Countdown to Health Care: Pray for the Dead but Fight Like Hell for the Living

Al, do you have any tea leaves to read on what I think is going to be the last big hurdle to a much better bill:

Doing away with the taxes on health plans in favor of the House formula for funding (a 5% tax on over 500 k individual income)? I know candidate Obama favored the House approach.

This could be a very good bill instead of just a good one if that comes out of conference!

Al,

You have no idea how much of refuge spot your blog has become for those of us who used to be on dkos but now find ourselves homeless. I wish there was a central portal where ALL serious policy discussion blogs including yours, free of all the screeching from left or right, could be located so that some of us could judge the merits or demerits of our government's actions without the blizzard of inanities we now see. Dkos and Huffpo (in a much much ealier incarnation) served that purpose somehow. Now they don't. And it is not about the presence of views I disagree with, it's the high decibel level and foolish nihilistic threats that grind me.

Anyway, I say if Sen. Robert who has seen decades come and go could stay up till 1:15 AM last night to gleefully cast his "aye" vote, knowing the unbelievable historical landmark that vote was, and even more so in a bitterly divided legislative body, then perhaps some of us can still endure this political climate.

So like you said the ohter day, "to Teddy" and Robert Byrd. The struggle continues, one footstep at a time.

Norm W - Conference committees are appointed by the respective House and Senate party leaders, with the majority party having the power to basically do what it wants.

Typically, some really crafty and liberal legislators - veteran committee chairs and such - end up on these things. So I would not be surprised if the conference agreement comes out more progressive than the Senate bill on some items and the House bill on others.

The sticky wicket, however, is going to be the abortion matters, as it is precisely Democrats in the House (and Nelson in the Senate) who will threaten to pull their votes if they don't get their way. Pelosi in particular is going to need to exercise maximum discipline on her side (remember the House version passed by, I think, two votes). That's the 800 pound gorilla in the room. The rest should come out demonstrably better.

Once again this atheist is "impressed" by the right-wing Xian fundie religitards' demonstration of "charity".

If this was an aberration, it might be somewhat forgiveable, however...

On another note, our pragmatic President is everything he said he would be (to those paying any attention).  I regret my vote not one bit.

My disappointment is reserved for those progressive commentators who I once held in high esteem (present company excepted!)  How can Rachel Maddow (for example) be so brilliant and yet so wrong...?

Al,

Do you think that the lack of a public option in the Senate bill might pull some moderate House Dems back in the fold, making the abortion issue less of, well, an issue, in getting passage in the House?

I guess the question is whether the are enough anti-public option but pro-choice Dems who originally voted against the house bill, but would support the Senate bill.

JCK - I think the conference committee members are going to have first and foremost in their heads the sense of what is possible in both houses to get through another final cloture vote of 60 in the Senate and a majority vote in the House.

There will be phone calls to various "problem" legislators in both Houses saying "can you live with this?" And deals struck to give people other things on other issues (and mainly budget stuff for their constituents) in order to get them to hold firm. (This, indeed, has been Nelson's game all along and to some extent Lieberman's, and may swing Snowe and/or Collins in the end, if needed... If NORAD suddenly gets moved from Nebraska to Maine, you'll know what happened!)

Al, your recent full-throated entrance into this bit of history-making has been well-timed. Nate and others have been terrific. In contrast, the Hillaryis44 crowd has embarrassed themselves marvelously.

However, I do have a couple of questions. Paul Starr at TPM has also been terrific--and clear. His concern today is about timetables and politics. Surely, the more crafty liberals in the Senate and House get this. (Where are all those former Kennedy aides, anyway?) But, do you think the administration will start shifting, not OFA, but its own political operation to do more substantively to ratchet up the energy level for liberal activists who are by all measures at a low-intensity setting. Or have the wet noodles become too easy a punching bag for the Obama political team--and somehow hurt us all? Here's the crux: as we approach the political theater of another election year, do you or does anyone here think that the administration is going to shift to a more forward-leaning posture (not in foreign policy) in terms of publicly fighting for signature issues. It may be venal, but it is the perception of the POTUS "fighting" for us that might reawaken the multi-hued, multi-classed army you mentioned below. Financial services reform seems a no-brainer (but there we have Summers, et. al. who haven't yet cleaned up their messes). Climate change is pending (even Byrd is on in his shift on coal). But the big kahuna is Immigration. This seems something that will kick start some real fights. If we win this Health Care battle--some other wins will need to follow-on.

