[Updated] Negotiating from Weakness on Health Care

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.

Tags: Health care, obama (all tags)



Re: About that speech next week....

 How did he do?

by QTG 2009-09-05 10:36AM | 0 recs
Re: About that speech next week....

sorry to break this but one speech will not save the house. It is high risk gamble which unfortunately he is forced to make due to his own misjudgments. Better speakers before him had tried to salvage healthcare reform by giving speeches to no avail.

by tarheel74 2009-09-05 11:57AM | 0 recs
Re: Thanks

now I don't have to watch it.

What did you think of the Republican response to next week's speech?

by QTG 2009-09-05 12:25PM | 0 recs

no better speaker has ever attempted healthcare reform, I'm not sure what you mean

by DTOzone 2009-09-05 02:02PM | 0 recs

I was wondering when Abraham Lincoln worked on health care reform.

by Dracomicron 2009-09-05 02:59PM | 0 recs
Re: Since

" On the evening of September 23, 1993, I sat in the gallery of the House of Representatives for President Clinton's speech introducing the administration's Health Security plan."

http://www.princeton.edu/~starr/20starr. html

I await your spinning of how Pres obama is better.

by bruh3 2009-09-05 04:06PM | 0 recs
Re: Since

What exactly do you think makes Clinton's speech better than Obama's next week?

by Jess81 2009-09-05 08:54PM | 0 recs
Re: Since

I don't think either men is better or worse. I don't tend to look at politics as you see it. I don't really care about either men's personalities.  I think they both are smart capable men who give great speeches that inspire people, BUT, if someone has a self interest involved like the insurance companies and conservatives do,t hen those abilities are not enough.  Being a gifted politicians is not the miracle cure or replacement for basic leadership. The willness to put skin in teh game , and yourself on the line. Clinton really only did that once, and ironically he won big- when he shut downt he government rather than compromise on trying to restore the progressive tax structure and addressing the debt. Pres Obama has yet to do this. And, no, rhectoric does not count. Saying he supports something does not count. The question is what will he do for it? Will he expend political capital even if the win is not certain? Many of you like the fact he's cautious, but like the old woman in traffice driving at 25 miles per hour while everyone else is going 50, being too cautious can be as dangerous as too fast. Whereas Clinton got hoodwinked because he was clueless about DC, Pres Obama is being hoodwinked because he buys into what some of you think of him (at least that's my charitable and hopeful explainationf or him repeatedly making the same mistake for months), which is unfortunately about being above the fray. This is what he should have  been doing for months, and not now as a last minute save. I am neither for or against the speech. It simply is not sufficient to replace what has been a leadership vacuum and him relying on his personal appeal.

by bruh3 2009-09-05 09:08PM | 0 recs
Re: Since

I didn't read your whole post - just the part about how you don't care about personalities.  If that's the case, then your writing is extremely unclear, because you always talk in terms of motivations: "so and so is just trying to" "so and so thinks" "so and so doesn't care".

You do this about both politicians and other bloggers.  Perhaps you realize this and therefore project it onto other people, but I'm an agnostic on why.  I just note that it's a consistent behavior.

by Jess81 2009-09-06 02:03AM | 0 recs
Re: Since

and as you will see, I elaborate on this point below.

by Jess81 2009-09-06 02:08AM | 0 recs
Re: Since

motivation in politics matters whetehr I care about it or not. BUT, what drives me is outcomes in policy. What drives you however is what? It certainly ain't policies.

by bruh3 2009-09-06 10:09AM | 0 recs
Re: Since

couple of follow ups-- my orginal comments stand, but I want to add to it.

a) understanding what motivates people is not my focusing on personality. that's focused on interest based negotiation in which you have to know what motivates teh other guy to understand what is happening

b) Personality politics is where you invest emotions in who they are. I think in your response you may not understand that. For example, my assessment of Pres Obama is not placing emotions into who he is. I don't really care other than and this important how who he is affects policy outcomes directly by his own action and how people will invest emotions into him and avoid the policy discussions by telling me how we should trust "the personality" of Obam rather than the actions and policies he does.  Most Americans in fact are personality driven in politics. THis is not a contradiction to them also having a sense of party loyalty int eh case of partisan. In fact, it is a tool used to make sure people who do not vote their district are elected time and again.

