White House as Helpless Victim on Health Care

Of all the posts I wrote this year, the one that produced the most vociferious email backlash -- easily -- was this one from August,
which examined substantial evidence showing that, contrary to Obama's
occasional public statements in support of a public option, the White
House clearly intended from the start that the final health care reform
bill would contain no such provision and was actively and privately
participating in efforts to shape a final bill without it. From the
start, assuaging the healt

Of all the posts I wrote this year, the one that produced the most vociferious email backlash -- easily -- was this one from August,
which examined substantial evidence showing that, contrary to Obama's
occasional public statements in support of a public option, the White
House clearly intended from the start that the final health care reform
bill would contain no such provision and was actively and privately
participating in efforts to shape a final bill without it. From the
start, assuaging the health insurance and pharmaceutical industries was
a central preoccupation of the White House -- hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama's campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN). Indeed, Democrats led the way yesterday in killing drug re-importation,
which they endlessly claimed to support back when they couldn't pass
it. The administration wants not only to prevent industry money from
funding an anti-health-care-reform campaign, but also wants to ensure
that the Democratic Party -- rather than the GOP -- will continue to be
the prime recipient of industry largesse.

As was
painfully predictable all along, the final bill will not have any form
of public option, nor will it include the wildly popular expansion of
Medicare coverage. Obama supporters are eager to depict the White
House as nothing more than a helpless victim in all of this --
the President so deeply wanted a more progressive bill but was sadly
thwarted in his noble efforts by those inhumane, corrupt Congressional
"centrists." Right. The evidence was overwhelming from the start that
the White House was not only indifferent, but opposed, to the
provisions most important to progressives. The administration is
getting the bill which they, more or less, wanted from the start -- the
one that is a huge boon to the health insurance and pharmaceutical
industry. And kudos to Russ Feingold for saying so:

Sen.
Russ Feingold (D-Wis.), among the most vocal supporters of the public
option, said it would be unfair to blame Lieberman for its apparent
demise. Feingold said that responsibility ultimately rests with President Barack Obama and he could have insisted on a higher standard for the legislation.

"This bill appears to be legislation that the president wanted in the first place,
so I don't think focusing it on Lieberman really hits the truth," said
Feingold. "I think they could have been higher. I certainly think a
stronger bill would have been better in every respect."

Let's
repeat that: "This bill appears to be legislation that the president
wanted in the first place." Indeed it does. There are rational,
practical reasons why that might be so. If you're interested in
preserving and expanding political power, then, all other things being
equal, it's better to have the pharmaceutical and health insurance
industry on your side than opposed to you. Or perhaps they calculated
from the start that this was the best bill they could get. The wisdom
of that rationale can be debated, but depicting Obama as the impotent
progressive victim here of recalcitrant, corrupt centrists is really
too much to bear.

Yet numerous Obama defenders -- such as MattYglesias, Ezra Klein and Steve Benen
-- have been insisting that there is just nothing the White House could
have done and all of this shows that our political system is tragically
"ungovernable." After all, Congress is a separate branch of
government, Obama doesn't have a vote, and 60 votes are needed to do
anything. How is it his fault if centrist Senators won't support what
he wants to do? Apparently, this is the type of conversation we're to
believe takes place in the Oval Office:

The President: I really want a public option and Medicare buy-in. What can we do to get it?

Rahm Emanuel: Unfortunately,
nothing. We can just sit by and hope, but you're not in Congress any
more and you don't have a vote. They're a separate branch of
government and we have to respect that.

The President: So we have no role to play in what the Democratic Congress does?

Emanuel: No. Members of Congress make up their own minds and there's just nothing we can do to influence or pressure them.

The President: Gosh, that's too bad. Let's just keep our fingers crossed and see what happens then.

In
an ideal world, Congress would be -- and should be -- an autonomous
branch of government, exercising judgment independent of the White
House's influence, but that's not the world we live in. Does anyone
actually believe that Rahm Emanuel (who built his career on industry
support for the Party and jamming "centrist" bills through Congress
with the support of Blue Dogs) and Barack Obama (who attached himself
to Joe Lieberman when arriving in the Senate, repeatedly proved himself
receptive to "centrist" compromises, had a campaign funded by corporate
interests, and is now the leader of a vast funding and political
infrastructure) were the helpless victims of those same forces?
Engineering these sorts of "centrist," industry-serving compromises has
been the modus operandi of both Obama and, especially, Emanuel.

