We Have Met the Corporation and It Is Us

on where we are and where we must travail. Yes, it's the holiday season and there's much to celebrate as we look forward to what needs to be accomplished. And, you have laid out just what we needs to worked on and worked out.

There are too many money quotes in this piece, but this one struck me and may be my favorite:

Post-sixties back-to-the-landers on the hippie left and post-eighties survivalists on the Christian right both pretty much failed to develop sustainable models of getting off the grid of corporate capitalism. Despite their attempted indoctrinations and home schoolings of their spawn, both found themselves abandoned and rejected by their own children in a single generation.

Yep, the boomers failed in this particular arena and many now want to crab about this rather than still work on the necessary fix. And, it's hard, hard work. It means that a person has to keep organizing and talking to people; many times folks unlike oneself and facing really different circumstances. And, it also means having these conversations while looking on how to unite people on dealing and correcting and making change.

Onward to 2010!

... judging by manager's amendments, the current conflict between the killbillers and the passbillers seems to be a good thing. At least in the shortrun. There seems to be enough momentum going to pass the bill, yet at the same there is a large amount of pressure not to compromise any further.

But let's keep that quiet, and let everyone play their part.

Sloane - I of course have studied Markos' theories of pressure upon Congress (indeed, in general, I've praised them as stated in his book), and read Nate's olive branch to that tendency that maybe, possibly, it has been "somewhat" helpful in making for a better bill, but in this specific instance, I think it is in the realm of unsupported supposition meant to justify the EPIC FAIL of this chapter in poutrage.

It presumes that without the loud whining by the bill-killers, Bernie Saunders wouldn't have prevailed on his amendments that improved the bill, that Senators Wyden and Klobuchar and others likewise wouldn't have pushed just as hard for theirs, or that Senators Boxer, Murray, Schumer, et al, would not have prevailed anyway in dismantling the Stupak amendment.

I know something about the sausage making process of legislation. It was my job to report it for many years, in the US Capitol and the Massachusetts State House. And the claims of interest groups (and yes, the Netroots has become a kind of interest group, with many of the same vices) of their influence over the process are often grossly overstated. What happens to any kind of interest group is that its goal increasingly becomes self-justification over actual policy progress. And that, too, is happening, sadly, to so much of the Netroots seeking to make the story about them.

I frankly disagree with Nate. I don't think the poutrage moved the bill one inch in any direction. But I do know that it decreased the sense of having a "win" that is so necessary to movement building, to inspiring people to organize and do more. On that, I can measure the concrete harm done. Whereas I can't measure with any evidence at all that the flurry of bill-killing poutrage made any difference at all in the manager's amendment to the bill.

This is better than reading Frank Rich on Sunday morning!  I'm not sure I could subscribe to a non-capitalist world (that's not true, I KNOW I couldn't as I'm one of those who you describe as too spoiled with the worldly pleasures of this capitalistic society) but I do appreciate your fine assessment of the hypocrisy of the "bill killers". 

I hope the bill passes and I called my senators. However, as a health care provider, I am developing a 10 year plan to remove myself from dependence on insurance companies. Honestly, that means developing a product that people (rich people) are probably going to pay cash for, not using their insurance. I got my MSW so I could take insurance, but it has been so frustrating. 

What you say here is important, and I expect I will be grappling with it as I engage in my own capitalistic schemes. (Or, I might be too busy and self-absorbed in my cozy North American life to honestly grapple with it.) To take what you said further, workers, or citizens, owning the means of health care production would involve challenging hundreds of years of saying "Yes, sir" to doctors, not knowing how to take care of ourselves, heal ourselves, eat right. It even goes back to the burning of the witches in Europe. Witches were likely community organizers, teaching people how to take care of themselves and removing dependence on priests and then later the male medical profession. Women's health clinics and know-your-body workshops are some of the few attempts at helping people take back the means of health care production that I know of. 

Thanks for this. I've LONG been asking the question, "But what do all those people do for a living when we abolish private insurance companies?" The most honest answer I've gotten was from a friend's father. Their family has been battling with insurance companies their whole lives due to multiple serious medical conditions. He snapped at me, "I don't really give a shit."

I love my job. I don't want to do anything else. But if I'm going to keep doing it, it's hard to imagine making a living at it with out collecting checks from News Corp or Disney or GE (soon to be Comcast)... I've had to continually work to be at peace with this. It takes engaging in my community in a productive way. Quitting my job to work for Obama, say. Or volunteering for a local charity. But you're correct. I admitted long ago this broken system provides a life I'm not prepared to give up. What I haven't been able to articulate until now is that it's this perspective that's rendered me incapable of communicating with the absolutists on this issue, and others for that matter.  It seems so obvious reading this but it hadn't clicked into place before. Thanks for helping me crystalize my thoughts. Hopefully, I can argue more productively now.

Have been fighting corporations since before Barnet and Mueller's book was published.

And some of us who have serious problems with the healthcare "reform" emerging from this Congress don't find your drive-by swipes to be at all amusing.

I haven't had health insurance since being permanently laid off by Firestone in 1982. The only reform here is that I will now be forced to pay insurance premiums to the same insurance companies who refused to take my money for over a quarter century.

Rip on those who disagree with you all you like Al, I for one do not appreciate a bill that turns my ass into a bicycle rack for the insurance banksters.

Our Dixified Republicans aren't afraid to break the system to get their way. How does compromise between all the various corporatized members of Congress further the cause?

Any more "wins" like this one and progs might as well just give the country back to Cheney.

Also written and dismissed in the 70s was Limits to Growth by Meadows.  It correctly predicted the inevitable consequence of an economic and social system that required infinite growth on a finite planet.  They were dismissed at the time, but their projections have held up well, and they updated their book a few years ago:

http://www.amazon.com/Limits-Growth-Donella-H-Meadows/dp/193149858X/ref=...

The takeaway is twofold - that the economic system cannot function much longer because the infinite growth paradigm has exceeded the carrying capacity of the planet (both in terms of natural resources like oil and in terms of environmental sinks like pollution).

I think that's another important piece of the macro picture here.

Pretty please? This is a discussion that needs to continue in parallel both here and on less friendly ground.

It is frightening that so much of the left wants to scrap a year's worth of work by the most liberal Congress in over 30 years (one which will almost certainly inch rightward with next year's elections, particularly if the pouting by the base continues) over the notion that the 30 million mostly poor and working-class people who would finally receive health-care as a result should be refused this care because they would "only" get to choose from an expanded, better-regulated range of the same corporations that provide health-care for Jane Hamsher, Howard Dean, Arianna Huffington, Tiger Woods, Bill Gates, and the majority of people in the country.

If the well-insured left succeeds in getting progressive House members to vote against a conference bill because it has no public option, they will have done the same thing the insurance companies have been doing for decades (and would no longer be able to do): denying people coverage based on their pre-existing condition... of being unable to pay!

Al,

You have perfectly captured the arguments I have been making to anyone within earshot, except you do so more succinctly and with greater writing finesse. I originally come from the African continent, the beneficiary of bitter wars/struggles for liberation. And I must tell you that throughout my graduate education here in this country and well into my professional teaching career here, I have often been dumbfounded by the way some of the socalled progressive left misconstrue how real progress is achieved. Yet, in fact the long tortuous histories of the African American and latino/a civil rights movements readily provide glaring clues for the "poutrage" class on how painstakingly slow real movement forward is.

Case in point: I lived in Austin, Texas during the rise of Whole Foods Market from its modest days into a huge conglomerate, and was amazed at the ideological invesment many had in the "progressive" stature of this company. They believed that buying lettuce from a gleaming wooden table rather than Kroger's steel and plastic tables, or buying a bag of peanuts with raffia-wrapped rather than mylar packaging somehow made them conscientious objectors to crass capitalism and contributors to the livelihoods of the world's poor. But they do not question the very structure of American consumerism that vacuums up 70% of the world's resources for just 300 million people. As you rightly ask, how prepared are we to REALLY give up our lives of relative comfort in order that the rest ofthe world's peoples can have true equity?

Meanwhile, when I went back to the continent this past summer during President Obama's visit to Ghana in July, a spirited taxi driver said to me after Obama's speech, that he wonders whether ALL Americans are seriously prepared to work with the rest of the world to solve the intractable problems plaguing it.  He asked whether Americans are prepared to give up their lifestyles. I did not have an answer. He smiled and said he fears President Obama will have more friends outside his own country than inside it. Well, here we are...