Thanks for all!

Brendan - I have voiced repeatedly my recommendation that OfA take on immigration reform full throttle, because of the rightness of the cause and also the smart politics of mobilizing an army that includes so many white, Asian-American and African-American organizers on behalf of Mexican-Americans and other immigrants who are so used to being left out in the cold that the pure pleasant shock and surprise of such a multi-demographic organizing effort would fire up voter turnout in 2010 from key base sectors like never before.

I don't know whether OfA is going to make this its next big effort, but there is another reason, politically, to do it as well: The 2007 Comprehensive Immigration Reform Bill had the votes lined up until Rush Limbaugh and right wing orgs flooded the US Capitol switchboard to scare 13 Democratic Senators into submission. A titanic battle of OfA vs. the right wing noise machine, if victorious, would break the morale of that noise machine for years to come. And that would have subsequent effects on more big issues in the future, too.

I know the OfA folks read this blog. So there, again, are my two cents.

Al,

One short term plus to doing immigration reform is also allowing a certain senator from Nevada to excite the Latino base for his tough re-election campaign.

In the old revolutionnary Universality Days, a Comrad emerged somehow as less of an individual for, to erect the Finality of THE’ Comrad, a person’s transience was devised as its primary building material, its primordial matter.

A living Comrad was worse off than a dead one; that was single payer for you. Your life, your health belonged to the Party, to the State; that was universal health care for you. Every living Soviet survived or thrived on some kind of ‘assisted in sync’ breathing; that was some noisy, high pitch, frequency driven, goose step sanity shaking, bridge demolition undertaking so propitious to a healthy, joyous, future driven and so worthy of emulation lifestyle for you.

I am wearied of ‘Universal’ for anything but for… Myself and Thyself. All Americans bar none, including prospective Americans, should have access to affordable health care…, of course; as all Americans bar none should be given the essential tools to assess and develop their own very personal, in vivo, perspective on their Health as an instrument of Freedom and liberation.

For some, liberation comes from pain, for others it comes from amnesia, and for a few, a very few, it comes from bonding to it in the realistic and idealistic Hope of freeing others from it.

My Health is my philosophical Sanctuary and Thy Health is thy’s, impervious to the whims of dictate or edict ‘du jour’. That is Universality for me.

Benevolent and consequential Universality thrives on conscious, sagacious Health. It demands Self-consciousness Reform, a melting into the Health ‘rebate’ sourness of an Education template sweetness; Education Reform fusing into Health-care Reform; a meeting of the autonomous outreaching fleshes and of the independant lucid minds.

Everything starts with Me, …I notwithstanding!

I don't mean to be so ready to switch gears from health care to other signature battles of this biennium, but as this bill goes (hopefully) to conference and final passage--this victory will need to be played against the noise machine[s] to precisely prepare the ground for a few more spring offenses.

Your point about that army for immigration reform is key (tied to OFA but not dependent on OFA). As you pointed to what seems years ago (I guess it was), those who actually marched in the 2007 immigration reform rallies were precisely 2 sitting senators, the President and Dearly Departed Teddy K. What better way to make this Congress, Kennedy's by way of fighting for his two key legislative concerns! Health Care has been exhausting--but it has also been revealing about the true dysfunction of the Senate and the lunatic cravenness of the minority party (and its "independent" enablers).

