Tuesday, March 30, 2010

the health care myths continue

I get a lot of right-wing emails. A large part of that is because of these posts. Friends send my posts to their right-wing friends or relatives (whom I refer to generically as “your right-wing brother-in-law”) and either the friend or his or her right-wing brother-in-law sends me his response. Then I get on his right-wing email distribution list and … they pour in. I read them so you don’t have to.

Based on years of this, and countless right-wing emails, I can make a few generalizations:

1/ They usually allege something factual that is an OUTRAGE. The odds are overwhelming (90+%) that the alleged “facts” are not true. Therefore you should always assume they are untrue unless or until you get them verified from a source you know from direct, personal experience to be reliable. But given the remote likelihood that they are true, it really isn’t worth spending much time attempting to determine that with certainty.

2/ Your right-wing brother-in-law doesn’t really care in the least that they are untrue and time spent trying to convince him of their falsity will never cause him to question either his opinions or the veracity of future right-wing emails.

3/ The likely veracity of the email is inversely related to the number of exclamation points or other expressions of OUTRAGE. The more OUTRAGEOUS the more certain you can be that the email is untrue.

4/ If the email concludes by telling you to send it to everyone you know, the odds of it being untrue are approximately 100%.

As the health care “debate” played out over the past year, there were all manner of viral lies about “death panels” and “free health care for illegal immigrants” and a “federal takeover of health care” and all manner of other things (spread not exclusively or even primarily by email but by FOX News and prominent Republican politicians who, like your right-wing brother-in-law, never really cared whether the stuff they were spouting was true). But until there was actually a bill signed into law, it was hard to definitively disprove all those allegations. That is one of the reasons why it was so important politically for Democrats not to abandon their effort at health care reform. Had the effort failed, the “health care bill” would have lived forever in right-wing mythology (and, eventually, the political conventional wisdom) as all those things it was alleged to be. Since it would have never actually come into existence, it would forever be everything its opponents claimed it was.

Now that health care reform has been signed into law, the right-wing myths haven’t stopped. But it becomes much easier to refute them or at least challenge them. If nothing else, it is now easier to ask, “Given that this is all about private health insurance to obtain medical care through private providers, where is the ‘government takeover” part?” Or, “Point out to me what in this new law is going to result in unplugging granny or free health care for illegal immigrants or health care provided through government ministries.” Or, “What parts of the new law do you want to repeal?”

That said, let me respond to a few of the myths that already seem to have gone viral.

First, let’s note a couple of general points. This law was endorsed by the American Medical Association (AMA), the American Association of Retired Persons (AARP), the American Nurses Association, the American Hospital Association, the Catholic Health Association and just about every other mainstream health policy organization. It was modeled on the
1993 Republican alternative to the Clinton plan, the popular and successful 2006 Romney plan in Massachusetts, and the Bob Dole/Howard Baker/Tom Daschle Bipartisan Policy Center proposal. It can fairly be described as a “centrist Republican approach” (admittedly, the “centrist Republican” has, itself, become a mythical creature).

Claims that health care reform is “Armageddon … that will ruin our country” (the
actual words of House minority leader Boehner) do not seem to be shared by the financial markets.

As of March 2, Intrade priced the odds of health care passing at 30%:

So presumably the equity markets had not priced in passage of the health care bill, even fairly recently.

On March 2,
the S&P 500 was 1118. It closed today at 1173, up 4.9%. The market has also been up since passage of the bill. So for all the right wing talk of Armageddon, the markets don't seem to share that view. At worst, they shrugged. At best, they viewed it as a positive development. Sure, you can say that there were other things going on in the US economy in recent weeks that might have had a bearing on equity prices. (Some, like a slight uptick in interest rates, would tend to drive equity prices lower.) But if health care reform was going to fundamentally, negatively alter one-sixth (or more) of the US economy, it is reasonable to assume that would be discounted in the prices of equities.

OK, now let’s go to some of the specific myths that have been circulating.