I'm struggling to understand how the health of the community could be improved in a manner that respects deomcratic values. I think the best models go back 100 years or so ... to a time when voluntary mutual-aid associations were much stronger, and many of them provided basic health care for their members. But, as you say, Americans really aren't prepared for that sort of conceptual leap at this point.

http://mason.gmu.edu/~ihs/s92essay.html

One question would help to clarify your reasoning for me: Would you still consider this bill successful if it increased the percentage of the economy controlled by private insurance companies by another 3-5%, thereby increasing their power and influence?

Another great blog entry! I couldn't agree more. It seems on dailykos that all the concern is over the health insurance companies and them getting all they wanted (which of course is not true). Furthermore, it is very difficult to find ANY concern on dailykos over people with pre-existing conditions. This is not great bill. But it is a start. If we didn't start, then we would have to wait until 2024. What good does that do?

Mark - If my writing merely amused those who I'm criticizing it wouldn't really be making its point, no?

I also don't have health insurance. And see enough loopholes in the legislation to continue not having it without legal problems. Your portrayal of it as something that will "force" you to get it ignores the complete unenforceable nature of its mandates, even if they do survive until 2014 when they would kick in.

Truth is, nothing, absolutely nothing, will happen to you or I for not signing up in that system. That's been the experience in Massachusetts, where nonetheless a higher percentage of the population has chosen to sign up for insurance that was made available to them than in any other state of the union. And they didn't do it because of unenforceable mandates. They did it because they wanted insurance for themselves or, often, their kids.

And if you keep calling progress that brings more options - not fewer - to poor and working folk "defeats," well, then you've already handed the country back to Cheney. So, yes, my goal wasn't to amuse folks like you, but, rather, afflict you in your comfort to care more about comforting the afflicted.

My inbox was jammed with links to this Bill Moyers program featuring Taibbi, as well as the latest poutrageous statements by Hamsher, Dean, Olbermann, and Moulitsas.

I was ready to hit reply and tell them that all of these arrogant, paternalistic "progressives" can suck it but I will send this piece instead.

And, thank you Al for pointing out the flaw in the argument that all of the kill billers have made the Senate bill more progressive.  Do they really believe that all of their self-important whining made a difference as opposed to the work of Jay Rockefeller, Chuck Schumer (a good, good guy on this issue), the White House team including the constant  pushing of President Obama, and others?

I am also tired of hearing that the President should have pushed more, done more, supported the public option more, started with single payer, not let Congress run the process, been more vocal, blah, blah, blah.  How did managing the process and writing the bill work for the Clintons?  Bill even pounded his healthcare reform publication on the podium before a joint session of Congress.  More importantly how did that strategy work for the millions of people who were un and underinsured? The fact that we are about to get major legislation through the House and Senate and into conference committee tells me that the White House has managed this just fine.

Erik: I am not our host to whom your question is addressed, but in my own reasoning, it does not matter to me at all if the percentage of the economy that is controlled by the health insurance industry were to go up by 5%. The numbers have to add up to exactly 100% in any case, so this would only mean that the share of the economy controlled by the huge banks, energy multinationals, defense contractors, and service industry would have dropped incrementally. Are these corporations more virtuous than the health insurance companies? Is this marginal shifting-around of capital among large business interests really a concern that makes it worthwhile to scrap a reform bill whose largest effect is to distributes wealth to the nation's neediest?

Is it the fault of the so-called "netroots" that the effort for movement building has been harmed?  Can't some blame rest on the White House for not managing its message better?  I think what has been most disheartening for me over this long, arduous year has been that Obama, who was a master of the political narrative over the election season, has seemingly lost this ability once in office.  Regardless of the political necessity of capitulating to Lieberman's narcissistic demands, the White House handling of that incident appeared very weak (and indeed was the trigger for the wave of cascade failure among progressive circles.)

That being said I'm optimistic about this health-care-foot-in-the-door bill, and look forward to using it as a springboard for further organizing, and further progressive reform for this country.  I just hope that for 2010 (bound to be as difficult a year for everyone as the last) the White House can regain its ability to lead the narrative effectively.

You write:

In lieu of any real plan, we are offered “feel good” solutions of lashing out against corporations. Lost in that discourse: the people down below. That is what has defined the health care debate on parts of the blogosphere. It doesn’t matter to some that 30 million people who don’t have any health insurance at all will now have theirs subsidized. To them, if the insurance corporations also benefit from it, then it is a moral “evil” that must be stopped.

Will those "30 million people who don't have any health insurance at all" actually get real access to health care or will they be eligible to pay for partially subsidized health insurance premiums for policies which charge unaffordable co-pays and deductibles, while capping yearly maxes and offering no reductions in obscenely expensive drugs?

I fail to see how mandating that Americans buy health insurance from private insurance companies, in which the government actually subsidizes premiums to private insurers for financial hardship is a " victory" which will energize the masses to putting an end to the capitalist economic system. It gives more money to private insurance companies to further entrench their profit-motive driven power.

Exposing Obama's pledge for "change" as being only a marketing tool to hide his DLC corporatist loyalties -- and those of the Democratic congressional representatives -- is a pre-condition to developing a deeper awareness of how ruthlessly capitalism exploits the majority.  This, in turn, is a pre-condition for thinking about, talking about and elaborating a plan to replace capitalism with an economic system that works for human beings.

As an American expat living in Venezuela, I have a front row seat on the development of a new template for organizing a socialist economic system.  The Chavez government is truly visionary, and implementing new forms of economic and social organization in face of the fierce opposition and constant obstruction of the capitalist oligarchy, both internal and global.

Thanks to the 1999 Chavez led Constitutional reform, Venezuelans now have a constitutional right to free health care, free education to the doctoral level, housing, nutrition, unionization, and community level democratic decision-making.

The simple existence of these rights and the programs to implement them here in Venezuela are a damn sight better inspiration and motivation to the working people of the U.S. than having the privilidge of buying crappy insurance which will not provide affordable health care.  Passage of this travesty of reform instead of taking private profits out of health care will demoralize the U.S. working class, make them give up political action, not inspire them.

The increasingly wide-spread criticism of the corporate ownership of the U.S. government, of which the so-called health care reform is a glaring example,  is an important step in generating the needed thinking about what a new, human society should be.  We should welcome it and expand upon it, pointing to the models of Venezuela, Bolivia, Brazil and Ecuador

Justina - While I wholeheartedly agree with your praise for the Bolivarian system in Venezuela (and this publication is one of the few in English that has pointed them out again and again over many years) I think your analysis of what is supposedly best for the workers and the poor in the United States is heartless to their own needs and desires. It's as if they're supposed to suck it in and suffer until revolution comes to their own land.

What is wrong with giving people more options than they have today?

I can tell you what is wrong with not doing it: That would leave an even more miserable status quo in place.

My writings are filled with reporting that demonstrates my defense of the poor and the workers in Venezuela. You would do well to do the same for the poor and the workers everywhere! We don't all have the luxury of waiting for the revolution to come. In the meantime, life can still be made better - or at least not worse - through step by step organizing and change.

Erick - Andrew beat me to it. The question is, where is that 3 to 5 percent market share coming from? Most probably it is coming from the current health care, pharmaceutical and banking industries (including that prey upon those who go bankrupt because of illness). Saying one group of corporations is somehow better or worse than another doesn't really pass the smell test.

I just want to add one thing.

The President has had incredible successes and is being torn down by white liberal anticorporatists with no foundational thinking on the state of the world today. They basically are whinning and spending money to hurt themseleves. A case in point, Jane Hamsher going after Joe Liberman's wife for working for the Susan Koleman foundation. Wow. That right there, IMO, is why the Medicare expansion died. And she has a history of screwing things up; see her putting Joe Lieberman in blackface and hurting the Lamont campaign.

She has misrepresented the situation on her blog and made it worst with her campaigns IMO. And she's screwed progressives from the inside; but yet she's hailed. It's frustrating.

30 million people will have a better life, the exchanges will create real regulations on the insurance companies and help those with insurance get good coverage. Instead of fighting to bring this on line in 2010, we had a stupid fight over a public option that was too weak to do anything!

The weakness of the netroots manfiested itself in this fight IMO. And it shows in the lack of wins on the board.

