Final Push For Reform

11 Mar


I’ve negotiated with my inner Kucinich and made peace with the health insurance reform bill.  It’s time to finish the job.

By the way, a couple of points on the status of the bill and the reporting I’ve seen/read on the remainder of the process. It’s important to note that we’re not “passing” healthcare reform through reconciliation. The bill(s) already “passed” with the required votes in both houses, a majority in the House and 60 votes in the Senate. Now, the House will pass the Senate bill and changes which affect the budget will be applied through reconciliation, a valid and well used procedure. That’s it. The big commie muslim socialist black man will not be (c)ramming his big black reform plan down anyone’s throat. Language matters. I digress…

The bill is not perfect and it is not what I wanted it to be when the process began and it is a product of a very flawed system.  However, it is the first step toward real, long-term reform in our healthcare system.  Incrementalism is the reality in our corporate political world until the bright shining day arrives when money is taken out of politics.


We’ve listened to what FreedomWorks, AHIP, PhRMA, and the rabid teabaggers had to say.  The bill has been watered down to the point where progressives barely recognize it anymore. The Democrats adopted 161 of 201 proposed GOP amendments to the Healthcare bill and did not receive one single affirmative GOP vote as a reward for their compromises.

The final Senate bill includes all four planks of the GOP’s proposed alternative plan, including buying insurance across state lines, tougher medicaid/medicare fraud prevention strategies, empowerment for states to implement the plan in different ways, tort reform and purchasing pools for small business. It’s all in the bill.

In fact, one could say that this bill combines the best parts of the GOP plan and the worst of the Democratic plan. Primarily, it lacks a public option, single payer provisions and is entirely based on regulating the private market.  It is possible that a public option could be brought back into the bill through reconciliation with 41 Senators now signed on to support that effort (including Schumer and Gillibrand), but I won’t hold my breath.

Since the Democrats would not receive one single, solitary vote no matter what bill they put forward, I thought they should have simply pushed forward a bill with a robust public option and the regulations needed to make an immediate impact on the system.  However, the will was lacking in the Democratic Party as many of the legislators are just as indentured to the insurance and medical lobby as their counterparts on the right.

So, the bill we have is the one the system is willing to give us at this point.  With a minority party more interested in opposing then governing, this is what happens.  When Democratic Senators are operating as lobbyists for Wellpoint, UHC and Aetna, this is what we get.  As is often said nowadays, it is what it is.  My hope is that once this bill is put in place, further reforms will be enacted, market protections will increase, coverage will be expanded and we’ll eventually end up with a more perfect healthcare system.  Perhaps the Democrats might embrace a simple four page bill that should have been the starting point for this reform process.  To stop now simply guarantees that nothing will be done.

I chose the “We are the ones we’ve been waiting for” video from the Obama campaign because it was a seminal moment in a historic campaign.  Whatever you thought of Obama then or whatever you think of him now, he speaks truth in that clip.  Change and reform are only possible if we advocate for it, fight for it, demand it.  If we push our legislators to demand better, more and faster.  Perhaps the grassroots on the left was disenfranchised from the start and were drowned out by the astroturf millions on the right during the formative portions of this process.  Perhaps the monied interests have a bigger ownership stake in our legislators than we do, but we have what we have.

The time is now for the grassroots to demand that something be done.  To remind them that we voted for this President and gave a sweeping mandate to the Democratic Party to enact this legislation, as imperfect as it is.

18 Responses to “Final Push For Reform”

  1. Mike In WNY March 11, 2010 at 7:54 am #

    You can sugarcoat the slippery-slope bill that appears to be heading to approval, however it is a violation of the 10th Amendment. The Virginia assembly has already passed a bill that will deal a serious blow to Washington’s plan and Virginia’s Governor said he will sign the bill. 34 other states are considering similar legislation.

    Simply put, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” Anyone who doesn’t understand the 10th amendment, to use parlance easily understood, is a fucking moron. There is no “right” or delegated power for federally controlled health care in the Constitution.

    • Alan Bedenko March 11, 2010 at 8:12 am #

      Yeah, I remember when Medicare/aid were struck down as violative of the 10th Amendment.

      • Mike in WNY March 11, 2010 at 9:21 am #

        Roosevelt set the stage for the passage of Medicare when he threatened to force retirement on 6 members of the Supreme Court over the “unconstitionality” of Social Security and other New Deal programs.  The Court got the message and abruptly switched their “interpretation” of the 10th amendment.  How convenient.

      • Mark March 11, 2010 at 9:32 am #

        Only wingnuts and shmibertarians think national health care is unconstitutional.The Constitution does not have to specifically grant a power for the power to be Constitutional. This has been well-established since Alexander Hamilton was Secretary of the Treasury. The Commerce Clause, the Necessary and Proper Clause, and the General Welfare Clause clearly give Congress the power to enact health care laws far more ambitious than this one. But if the people of Virginia love death so much, perhaps they could be excluded.

      • Eric Saldanha March 11, 2010 at 9:39 am #

        abruptly switched their ‘interpretation’ of the 10th amendment”?

        But, of course…if by “abrupt,” you mean almost 30 years after FDR’s court-packing scheme.

        To be fair, though, you may have referred to the Court’s left turn during the latter stage of FDR’s time in office. Which was achieved, constitutionally, by the retirements of five Justices (and the deaths of two others) giving FDR many opportunities to nominate Justices that were more sympathetic to his legislative agenda.

      • Mike in WNY March 11, 2010 at 10:21 am #

        @Mark, your view of the Commerce Clause, the Necessary & Proper clause and the “General Welfare” statement summarily voids the Constitution and allows Congress to do anything it wants.  The intent of those clauses are based on plain English and clearly expounded upon by the authors of the Constitution.  States are starting to fight back against the overly broad interpretation of the Commerce Clause, specifically as it relates to 2nd Amendment rights and guns manufactured and sold within a State.  The States have the power of nullification, which supersedes Supreme Court decisions, regarding the constitutionality of federal legislation. 

