professional, and small business stratum) had 50.5 percent, which means that just 20 percent of the people hold 85 percent, leaving only 15 percent of the wealth for the bottom 80% (wage and salary workers). In terms of financial wealth (total net worth minus the value of one's home), the top 1 percent of households hold an even greater share: 42.7 percent. Go back to 1979 and you'll find that the top one percent owned just 20.5 percent percent of all privately held wealth. In other words, the share held by the top one percent has expanded by 68.8 percent thanks to the policies set in motion under Ronald Reagan. That transfer of wealth, a near 15 percent share of the nation's wealth, was by design not by chance. It was accomplished by shifting the tax burden from the top 1 percent to the middle classes.
Wrapped in their mantras of limited government and lower taxes, the GOP too often sways a disturbingly large segment of the US population to vote against their own economic self-interest. They have successfully sold the myth of the free market packaging it with the dubious assertion that all government is inherently inefficient if not evil. But we have failed to accurately convey the cost of limited government and lower taxes to the American people. The double hit from this world view is that we neither have universal healthcare coverage and pay far too much for the coverage that we do have. It's not big government for big government's sake that we are after but effective government of sufficient capability and dexterity to tackle thirty plus years of accumulated avoidance of socio-economic issues that can no longer be ignored such as our failing healthcare system.
Now for a review of the Blair House Summit as it was seen by some of the nation's leading political observers. Over at CBS News, Marc Ambinder finds that the summit was a tie and in that that's good news for the GOP. He writes:
The political world watched the proceedings at Blair House looking for theatre: instead, a policy fight broke out. This time, both sides came armored, and there was no referee. It was a wash -- and the tie goes to the Republicans.
The key question on the table was not whether Democrats and Republicans could come up with ways to compromise; it was whether the White House could move public opinion in a way that helps Nancy Pelosi get the votes she needs to pass the Senate bill in the House. That's unlikely.
Dick Durbin, the Senate's number two, even made a point of hinting to reporters midway through that the Senate was ready to pass health care legislation under reconciliation rules, which avoids the 60-vote threshold.
Indeed, Republicans were successful when the focus of the debate was on process -- the details of the deals that Democrats and the White House struck with key states and the (seeming) lack of transparency. The Democrats have an answer to this: if you want to find a pure debate on a pure bill, you'll have to look to . . . another universe entirely, because this is how legislation gets done.
But the Democratic answer is callous, and Republicans know it: this debate is not about a weapons system, it's about a fifth of our economy, it's about life and death -- and deals that take health care goods from one state and transfer them to another just don't play.
Of course, Republicans have been just as callous: their bill doesn't really expand coverage and rests on questionable policy premises, something that the president -- probably really the smartest guy in the room -- was at ease to point out, repeatedly. (Dozens of good Republican ideas were adopted by the Senate and the President; the thrust of both bills -- a market-based insurance exchange -- is a conservative idea).
All the Democrats asked for, really, is more money to pay for people who can't afford insurance and a rebalancing of the rules on insurance companies. Once the bill became political poison (thanks to Republican demagoguery and Democratic errors), not a single Republican could resist the political temptation to kill it.
For a year, Democrats have been on the defensive about their health care proposals. Republicans have been generally dishonest about them -- the Congressional Budget Office, for example, predicts higher premiums for a small fraction of folks who will get better insurance plans. To the extent that the president kept returning the focus to substance, it was to defend, rather to press the fundamental case for health care reform.
It would be folly to dispute that this legislative process was convoluted and lacked transparency. It most certainly was but in the midst of Ambinder's analysis is a solitary fact that bears expanding and touching on. This debate is "about a fifth of our economy." Well, it's actually about one-sixth of our economy though with healthcare costs rising as fast as they are, they will be one-fifth of US GDP before the end of the decade. That quibble aside, the point is that this debate is about one-sixth of the economy. The bigger point is that our healthcare costs shouldn't be consuming 17 percent of GDP when no other advanced industrialized nation spends more than 11 percent getting far better results both in terms of coverage and in socio-economic metrics.
What that means is that about 45 percent of US healthcare expenditures are inefficiently allocated. Part of that amount is, of course, a transfer of wealth that goes to support the lavish salaries in the insurance industry but the bigger picture is that ultimately such an inefficient allocation of resources is a national security problem. No country can afford to misappropriate such a large percentage of its GDP on an annual basis. So when the GOP brings up that this debate is about one-sixth of the US economy, the answer back has to be that therein lies the problem. There are opportunity costs to consider, what we spend on healthcare takes away from other pressing priorities. It's not just about containing costs. We need to bring healthcare costs to within OECD norms while making coverage universal so that we can tackle education, infrastructure, the national debt, etc. The national security angle needs to be stressed more.
Over at Politico, Glenn Thrush too finds that there was "no clear winner" with the tie going to the GOP.
President Barack Obama’s Blair House health care summit was billed as political theater — but it was so dull in parts, it’s hard to imagine anyone would demand a repeat performance. And boring never looked so beautiful to House and Senate Republicans.
Seven thick hours of substantive policy discussion, preening and low-grade political clashes had Hill staffers nodding at their desks, policy mavens buzzing — and participants declaring the marathon C-SPAN-broadcast session a draw.
But in this case, the tie goes to Republicans, according to operatives on both sides of the aisle — because the stakes were so much higher for Democrats trying to build their case for ramming reform through using a 51-vote reconciliation tactic.
“I think it was a draw, which was a Republican win,” said Democratic political consultant Dan Gerstein. “The Republican tone was just right: a respectful, substantive disagreement, very disciplined and consistent in their message.”
The White House and Hill Democrats had hoped congressional Republicans would prove themselves to be unruly, unreasonable and incapable of a serious policy discussion — “the face of gridlock,” as one Democrat put it hours before the summit.
That didn’t happen Thursday. In the 72 hours leading up to the encounter, Republicans drove a hard bargain with the White House over the seating arrangement — securing a massive square table that put them on a visual par with the president — to underscore their parity and seriousness. The move, ridiculed by White House press secretary Robert Gibbs at the time, paid off.
Obama wasn’t able to dominate them like he did last month during an encounter with House Republicans in Baltimore, when he delivered zingers high above the GOP from a conference room podium.
David Gergen on CNN was more effusive in his praise: the GOP had their best day intellectually-speaking in years. Paul Krugman saw it differently. Writing in the New York Times, he found that "what was nonetheless revealing about the meeting was the fact that Republicans — who had weeks to prepare for this particular event, and have been campaigning against reform for a year — didn’t bother making a case that could withstand even minimal fact-checking."
Beyond the numerous misstatements, Dr. Krugman noted that the GOP touted how their plan would cover an additional 3 million. Given that number of uninsured is some 47 million, that's spit in the ocean. He further elaborates:
What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.
One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.
In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.
Dr. Krugman also asks what did we learn from the summit? His takeaway was "the arrogance that the success of things like the death-panel smear has obviously engendered in Republican politicians. . . at this point they obviously believe that they can blandly make utterly misleading assertions, saying things that can be easily refuted, and pay no price."
I'll be more blunt. The Democrats came to salvage an imperfect bill that was the result of an imperfect process but one that nonetheless provides real solutions to a wide swath of Americans who face real problems, the Republicans came to savage everything that stands in their path to power. Theirs truly is the politics of a scorched America. Only time will tell whether we have salvaged the nation or allowed the GOP to further savage it.