Al, here's a small point to agree with you from someone who has been using and writing about Linux and Free Software for a long time.  Most of the work on Linux gets done by corporate developers "on the clock," working for large IT companies such as Intel and IBM. And the same is true for other key Free Software projects such as Mozilla Firefox, whose primary source of revenue is Google ad money.  Even the print server software on your typical Linux system is developed at Apple.

The big difference is that a sweatshop employee can't quit and get a different job making the same product for a better employer, and thanks to the "reciprocal license" terms of the GPL, and the norms that go with it, many Free Software developers can.  Part of "Linux-izing" the economy will have to include re-writing some of the contracts under which individuals agree to exchange work for money.

Thank you, you've provided an argument that I'll reflect on and consider more carefully.

This is a terrific post, and a terrific discussion in the comments. The "anti-coporatism" of many on the left today seems to extend no further than "revenge". They aren't concerned about what is the best economic and financial policy we can expect to achieve today, they want revenge on Wall Street. They aren't concerned about what is the best healthcare policy we can achieve and the best outcome for the poor and uninsured, they want revenge on insurance companies. Apparently just because it makes them feel good.

In some of the more extreme cases it become nihilism, where the result is to destroy without putting anything in its place. The Republicans have come to embody this nihilism. If they can't govern the country, they want to make it impossible for anybody else to do so. But some on the left, with their blind lashing out, apparently also want to make it impossible for any progressive change to occur at all. It worries me if this tendency on the left begins to have an actual impact.

Even though watching you ream beautiful losers is my favorite spectator sport (and really, people who are so committed to losing, even when they win, develop a stunning virtuosity about it -- Glenn Greenwald: the Horowitz of losers!), the MOST outstanding feature of this political moment is how much our politics has grown up.  The Eyeores can't take it away from us.  This is going to pay huge dividends in the long run.

I noticed even Markos admitted on MTP (around the 3:00 mark) that the bill was "marginally better" than the status quo and a "first step".

There is plenty of good ammunition for organizers to march forth with from this great victory.

Ezra Klein's column 12/19/09:

This is a good bill. Not a great bill, but a good bill.

Imagine telling a Democrat in the days after the 2004 election that the 2006 election would end Republican control of Congress, the 2008 election would return a Democrat to the White House, and by the 2010 election, Democrats would have passed a bill extending health-care coverage to 94 percent of Americans, securing trillions of dollars in subsidies for low-income Americans... It is, without doubt or competition, the single largest social policy advance since the Great Society.

http://voices.washingtonpost.com/ezra-klein

Paul Krugman in a column titled The Insincere Center also praised the bill, commenting "....it represents a rejection of the view that the solution for all problems is to cut some taxes and remove some regulations. In that sense, what’s happening now, for all the disappointment it represents for progressives, is a historic moment."

http://krugman.blogs.nytimes.com/2009/12/19/the-insincere-center/?src=tw...

over on DailyKos?  I'd do it, but if I could only copy and paste 3 paragraphs, it wouldn't cover many of the points you make, unless I rephrase it all, and my specialty isn't writing.

Yes, you'll probably get a lot of flack for it, but a lot of praise too.  Right now the top recommended diary is one from Sen. Al Franken (D-MN) on why he supports the Senate bill, and a LOT of Kossacks did recommend it.  Another rec list diary is about Yale professor Jacob Hacker, credited with coming up with the public option, saying he's supporting this bill too.  So there's a lot of divided opinions among the netroots, and perhaps more support for passing this crappy bill than you would think.

And if you won't go over there, then give me permission to repost your entire post, LOL.

http://www.tnr.com/blog/the-treatment/why-i-still-believe-bill

BruinKid - You have my permission to post it in full. Remember to indent the blockquotes and include the few links there are in it, as well as a link back to The Field.

I myself am on vacation from arguing with so many anonymous commentators, both trolling infiltrators and those who are so easily manipulated by them. But if you want to use my words to have at it with them, be my guest!

Just terrific piece. Very very well done.

Thank you.

I'd suggest that you post it on places like the Daily Kos, but i fear for your life...

Thanks Al, for being a voice of reason in the storm of pouting whiners.

a) Sheldon Whitehouse's brilliant speech on the Senate floor calling out the open fascism of the Republicans - the allies of our nitwit self-selected "progressive leaders"  in attempting to stop this bill

http://www.c-spanvideo.org/program/ID/217151&start=6430&end=7371

b) http://www.eurotrib.com/story/2009/12/15/18342/018

"So the "anger left", which has been fuming about Obama since the primaries naturally incorporates ambient prejudice its critique -- to make up for the missing analytical content. There's a lot of anger that sounds a lot like the "knife-in-the-back" so beloved of the far right. There is a good deal of dishonesty in that the goals of some of the most prominent Anger Leftists are clearly to climb the policy/pundit hierarchy. But there is no real effort to understand how economic policy is driven by the imperatives of the corporate and military elites, and delegated to a small insular group of "intellectuals" who inhabit a tiny ideological spectrum (from Krugman to Hayek). Instead, we learn that Tim Geithner is a bad man. Rather than examine how the ideology and raw power of economic and military elites shapes congressional processes, the media, and who can get jobs in the Administration, we are asked to demand that Ben Bernanke be brought to justice for, shock, operating the Federal Reserve to benefit banks. In fact, people who do attempt to look at structural issues are derided as "stooges" or paid White House staff."

on DailyKos, along with some comments of mine interspersed about.

All I can say is, "fire in the hole!!!!!!!"

Thank God,  I could no longer hear myself think amidst the din of those shouting "kill the bill".   This bill will actually help my family and several other individuals I know who are currently uninsured, it is not exactly what I hoped for but it is better than I thought it would be.  Having been involved in progressive politics for 36 years, my experience has been that every single move forward requires a first step. 

...that what a lot of folks were looking for was an anti-corporation bill and not a health-care bill. I always saw that as the primary motive for an insistence on the PO, particularly during its last throes.

I have a feeling these ideological proxy wars are very common on the left. Would've been easier to say that this wasn't about insurance companies, wasn't about corporations, but about healthcare (no shit, right? Nope!) At least there'd've been a talking point to balance things out.

Ideological wars on the right too, but backwards: liberals have a tendency to believe legislation is a trojan horse when it isn't, and conservatives have a tendency to make legislation a trojan horse because it is (unless you're conservative; then the argument is likely vice-versa and equally valid. Huh...)

Anyway, this kind of raises the question: if it isn't really about healthcare, what are people actually arguing over? I don't have nor do I really want health insurance (bill collectors either way, right?), so I never really cared. It's crass, but true... and I also got sucked up into Hamsher's arguments for a while. Was that even ever about healthcare?

I guess this whole thing is wanting for a little honesty above, really, anything else. We can blame Lieberman et al, or we can blame ourselves for an almost wanton lack of clarity. Touché.

(...said the preached to the preacher...)

This is a very interesting post and I will digest it and comment on it later - I agree with much, but not all of the analysis, so I've been converted to a "pass the bill"

Here's a Kos diary from deoliver, on Hamesher from an organizer's perspective. Currently on the rec list

http://www.dailykos.com/story/2009/12/20/817242/-Sorry-Miz-Jane-Hamsher.-No.-

Point: the community is far from monolithic.

Al, I think many of your comments on the country already being controlled through a corrupt corporate hierarchy is a good point.  However, I would like to think that we can channel this blogospheric anger into something productive-- like movement to single payer or a public option or, even more importantly, towards social democracy as opposed to the neoclassical economic model we have now. 

As to another part of your post, I'm wondering if you have read Roberto Unger's theories on structuring local egalitarian communities loosely bound together.  His theories seem similar to yours in many ways.  I think,  however, its difficult to see how complex organizations (like the nation-state) can be successful using this framework.  While you can have communities small enough to be bound together solely by egalitarian solidarity; it seems like there is a real problem coordinating complex tasks in a large organization without authority/hierarchy.  Have you seen any models in Latin America which overcome this problem ?    

“I have yet to see a single-payer health proposal, for example, that honestly admits that removing insurance corporations altogether would cause hundreds of thousands of Americans that work for them to become unemployed.”

Simply untrue.  Well, it may be true that you haven’t seen it, but it’s definitely there.  HR 676 has provisions for retraining and hiring displaced Insco employees as well as extended unemployment benefits .  (see Section 303(e)).

Additionally, estimates show that if 676 were passed 2.5 million new jobs would be created overall.  That’s 2.5 million net, including the losses in the insurance industry.