I spent time recently with a dear friend whose family is at the crosshairs of immigration reform. My friend, a registered Independent and strong Obama supporter has 1 issue: comprehensive immigration reform. He knows through the experience of his own family how the system (corporations, small employers, government, and individuals from both sides of the border) all use the current failed immigration system for their own games. On the ground, everyone gets the need for substantive and far-reaching, and rational change. And on the ground, real people are really hurt. This guy, is part of that army you mention, but he needs to know that his President has his back too. Living in the relatively recently bilingual deep South (and it IS bilingual), he would be on a serious frontline--but he'd be fighting for his own damn family. This is not an uncommon situation. But, OFA and others, including the President, do need to communicate something to this friend of mine--and his family. This guy has the language to speak to his people locally about these issues. But he needs something (guts) from the people up top.

This would also be one hell of a FUN fight. I say, bring it on!

But, first, the matter of health care......(gasp!).

Hello Al,

I am writing to you from Chicago -- the home of community organizing...  Anyway I think that Barack's experience as an organizer shines through to us who are old-timers in the field and continue to pound the pavement attempting to make social change.  Alinsky always pointed out the importance of forward movement, on taking "wins" small and large, as critical to any sort of social change.  Bayard Rustin knew this. Diane Nash knows this.  James Bevel knew this.  All of these community organizers toiled in the background to help me as a Black woman live the life that I do today.  It was done without fanfare but methodically and strategically.  To me Jane Hamsher and her crew have shown themselves to be craven during this episode.  Her admonition to partner with the "tea partiers" was the final straw.  I have heard from countless progressives of color since then suggesting that this signals an open embrace of straight up racism.  Unbelievable that they have become so brazen.  Unbelievable that so many white progressives have been silent on this matter.  There can be no coalition building in this climate.  None.

There is a diary on Daily Kos which states that Howard Dean on MSNBC has suggested to pass the bill...

In a republican caucus filled with world-class d-bags, Tom Coburn is working hard to win the title of biggest republican asswipe d-bag of them all, at least in the past year.  Counseling bribery for Ensign's adultery, blocking veterans' benefits for no goddamn reason, now this.  What a tool.

Note of caution, too, on the enforcement of the penalty/tax situation: just because there is no criminal enforcement procedrues or property liens contemplated in the present bill doesn't meant that the I.R.S. can't make your life miserable over this stuff.  As it stands, the vast majority of I.R.S. enforcement actions are civil, not criminal, and the fines and penalties get really big, really fast.  And while I'm not a tax lawyer, perhaps another reader can confirm (or deny) that civil penalties or fines could easily eat up any tax refund a filer may be expecting.

Welcome back, Al.

I thought this was nice reminder from Booman, posted when the cloture vote passed:

Update [2009-12-21 1:23:56 by BooMan]: Senate invokes cloture on Reid's manager's amendment by a 60-40 vote. I will remind you that we needed every single victory from 2006 and 2008 to achieve this. We needed Tester and Webb and McCaskill and Whitehouse and Klobuchar and Franken and Begich and Merkley and Sanders and the two Udalls and Brown and Cardin and Hagan and Casey and Hagan and Shaheen and Warner. We needed to seat Bennet and Burris and Gillibrand. We needed to replace Kennedy with Kirk. With had to flip Arlen Specter to the Democratic Party. If we lost any single one of those battles, health care reform would be dead. Instead, it lives. And you have yourselves to thank for that. Your activism made the difference.

It certainly gives one pause. Hard work from all.

lt it is refreshing to see some rational discourse about health care here.

For me, DKos is now terminally toxic. The ultimate shark-jump came earlier today, when Al Franken posted a diary, and got crucified.

The following comment got no less than 59 recs:

"He's being a good Democrat and using his good name, as he's new and hasn't had a chance to disappoint until now, to help sell this shit sandwich for the team."

"I'm not buying the shit you're trying to peddle here."

Al,

I agree with your suggestion that a trued coalition to push immigration reform would be huge structurally for the democratic and progressive agenda, as well as politically energize everyone to the polls.