Myth #1:

There has been a lot of hype around the announcement by AT&T that it was taking a $1 billion charge against earnings this quarter because of the health care reform law. Caterpillar says it will be taking a $100 million charge. Deere and 3M are also taking charges. Rupert Murdoch, through the Wall Street Journal editorial page, is, as usual, leading the charge on this issue. In an editorial entitled “
ObamaCare Day One: Companies are already warning about higher health-care costs,” Murdoch’s minion’s claim these charges reflect an increase in costs “this year alone” and are "a small measure of the destruction that will be churned out by the rewrite of health, tax, labor and welfare laws that is ObamaCare, and only the vanguard of much worse to come." How, you might ask, could these charges reflect an increase in costs “this year alone” when most provisions don’t take effect until 2014 and even most of those that take effect this year don’t kick in until late September? The answer, of course, is that these charges have nothing to do with costs “this year” – the Journal’s editorial board is, as usual, making stuff up.

I have already received a few right-wing emails on this subject and today even the New York Times picks up the issue in an article entitled, “
Companies Push Repeal Provision of Health Law” – a classic example of “he said/she said” journalism. So what’s the scoop on this supposed big increase in corporate health care costs?

Back in 2003, George W. Bush and the Republican Congress passed the Medicare Part D program, a
$10 trillion unfunded liability that extends prescription drug coverage to seniors on Medicare. There was concern that with Medicare now offering this prescription drug coverage some companies might drop it from the health care benefits they are already offering their retirees and dump the cost of the federal government. So the Republican Congress gave them a kickback – a subsidy equal to 28% of the cost of a company’s retiree drug benefits – equal to around $1300/year per retiree on average. Not only did the companies get the subsidy, but they didn’t have to report it as income. But here is the really cool part: They also got to deduct the subsidy as an expense. That’s right. The federal government gives them money and the companies get to deduct it as an expense. In normal accounting, an expense is something you PAY not something you RECEIVE.

In retrospect, that looked pretty dodgy. So as part of the health care reform act, Congressional Democrats ended the tax deduction. They didn’t end the subsidy. And they didn’t make it taxable. They only ended the tax deduction for the tax-free subsidy. Yes, folks, this is the new Republican/Chamber of Commerce/Wall Street Journal/right wing rallying cry: “It is an OUTRAGE to take away the tax deduction that big companies get for their tax-free government handout.”

Federal officials estimate that eliminating the tax deduction will raise around $4.5 billion in revenue over ten years. That is roughly the same amount that the health care legislation provides in additional subsidies for companies that maintain retiree health plans. In other words, it's a wash. And the Business Roundtable, an association of chief executives, has estimated, “that health care reform will reduce insurance cost trends for businesses by more than $3000 for each employee over the next 10 years.”

So if ending this bogus deduction only raises $4.5 billion over ten years, how does just one company, AT&T, end up with a $1 billion write down in just one quarter? Good question. I suggest some enterprising reporter delve more deeply into their accounting. Presumably they are claiming that this is the actuarial value of that tax deduction in perpetuity discounted back to the present. That means that the undiscounted tax benefit would have had to be several billion dollars which doesn’t appear to be consistent with the estimated increase in federal revenue. And since when do companies capitalize the benefit of tax loopholes? I suspect that there is a lot more going on with these write offs – like using “ObamaCare” as an excuse to belatedly fix some wildly unrealistic assumptions in their pension accounting.

But I digress.

That is all too much to expect the average misinformed Wall Street Journal reader to discover. All they know (or think they know) is that ObamaCare is bankrupting corporate America (despite the fact that investors appear to believe that the earning power of corporate America is undiminished).

Myth #2:

Another myth that’s going around is that the IRS will be hiring 16,000 agents in order to enforce ObamaCare. George Will even spouted it on ABC’s This Week on Sunday. After dismissing his co-panelist Paul Krugman as someone who received a Nobel Prize “in economics, not practical Washington wisdom,” Will showed his own “Washington wisdom” by
claiming: “One of the ways that this simple, workable legislation is going to be made to work is the IRS is going to hire about 16,000 new agents.” Apparently this bogus claim started with a press release from a Republican Congressman from Texas citing Republican staffers as his source. It was quickly picked up by the right-wing noise machine (complete with pictures of soldiers in battle gear) and then carried over into the mainstream media and stated as fact by shills like George Will. You probably won’t be surprised to find out that it isn’t true. The IRS Commissioner refuted it in a House Ways and Means Committee hearing on March 25th.

At year end, employers and insurance companies will send out evidence of insurance coverage just as they send out W2 and 1099 forms today. Taxpayers will attach those to their tax returns and that will be the end of it. The IRS has no intentions of going beyond that to verify coverage.