So no, critics of the bill aren’t ignorant of the needs of working people.  A lot of us are working people (even with corporate-made computers and college educations!).  And a lot of us still think this is bad idea for very substantive reasons.

But hey, name-call away!  If the Dems lose elections, there will always be us “poutragers” to blame for it.  In the meantime I’ll be scraping together my unemployment money to buy shares in Cigna.

I think a big problem is that it entrenches corporate interests making single-payer - if was ever a posibility - nearly impossible. It's also politically tone deaf, if, as I believe happens, the mandates kick in immediately but protections don't kick in until 2014.Not to mention it's simply doomed to failure because the business model of private insurance is incompatible with life.

The GOP will run on repealing the mandates and subsidies (which they'll call welfare) and will win the middle.

Bill killers aren't saying no bill. They're saying get to work on a good bill.

This artificial deadline imposed on the process shows that Congress doesn't take it very seriously.

You hit the nail on the head. The socio-economic make-up of the kill-bill leaders is the glaring elephant in the room, and their opposition to it is almost predictable. These people have benefitted from the current system. I have seen Taibbi brag on television about the luxuries showered upon him and other journalists during the primary season by their corporate employers. It is quite funny that he became such a vocal advocate of killing the bill. Why should he care if the plan covers 30 million people? He’s got his.

They are not interested in real change because they and their children would actually have to compete with others. The sad part is some of their followers are not in the same position should the window of opportunity close and the status quo continue. As wealth is consolidated into the hands of a few, competition is wiped out on many levels and in every sector. These people have carved a niche for themselves, so they can afford to have existential and symbolic arguments while the status quo is unacceptable for most people.

It is no surprise that as we are getting closer to covering 30 million people in need and finally passing a rather imperfect something, these are the same folks who are ready to kill the bill over writing that was on the wall 3 months ago. It is not anyone’s fault that they just figured out there would be no public option and discovered the downside of mandates, except their own. They never had the votes for the public option, not with Lieberman and Nelson in our caucus of 60. If you thought Obama could just karate chop Lieberman into voting for the public option (especially when he has nothing to lose), then I have a bridge to sell you.

But, but it’s all Obama’s fault that Lieberman and Nelson are crooked, and the leadership made a deal with them anyway to get something done and not play purity games. He’s a corporatist -- like our complex problems start and end with Obama. And where were their anti-corporatist rants when the Glass-Steagall Act was actually being repealed? Or this doozy . . . I didn’t get what I wanted, so I am a teabagger now -- it’s easy to leap into bed with reactionaries when you’re a PUMA at heart.

You really can’t make this stuff. Thanks Al for finally addressing the giant elephant in the room.

@Rhoda – You are on to something. It cracks me up how she whips up some of the Netroots into fool’s gold expeditions. They defend her when her actions are indefensible. I watched her two paid goons on DailyKos run off a diarist over a health care discussion over patents. She brought an alternative view to the discussion, and the FDLers impugned this woman’s character over nothing. “Blackface” Jane seems to have the personality type of a demagogue but is kind of a giant boob at actually being one. It is kind of funny how she tries to step into the middle of an issue, and it quickly backfires. She really makes Al’s takedowns too easy. We need to handicap his future takedowns in some way. If she were smarter, she would actually be quite dangerous.

@rootless-e Nice post. I like how you take on some of their intellectual dishonesty and their choice of language. It also annoys me to no end when people say he was a progressive when he was always centrist. The actual political trajectory of fundamental change is another annoying one of their greatest hits of dishonesty. My current favorite is when they downplay the risks and problems of reconciliation in the healthcare debate.

Thanks for posting this on Dkos.  The comments are an interesting mixture of egos, light thinkers and some good posts.  But I've noticed that while it looks superficially like it's about 50/50 for and against Al's viewpoint when you actually look at the anonymous tag lines it's really only 2-3 anti provacateurs that keep the ball rolling with repeated argumentative posts against many more that are supportive.

There was some hilarious back and forth on the subject as to whether or not Al Giordano is a "centrist" with one of the commenters responding that "Giordano is to the left of Hugo Chavez and Fidel Castro".

I liked commenter Norbrook's description of "progressives".

The reality is that most progressives do not constitute a "base."  In political terms, a base is a steady, dedicated, reliable group which has one or more issues in common.  They show up to vote at elections.  They work - and often run - the party apparatus.  They run the local elections and for local offices.  They donate money to those elections, as well as doing campaign work.  They're the ones who show up, day in and day out.  You can count on them - and you know you have to consider what they want to keep them.

Progressives?  Progressives aren't a base.  From what I've seen here, I wouldn't rely on them.  They jump from issue to issue.  They leave when they don't get their way, and they don't want to be bothered with all the small stuff.  They're "big picture" and they'll let you know that as they move their show around.  They'll jump candidate to candidate, depending on what the particular issue is "hot" with them at the moment.    Sometimes it's useful when they're with you, but no one relies on them to get elected - at least more than once.   For that, you look to a real base.

Yeah, I love this claim that the Netroots are the Democratic "base". They also think they are much more numerous than they actually are.

Currently (Sunday evening) the Senate is debating with the first of six votes scheduled for 1 am on Monday. This is the cloture vote on the manager's amendent and requires 60 votes. Two more votes will come around 7 am on Tuesday, the final vote on the manager's amendent (which requires only 51 votes) and a cloture vote to end debate on the healthcare bill itself (as updated by the manager's amendement). The second of these votes requires 60. There is another set of two votes at 1 pm on Wednesday. These are the final vote on the healthcare bill (51 votes here) and a cloture vote (60 votes) on a procedural move to merge the healthcare bill into a House bill that is serving as a legislative vehicle. The very last vote is Thursday at 7 pm, the final vote on the legislative vehicle (51 votes).

So, six votes, of which three require 60 votes and three require 51.

Then after the Senate has finally passed the whole thing, the House and Senate have to have a conference to reconcile the differences between the two. The conference will produce a "report" which is the final, compromise bill. The House and the Senate each vote on this, with no opportunity to amend it. The Senate will need 60 votes to end debate (cloture) on the conference report and put it to a final vote.

Only after both the House and the Senate have voted in favor of the conference report does it go to Obama.

So there is a lot still to do, and we will not likely see the final bill signed into law until mid or late January. But getting a solid bill out of the Senate is one of the most important steps and Christmas Eve will be a time for celebration.

Thanks for a well-considered contribution on the reaction of the left to the senate healthcare debate.  You really made me think and reconsider my angst about the outcome of the senate process.  I was one guilty of focusing on how this benefits Cigna et al. and hardly thinking at all about how it helps those down below.  Thanks for giving me the kick in the pants I needed to view this from another perspective.

Your clearly articulated perspective got me through the most depressing moments of my temporary [but proud] career as an Obama for America field organizer. I'm so glad that you've weighed in on the HCR situation- the self-righteous, self-immolating "left" is driving me totally crazy. I do wish you'd post directly on DKos, so that your voice would be heard with the maximum amplitude.

Well speaking of bizarro world!!

Jane Hamsher now joins forces with Club for Growth Grover Norquist, anti-feminist Phyllis Schafly, Robert Borosage and the teabaggers in tehir new "populist" opposition to this administration. Well as they say when you lie with dogs you get fleas. Here are her words in response to the diay on dailykos.

http://www.dailykos.com/story/2009/12/20/817242/-Sorry-Miz-Jane-Hamsher.-No.-

"I’m not afraid to join cause with the libertarians if they’re right about something, as I wrote the other day — new and interesting alliances are the lifeblood of change.  We have a difference of opinion over what we think the role of government should be, but I think they’re coming from an honest position."

It's the Republicans who are trying to kill the bill, not the progressives.  The progressives of all stripes are trying to improve it.

When the Senate Finance Committee passed its bill, Governor Howard Dean and the AFL-CIO's Richard Trumka set out their criticisms very clearly.  Dean gave his suggestions for using reconciliation to pass a better bill. Then, only two days ago, Senator Reid disclosed his "Manager's Amendment to the Senate Finance bill. Dean's review suggested it was an improvement on the original.

But, there is, as yet, no final bill, so no one of us knows for sure who will be helped and who will be hurt by this legislation.