I was wondering though, if EFCA may not have to be acted upon FIRST in order to secure labor support for immigration reform. You understand the necessity for coralling a REALLY steadfast blue-collar support for the delicate dance of the immigration fight, especially if they lose the fight to prevent the taxing of cardillac healthcare plans when the HCR bills go to conference.

What do you think?

Because Obama Is A Corporate Tool (3+ / 0-)

Zizi - I highly suspect that Secretary of Labor Hilda Solis will be captaining the administration's efforts for immigration reform in Congress.

I haven't read the first version of the bill (it does appear on line, I'll try to dig that up) but I'd also bet that it doesn't make the mistake of the 2007 bill of lumping in H1 visas (200,000 people) with overall path to citizenship (12 million people). The inclusion of the former in the 2007 bill did cause some opposition from some friends of labor (including Sen. Bernie Saunders of Vermont). The smart move would be to separate the two matters and deal with them in separate legislation. (The last time, the H1 visas were included in part to get corporate support for the bill.)

Since Solis will be captaining the Employee's Free Choice Act efforts, too, it makes a lot of sense to have her coordinate this next big immigration push with labor. We'll see, but that's the talk I've heard around the water cooler...

Here's the e-mail I received from Pres. Obama via OFA an hour ago. As one of the future 30 million without insurance, I am ready for the work needed to finish the job.  Over 1 million phone calls to Congress later,  I'd say I'm not the only one.

Lorie --

Early this morning, the Senate made history and health reform cleared its most important hurdle yet -- garnering the 60 votes needed to move toward a final vote in that chamber later this week.

This marks the first time in our nation's history that comprehensive health reform has come to this point. And it appears that the American people will soon realize the genuine reform that offers security to those who have health insurance and affordable options to those who do not.

I'm grateful to Senator Harry Reid and every senator who's been working around the clock to make this happen. And I'm grateful to you, and every member of the Organizing for America community, for all the work you have done to make this progress possible.

After a nearly century-long struggle, we are now on the cusp of making health insurance reform a reality in the United States of America.

As with any legislation, compromise is part of the process. But I'm pleased that recently added provisions have made this landmark bill even stronger. Between the time when the bill passes and the time when the insurance exchanges get up and running, insurance companies that try to jack up their rates do so at their own peril. Those who hike their prices may be barred from selling plans on the exchanges.

And while insurance companies will be prevented from denying coverage on the basis of pre-existing conditions once the exchanges are open, in the meantime there will be a high-risk pool where people with pre-existing conditions can purchase affordable coverage.

A recent amendment has made these protections even stronger. Insurance companies will now be prohibited from denying coverage to children immediately after this bill passes. There's also explicit language in this bill that will protect a patient's choice of doctor. And small businesses will get additional assistance as well.

These protections are in addition to the ones we've been talking about for some time. No longer will insurance companies be able to drop your coverage if you become sick and no longer will you have to pay unlimited amounts out of your own pocket for treatments that you need.

Under this bill families will save on their premiums; businesses that would see their costs rise if we don't act will save money now and in the future. This bill will strengthen Medicare and extend the life of the program. Because it's paid for and gets rid of waste and inefficiency in our health care system, this will be the largest deficit reduction plan in over a decade.

Finally, this reform will extend coverage to more than 30 million Americans who don't have it.

These are not small changes. These are big changes. They're fundamental reforms. They will save money. They will save lives.

And your passion, your work, your organizing helped make all of this possible. Now it's time to finish the job.

Thank you,

President Barack Obama

H-1B  is indeed in the immigration bill. It's my understanding after reading the Gutierrez immigration bill (keep in mind I'm not a legislative analyst) that H-1B visas would actually be restricted in the application process. One restriction says “if the employer employs 50 or more employees in the United States, the sum of the number of such employees who are H-1B nonimmigrants plus the number of such employees who are nonimmigrants...may not exceed 50 percent of the total number of employees.” It would even make sure that the employer had “not solely recruited individuals who are or who will be H-1B nonimmigrants" to fill jobs. I'm guessing this is more a shout out to labor, and such provisions aren't going to fly in the Senate. Just my guess though.... Guest workers will definitely be debated in legislation though, if this bill is any indication.