Don’t tell anyone, but the fun little secret of the individual health care mandate is that it
really doesn’t have any teeth. Penalties are low and if someone refuses to pay, the law specifically says that no criminal penalties or liens can be imposed. Soldiers in battle gear won’t be bursting through your door. Fortunately, the experience in Massachusetts suggests that the individual mandate encourages most people to buy insurance even if would make economic sense for them to just pay the penalty … or to refuse to pay it altogether. With something like $300 billion a year in tax evasion, the IRS has bigger concerns than whether or not you buy health insurance.

Myth #3:

I have received this viral email at least a dozen times. I bet you have too (if not, you probably will). It is the “proposed 28th Amendment” to the Constitution that would require that all laws apply to members of Congress. Here is a bit of it:

Subject: An idea whose time has come

For too long we have been too complacent about the workings of Congress. Many citizens had no idea that members of Congress could retire with the same pay after only one term, that they didn't pay into Social Security, that they specifically exempted themselves from many of the laws they have passed (such as being exempt from any fear of prosecution for sexual harassment) while ordinary citizens must live under those laws. The latest is to exempt themselves from the Healthcare Reform that is being considered...in all of its forms. Somehow, that doesn't seem logical. We do not have an elite that is above the law. I truly don't care if they are Democrat, Republican, Independent or whatever. The self-serving must stop. This is a good way to do that. It is an idea whose time has come.

Have each person contact a minimum of Twenty people on their Address list, in turn ask each of those to do likewise.

In three days, most people in The United States of America will
have the message. This is one proposal that really should be passed around.

Proposed 28th Amendment to the United States Constitution:

"Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and/or Representatives; and, Congress shall make no law that applies to the Senators and/or Representatives that does not apply equally to the citizens of the United States."

Note that bit about sending it to 20 people. Not quite as strong as telling you to send it to everyone you know, but probably more effective by making the task more specific and manageable. In any event, it’s a sure tip-off that the thing is bogus.

So here are the

FACT: Members of Congress are NOT exempt from paying into Social Security.
FACT: Members of Congress are NOT exempt from any other laws of general applicability (including any dealing with sexual harassment).
FACT: Members of Congress CANNOT retire after only one term with their full Congressional salary. Members of Congress make $174,000 year and receive the same retirement benefits as other federal workers (for which they pay in 1.3% if their salary in addition to the 6.2% Social Security tax). Members of Congress do not begin vesting rights until they have served for five years and are not eligible for a pension until they've completed 20 years of service or after they reach the age of 62. According to the Congressional Research Service, as of October 1, 2006, 413 retired Members of Congress were receiving federal pensions based fully or in part on their congressional service and their average pension was $35,592.

And, specifically with regard to the new health care reform act,
Section 1312 explicitly provides that the only health care plans that may be offered to members of Congress and their staff are those provided on the new exchanges set up under the law. So not only are Members of Congress and their staff not exempted from the law, they are the only Americans who will explicitly lose their existing employer-provided health insurance and be required to get their insurance through the new exchanges.

These aren’t the only “myths” (a polite way of saying “lies”) about the health care reform act going around. And I’m sure there will a lot more. The problem with these myths is that they are potentially limitless. There is literally no limit to the stuff people can just make up. But it takes time to refute them (and some, by their nature, cannot be definitely disproved – like how to you “prove” what’s not in a bill that hasn’t even been written?). At some point you would think that they would undermine the credibility of those who propagate them. (But, then, that would assume that falsity is a “bug” rather than a “feature” with these things.)

On a lighter note, let me end with some
further health care myths:

Some myths about the current healthcare bill explained.

There's been a lot of talk about this lately, so I figured that I'd clear up a few common misconceptions people seem to have about the recently passed Health Care Reform bill.

Myth 1: With the passage of HCR, bears will be allowed to roam hospitals, devouring those patients too sick to hide or flee.

Status: FALSE

The ursine provisions of the health care bill remain controversial with the AMA and other organizations, but, basically, all they do is recognize that in some rural areas, particularly in the Dakotas and Alaska, bears have been acting as health care professionals for decades, and puts them into the category of other alternative health professionals, such as acupuncturists, osteopaths, and killer bees. Bear attacks may be available under some health plans, but those treatments are entirely at the discretion of the insurers.

Myth 2: MRIs are once again to be termed "Nuclear Magnetic Resonance Images", and once again, a small percentage of those undergoing this procedure will gain super-powers that will allow them to perform great feats, at a cost to their humanity.

