I took a moment, yesterday, to chat with Ezra Klein about where we were--and where he was--on this whole health care thing. Most of you know that in regards to reform, I've basically outsourced my blog to the dude. I figured I'd complete the process by picking up the phone and picking his brain. Much like mixed metaphors, the results are in.
Can you paint the stakes in detail? What will be the cost of not passing this bill?
I'm going to put the choice very simply-- If you pass the bill things get quite a bit better. If you don't pass the bill things just continue to get worse. We all spend our time saying that this is not a perfect bill. That this is not our first choice. That If I were king I'd create a single-payer utopia. That's because we're intellectually honest. But that's been a mistake. It's obscured the fact that this bill is a tremendous improvement in the situation.
The basics of it remain the same. The people who really get helped are the people who end up without a large employer giving them insurance. For those people, this bill is a hedge against extremely bad luck. It's a hedge against the worse part of the system--You lose your job because you have breast cancer and now no one will insure you. You have out of pocket medical bills that go up to 90 thousand. On an average day, none of that happens to us. But there comes a day that is not the average day, and that's when everything goes wrong. This bill says we won't allow it to go too wrong.
Beneath that there is the basic subsidy scheme. In 2019 you're spending 200 billion a year in subsidies on poor people. When was the last time you've heard about government helping low income folks like that? It just doesn't happen anymore.
Two weeks ago, and maybe even a week ago, you were very optimistic that whatever happened in Massachusetts, health care reform would pass...
I did not account for some things. What i looked at was the underlying reality--the bill had passed both the house and senate. There was a pretty clear compromise between the two. You had a race against an almost historically bad candidate, and that would change one vote in the Senate. But yeah, I thought the House might not love the Senate bill but they'd recognize that it's better than nothing, and then they could make a fairly small number of changes through reconciliation.
The other thing I thought, and maybe this is core to my misunderstanding, was that Democrats understood how important this was, morally and politically. Whether it's been signed into law or not, it's been voted on. To not sign this bill is to take all the political pain of health care reform and get nothing for it. Second, to let this go now when they were so close of doing something historic for people who so desperately need help...Look, I can understand why Jon Kyl, who doesn't think this is a good bill, won't vote for this bill. We disagree, but I understand his position. I don't understand the position of an Anthony Wiener or name your blue dog Democrat. They are the ones who now say we'll abandon this because I'm tired. Or because I'm scared for my seat. But they're also the ones who know how many people the bill will help. Who agree on the basic premises of the legislation. And if you agree on that -- if you agree that the bill will save many, many thousands of lives and save people's homes and prevent chronic pain and infirmity and all the rest -- then rejecting it is another level of moral decision entirely.
Calling that irresponsible, I think, is too soft. I didn't think they'd go there.
So with that in mind, what's your perspective on "Democrats" in general, on the party as a whole?
Before we get into this, some people like to dismiss it as an angry or
panicked reaction. But my health care
insurance is not in doubt here. My pulse is slow and steady. We
obviously all agree there's some
point at which the base should not support the Democratic party anymore.
launched a war in Yemen, for instance, or tried to abolish Medicare.
You can argue about whether this
rises to that level. But we need to be clear that this is not a
situation where Democrats can't pass health-care reform, or can't break
a filibuster. Democrats are
choosing not to pass health care reform. If they make that choice, and
the base wants to have any hope of legislative progress in the future,
have to then make yourself clear about the ramifications of this sort
Awhile back I linked to your comment that the purpose of a majority isn't to simply sustain itself, but to actually use the power it has and, eventually, lose that majority.
I was talking with a friend recently, and was asking how many lives saved would make it worth losing a reelection. I'd like people to be clear about that. We don't like talking about outcomes because it's uncomfortable. But if you know you'll revert back to the mean, and that we will not have one party dominance--and we will not and should not--if that's true, then you have to think of rare majorities, like the one Democrats have now, as moments to make concrete improvement in the lives of people.
