[Updated] Negotiating from Weakness on Health Care
by tarheel74, Sat Sep 05, 2009 at 09:16:34 AM EDT
It is becoming increasingly evident that right now due to a complete lack of leadership from the White House, the President is now negotiating from a point of weakness. Recently we heard that the President got in touch with the Progressive caucus and asked them how much are they willing to compromise on health care reform:
All in all it appears very much as if the President is feeling out how willing the House will be to support a bill that falls short of their earlier demands for a Medicare-like public option available to all consumers without any triggers.
Update [2009-9-5 16:24:26 by tarheel74]:
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Members of the progressive caucus have been quite vocal about the lack of leadership from the White House. Anthony Weiner went on Rachel Maddow's show to say that "we really haven't had Presidential leadership the way we needed most". It took a near revolt from the progressive caucus for the White House to start paying attention. Even then MSNBC reports that the President proposes to do his take one for the team routine to the progressives on Wednesday:
NBC's David Gregory reports that the president is preparing to tell liberals in Congress that it's time to be good soldiers. "While he is expected to stand behind the idea of a public option, he is also expected to stress that it can't be MORE important than some of the other reforms that are possible this year, including insurance reform that would guarantee coverage for individuals with pre-existing conditions," Gregory says.
But going beyond all the speculations of this speech what does this say about the negotiating style of this President? Charlie Cook did an analysis of the current debate and he found something that is quite disturbing (h/t TPM):
Before long, his strategy of letting Congress take the lead in formulating legislative proposals and thus prodding lawmakers to take ownership in their outcome caused his poll numbers on "strength" and "leadership" to plummet.
One might want to stand back and ask why? The reasons are the following: The goal of progressives has always been to see something like single payer being negotiated, I mean with a supermajority in the senate and the house and a Democratic President one would assume that something like this will be given a serious look. However as Matt Taibi reports in Rolling Stone (ed: excellent article, highly recommended):
Last spring, when he met with Rep. Lynn Woolsey, the co-chair of the Congressional Progressive Caucus, Obama openly said so. "He said if he were starting from scratch, he would have a single-payer system," says Woolsey. "But he thought it wasn't possible, because it would disrupt the health care industry."
So the single-payer option was not even considered to preserve the current insurance industry. So the end point is gone. That leaves us with the incremental reform that is the public option that is being gutted so effectively now. Even if one takes into consideration the cost of such a public option, even without it we are faced with a trillion dollar bill, which as Roger Simon put it on the Ed Show, will funnel 47 million new customers to the insurance industry, in other words a very expensive corporate welfare. However when even that number is being reconsidered one has to ask what would the final bill really achieve. McClatchy reports the following:
This month, under pressure from Republicans and conservative Democrats to draft a less expensive bill, the Senate Finance Committee also may lower the maximum annual income that a family could earn to qualify for subsidies, from four times the federal poverty level (about $88,000 for a family of four) to three times of poverty ($66,000 for that family). That would mean millions of Americans would not be eligible for subsidies.
"For those who thought there was going to be broad coverage, I just don't see that as in the cards," says Joseph Antos, a health care economist at the American Enterprise Institute, a conservative think tank. "It's too expensive and there's going to have to be some paring back of that expectation."
Reducing subsidies too much could threaten the entire Democratic health care strategy.
The craziness of this notion that force people without insurance to buy even more expensive insurance is unfathomable. It is like saying "if they can't have bread let them eat cake". Ezra Klein who has been wont to peddle anything and everything from the White House off late, had this to say:
I'm firmly on the record as being willing to support all manner of compromises on health-care reform. Policy dogmatism has not, over the long history of this issue, proven a successful strategy. But there's an increasingly evident path by which health-care reform begins to hurt the very people it's meant to aid. As Jordan Rau reports, making health-care reform affordable for the centrists in the Congress could make it unaffordable for the people.
The basic structure of the bill has three main planks working in conjunction with each other: The individual mandate creates a mechanism for a universal, or near-universal, system. A universal, or near-universal, system creates the conditions for insurance market reform. The subsidies make the individual mandate affordable for people to follow.
There are a few ways to destabilize this system. The most likely way is to reduce the subsidies so that the individual mandate isn't really affordable. That seems to be happening even as we speak. At that point, reformers have two options, both of them bad.
So while the President has already given away his main bargaining chip, the Senate Finance Committee is giving away the whole house. We are left with either a bad bill without public option and mandated coverage, or a worse bill without public option, with scaled back subsidies and mandated coverage. But it can get even worse. If anyone here thinks that passing a bill with concessions to the public option will see it sailing through the Senate and Congress, they have something else coming. The Republicans have been able to gin up support for the insurance industry, the industry that everyone supposedly hates, by painting the public option as a communist take-over to kill grandma. Think what they will do when the bill without public option that asks for subsidies by taxing the rich comes to the Senate floor? There will be talk of socialism, communism, class warfare and everything that you can imagine. If the President is now willing to throw away his bargaining chip even before the bill comes to the Senate floor for final consideration, what other concessions will we see?
A concession on public option is now not just a progressive problem but it is also a Democratic problem and a problem with the White House. As Markos Moulitsas said yesterday on Countdown, "this emboldens the Republicans knowing that the White House is weak and they negotiate from a position of weakness, even when dealing with legislation, policy, that is incredibly, incredibly popular with the American people".
Dan Balz, the great "bipartisan sage" of the Washington Post had this to say:
The Windsor meeting showed that Obama can do little at this point to mollify his harshest critics. To win this battle, he now must satisfy proponents, many of them liberal Democratic activists who are increasingly energized and hungry for him to make good on his promise of real change. But he also must reassure those in the middle, who see flaws in the current system but who worry about the cost and scale of government involvement in the changes that might be coming.
That is how August changed the health-care debate.
To end this diary I will leave you Bill Moyers' closing essay from his show yesterday:
Come on, Mr. President. Show us America is more than a circus or a market. Remind us of our greatness as a democracy. When you speak to Congress next week, just come out and say it. We thought we heard you say during the campaign last year that you want a government run insurance plan alongside private insurance -- mostly premium-based, with subsidies for low-and-moderate income people. Open to all individuals and employees who want to join and with everyone free to choose the doctors we want. We thought you said Uncle Sam would sign on as our tough, cost-minded negotiator standing up to the cartel of drug and insurance companies and Wall Street investors whose only interest is a company's share price and profits.