That said, Solis would no doubt be a great person for the immigration debate, considering her own personal story and experience, not to mention she's a long friend to labor. Just as important, I think, will be Gary Locke, to help persuade business. Seems like this could be a two-pronged approach. Both are really sympathetic on the issue, and have spoken on it together in public already.

It's even more precarious.  One of those two votes was from Republican Joe Cao, who represents New Orleans, and is very, very, very pro-life.  The Stupak amendment was the only reason he voted yes, and he's made it quite clear that without those kinds of regressive restrictions, he won't vote for it.

BTW, how did you do that "@ Brendan" thing and have it link back to the comment he wrote?  I can't seem to format that.

Aptly, an article appeared earlier today noting that Obama has tapped 48 Hispanics for non-judiciary posts needing Senate confirmation. 35 have already been confirmed compared to 30 by Clinton and 34 by Bush in the first 20 months in office.

I clicked on your link at dkos, about the unenforceable mandate.   You left something out--

"If the mandate is a good idea- then it should be enforced meaningfully. If the mandate is a bad idea- then it should be scrapped. If the penalty is too high then let's reduce it or rework it. By having a draconian mandate and a sizeable penalty, but at the same time opening a Mack Truck sized loophole- is just cynical legislating. Even worse- this loophole will only be available to certain people. Self employed people will be able to benefit from it. Employees who have their taxes withheld from their paychecks, and who usually expect a tax return (EIC or home owner's deduction, etc) will be out of luck- since Uncle Sam will just deduct the $750 penalty from the tax return."

Also, of course, some people are likely to think they have to buy insurance because they've been told about the mandate and not told that the legislation is self-contradictory.

Donald - But you know who else won't be effected by the non-mandatory mandate? Unemployed folks. People working at minimum wage (they're not getting $750 back as tax rebate from Tio Sam). In sum, the people who can't afford it.

If you're getting $750 back from the IRS you're already probably in a fairly decent job and wage level. If you prefer not to purchase health care, and the government puts those seven-and-a-half Benjamins into other people's health care instead, that's not a completely unreasonable way to have you subsidize a system for the rest of your neighbors even if you don't want to be in it.

My objection to the mandate in previous bills was that it would effectively force people to hand over personal information to insurance companies (or even a government health agency). It's the personal information that is sacred. Not the money.

It seems to me that as half-baked and double-speaking the non-mandatory mandate is, it satisfies right-to-privacy concerns, it is progressive (in that it only impacts wage earners above a certain level), and they can't put anyone in jail or take away anyone's home or raid anyone's bank account to do it. If one can get past a distaste for DC doublespeak, it's kind of clever, actually.

I see that Bernie Sanders did get something in return for supporting the current legislation:  an additional $10 billion for community health centers and public health doctors/nurses.

http://sanders.senate.gov/newsroom/news/?id=A23978B9-78B0-411B-A420-ADC5...

He says this will provide free health care for another 25 million people.  Free health care.  That's one answer to the complaint that progressives don't know how to negotiate.

How ironic that the creators of the healthcare "death panel", i.e., Republicans against any reform, now have formed their own official death panel with Senator Coburn as their head grim reaper.

Okay, Al, that sounds like a good point.   I'm trying to figure out whether it's good to pass this thing and while I'm as disgusted as the people you label poutragers, I'm leaning towards your stance.   It sounds like it does more good than harm.   Or that's where I am at the moment.

I think, though, that you and your opponents  on the left would do better to stop the namecalling.   It seems endemic on the left (and I've done my share, not that it matters much.)   But I don't think it's helpful in changing minds.  Argue calmly and rationally (as you just did with me) and if the facts are on your side, you'll win over most people.