Initially, after the Senate Finance Committee passed its bill -- without a public option or a medicare buy-in, but with the mandated purchase of private insurance -- many of us on the left were enraged that the Obama administration had pandered to the private insurers and drug companies by not fighting for a bill which gave full coverage and reduced costs to all the 47 million people who don't have insurance -- and to the 50 million who are under-insured.

Many of us yelled long and loud about it.  As a result of that outrage, Reid's "managers bill", some 385 pages of it,  contains some provisions which seem to improve the Senate Finance bill, but it is still not easy to see what and where those improvements are.  The original bill is reportedly over 1000 pages.  It still potentially deprives one half the population of the ability to access abortion services, by allowing individual states to prohibit payment for abortion services, a terrible retreat from the 2008 Democratic Party platform, not to mention Roe v. Wade.

Hopefully, if we keep yelling about the need for affordable access, including co-pays and rescission rules, a conference committee version will improve the bill for the benefit of 99.8% of us who are not millionaires and not corporate managers -- and the 50% of us who are not male.

Jane Hamsher, who I don't always agree with, has done a tremendous amount of work to get decent health care legislation passed.  As a victim of three bouts with cancer herself, she is well aware of many of the problems with private insurance.  Indeed, we are all aware that ultimately only a single-payer, Medicare for All type bill or the absolute removal of profit-driven private insurers are the answers to reducing costs and providing full, affordable coverage to all Americans.

Before his presidential campaign Obama acknowledged the necessity for a single-payer system. During his campaign he watered it down to an ill-defined "public option".  Upon his election, he and the Democratic Party leadership refused even to allow single-payer to be discussed, let alone be scored by the CBO to provide an accurate estimate of just how much money would be saved by a Medicare for all type plan. By refusing to allow informed debate on single-payer to cover all Americans, Obama and the leadership deprived the majority of Americans of what they needed while depriving all the taxpayers of a real cost savings.

Having reviewed the proposed "Manager's " 385 page amendment to the Senate Finance Committee bill, I'm still not clear on its real impact for those 47 million uninsured and the  50 million who are under-insured.  I trust Howard Dean when he says its represents an improvement.  But clearly, we are still not yet close to providing affordable health care to all those who need it.  Until we know whats in the final bill, we on the left need to keep yelling so that any further changes aren't just more gifts to the private insurers and the conservadems they've bought and paid for.

Logically, no one who cares about providing the broadest possible coverage at the lowest possible price should be shouting "Pass this Bill"  or "Kill this Bill" until we have gotten the best possible deal in the final bill that we can.

We have one more shot if we can push for a conference committee to reconcile the best parts of House and Senate Manager's Amendment bills.  At the conclusion of that process is the time to decide whether we should support passage, try to get the best parts passed through reconciliation or advocate killing the bill and starting over.

In the meantime, exposing the Democratic Party's sell-out to, and control by,  corporate interests is extremely important to generate support for electing progressives to replace the "Blue Dog" conservadems and, hopefully, to remove the power of the DLC to further pervert the Democratic (and democratic) agenda.

Al,

When you talk about winning, the Mercury Cafe in Denver comes to mind during the dem convention and me yeling at Larry Everest. Man was I pumped up.

http://www.youtube.com/watch?v=05Y1rMkdFLw

First of all, I agree with most of what you're saying, and it is making me feel better about the messy bill in Congress.  I especially agree with: “Meanwhile, any actual progress in improving the lives of the poor and the working class must be, according to them, halted, even demonized, if it doesn’t simultaneously and immediately overturn the existing reality of corporate domination of our world,” I have personally confronted this thinking in comments on diaries I’ve written on a number of different issues. And “making perfection the enemy of the good” is the best summary of some people’s argumentation I’ve heard.

But I think you’re taking some aspects of the progressive blogosphere a little too far, and painting things with an overly broad brush. So I just want to pick at a couple of things. I read the Moyers Journal transcript. I disagree that his first concern isn’t everyday people. First, Moyers’ reporting has a running theme of the outsized influence of corporate money on America, and his introduction to that segment of the Journal, which set up the Taibbi segment, was consistent with that theme. Why would he jump into something that wasn’t what the segment was supposed to be about? In any case, Moyers’ underlying assumption is that corporate interests run contrary to the interests of the people. The mention of polls indicating that 30% of the public was in favor of a medicare buy-in, but that the Democrats killed it anyway was indicative of that. Also, further down in the transcript, there is talk about Congress members hearing about all the financial pain people in their districts are going through right now, and about how Obama is too disconnected from that. Pick apart the assumption about corporate interests if you like, but I think Moyers’ concern with the interests of regular people is implicit. So I’m wondering why you started with Moyers instead of something like the New York Times.  I also think people really need to be reminded about corporate manipulation -- otherwise, as I’ve seen teaching college students, they are very easily manipulated by the media, including manipulated into voting for Congressional reps who vote against their interests.

I also think Olbermann has to be credited with giving people a lot of hope and an outlet for frustration during the darkest days of the Bush Administration. He was a voice in the wilderness for many of us, and the caricature of himself that he invented was part of his appeal. Yes, the show is now entirely too formulaic, but he and Rachel Maddow provided a counter to Fox News at an important time. I don’t think they’re emblematic. Rather, we need them in addition to the boots on the ground. It’s not one or the other.

But I see your point, and a personal example comes to mind. While we were doing the fundraising push to buy a house for Pretty Bird Woman House, somebody started insisting, and I really mean insisting over and over, that we build our own house out of STONE in the middle of the prairie. I guess that was his idea of being off the grid or something. The only way I stopped this person, and a small chorus of followers, was to ask whether he was willing to go out there with a truck and organize all this rock collecting he was advocating (not to mention whether he was going to actually find any rocks, since he didn’t know anything about the environment or the population). He was totally unwilling to actually DO anything. All he wanted to do was insist that he knew what we should do, and then complain when we were just getting a normal house. No matter what the women we were helping actually wanted (a nice little ranch), the coolness and nontraditionalness of a stone house had to be promoted at all costs. So, I do see where you’re coming from.

On the issue of a single payer system putting the insurance industry out of business, you missed some conversations. There was consideration at Kos about what to do with those employees. One thing discussed was that the industry could still be used to process medical claims, since medical system would be so much bigger under a single payer system. Right now, much of the place has degenerated into name calling so it’s a waste of time to pay too much attention to it, but things weren’t always like that. In fact, right now, Mcjoan has an informative piece on the major provisions of the bill. http://dailykos.com/hotlist/add/2009/12/20/2221/7666/main//.

Also,  it seems to me that some people are indeed just starting to recognize the extent to which corporations dominate everything, and are trying out their analyses. Yes, I understand your larger, very coherent point, but I think it is very good that this social fact is being place so front-and-center in the discourse. We are not going to replace any systems unless people become aware of the nature of their reality. When that book was written in 1976, people had to be educated about the nature of corporate America. There is much more awareness now, and it will be reflected in the discourse.

The other thing I want to point out is how organized the Republican disinformation machine is, and has been since Reagan. We really need prominent voices to counter it, and call it out on its motives. The progressive blogosphere and associated commentators do perform a useful service in this regard. Does it get excessive at times? Yes. But I’m not terribly bothered by the excess.  That's because I’m more worried by the thought of what happen if everyone suddenly shut up.

but I agree with you 100%. This whole "corporatist" BS I see at Kos all the time drives me crazy. There are a couple of diarists over there that even take money from a corporation with one hand and gleefully hammer Obama with the other for taking the corporation's side over "the people", for "selling out" the Public Option (that in it's House incarnation would have provided insurance coverage to 1.5% of the population). It's insanity.

Thanks for taking the time to post about northern America and giving a perspective that makes me think hard about my place in it and my responsibility to those with whom I share it.

as always, Al.  No one seems to understand how incrementalism works.  I've been reading Glenn Greenwald for a while, but I'm about ready to give it up.  I like his media criticism, but whenever he talks about the Obama administration (on civil liberties, health care, or nearly any other issue), his complaint is the height of predictability: It's not enough.  Well, we'd all like things to change overnight, but that's just not the way the world works.  His latest post fits your above post to a tee- shouting aobut the evils of "corporatism" and how this bill strengthens that idea, while barely paying lip service to the idea that it might help others.  Worse, even- he acknowledges that it might help others, but says that the "creeping corporatism" is a more important issue.  It sounds like an unrealistic idealism is driving his objections, and that's probably true for many.  I'm sure most of the people who disagree on the left envision roughly the same dream world, but the complainers seem to insist that it happen all in one step.

