Up On A Tightrope

Well, frumps, despite the amount of time spent “in the crucible,” it appears that Health Care Reform legislation is still an ungainly glob of base metals that may never be transformed into actual gold.

This morning’s headline on the Huffington Post home page blared:

LEADERLESS

Senate Pushes For Public Option Without Obama’s Support

To me, that feels like an overstatement, given some of the qualifications contained in the article below the headline. The headline is, however, attention-getting and a little inflammatory which may be exactly what is needed at this point in the reform process.

It All Boils Down to the Public Option

If you are feeling confused following the day-to-day passage of the various versions of health care reform being beaten into shape in both houses of Congress you are not alone. If this thing were hooked up to an EKG monitor, surgeons would be prepping to implant a pacemaker – STAT. And all of those erratic peaks and valleys are occasioned by one small, but critical, aspect of health care reform that has become known as the “Public Option.”

If you’ve been hiking in the Himalayas all summer and you’re not sure what that means, here’s my simplistic definition: the Public Option – to be or not to be – determines just how screwed the public will continue to be by insurance carriers.

If you’ve ever been turned down for policy after policy while your sky-high COBRA coverage is running out; if you’ve ever had a claim denied and spent days on the telephone trying to understand why; if you’ve ever been told that you can have coverage, it just won’t cover any recurrence of your cancer which is in remission; if you’ve ever had your coverage cancelled for being twelve hours late on a payment – well, a strong Public Option would mean that those things will never happen to you or your dependents in the future.

You might ask, “well, if that’s true, who could be possibly be against the Public Option”? Short answer: the health care insurance industry. And that industry holds much more powerful (read financial) sway over Congress than you and I who live at the bottom of that particular “food chain.”

Where It Stands

Over the past week, daily reports coming out of Congress, primarily from Harry Reid, Majority Leader in the Senate and Nancy Pelosi, Speaker of the House have been encouraging to those who favor a robust Public Option being included in the final bill.

The White House has signaled in the past that it leans toward the Senate version of the bill so it’s been especially important to Public Option advocates that the Senate version contains a Public Option going into conference that will craft the final bill from the House and Senate versions.

The House version has always included a Public Option but coming out of the Senate Finance committee, the Senate version, or Baucus Bill, did not. In the intervening time period, Harry Reid has emerged as a stand-up advocate for adding a Public Option “flavor” that allows for individual states to “opt out” of offering a Medicare-like option. He has gathered just about enough support among Democratic senators to include that option in the Senate’s legislation and, according to his whip count, needs only one or two Democratic hold-outs to support inclusion of the PO.

The difference is that if both the House and Senate versions of the bill include a Public Option, it signals a pretty clear popular mandate and makes it more difficult to remove from the final bill that results. If the Senate bill goes to committee without a Public Option, of any kind, it becomes much easier to produce a final bill that has no such option

Accordingly, Harry Reid has asked President Obama to do a little arm-twisting in order to get the last one or two votes needed to beef up the Senate’s version of the bill.

“Leaderless” or Not?

That’s where HuffPost comes up with their “Leaderless” headline. Various democratic sources, usually cited as “aides” are indicating that the White House has reacted “coolly” to Reid’s request for the President’s help in pushing the Public Option into the Senate bill.

The “official” White House response to that buzz, however, is “no such thing.” According to HuffPo’s coverage:

“White House aides responded to the pressure not by embracing Reid’s more aggressive stance, but by denying reports that he was discouraging the opt-out proposal.”

“The report is false. The White House continues to work with the Senate on the merging of the two bills,” said Dan Pfeiffer, a top White House aide whose portfolio includes health care. “We are making good progress toward enacting comprehensive health reform.”

“But the push-back, say sources with direct knowledge of deliberations between leadership and the administration, does not square with Obama’s private indications to Senate leaders. The sources say that the president has left little doubt about his apprehension with an opt-out approach.”

Up On A Tightrope

Progressives feel that the US electorate stands to benefit tremendously from health care reform that includes a robust Public Option (which has come to mean Medicare + 5%). And, in my opinion, they’re right. In addition, I expect that if the program were to succeed, it would eventually convert nay-sayers to true believers, just as Medicare has done.

What most of us are not in a postion to know or fully appreciate is how much of Barack Obama’s total political capital could be sucked up by this one reform occurring in the first year of his administration. And how a loss, at this time, could adversely affect his prospects for carrying out the rest of his agenda.

The Huffington Post article cites a source as saying just about exactly that in this quote:

“It is not philosophical but is a matter of political practicality.”

