"Commitment" to Health Care Reform

I think Paul Krugman simply has this completely wrong. Paul writes:

Paul Krugman: Bad health care omens: This is disturbing:

Mike Lux, a veteran of the Clinton health care wars, pointed out today that Obama is using as a surrogate on health care Bush Dog Democrat Jim Cooper. Cooper spent a good amount of time in 1993-1994 working to undermine Clinton's health care plan by offering more insurance friendly proposals with former Senator and current lobbyist John Breaux.

This fits in with my sense, based on everything we've seen in this campaign, that Obama just isn't all that committed to health care reform. If he does make it to the White House, I hope he proves me wrong. But as I've written before, from my perspective it looks as if a dream is dying.

What Mike Lux, "veteran of the Clinton health care wars," knows--but is very careful not to tell you--is that in 1993-1994 health care reform needed 60 votes in the Senate in order to defeat a Dole-led filibuster, and that Sen. John Breaux (D-LA) was vote 55. "undermin[ing] Clinton's health care plan by... [working] with former Senator and current lobbyist John Breaux" translates as "working on bills that might actually pass the senate."

Mike Lux knows this. He just hopes that his readers don't.

Comments

[albrt]

Do I have this straight - the HRC surrogate's criticism is that Obama's surrogates work too closely with Blue Dogs? That would be a pretty good indication of both a willingness to say anything to get elected and a lack of judgment about the likely effects of tactical positions. Perhaps more importantly, this sounds like somebody is not anticipating additional support from Blue Dogs (or surrogates) who happen to be superdelegates.

[R. Vangala]

Paul has really lost my patience with respect to the issue of universal health care. For a while, I was rather inspired by his commitment to its implementation, and his vision for how it could function as a "gateway drug" that would then make a more extensive social safety net politically realistic. These days, he appears interested in the issue only insofar as it can be exploited to undermine Obama's progressive credentials. I am not alone among Obama supporters in having some qualms about his proposal for universal coverage, but I, like others, do not think that such qualms should cause us to turn a blind eye to all of the other respects in which a vote for Obama is a better bet for progressives than a vote for Clinton. Someone not well-informed about contemporary American politics with progressive leanings would leave a Paul Krugman column with the impression that the nominating contest between Obama and Clinton is a contest between The Benedict Arnold of Progressivism and The Answer to All of Our Prayers, respectively.

[elliottg]

Anyone who employs David Cutler as a key adviser for healthcare is insufficiently committed to healthcare reform in my opinion. BUT Hilary's plan is terrible despite what Krugman says. Both plans are practically and politically infeasible so I would rather start with an Obama rhetorically and policy wise (no mandates) than a Hilary when the Democrats actually get serious about healthcare reform rather than the asinine, complex, mediocre plans that have been put forward so far (except for unelectable Kucinich).

[Ken Houghton]

Then who were votes 56-60?

[Kerrey, Chaffee, Packwood, et cetera...]

As Barrack Obama demonstrated last week on FISA, it's easy to take a position you know won't survive. (John McCain's vote can be seen as signaling; Hillary Clinton's non-vote on a whitewash was pragmatic, and signaled to be such.)

Those of us who were not deeply involved with the Clinton White House saw that Breaux was being pitched as a supporter and realized at that point that any realistic hope was gone.

[Well, then realistic hope was gone on September 1, 1992, wasn't it? By then it was clear that Clinton *wasn't* going to get a majority and wouldn't sweep in a whole bunch of northern Democrats to change the complexion of the congress in a liberal direction. Therefore the laws that pass are the laws that key centrist senators like John Breaux support, aren't they? Anyone who ever thought that laws would be enacted without the support of John Breaux and senators like him--AAUUGGHH! THE STUPIDITY!! IT BURNS!!!]

But we weren't Serious Economists counting on "Senator 55" to give hope that would fool the voters even less than Medicare Part D would.

[Max Power]

BUT Hilary's plan is terrible despite what Krugman says

This is true. Neither Obama nor Clinton are as yet game to propose funding universal health insurance with (gasp) actual taxes. You know, the way every other country in the world funds universal health insurance.

Without the courage of convictions to cross that line, it's difficult to see either plan overcoming a well-funded and well-organized defense from entrenched interests.

And, for pete's sake, Krugman's "a dream is dying" rhetoric is just absurd.

[jerry]

Max, if we go by your analysis the only absurd element of Krugman's rhetoric is that the dream is already dead.

[lerxst]

Krugman might want to consider ...y'know maybe aiming a little of his firepower at McCain's health plan which really is stunning in its platitudes

(see:
http://econ4obama.blogspot.com/2008/02/mccains-platitudes-on-health-care.html)

for example:

"Insurance should be innovative, moving from job to home, job to job, and providing multi-year coverage.

We must do more to take care of ourselves to prevent chronic diseases when possible, and do more to adhere to treatment after we are diagnosed with an illness."

Unfortunately Krugman is now starring in an anti-Obama mailer being sent out by the Clinton campaign...talk about demagoguery

(see:
http://firstread.msnbc.msn.com/archive/2008/02/17/673452.aspx)

[PDX Pete]

Why is it that every account of the Health Care failure of 1993 ignores the critical fact that Bob Dole rounded up 40 votes and said no? Isn't that the entire reason that the Clinton plan failed?