On the other hand, he has made one good point that I have trouble refuting: If you say, up front, "anything's better than the status quo," aren't you giving away your leverage?  By telling people that you'll vote for a bill, any bill, no matter what's in it, doesn't that tell them to feel free to muck around with it, because there's no downside?  I'm not sure...

By the way, anyone who wants a levelheaded look at the dangers of corporations taking over the government should read Robert Reich's Supercapitalism.  I can't recommend that book enough- he appreciates the dangers of unfettered capitalism without giving in to hysteria.  And the main point is that attacking corporations for making money is completely counterproductive.  They are in business to make a profit, and they can't cut into their profits for the "public good," because if they do so they'll simply be undercut by more ruthless competitors (this was different in the 1950's- the change is structural, not personal).  So railing at companies who abuse workers, the environment, etc. is dangerous, because the people who do it expect corporations to be shamed into cleaning up their act.  Instead, they need to be forced to do so- making every company follow the same rules would eliminate the problem of competition preventing social good.  Reich goes much deeper than I can in one paragraph, but again, I can't suggest it enough.

Just finished watching on C-SPAN as the Senate voted 60-40 to invoke cloture in the first of six votes needed to pass healthcare reform. Times like these I am glad to be on the West Coast, as it is just after 10 pm here.

Now we just have to pass through all the procedural hoops to bring this baby home!

It's late; I'm tired; I'm writing from rural, working-class West Virginia where two feet of snow are on the ground at the lower elevations. I'm also weary from a weekend of digital "combat." I will link to a dialogue from dkos this morning which began with my reply to kill-biller who, in the course of arguing the evil of mandates and absence of cost controls in the Senate bill, said the kill-it tactic could open the door to seizing a crippled Democratic Party and purging it of corporatists. "Nothing to lose," he/she chortled gleefully.

All you highly-advanced political smarter-than-thou's like to trash the supposedly hypocritical liberal/lefty middle-class consumerists, but an explanation of the bill would be more helpful than a lecture about what cretins we doubters are.  I know the talking points about the great good the bill does, and I understand and support incrementalism.  However, the fact that none of the bill's unconditional supporters seem to be able (or maybe willing) to articulate where actual savings to actual citizens will come from makes me uneasy.  I want this increment of change to last, and worry that if the program costs individuals too much there will be huge pressure to weaken it further.  Is it really so bad to be concerned about keeping the reform the Senate is about to pass?

Fuckin' A, Al. I'm so glad someone is saying this, and saying it so well. This was my favorite bit- "Also forgotten in this born-again anti-corporatism is what Alinksy, Gandhi and others have demonstrated: To create and sustain successful political movements and revolutions, you have to turn small triumphs into ever increasing larger ones. If you don’t have victories along the way and call them that, the people lose hope and motivation to back any movement or revolt."

I also think one of the biggest psychological drags on the left has been how *long* the process has taken, moreso than the result. To slog and slog and slog and slog just saps one's energy- particularly if one starts with unrealistic aspirations and has to watch them get chipped away, as they must. And, frankly, I think this was part of the reason why Republicans fought so hard to slow down the process- they turned it into a war of attrition, and I'm sad to see so many progressives fall victim to their tactic, often by their own hand.

There's also a strong psychological effect regarding "uncertainty". In short, people hate it. And this whole long process has been perpetually uncertain in its outcome, and that has had a psychological toll, too. In a way, I think that making the process more public, in this case, actually demotivated a lot of people.

Once the bill is passed, and the new year starts, many will breathe a sigh of relief (even those who say they don't like the bill), because it's finally over and the outcome is known, and we can look forward to the next big challenge. And we can also finally sell the bill to the rest of the public; before, one of the biggest problems in selling its virtues was the fact that it wasn't clear what we needed to argue for. Now we have something to sell, and I think the general public will soon enough be at least 50/50 about the bill, and that will mitigate our losses in 2010.

Al,

Your copied post did in fact make the rec list at DKos for a period of time.  I tipped and recced it myself, as it represented the strongest argument I had yet heard for passing the bill.  Part of the problem is that most of the people advocating for it to this point had simply been spouting party-line talking points.  I think I'm in the process of going from staunch opposition to the bill to tepid support, and your post played a significant part, though it is simply a part of the "progressive backlash against the progressive backlash".

One argument you made in the comments to this thread that I must dispute though, is your refusal to give any credit whatsoever to the progressive blacklash in preventing the Senate bill from being watered down even further.  First, I think Lieberman is motivated at least in part by revenge towards those who supported Ned Lamont in his 2006 Democratic primary race.  I don't think Lieberman was ever going to sign onto the bill until the netroots screamed bloody murder.  Second, I myself called Sherrod Brown early last week (a type of activity I rarely do), asking him to oppose the Senate compromise.  If I were willing to do so, I imagine that there were many phone calls to senators from progressives asking them to oppose the bill.  Realizing that it was approaching the point where support from the base would collapse, I think the backlash may have convinced the movers and shakers in the Senate to stand firm against any further watering down of the bill.  Keep in mind that it is not just the left that hates the mandate, but a sizable majority of the American people.  Finally, Democratic leadership has given the impression of caving in to the slightest opposition throughout this process.  I recall during the summer, how end of life counseling was taken out of the bill in response to the ridiculous charge of "death panels", without any effort to explain why the charge was bogus.  Drafting legislation is a negotiation, and those who announce support for whatever deal is reached have no leverage whatsoever to have meaningful influence in that deal.  Those who force the leadership to earn their support are the ones whose demands will be given weight.  Most importantly, when faced with a stubborn adversary in a negotiation, establishing leverage often requires demonstrating one's own willingness to walk away from the negotiation.

Ben in Ohio

@Rob:

"Worse, even- he acknowledges that it might help others, but says that the "creeping corporatism" is a more important issue."

Look, total capitalist capture of government is a serious issue.  If I may keep Godwin at bay for a moment:  Living standards improved overall in Nazi Germany as well as Stalinist Russia (for the people that weren't being slaughtered).  Living standards have been improving steadily in China, an awful authoritarian society, for the last 30 years.  None of us would want to live in those societies.  Material gain isn't the only measure of good legislation.

Obviously we're not anywhere near that, but taking material gains at any price can bear a heavy cost.  If your means aren't in line with your ends, you can end up worse off than you were before.  You might alleviate some suffering in the short term, but if you do it by  entrenching the system that causes the suffering it's highly debatable whether or not that's worthwhile and won't in fact cause more suffering over the longer term.  It's not "unrealistic idealism", it's a pretty hardheaded coming-to-terms with costs and benefits.

Certainly much less idealistic than imagining that if you don't take a confrontational stance toward people in power and put real pressure on them that they'll give you something at the bargaining table.  As you note.

It's a real question and a very important debate, and slagging opponents off as a bunch of privileged college-kids does nothing to advance it.

Lenore - Various policy bloggers (Ezra Klein in the front row) have "articulated where actual savings to actual citizens will come" repeatedly.

Nate Silver posted this entry to 538 on December 15 and also to Daily Kos where it remained on the recommended list for the better part of a day. So your statement that "none of the bill's supporters" have been "able (or willing)" to answer that question is just not true. Nate even offers handy visual aids in the form of bar graphs to show what the bill saves an average family.

But you know what? One can repeat these hard facts over and over again to people who really don't care what happens to the working and poor folks and they go in one ear and out the other. And after watching this happen again and again, I walked into the room with my Chicken Little vaccine syringes and a baseball bat to get the attention of y'all. It seems to have substantially worked, too. "The progressive backlash against the 'progressive backlash' indeed." Which brings me to...

Scats -

Actually, the gut-check on those I term the "white college-educated bloggers" and reminder that there are millions of folks worse off than them that they have been ignoring in this debate has had a positive effect. As Norm W points out above, not all college educated white folk feel threatened or offended by reading such gut checks because they know it's not aimed at them, that their behavior has been different.

As for the preemptive invocation of Godwin's Law, I suppose that would refer to the mandates. As one who is generally of outlaw tendencies, I'd take my chances with these mandates. I don't see them as enforceable and the Massachusetts experience demonstrates how impossible it is to enforce them.

Capitalism took over the US government long ago. This bill does not substantially change that except to the extent that the US government wades into health insurance coverage and forces more private sector resources (percent of Gross National Product) into health care. It is not taking those resources from government and putting it into the insurance companies. It is taking them from private sector capitalism overall and putting them into a different sector of private sector capitalism. The net gain for the private sector overall is probably a net loss, as government will grow from this, too.