It’s been pretty clear, throughout, that Obama has sided with the idea of a Public Option trigger, also a favorite of Olympia Snowe and Obama’s Chief-of-Staff Rahm Emanuel (strange bedfellows, indeed).

An aide had this to say about that:

“He’s been so convinced by his political people from the beginning that we can’t get a bill with a public option, he’s internalized it. Even though it’s now become obvious we can get a bill without selling out the public option, he’s still on that path,” said a top Democratic source. The White House, he said, continues to assure progressives it’ll improve the bill in conference negotiations between the Senate and House, but advocates are unconvinced.”

Progressives feel, adamantly, that a triggered Public Option is no Public Option at all and this is why:

“A trigger would implement a public option only if insurance companies failed to meet certain benchmarks over time and it would only be implemented in the regions of the country where those benchmarks weren’t met. The Medicare prescription drug proposal passed in 2003 includes a “trigger,” but the public provision has never been activated despite soaring drug costs. The industry can help craft the trigger language and can game its stats to prevent it from becoming reality.”

“The current state of our health system should be trigger enough for anyone who’s paying attention,” said a congressional aide in the middle of the health care battle. “The American people pulled the ‘trigger’ in November.”

Send Me a Sign, Lord

In the midst of all of this turmoil, Anna Quindlen’s voice of reason weighed in with her article for Newsweek entitled Hope Springs Eternal. I can’t recommend this article highly enough for anyone who is over in the Promises Made; Promises kept camp tallying up Obama’s track record, so far. It certainly proved to be the perfect “Chill Pill” for me. I’m going to throw an excerpt at you that is apropos of my subject, today, but do go read the entire article when you get a chance.

Here’s the excerpt:

“Even the astonishing domestic successes of the Johnson administration in 1965 were built on previous gains; the Voting Rights Act was begotten not only of the civil-rights marches, but also of Brown v. Board of Education. (And of hard-core politicking, of course. You have to wonder whether Lyndon Johnson would have gotten away with handing out public-works projects like cheap cigars if today’s blogosphere had been around to record it in real time.) But there is one legacy of that year, a year that also saw the passage of Medicare and immigration-reform legislation, that may be instructive today. It’s best summed up by the historian Doris Kearns Goodwin. She served as an aide in the Johnson White House, and her voice still carries the vibrato of excitement when she recalls that time.”

“LBJ promised the members of Congress that they could someday say they’d made history,” she says. “This Congress has never known the joy of that accomplishment. They haven’t ever been part of an institution that moves collectively to change history for the benefit of the American people.” She also notes that the presidents who have made real change have always done so in the same way: “Each of them had the country pushing the Congress to act, the people and the press both. The pressure has to come from outside.”

“So if the American people want the president to be more like the Barack Obama they elected, maybe they should start acting more like the voters who elected him, who forcibly and undeniably moved the political establishment to where it didn’t want to go.” (My emphasis)

Election’s Over Folks, Now the Work Begins

Wow, how’s that for a call to action? Maybe too many of us believed that the huge, sustained, historic effort to elect Barack Obama would be the whole job. Maybe we didn’t realize the extent to which that was only the beginning of our commitment. Maybe instead of retiring to our armchairs to watch our president at work, we need to get up off our butts and support him loud and long in all of those things that he wants to do for us. Maybe we need to defend him more demonstrably or at least as demonstrably as those who are constantly criticizing him, embarrassing him, insulting him and hoping for his failure. We put Barack Obama in the White House and we should not abandon him there. As in all other aspects of life, something worth fighting for is equally worth protecting if you’re strong enough and lucky enough to get it.

I never thought I’d be saying this but maybe we need to take a page out of the Tea Party playbook. Progressives would probably prefer a Kegger, so call it what you will. The important point is that Tea Party-ers came sailing out of a place that they felt was one of utter defeat for those things that they revere. They fought and they fought hard. Maybe they fought ugly and maybe they regret some of the tactics but I doubt they regret the strategy. They felt oppressed and they fought back with everything they had.

Maybe what Obama needs from us is a demonstration of how much we care and how much we need from him so that he doesn’t have to get his notions of what his constituents crave from polls and pundits and Rahm Emanuel’s back office. Maybe if we all stood up in the National Mall and said we’re here to help you, we’ve got your back, remember us? We just might be able help our President help us. It certainly got a lot of attention for the right wing fringe, just imagine what it might do for a hundred times more of the Democratic Majority.