Indeed,
we've seen before what the White House can do -- and does do -- when
they actually care about pressuring members of Congress to support
something they genuinely want passed. When FDL and other liberal blogs
led an effort to defeat Obama's war funding bill back in June, the White House became desperate for votes, and here is what they apparently did (though they deny it):

The
White House is playing hardball with Democrats who intend to vote
against the supplemental war spending bill, threatening freshmen who
oppose it
that they won't get help with reelection and will be
cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said
Friday. "We're not going to help you. You'll never hear from us
again," Woolsey said the White House is telling freshmen.

That's
what the White House can do when they actually care about pressuring
someone to vote the way they want. Why didn't they do any of that to
the "centrists" who were supposedly obstructing what they wanted on
health care? Why didn't they tell Blanche Lincoln -- in a desperate
fight for her political life -- that she would "never hear from them
again," and would lose DNC and other Democratic institutional support,
if she filibustered the public option? Why haven't they threatened to
remove Joe Lieberman's cherished Homeland Security Chairmanship if he's
been sabotaging the President's agenda? Why hasn't the President been
rhetorically pressuring Senators to support the public option and
Medicare buy-in, or taking any of the other steps outlined here
by Adam Green? There's no guarantee that it would have worked -- Obama
is not omnipotent and he can't always control Congressional outcomes --
but the lack of any such efforts is extremely telling about what the
White House really wanted here.

Independent of the
reasonable debate over whether this bill is a marginal improvement over
the status quo, there are truly horrible elements to it. Two of the
most popular provisions (both of which, not coincidentally, were highly
adverse to industry interests) -- the public option and Medicare
expansion -- are stripped out (a new Washington Post/ABC poll out today shows that the public favors expansion of Medicare to age 55 by a 30-point margin). What remains is a politically distastrous and highly coercive "mandate" gift to the health insurance industry, described perfectly by Digby:

Obama
can say that you're getting a lot, but also saying that it "covers
everyone," as if there's a big new benefit is a big stretch. Nothing
will have changed on that count except changing the law to force people
to buy private insurance if they don't get it from their employer. I
guess you can call that progressive, but that doesn't make it so. In
fact, mandating that all people pay money to a private
interest isn't even conservative, free market or otherwise. It's some
kind of weird corporatism
that's very hard to square with the common good philosophy that Democrats supposedly espouse.

Nobody's
"getting covered" here. After all, people are already "free" to buy
private insurance and one must assume they have reasons for not doing
it already. Whether those reasons are good or bad won't make a
difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn't or didn't want to write. Indeed, it actually looks like the worst caricature of liberals: taking people's money against their will, saying it's for their own good
--- and doing it without even the cover that FDR wisely insisted upon
with social security, by having it withdrawn from paychecks. People
don't miss the money as much when they never see it.

In
essence, this re-inforces all of the worst dynamics of Washington. The
insurance industry gets the biggest bonanza imaginable in the form of
tens of millions of coerced new customers without any competition or
other price controls. Progressive opinion-makers, as always, signaled
that they can and should be ignored (don't worry about us -- we're
announcing in advance that we'll support whatever you feed us no matter
how little it contains of what we want
and will never exercise raw political power to get what we want; make sure those other people are happy but ignore us). Most
of this was negotiated and effectuated in complete secrecy, in the
sleazy sewers populated by lobbyists, industry insiders, and their
wholly-owned pawns in the Congress. And highly unpopular,
industry-serving legislation is passed off as "centrist," the noblest
Beltway value.

Looked at from the narrow lens of
health care policy, there is a reasonable debate to be had among reform
advocates over whether this bill is a net benefit or a net harm. But
the idea that the White House did what it could to ensure the inclusion
of progressive provisions -- or that they were powerless to do anything
about it -- is absurd on its face. Whatever else is true, the
overwhelming evidence points to exactly what Sen. Feingold said
yesterday: "This bill appears to be legislation that the president
wanted in the first place."

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