And, as I've said, it is my calculation that a victory at this stage leads to more victories down the road, toward public options and eventually single-payer.

On the other hand, a defeat at this stage slams the door for a generation or more on both those things.

OK, so "all" was wrong; my bad for posting late at night.  I did read Nate Silver's piece with interest, but I guess I missed the part where he explained where the savings come from; the article I read just said how much he calculated the savings to be and refuted various chicken-littlings running around on the web.  I'll read the Klein article today in hopes that I get more than recycled lists of the bill's virtues.

It's not enough to tell me that government subsidies and guaranteed-issue policies will insure more people; that's good, but unsustainable unless some cost savings can be shared between the government and those people to prevent insurance from being too expensive.  That last part is what I've not seen yet.  I'll keep looking, of course.  Usually when I read all the usual suspects' blogs I find something with meat on its bones, but not in this case.  Perhaps the political hysteria ate people's brains, as it so often does.

And I wasn't taking it personally.  I had just hoped for information, and what I got was an offer of a vaccine that I don't need right now.

"And, as I've said, it is my calculation that a victory at this stage leads to more victories down the road, toward public options and eventually single-payer."

How?  How do you see that playing out?  What's the path from here to single payer?  If I could see that, I'd get on board.

structural determinants of conditions of possibility include, overwhelmingly, micropolitics (the constitution of relations of power from below).

Scats - Bernie Saunders himself says that had his single payer bill gone to the floor it would have gotten no more than five votes in favor. So had that been the final version of this current bill, it would already be dead in the water. There is absolutely no scenario to get it to the finish line in 2009 or 2010 (this Congress).

If the current bill fails it will be a generation before *any* kind of health care bill has a chance.

But if this bill passes, and health care is established finally as a responsibility of the US government, watch what happens when the insurance companies inevitably disappoint through their greed: Then the din to "fix the program" begins, and because it is already in place, that's when it becomes political suicide for the 40 GOP bill killers and the five or ten worst Democrats (and the remaining 45 who support public option but not yet single payer) to not go the next logical steps.

First would be a limited public option. Later a robust public option. Eventually, as everybody has said, public option will lead to single payer. It's going to take ten years for all this to happen. But you've got a much better shot if this bill passes than you will if it doesn't.

Oh, and you still have to go out and organize for it. Nothing pops out of the head of Zeus!

Obviously single-payer wouldn't have passed this year.  And obviously you have to organize.  No one's arguing that.  The question is how and to what end.

So a public option is a key stepping stone on the path to single-payer.  And with a president at the height of his popularity, strong congressional majorities, citizen organizing the highest it's been, a weak and discredited right-wing, and insurance companies at a nadir of public trust, even a weak public-option still can't get passed. Somehow in the future though, it will get passed because...why?

People will somehow be even more mad at insurance companies and Republicans?  And Republicans won't point to the continued crisis and say that Dem reforms clearly don't work?  And the public won't be mad at Democrats, who've been in power and claimed they fixed it, for not actually fixing it because...?  And insurance companies won't be dumping their new government subsidy cash into fighting further reform because?

Seems pretty far fetched to me, but good luck!

whoops.  didn't mean to sound sarcastic.  seriously.  good luck.  It would be great if it worked out that way.

I was wondering that myself-i.e. how we know it's necessarily going to be improved upon.  I'm hopeful but not exactly Of Faith, you know; I can see even the good bits being chipped away in later years, once more R's are back and/or once people are paying less attention.

That said, I think-I *think*-there's sufficient case for the bill to be passed even with the understanding that this, or close to it, is likely as good as it gets for a while.  I am still listening to people on the left who have serious objections to specific pieces.  People like Hamster grandstanding and calling to "kill the bill" along with the tea partiers and the likes of Grover Norquist (?!), though, are enough to push me back into supporting the bill just on the principle that those people have indeed been footstampy douchebags who've hurt more than they helped.  

I think you make very good points here-that a lot of the crying out for a "public option" doesn't really do much more than reshuffle.  I do think that there's an argument to be made within the context of capitalism as we know it-if there's a public option set up as genuine "competition" that that's healthier than the oligarchy we have now.  In theory.  But, I have no idea if it'd actually work that way.

FetchMyAxe - "Footstampy douchebags!" Ooooooh, that is SO going into the lexicon. That's perfection.

Obviously we can't know what Congress will do in the future, especially if the mid-term elections in 2010 do not go well for the Democrats.

However, as an example, Congress recently passed a $154 billion jobs bill (attached to a defense appropriation bill) that extends and expands several parts of the stimulus. Obama signed this into law on Saturday. And this is something that was just passed 9 or 10 months ago.

Historically, Social Security was greatly expanded after it was passed (I often amuse myself imagining today's Poutrage Club reacting to how weak Social Security was when first passed). Medicare and Medicaid have been strengthened again and again since their passage.

The immediate short term may not see a lot of changes but in the medium and definitely in the long term, Democrats will come back again and again to improve healthcare. History shows this to be the case.

One of the strongest components of the Zapatista struggle is their humility in using "la consulta": letting the people discuss and decide, explicitly rejecting "vanguardism" of an elite.

The best project for bringing real people power to the U.S. is the National (ballot) Initiative for Democracy, led by former Sen. Mike Gravel: http://Vote.org

Nobody knows all the answers. We were mostly raised to repeat the errors of the past. But answers there are, and this is a way to find and try them without dominators imposing their ego-bound ideas.

Understandably, some side discussions have started in the comments and even the original article occasionally drifted from the important discussion it's participating in: a praxical debriefing, about the US health care struggle, that has naturally started since it is now obvious where all the chips will fall in this milestone legislation. Specifically, who can claim victory and who suffered a defeat? And, more broadly, what could practically be done better and what worked, in either case. And, per Al's stated affiliation :), what is this analysis for anti-capitalists of all stripes?

In this case, it should be acknowledged that the "public option" would bring about extreme change and a significant shift to the left for US society. A government program that was truly accountable on a federal level (something difficult to achieve, in and of itself) and really offered insurance that wasn't profit-driven, the reality is that no private insurance company could compete with it, in the long term. I think you would see an attempt at consolidation in the insurance industry but, eventually, they just couldn't compete with a well-done non-profit alternative. That's why the public option is so extreme: it would bring down a huge industry and provide a working model for a US form of "nationalization". It's also why it brings up the question of what will happen with the enormous number of unemployed ex-industry workers.

Given that the public option is now something that has been put out into the national debate (honestly, I didn't really believe something as little as THAT would even be possible 5 years ago) and remains a goal that can be fought for, I DO think it is worthwhile for anti-capitalists to push for this option -- now and moving forward.

That said, it will be easier to fight for the public option on the shoulders of new health care law that will establish certain entitlements, a bunch of case law that can be built on, etc.

The current bill -is- a victory in that it will make into law a number of demands that come from the health care movement and, conceivably, be used to build towards greater victories. But, that doesn't mean that it will pan out as a victory for working and poor people -- just as a public option could be hijacked during execution to not actually help working/poor people. The mandatory insurance law, in particular, makes this possibility more likely.

The fight is never over -- once all this stuff is law is when activists will be faced with the daily grind of court cases and procedural battles and, I would propose, towards more dramatic reforms, such as the public option or (even more unlikely) single-payer.

It -is- important that this bill actually -weaken- the insurance industry -- and I say this from a pragmatic point-of-view, not from "revenge" and acknowledging that some people will lose their jobs in the process. But, the power of the insurance industry has to be reduced for future victories and it's important this this legislation does that. This legislation does seem to do this but we'll find out once things get going.

So, to summarize my point:

1) Everybody has to vent about stuff and praxical cohesion is important so it's good to always take these discussions and step back from them to discuss the practical and praxical: what should be done moving forward and how can it be done better, given where we are now?

2) The legislation is unquestionably a step forward -- a left movement WAS able to get some important reform measures passed by an overwhelmingly Democrat-led Congress. But, I do think it is weak enough that we should be cognizant of the fact that it will involve a lot more activism as all this stuff becomes law and how it works in real life is battled over. I think a lot of people are getting heated about essentially coming to this practical conclusion.