I used to be personality driven with CLinton. I would say "I trust CLinton because I like Clinton." Now, I would say "this is my policy objective, and these are the forces at play in politics including clinton's motivation that are going to get in the way of that or aid it."

by bruh3 2009-09-06 10:24AM | 0 recs
Re: Since

Here's Big Tent Demcrat discussing how everyone has a different interest in the healthcare battle and that is af actor in policy outcomes politically:

http://www.talkleft.com/story/2009/9/6/1 31346/8062

Thus when I discussing other people's views, I am not telling you my own. I telling you what their views are, and how that impacts the underlying goal of healthcare reform. In my perfect world, personality driven politics would not matter, but thats whole separate from being a realist that people around me do make decisions based on "I like Obama" or "I like his biography or identity" or any number of other proxies they use to circumvent the conversation of whether we are holding him accountable regarding policy objectives that are in our own interest versus whatever his interests may be as a politician.

by bruh3 2009-09-06 10:33AM | 0 recs
Re: Since

Just making broad generalizations, it's probably a good idea to make a couple of assumptions about politicians: they are rational, for the most part, self-interested and altruistic to varying degrees, and respond to persuasion and or threats to varying degrees.

That's it.  I don't think you can put them on a couch at 2000 feet.  And while I can imagine it's hard to do this, I don't think the other definition of personalizing is useful either: being excessively angry or happy with what they do.  Except them to be self-interested because they will be.  If you don't, you'll limit your effectiveness and you'll be disappointed again and again.

Above you said "I don't look at politicians the way you do", and then drove right into personalities, and in fact have only really left it for a few spells during this entire debate.  I don't know what reason you projected that onto me.

by Jess81 2009-09-06 11:29AM | 0 recs
Re: Since

Humans are both rational and irrational, and no politidcians are anot always rational. Next you willb e saying that economics is correct to claim all consumers are rational actors. I am ot puttuin the on the couch. I am observing their behaviors just like others ar edoing who come to similar conclusions as me. I know many of you like to use me as your whipping boy, bu tthe reality is that questions I am rasing and thea rguments ai make are not . The fact you steadfastly refuse to admit a behavior means what it means is the problem. pretending that Obama's obession with post partisanship is not a motivation problem with regard to polciy outcomes creates a problem with you underwstanding that in my mentioning this I am not based on personality- I am based on understanding how interests , including the irrational ones, play a role in outcomes of policies.

Here's another diarydiscussing another aspect of what I discuss here:

http://www.dailykos.com/story/2009/9/6/7 77915/-Negotiations-101

by bruh3 2009-09-06 12:08PM | 0 recs
Re: Since

short answer to your question: Clinton feels your pain, and Obama is the spiritual leader. They use diffrent approaches, but they are both very good at their approaches. However, that's how they give speeches. The ability of Pres Obama to give a good speech is not at question on Wednesday. His leadership is.

by bruh3 2009-09-05 09:18PM | 0 recs
Re: Interesting

That it is Obama's character you question, and you despise the word compromise. And you judge an historical failure as better than a future event that has some non-zero chance of success.

You're going nowhere if you don't at least drop that "Harken to me, I know the Future!" crappola.

by QTG 2009-09-06 04:25AM | 0 recs
Re: Since

Bill Clinton and John F. Kennedy

by tarheel74 2009-09-05 07:29PM | 0 recs
Re: Since

I suppose it's subjective, but not a whole hell of a lot of people would agree with you on the first one.  By which I mean it would be difficult for me to find anyone.

by Jess81 2009-09-05 08:56PM | 0 recs
Re: Since

Bill Clinton, regardless of  how much I hate his screwing up by the Democratic Party, is and was considered one of the most gifted politicians in a generation.  The irony of yoru post is that there is a lot of commonality between Clinton and Obama. Outside of Clinton's self destructive streak (which Obama does not share), his other flaw, which he shares with Obama, is that he was obsessed with people liking him, especially his enemies. If you look at Pres Obama, and it did not occur to him until recently to sit down with the progressives there is that similar trait. This is ironic because Obama has spent so much time trying not to be like clinton in terms of what clinton did that he missed the point. Clinton's flaw was that he wanted to please everyone not specifically how he tactically addressed healthcare. In both cases, knowing that about both me, it allows for a party like the GOP, conservatives like Baucus and corporate interests like the insurance companies to play the flaws.

by bruh3 2009-09-05 09:16PM | 0 recs
Re: Since

Okay - great example right here.

Now this is off topic, but you talk about not caring about motivations, and then you write this:

...his other flaw, which he shares with Obama, is that he was obsessed with people liking him, especially his enemies. If you look at Pres Obama, and it did not occur to him until recently to sit down with the progressives there is that similar trait. This is ironic because Obama has spent so much time trying not to be like clinton in terms of what clinton did that he missed the point. Clinton's flaw was that...

I mean what is THAT?  Even Maureen Dowd would condemn that for being too purple.