Status: FALSE

While this provision was included in earlier versions of the bill, it was dropped in the face of a strong opposition by Senator Keene and others.

Myth 3: ObamaNaziSocialismAntichristApocolpyseRevalations4:15SicSemperTyranisTaxedEnoguhAlready!

Status: That's not a myth, that's a bunch of words, some of which are misspelled.

Myth 4: A provision of the HCR bill calls to the Lord Above, to send down a dove, with beak as sharp as razors, to cut the throats of them there blokes, what sells bad beer to sailors.

Status: Partially true.While this language does exist in the current version of the bill, it is unlikely to stand judicial scrutiny, as it will probably be seen as a violation of the separation of church and state. However, this is merely echoing faith-based programs enacted by individual states. The dove attacks on campus area bars selling Rolling Rock to University of West Florida Argonauts, for instance, can only be applauded, as Rolling Rock is swill.

Myth 5: In order to pay for the mandates of this bill, President Obama has traded the treasury of the United States for a handful of magic beans.

Status: FALSE

Only one government-owned cow was traded for these beans, which have already more than earned back the initial investment. Also, since the treasury of the US currently contains less than negative fourteen trillion dollars, wouldn't you want to trade it, for just about anything?

Myth 6: The HCR bill will allow communists control of our vital bodily fluids.

Status: TRUE

Yeah, this one is totally real. But, to be fair, there aren't that many communists
left, and those that there are don't actually want that many bags full of lymph and phlegm.

Thursday, March 25, 2010

the bipartisan health care reform law

I agree with Vice President Biden that this week's enactment of historic health care reform legislation was a big ... er, deal. It's an achievement the whole country should be proud of.

In my post last week ("president romney's first year"), I imaged a parallel universe where Mitt Romney won the 2008 presidential election and how the policies and performance of President Obama's first year might have been perceived had they been those of Romney instead. As it turns out, Berkeley economist Brad DeLong had the same thought:

Over in that alternative branch of the quantum-mechanical multiverse in which Mitt Romney was elected President in November 2008, this health-care bill ... passed the House of Representatives 352-83 and passed the Senate 79-20, with near-solid Republican support. Left-wing Democrats whined that it was not real
reform. The David Broders and David Brookses of the world trumpeted it as an
extraordinary victory for American bipartisanship.

Instead, we are here -- where a nearly identical plan appears very, very

We truly live in a weird world.

DeLong has lately taken to calling the new health care reform law "RomneyCare" to highlight the fact that the health care reform bill that President Obama signed into law this week follows the same basic contours as Mitt Romney's successful and popular Massachusetts plan (
you can read a good history of that plan here).

It is basically the same plan that
Republican's proposed as an alternative to the Clinton health care plan in 1993 (follow that link for a good comparison of the '93 plan with the new law).

In other words, Democrats just passed the Republican health care reform plan -- without a single Republican vote.

Bear in mind, the bill that was signed into law this week was endorsed by the AMA (which has never before supported any health care reform effort), the AARP (I'm pretty sure they're not out to "kill granny"), the American Hospital Association, the American Nurses Association, the Catholic Health Association, a group representing 59,000 Catholic nuns, and way too many other groups to list. But it didn't get a single Republican vote out of 198 Republicans in the House and 41 Republican Senators.

Among those who helped
design the Romney plan was the conservative Heritage Foundation. It's principal architect was MIT economist Jonathan Gruber, who also advised the Obama administration. Although Republicans are now decrying the "individual mandate," it was the centerpiece of Romney's "Personal Responsibility" plan. Here he is in a 2006 Wall Street Journal op-ed touting his new law:
... I proposed that everyone must either purchase a product of their choice or demonstrate that they can pay for their own health care. It's a personal responsibility principle.

Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian.

The Romney plan also covers abortions. (Babykiller!!)

This week Republicans have taken up the theme that the individual mandate is not just bad policy ... but unconstitutional. Among those leading the torch-and-pitchfork crowd against President Obama's health care act is none other than ... Romney himself, who on Monday called the bill that garnered 60 votes in the Senate and a majority in the House, "
an unconscionable abuse of power." Romney has also joined the Republican chorus claiming the act is unconstitutional -- although he has so far inartfully dodged all questions on whether the thinks the individual mandate is constitutional. But that is the focus of the Republican attorneys general of 13 states (including Washington State's ambitious Republican attorney general) who this week filed a lawsuit claiming the individual mandate is unconstitutional. Most serious legal scholars consider that suit nothing more than frivilous partisan grandstanding -- unless the current radical majority on the Supreme Court decides to overturn a few generations of court precedent (as they did in the Citizen's United case that overturned a century of restrictions on corporate money in our electoral system). Republicans apparently were against "judicial activism" and "frivilous lawsuits" before they were for them.