One thing that people will get is that the Democrats can't govern. They will not have an opportunity like this again. Seriously, this was not enough? 60 votes in the Senate. A large majority in the House. A popular president. And you can't govern with that? Politics is about getting something done for real people. If it isn't, then what is the point of this party being elected to anything?
I don't want to
underplay the accomplishments that they have made. But to walk away
from this is to betray everything they did, and didn't, do to make this
happen. And that's a betrayal of everyone that backed them on this.
So where does Obama fit in on this? How much power does he actually have to influence this process? Should he be doing more?
I find this to be the hardest of all the topics, because it's opaque to me. I'm talking to people on the Hill and they're screaming that they arent getting any leadership from the White House. I think the White House had a completely defensible political theory on this--They'd let Congress do this, and keep their heads down. But their theory just hasn't been born out.
What the White House tells me, and tells others, is that they're waiting for the smoke to clear. I read the interview that Obama gave to ABC News and what struck me was how much it was like the interview I'm giving you now. It was an observational take. I thought it was a very good observational take. But that's something that a lot of people can do. A lot of people can't be president. I don't know that he can pull a rabbit out his hat, but you dont want to go so far in the other direction that you forget he is the de facto leader of the party
He never seems particularly comfortable with that last part--leader of the party. That is, by definition, a divisive role. He seems, for better or worse, much more interested in being "president."
I'd maybe go a step further-- I think Barack Obama would have been happier in the presidency of 100 or 200 years ago when it was weaker. The problem is that even as it, in reality, quite weak, it's expected to be quite strong. And I don't think Obama has been strong on the things he could be strong on.
What I come back to is that Obama gave one major speech on health care. The timing of that was telling. His speech came in September when the bill was coming out of the Senate finance committee, when he felt he had to push it the final ten yards. It was a speech that was meant for Congress, not the American people. He did not give a speech when health care began. There was no speech explaining what needed to be done, why it needed to be done now, and how Obama meant to do it. There was no explanatory speech to the American people. Would such a speech have mattered? it's hard to say. But that approach wasn't tried. it was all inside game.
if there had been no Massachusetts election we'd be having a different
conversation. What Brown's election did was expose existing weaknesses
that the administration was hoping to paper over.
So reading your blog, I'd say you've gone from being really calm and reasoned about this to somewhat more alarmed. I know a lot of us read you and and Jon and think, "Well these guys aren't flame-throwers, their going to give us the straight unvarnished dope." So to see you so pessimistic this week made a lot of us over here especially glum.
Look I've tried very consciously to be calm during this process. i think its part of my job. But I don't want to let being calm keep me from being clear. Health care reform is in terrible trouble, and the thing that's so appalling is that they could pass the bill. They could do it in 24 hours. It isn't just that health care reform is in trouble, it's that its a needless kind of trouble.
do want to make the distinction between being pessimistic and being
panicked. I think people for assessing the situation, the problem is
panic. Forget saving the majoirty, try saving a chance to look in the
mirror. This is still about much more than them. I get emails saying
"I'm feel really bad for you" or "This must be really hard." And I
appreciate that, but this isn't about making bloggers comfortable and
it shouldnt be about making congressmen comfortable. If we fail this
time, I dont know if we'll ever try this again.
There's always been this critique out there that Obama, even as a candidate, never grasped the nature of his opposition. I don't know if I bought that, but this past week has made me think about it more.
I think that after no representatives voted for the stimulus they had a pretty good idea as to what they were dealing with. I don't think they've been playing a strategy based on getting Republican votes for a long time now. I think people mistake Obama being above the fray, for him not noticing the fray.
But that said, I think that the question is
outcomes, as it always is. The question is "Is the strategy working?" I
think they haven't figured out how to neutralize the danger posed by
their own members. With a 60 vote majority, the problem has not been
Republicans, it's been Democrats. It's been Max Baucus spending three
and a half months on the Gang of Six.
Was that ultimately a waste of time?
I think you can make an argument that the Gang of Six showed so thoroughly that Republicans wern't voting for this, that it put moderates on board. Can you blame Baucus for not seeing that Coakley would lose? No, I don't think so. But looking back, the Gang of Six was a bad idea.