The Can't-Do Blue Dogs
By Harold Meyerson
The Washington Post: July 22, 2009
Watching the centrist Democrats in Congress create more and more reasons why
health care can't be fixed, I've been struck by a disquieting thought:
Suppose our collective lack of response to Hurricane Katrina wasn't
exceptional but, rather, the new normal in America. Suppose we can no longer
address the major challenges confronting the nation. Suppose America is now
the world's leading can't-do country.
Every other nation with an advanced economy long ago secured universal
health care for its citizens -- an achievement that the United States alone
finds beyond the capacities of mortal man. It wasn't ever thus. Time was
when Democratic Congresses enacted Social Security and Medicare over the
opposition of powerful interests and Republican ideologues. In fact, our
government used to actually pave roads, build bridges and allow for secure
retirements by levying taxes on those who could afford to pay them.
To today's centrist Democrats, this has become a distant memory, a history
lesson they cannot grasp. The notion that actual individuals might have to
pay to secure the national interest appalls them. In the House, the Blue
Dogs doggedly oppose proposals to fund universal coverage by taxing the
wealthiest 1 percent of the nation's households. Their deference to
wealth -- whether the consequence of our system of funding elections or a
byproduct of the Internet generation's experience of free access to
information and entertainment -- is not to be trifled with.
Centrist Democrats' opposition to health reform verges on the incoherent. A
caucus (the Blue Dogs) formed ostensibly to promote balanced budgets now
disapproves of the proposed taxes that would cover the expenses of the new
programs. The congressional centrists say, commendably, that they want to
squeeze more economies out of the system, but they oppose giving more power
to an agency that would set the payment scales for physicians.
Congressional incoherence grows even worse on other issues. How to explain,
for instance, the widespread congressional support for a bill that would
require General Motors and Chrysler to keep all their dealerships open? This
legislation is co-sponsored by numerous Republican conservatives who
actually opposed the administration's efforts to keep General Motors and
Chrysler in business. "Distribution, sí; production, no!" is by any standard
a loony battle cry.
The Republican opposition to President Obama's push for health-care reform,
on the other hand, makes clear political sense. If they can stop Obama on
health care, as South Carolina Republican Sen. Jim DeMint recently noted, it
"will be his Waterloo." Why Democrats of any ideology want to cripple their
own president in his first year in office, and for seeking an objective that
has been a stated goal of their party since the Truman administration, is a
more mysterious matter.
Is the additional tax burden on small businesses their concern? If so, good
news: The Center on Budget and Policy Priorities has found that only the top
4 percent of those businesses would be affected by the surcharge that House
Democratic leaders proposed, and that's based on the original proposal,
before Speaker Nancy Pelosi altered it to include just the wealthiest
fraction of the top 1 percent of Americans. Would such a tax impede an
economic recovery? In downturns this severe, it's been broad-based consumer
spending and public-sector investment that have revived the economy. Private
investment doesn't jump-start a revival of purchasing; it follows it.
But the big picture here, of which the resistance to reforming health care
is just one element, is our growing inability to meet our national
challenges. Almost all of the major nations with which we trade, for
instance, have quasi-mercantilist policies that lead them to champion their
own higher-wage growth industries, often in manufacturing. In America alone
are such policies considered anathema. In consequence, as the Alliance for
American Manufacturing reports in a new book, we shuttered 40,000 factories
from 2001 through 2007 -- the years, ostensibly of prosperity, between the
past two downturns. The diminution of manufacturing, which employs just 11
percent of the U.S. workforce, may please Wall Street, which looks with
disfavor on decent-wage domestic production, and Wal-Mart, which tripled its
purchases from China (from $9 billion to $27 billion annually) during
roughly the same years those American factories closed, but it poses a clear
threat to the nation's economic, and even military, power.
But act on behalf of the nation as a whole, even if it means goring Wall
Street's or Wal-Mart's oxen? Perish the thought. Pass a health-reform bill
that will cover 45 million uninsured Americans and slow the ruinous growth
of health-care spending? Not if somebody, somewhere, actually has to pay
higher taxes. Hey, we're America -- the can't-do nation.
As our former president might put it, Heckuva job, Brownies.
***
http://www.truthout.org/072009U?n
Obamacare Is at War With Itself Over Future Costs
by: Robert Reich
Robert Reich's Blog: 19 July 2009
Right now, Obamacare is at war with itself. Political efforts to buy off
Big Pharma, private insurers, and the AMA are all pushing up long-term
costs - one reason why Douglas Elmendorf, head of the Congressional Budget
Office, told Congress late last week that "the cost curve is being raised."
But this is setting off alarms among Blue Dog Democrats worried about future
deficits - and their votes are critical.
Big Pharma, for example, is in line to get just what it wants. The
Senate health panel's bill protects biotech companies from generic
competition for 12 years after their drugs go to market, which is guaranteed
to keep prices sky high. Meanwhile, legislation expected from the Senate
Finance committee won't allow cheaper drugs to be imported from Canada and
won't give the federal government the right to negotiate Medicare drug
prices directly with pharmaceutical companies. Last month Big Pharma agreed
to what the White House touted as $80 billion in givebacks to help pay for
expanded health insurance, but so far there's been no mechanism to force the
industry to keep its promise. No wonder Big Pharma is now running "Harry and
Louise" ads - the same couple who fifteen years ago scared Americans into
thinking the Clinton plan would take away their choice of doctor - now
supportive of Obamacare.
Private insurers, for their part, have become convinced they'll make
more money with a universal mandate accompanied by generous subsidies for
families with earnings up to 400 percent of poverty (in excess of $80,000 of
income) than they might stand to lose. Although still strongly opposed to a
public option, the insurance industry is lining up behind much of the
legislation. The biggest surprise is the AMA, which has also now come out in
favor - but only after being assured that Medicare reimbursements won't be
cut nearly as much as doctors first feared.
But all these industry giveaways are obviously causing the healthcare
tab to grow. And as these long-term costs rise, the locus of opposition to
universal health care is shifting away from industry and toward Blue Dog and
moderate Democrats who are increasingly worried about future deficits. My
sources on the Hill tell me there aren't enough votes in the House to get
either major bill through, even with a provision that would pay for it with
a surcharge on the richest 1 percent of taxpayers. House members don't want
to vote for a tax increase before their Senate counterparts commit to one.
Yet the Senate continues to be in suspended animation because Max Baucus and
his Senate Finance Committee still haven't come up with a credible way of
paying for health care. In his testimony last week, Elmendorf favored
limiting tax-free employer-provided health benefits, but organized labor
remains strongly opposed.
Obama has less than three weeks before August recess. Chances are
dimming that he can get some form of universal health care passed in both
Houses before the clock runs out. The Democratic National Committee is
running ads favoring passage in Blue Dog states and districts, but that
won't be enough. Now is the time for the President to begin twisting arms
and knocking heads. To control long-term costs, he'll also have to take away
some of the goodies that have been promised to the health-industrial
complex, and maybe even cross Big Labor. He also needs to come out clearly
and forcefully in favor of a way to pay for the whole thing - ideally, in my
view, a surtax on the top.
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