One reads that the plan was too complex, that Harry & Louise didn't like it, there are 1,000 things said, but never mentioned is that the Republicans had 40 votes, and that was the ball game.

Even here, it is stated that Clinton was trying to get to 60, but it is not mentioned that Dole had to get to 40.

The reason that this is still important is that in 2009, Republicans will try to count to 40, again. They may or may not get there. That will determine whether or not it happens.

[Nicholas Beaudrot]

Lux takes the opposite view from you on this.

You have some long post where you detail the four groups that were queasy about voting for various health care bills. One was the leftmost fifth of the Democratic Party, who seemed to want to vote only for a bill that would be truly universal. And there were two more. And then there was "centrist Democrats and Moderate Republicans". Clinton's task was to write a bill that would please three of these, and then convince the four that they should hold their nose and vote for it anyway. If one forecast that Clinton was popular (and we don't know if he was), then one could believe that public spirited Republican Senators in swing-ish states (Cohen, Durenburger, Danforth, Packwood, Specter etc), might be convinced to vote for the bill. Now, not for the bill that came out of the WH, obviously, but something better than what John Breaux was cooking up.

And, of course, legislation emanating from John Breaux's office uniformly sucks, in the opinion of most of the blogosphere. Breaux is viewed, rightly, as a total sellout on a large number of issues, who's gone on to make seven figures as a lobbyist. Google "John Breaux site:matthewyglesias.theatlantic.com" or "John Breaux site:ygleisas.typepad.com" for more. Given the choice, I would have rather passed nothing, or some teensy incremental reform (PBoR, SCHIP, expand Medicare down to age 55) rather than pass the Breaux bill.

There was, I think, an awful lot of howling from various centrists Democrats-Boren, Breaux, Cooper, to a lesser extent Nunn-starting very early in the Clinton Presidency. Much more so than there ever was from McCain, Specter, Lincoln Chafee, etc.

[Anton Favorini-Csorba]

However, the important point is not that Breaux voted for the bill, but that the measure failed. There is a standard practice in Congress called "Catch and Release Voting" whereby political parties (particularly the Republicans because their party leadership is more centralized) make strategic calculations as to which congressmen vote for/against which bills in order to preserve images of political independence for certain politicians. The party - almost always knowing beforehand how the vote will turn out - allows as many congressmen to vote against the bill as they can, which is why it is so common to see a vote to end debate fail by 59-41, far more than would occur simply by chance. This is the same mechanism by which John McCain can seem to be a "maverick" and then later go to speak at Bob Jones University.

The point of all this being that I would bet that the Republicans allowed Breaux to vote against the bill precisely so people would later assume that he was actually for it.

[Josh G.]

We'll never get anything done as long as we accept the notion that it takes 60 votes in the Senate to pass a bill.

Where in the Constitution does it say that? Nowhere. The filibuster is purely a matter of Senate rules and could be abolished at the next session if the rulemakers decline to bring it back. At the very least, we should make the Republicans actually hold a filibuster. Make them get up there and read the phone book for 5 days straight. Make them do their obstructionism in the open, not just kill a bill because we don't have 60 votes. This is worth fighting for! Enough of this procedural crap. The Senate rules weren't handed down from Mt. Sinai and they are not doing the country any good. Away with them!

[me]

Americans need healthCARE, not more expensive, middleman profit-taking, preexisting condition insurance.

[bacon]

[Well, then realistic hope was gone on September 1, 1992, wasn't it? By then it was clear that Clinton *wasn't* going to get a majority and wouldn't sweep in a whole bunch of northern Democrats to change the complexion of the congress in a liberal direction. Therefore the laws that pass are the laws that key centrist senators like John Breaux support, aren't they? Anyone who ever thought that laws would be enacted without the support of John Breaux and senators like him--AAUUGGHH! THE STUPIDITY!! IT BURNS!!!]

You cannot achieve compromise dealing with someone who does not want to deal with you at all and knows that you cant force him. Insurance companies want no changes in the status quo period and proven that they can kill any legislation that wants to change it. Kerry's plan was the most business-friendly plan you can imagine and they just ignored it. The only way to change American health care system is to build the coalition of interests that would force insurance companies to the negotiating table. Without that, any attempts to buy the vote of one senator or the other by watering down your plan is utterly useless.

[Justin X]

In considering the implications of Krugman’s continued vendetta against Obama, the following apt headline comes to mind:

"Krugman Has Met The Enemy, And It Is Him"

http://www.huffingtonpost.com/2008/02/18/krugman-has-met-the-enemy_n_87297.html

[bakho]

So part of the reason why we don't have universal health care today is because McCain voted against it in 1993?

In that case, it would make sense to beat the Republicans over the head for blocking health care last time. If they come out with enough bruises, they will be less likely to block it this time? (Although given the recent filibuster record, obstructionism does not seem to bother them at all.)

[JoNF]

Re: Why is it that every account of the Health Care failure of 1993 ignores the critical fact that Bob Dole rounded up 40 votes and said no?

When did this happen? As I recall, the Clinton Plan never even made it out of committee, yet alone to a filibuster. And Dole (a supporter of universal healthcare, at least before he was bound and gagged by the far Right) was ready to wheel and deal, except that the Clintons never bothered to approach him.