Among the current Republican senators who co-sponsored the 1993 Republican alternative, which included an individual mandate, are Kit Bond (R-MO), Robert Bennett (R-UT), Orrin Hatch (R-UT), Richard Lugar (R-IN), and Chuck Grassley (R-IA). Republican Senators who have
co-sponsored another bill built around an individual insurance mandate include Lindsey Graham (R-SC), Mike Crapo (R-ID), Judd Gregg (R-NH), and Lamar Alexander (R-TN). And Olympia Snowe (R-ME) actually voted for the Senate bill in committee. Apparently, all were for a Romney-style "Personal Responsiblity" plan before it became an unconstitutional OUTRAGE.

The plan that was passed into law this week is also essentially the same as the proposal put forth last summer by the the
bipartisan Bob Dole/Howard Baker/Tom Daschle group. As Jonathan Cohn describes it:
Earlier [last] year, a group of former Senate majority leaders--Republicans Howard Baker and Bob Dole, along with Democrats Tom Daschle and George Mitchell--showed how that might be accomplished. After negotiating with each other for more than a year, as if they were still in office and representing their two parties, the group (minus Mitchell, who had since joined the administration) unveiled a fully fledged health care reform proposal in June. They released it through the Bipartisan Policy Center, a think tank they’d establish precisely to advance proposals like these. And, at least on paper, it looked like the kind of scheme members of both parties could support in good conscience.

The Center’s proposal had the same basic architecture as the plan Obama put forward in his presidential campaign and that congressional committees have been debating this year. Everybody would have to get insurance; in exchange, government would make sure everybody could get insurance, by subsidizing the cost for those who needed financial assistance--and by creating a marketplace in which people without access to employer policies could get coverage regardless of pre-existing conditions.

The major point of departure between the various Republican plans and Democratic proposals earlier in this process had been the inclusion of a "public option" in the Democratic plans. But as we all know, the public option was dropped along the way (thanks, primarily, to Joe Liebermann and Ben Nelson). So, as it turns out, the bill that passed Congress was actually more conservative than the Dole/Baker/Daschle plan, which included state-based public options and a triggered public option at the federal level:
Instead of a single public-insurance plan into which people could enroll, the Center’s proposal would have given states the option of creating independent insurance plans to compete with private insurers; it allowed the federal government to step in with its own plan only if, after five years, there was evidence the system needed more competition.

Yes, former Republican Senate leaders Dole and Baker were willing to go further than Congressional Democrats. Who knew Dole and Baker were totalitarian socialists?

Now repealing health care reform is joining taxes, abortions, guns and gays among the list of Republican "lithmus tests." But as people learn what is really in the new law (e.g., no "death panels", "free health care for illegal immigrants" or "federal funding of abortion") they are finding out that there are a lot of pretty cool things in the bill.

Among the provisions that kick in this year:

NO DISCRIMINATON AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS: Prohibits health insurers from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)

ENDS RESCISSIONS: Bans insurance companies from dropping people from coverage when they get sick. Effective 6 months after enactment.

EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS INSURANCE - Requires health plans to allow young people up to their 26th birthday to remain on their parents insurance policy, at the parents choice. Effective 6 months after enactment.

SMALL BUSINESS TAX CREDITS: Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)

BEGINS TO CLOSE THE Medicare Part D Donut Hole: Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand-name drugs in the donut hole; also completely closes the donut hole by 2020.)

NEW, INDEPENDENT APPEALS PROCESS: Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.

ENSURING VALUE FOR PREMIUM PAYMENTS: Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

IMMEDIATE HELP FOR THE THOSE WITH PREXISTING CONDITIONS (INTERIM HIGH-RISK POOL): Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool. Effective 90 days after enactment.

COMMUNITY HEALTH CENTERS: Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.

INCREASING NUMBER OF PRIMARY CARE DOCTORS: Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

And that is not even remotely a comprehensive list.