        @Eric, to clarify, FDR threatened the Supreme Court justices, and federal judges, with mandatory retirement after age 70.  Even though he failed to convince Congress, the threat was enough to sway the Court to approve Social Security.  That laid the foundation for the passage of Medicare in the 60’s.

  2. Mike March 11, 2010 at 8:30 am #

    This post is dilusional… OFA would be proud.
    Reconciliation is a procedural nightmare.
    Now we have the “Slaughter Solution, ” a way to pass the bill without Dems having to vote for it.
    Good luck when reality strikes, it will be like Bedenko’s Massa awakening…

  3. Brian Castner March 11, 2010 at 8:40 am #

    “In fact, one could say that this bill combines the best parts of the GOP plan and the worst of the Democratic plan.”

    Thanks for writing this post – you’ve turned me into a supporter of the bill, based in large part on the quote above. Personally, I think allowing insurance companies to work across state lines will do more to lower costs than any other provision. So if Dems get to cover more people, and Rep get actual cost control, isn’t that how the process is supposed to work?

    That being said, please have some cognitive reality on reconciliation. I know Republicans have used it more often. But its for budgetary, not policy matters. As in, to get the balance sheets to line up on similar bills, not to decide if abortion should be federally funded. That’s more than a balance sheet issue.

    • Eric Saldanha March 11, 2010 at 9:44 am #

      “…not to decide if abortion should be federally funded…”

      That’s been decided….the reform bill does not provide government funding for abortions, except in the cases of rape, incest, or a threat to the mother’s life….the exact same exceptions granted under current law.

      • Brian Castner March 11, 2010 at 9:48 am #

        Agreed. But if I understand it correctly, based on what I heard on NPR yesterday, one of the items to be decided in reconciliation is the Stupak ammendment. Its obviously not in the Senate bill. So, to get the Stupak crowd onboard (12 reps, last I heard), they are promising to add his restrictions back in, on a separate reconciliation vote, after the House passes the Senate bill. That’s the kind of basic policy that was not meant for reconciliation.

  4. Colin March 11, 2010 at 3:22 pm #

    Maybe these reforms will help, and maybe they won’t. Considering how much conservative taint they contain, I’m not that optimistic. I guess we’ll see. But this really stood out for me:

    “Perhaps the grassroots on the left was disenfranchised from the start and were drowned out by the astroturf millions on the right during the formative portions of this process. Perhaps the monied interests have a bigger ownership stake in our legislators than we do, but we have what we have.

    The time is now for the grassroots to demand that something be done.”

    That “was disenfranchised” is a bit loosey-goosey to me. The grassroots left wasn’t somehow, mysteriously, passive-voicedly excluded from this process. They were actively excluded, derided, and written off by Obama as part of a broad “let’s shit on our left wing” program that included healthcare reform, Guantanamo, Afghanistan, DOMA, etc.

    Maybe that strategy is wise if it wins some conservative support that wouldn’t otherwise be there — and there’s not exactly an avalanche of that happening — but it makes mobilizing that grassroots support pretty tough.

    • Mike March 11, 2010 at 3:36 pm #

      There is no Conservative support… This is Dem on Dem, they own it.

      • Alan Bedenko March 11, 2010 at 5:11 pm #

        Then repubs own the status quo

      • Mike March 11, 2010 at 5:46 pm #

        Fair enough… I’ll take those odds.

    • Christopher Smith March 11, 2010 at 8:53 pm #

      I don’t disagree with any of that and since I’ve written it before, I was trying to focus on what’s next, not what happened.

      Also, I felt that the negotiations should have started with single payer and that Obama should have brought all parties to the table at the start in a manner consistent with the healthcare “summit” we just witnessed. Progressive, Centrist and Conservatives all in the room together working within a policy framework established by the President. We would have had better discussions about the benefits of single payer and the right would have had the opportunity to shill for market based reforms.

      A bill emerging from that process would probably look quite similar to what we have now, with less political blood spilled along the way. However, looking back on Obama’s plan during the campaign, this bill looks a lot like his original proposal, minus the public option and with an individual mandate. Big changes, but ones that may be remedied in the future.

      A much better written version of my current thoughts on why we can’t wait can be found over at Ezra Klein’s site:

      Over the past hundred or so years, the health-care system has gone from a very small portion of our economy to about a fifth of it. That’s a remarkable rise. And it has been accompanied by a similar rise in the political power of the health-care industry. I’ve previously argued that the history of health-care reform is a history of decreasing ambition: FDR and Harry Truman propose something like single-payer, John F. Kennedy and Lyndon Johnson ratchet back to single-payer for seniors and poor people, Richard Nixon and Bill Clinton offer national systems that rely on private providers, and now President Obama is building a private system that’s initially limited to small businesses and individuals.

      There are a lot of reasons for that. One is that political defeat engenders future timidity. But another is that the gaps between proposals give the health-care industry time to grow even larger and more politically powerful, which means that the next president who takes up the issue is faced with a more daunting task and pulls back his ambitions accordingly.

      The time is now.

      • Mike March 11, 2010 at 9:45 pm #

        Hurry up and bring it… if you can.

  5. jesse March 15, 2010 at 5:27 am #

    Any time you hear “the time is now” it’s a statist pleasuring himself.


  1. The Tea Party Circus | - March 21, 2010

    […] I’ve been over what’s in the bill and I don’t feel the need to delve into yet again.   Most of my readers have established positions and are bunkered in their ideological foxholes.  You’re either dug in and support it or you’re vehemently opposed to the bill. […]

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