Back on topic, I was simply making a statement that Obama is a very good speech-maker.  I think Clinton probably has better political instincts, but as I said these are highly subjective judgments.

by Jess81 2009-09-06 02:07AM | 0 recs
Re: Since

This is interesting to me- do you understand the difference between personal preference and what otehrs use to make their decision? When i say I dont care about personality, it does notmean I do not realize that my motivation is not that of others?

by bruh3 2009-09-06 10:10AM | 0 recs
Re: Since

Honestly, I don't think it would even occur to you psychoanalyze the most scripted and guarded people in the world were you not trying to attach fun personalities to this.

by Jess81 2009-09-06 11:33AM | 0 recs
Re: Since

You did not read a word I said. Your framing this as pscyhoanalysis means you do not understand we are discussing basic concepts of negotiation strategy.

Here again is anotehre diary from someone who negotiates for a living in trying to discern from behavior what are interests involved hwhen one is trying to accomplish a particular policy goal:

http://www.dailykos.com/story/2009/9/6/7 77915/-Negotiations-101

You really should learn more about the concepts I am using. i don't have the time or patience to keep telling you that it is not psycho analysis- that it is interest based negotiation that drives my discussion. You will have to do the research yourself.

by bruh3 2009-09-06 12:11PM | 0 recs
Re: Since

clarification: the way that this need to please worked out with both  men is that they got to the people who do not l ike them and try to get them on board rather than focusing on building the coalition of those who do like them and their goals. According to Mike Lux (if I am remembering correctly) it was the focus on trying to convince the conservative Democrats that killed CLinton's efforts. He kept trying to focus on them so much that he ended up with this complex piece of legislation which was hard for people to understand. So, the conservatives waited clinton out as theya re doing now with Pres Obama. Yes, the rationala nd tactices differ bu the use of the underlying flawed strategy is still there. Indeed, the early players such as Bill Kristol who wrote the memo that advocated the strategy for killi ng CLinton's reform effort made similar arguments regarding Obamacare, and how to kill it. You are seeing those strategic and tactical movements playing out now that Kristol mentioned back in Nov or Dec of 2008.

by bruh3 2009-09-05 09:24PM | 0 recs
Re: Since

Clinton is definitely a better politician; he was much more experienced at dealing with the right wing smear machine as was Hillary. Much More.  Regardless, Obama is mine and all of our president and what we need to do is to urge him to work more closely with the Clintons to overcome this hurdle. BTW one of the big differences now wrspct the health care reform and then was that Clinton had to deal with a Republican dominated congress. Now, Obama has a Democratic dominated congress, which makes this level of re-framing, stagnation and conciliation even less excusable. But, at the end of the day, I only fault the Obama administration for not being on top of the marketing aspect of this, allowing the GOP to get on top and acting too conciliatory. I will never wring my hands and say if Clinton was in office...b/c they are clearly not.  So we must move on recapture this or move on and not vote a policy in for the sake of checking it off the list that has far bigger consequences, which is something I am concerned about.

by jrsygrl 2009-09-07 12:17PM | 0 recs
Re: Since

I don't think Clinton would have been any better. I am merely answering the question of whether Clinton was a good speaker or not. He was a good speaker just like Pres Obama, but I woner if that is enough.

by bruh3 2009-09-07 12:53PM | 0 recs
Re: Since

maybe you should take a few lessons in public speaking especially ex tempore speaking. Only then you will realize that Bill Clinton is not just a better public speaker but an awesome public speaker.

by tarheel74 2009-09-06 06:33AM | 0 recs
we have to remember

that health insurance isn't health care, insurance may make health care affordable, or it may not.  

I'm not willing to pick on Barack until after his speech.  Single payer has never been plausible here, our insurance and our health care are in private hands.  What is plausible is medicare for all because that will reduce the obscene profits, both in health insurance and in health care, and it will discourage exploiters from going into this 'business.

When there is rent control, the price of homes stabilizes and those who need to make big profits move to communities where there is no rent control. Since we still have a democracy we're allowed to make laws that make it harder for rich people to get richer.  

As long as we don't have a medicare-for-all option, insurance companies will be receiving public welfare.  Their ability to make obscene profits will be 'protected,' at the expense of our health.

by anna shane 2009-09-05 03:06PM | 0 recs
the 1996 HIPAA (Kennedy-Kassebaum)

was wonderful, bipartisan health insurance reform that (among other things) was supposed to ban rescission. Trouble is, it didn't solve anything.

The direction Obama appears to be headed would be worse than the status quo. It is telling that even Ezra Klein can't make up a story to sell mandates with no public option and fewer subsidies.

Though it will be extremely hard for Progressives in the House to stand up to the president, they would be doing him a favor to vote down the bill if he caves on the public option.

by desmoinesdem 2009-09-05 07:23PM | 0 recs
Re: Amped up?

good luck with your plan to provoke comments with that 'democrats are pussies' remark on your latest "diary".

by QTG 2009-09-12 09:16AM | 0 recs


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