And, I think we can also learn from this the actual limits of the Democrat Party: given that they could have passed a broad range of bills, this was the limit of where they were willing to go.

and DemocratIC-led.  Only mentioning it since I see it a couple of times in your comment.

The whole "Democrat Party" thing is an old trick Repubs have been using for decades, and they're really trying hard to make it the norm today now that have almost complete control of the MegaMedia.  Even William F. Buckley refused to use it though:

http://www.newyorker.com/archive/2006/08/07/060807ta_talk_hertzberg

Just want to make sure we aren't doing Lush Limpbaugh's dirty work for him.

I am not a liberal elitist, Al. I have been unemployed 10 months and have no insurance. My problem with the capitulation on the public option is that the capitalist health industry has been raising rates at double-digit annual levels all my life. So what good does it get me to buy a policy on the exchange from the companies that keep raising their rates? Even if there's a subsidy, it has to offset those increases. When the Republicans inevitably lie their way back into a Congressional majority, they will slash the subsidies.

It is depressing to watch a process where it was PROVEN by the CBO that a more radical bill would create greater savings, thus qualifying it for a 51-vote reconciliation victory, yet our government and media elites simply could not accept the idea that the government could save more money than the marketplace because medical markets DON'T WORK. That is what we're up against. Reagan and his minions brainwashed us so thoroughly that we can't believe data that refutes his paradigm.

So now we're back to normal politics, where the Left wins and its supporters go back to living their private lives, and the Right terrorizes the country into paralysis and retakes Congress during the midterms and begins the same process of sabotage and subversion that they began in 1994.

Will this country even survive one more such cycle?

Al, you implied that foreign countries don't do health care very differently than we do. But you've seen the numbers; Canada and Europe are spending about 1/2 what we do and getting better results. Even RWANDA, a decade after it was completely wrecked by genocide, has national health insurance. The poor everywhere else have gotten better health care via state recognition that private insurance does not function according to market theory. The Republican response to those facts was to demonize Canada, Britain, Germany and France as communist, fascist, totalitarian hellholes that murder their elderly. And they got away with it!

The Right is diverging the American mind from global reality. It is creating a faith-based bunker in which theocracy can prevail despite its empirical inferiority. We can't use facts about our worsening lives relative to the rest of the world, or the role of American power in worsening lives in countries like Honduras, because Americans no longer vote on fact, but on tribal cultism. The black tribe saved us from McCain/Palin last year by voting 95% for Obama, but they will stay home next November and the Christian fascist tribe will vote 99% for deranged maniacs. Those of us who don't belong to tribes are only impelled to vote by rage because we no longer believe that organized secular progress can pass the corporate veto.

That was the Right's ultimate victory. To convince us that humans cannot organize for secular progress. That rather than endure the slow slog of progressive organizing to painstakingly improve empirical processes, we are supposed to engage in tribal rituals to supplicate God (or his Invisible Hand) to shower us with prosperity, and if things still go bad, then we ritualize twice as hard. We have become a medieval people, while the rest of the world moves on without us. It took the shocks of the Civil War and the New Deal to snap us out of that kind of thinking in the past, and I don't see our senile society being able to rise to another such occasion until it finally falls away to a non-white majority that wields power with a vengeance.

I see a pattern here in Al's lashing out at anyone who has the temerity to criticize our Glorious Leaders. First, he was critical of anyone, such as Eva Golinger, who dared to point out that the not-so-invisible hand of the Obama Administration was behind the coup in Honduras, as such criticism was deemed not so important anyway, because the people's grassroots movement was going to peel away the support for the coup-mongers, leaving only a small segment of civil society among the oligarchy and the Supreme Court who support it. This is what happens with a community organizing approach that fails to take into consideration the fact that larger forces are at work. Well, now that events on the ground and from above have proven him wrong, due to the fact that the overwhelming political and economic power of the USA has in fact sustained and legitimized the coup, helping it to survive, I'm not surprised that Al hasn't written much of late on Honduras.

Instead, he's taken to lashing out at anyone who has the temerity to criticize the fact that democrats in the house and senate, backed by their Great Leader, have openly received huge sums of money and intellectual support from the lobbyists of the health insurance and pharmaceutical industries, leading to a corrupted legislative process where the lobbyists themselves have ghost-written the bill. So we have a bill whose only benefit is that 20-something million people will now be forced to purchase federally-subsidized, mediocre health insurance which will only cover such a small percentage of their medical bills should they become seriously ill that they will end up in the poor house as well as the hospital. With private plans as the alternative, estimates are that more than $450 billion in taxpayers' money will be transferred to private heath insurers in order to allow the uninsured to gain coverage. However, that coverage will be something akin to the lowest form of car insurance – you get by before the eyes of the state, but get into an accident and you will find yourself facing massive debt. Estimates are that the low-coverage plans would only cover 60% of costs. Even worse news comes for the more than 20 million people who will likely remain uninsured. They will now also have to forfeit 2% of their annual income because of it. A nightmarish scenario indeed –uninsured and penalised! And we're supposed to be eternally grateful for this and not complain? Let's not even discuss the erosion of women's reproductive rights, or the not so thinly veiled attack on unions in the form of an excise tax on so-called cadillac plans, or the fact that medicare coverage is being stripped to the bone to help pay for this 2000 page monstrosity.

Wow. Small wonder Saul Alinsky and his top-down, anti-woman methodology comes in for ruthless criticism by such veterans of the Civil Rights movement as Charles Payne and John Salter.  You lost me when you put Alinsky and Ghandi in the same sentence.

Greg McDonald - With that kind of paranoid pessimism I'm reasonably sure that I couldn't "lose" you because I never sought, had or tried to keep you or those like you. I will continue to report on Honduras' *continuing* civil resistance long after you people decide its not a worthwhile prop for your Eeyore "woe is us" rantings. But you behave as if la lucha there is over.

People like you *always* act that way in the middle of any struggle. Then at the final victory you come out into the streets and try to take credit for it.

So let me try to "get" this: Saul Alinsky's writings and the wisdom of his experience are meaningless and should be ignored, the failure of the Obama administration to effectively respond to the coup in Honduras "proves" that it planned the coup all along, and the status quo in the US health care is much better than the current bill. How could I ever "have" someone with zero capacity to see struggles over the long term and how they get to victory? I frankly wouldn't want you.

It is hard to stand there and watch a suicide happen right in front of you--and be able to do nothing to stop it.  I think that's what the Dems have done with this bill, and when the whole thing is shown to be the flop it has been in Mass., the Repubs will point to their resistance and have an I-told-you-so-moment.

I agree with you, Al, that this is a step forward, but there are always unintended consequenses.  The insurance industry dictates medical practice, because THIS will be covered but not THAT.  Will this 'bad boy' industry change it's ways now?  Will doctors now be able to act in the best interest of the patient rather than use a protocol that is covered, but not as good?  I'd like to say yes, but the behavior of Wall Street corporados gives me pause. Will this be any different? How about alternative medical practice, like Naturopathy and Homeopathy? Will these be covered?

What about Medicare (with all it's faults) for all?  The insurance industry still has a place there.  It can be phased in as well.  How about the same program adjusted to our scale that Rwanda has?  Would that be too much for us to afford?  Have we given ALL our money to the banksters?

The hand-wringing over the people who work in the Insurance Industry being thrown out of work is as specious as would have been the argument, at the turn of the last century, that the new motor driven vehicles should be outlawed so that buggy whip industry jobs could be preserved.There are other sectors of the insurance industry besides the health care sector to absorb many of these displaced workers.

What-is-to-be-done can be easily resolved by organizing on anarchosyndicalist principles, which are:

Solidarity.  Direct Action.  Self-Management.

Avoid creating 'leaders' but work to develop 'leadership' among all in your organization.  Bottom up, not top down.

As an anarchosyndicalist, I regard electoral politics with the same regard I have for WWF wrestling. Entertaining, but all sound and fury, signifying nothing. I still send emails either of applause or condemnation to my reps in both Houses on the chance it will make some difference.  Jesse Ventura had a good idea - Congress should be dressed in NASCAR style uniforms with the names of their chief sponsors displayed. Congress is bribed by corporate interests, only they call in Campaign Contributions.  Money talks, letterwriting walks.

Thank you all for your reasoned opinions presented here.  Have as happy a New Year as circumstances permit.

I live in a remote rural region, am on line via dial-up, and have never voted for a corporate candidate, Dem or Repub.  There's no government like no government...