Given all the popular stuff in the act, it's not surprising that some Republicans are already starting to back away from calls for total repeal (except when talking to their crazy base and the tea party crowd). Yesterday,Senator John Cornyn (R-TX), the chairman of the National Republican Senatorial Committee, said:

"There is non-controversial stuff here like the preexisting conditions exclusion and those sorts of things. We are not interested in repealing that. And that is frankly a distraction."

So now Republicans, like Cornyn, are FOR the really popular stuff, like the ban on preexisting condition exclusions. Their argument is with all the "other stuff" (for example, how you go about paying for it -- Republicans don't like to pay for our government). But all the "other stuff" flows from the ban on preexisting conditions.

If you say the sick can't be excluded from the insurance market, then people will just wait until they get sick to buy insurance. That will make insurance more expensive and cause more healthy people to drop their insurance, which will further raise rates and cause more healthy people to drop out, further raising rates, in what is known as the "insurance death spiral." That's why if you eliminate preexisting conditions, you have to include an individual mandate -- what Mitt Romney called "personal responsibility" when he was selling his Massachusetts plan. And if there's a mandate, there needs to be tax subsidies to make sure people can afford what they're being required to buy (just like in Massachusetts). And then of course, you need to define what they're being required to buy, and so you get minimum benefit regulations.

There you have it -- the basic structure of the health care reform that just passed Congress. It also happens to be the approach to health care reform that has long been advocated by Republicans as an alternative to a single-payer system (like the hugely popular Medicare system which
Republicans now consider sacrosanct -- except when they are trying to kill it) or other more government-oriented approaches. Near universal coverage achieved entirely through private insurance companies and private health care providers. Just like RomneyCare and the 1993 Republican plan.

But, of course, everyone knows what's been going on here. Republicans have been very open about it. Their lock-step obstructionism was never driven by the specifics of the health care reform plan -- or the details of any other particular legislation. It started in the very first days of the Obama administration -- at a time of a national economic crisis. The New York Times last week had a good piece on
Senate Republican leader McConnell's strategy of obstruction:

Before the health care fight, before the economic stimulus package, before President Obama even took office, Senator Mitch McConnell, the Republican minority leader, had a strategy for his party: use his extensive knowledge of Senate procedure to slow things down, take advantage of the difficulties Democrats would have in governing and deny Democrats any Republican support on big legislation.
In the process, Mr. McConnell, 68, a Kentuckian more at home plotting tactics in the cloakroom than writing legislation in a committee room or exhorting crowds on the campaign trail, has come to embody a kind of oppositional politics that critics say has left voters cynical about Washington, the Senate all but dysfunctional and the Republican Party without a positive agenda or message.

But in the short run at least, his approach has worked. ...

On the major issues — not just health care, but financial regulation and the economic stimulus package, among others — Mr. McConnell has held Republican defections to somewhere between minimal and nonexistent, allowing him to slow the Democratic agenda if not defeat aspects of it. He has helped energize the Republican base, expose divisions among Democrats and turn the health care fight into a test of the Democrats’ ability to govern.
The strategy that has brought Senate Republicans where they are today began when they gathered, beaten and dispirited, at the Library of Congress two weeks before Mr. Obama’s inauguration. They had lost seven seats in November, another was teetering, and they were about to go up against an extraordinarily popular new president and an emboldened Democratic Congress.
As the year went on, Mr. McConnell spent hours listening to the worries and ideas of Republicans, urging them not to be seduced by the attention-grabbing possibilities of cutting a bipartisan deal. “I think the reason my members are feeling really good,” he said, “is they believe that the reward for playing team ball this year was the reversal of the political environment and the possibility that we will have a bigger team next year.”
Mr. McConnell is credited with a very effective run over the last 15 months — though being minority leader has distinct advantages over being in charge of making the Senate function.

“Throwing grenades is easier than catching them,” acknowledged Senator John Thune of South Dakota, a fellow member of the Republican leadership.

McConnell's stategy has been effective because many voters (aided by media coverage that treats all policy debate like a sporting event) base their judgments on whether a policy is reasonable by the level of bipartisan support. Lock-step partisan opposition sends the signal that legislation is extreme. As McConnell explained in the New York Times piece:
“It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out,” Mr. McConnell said about the health legislation in an interview, suggesting that even minimal Republican support could sway the public.

McConnell made the same point to National Journal:
Then as the year unfolded -- whether it became the stimulus, the budget, Guantanamo, health care -- what I tried to do and what John [Boehner] did very skillfully, as well, was to unify our members in opposition to it. Had we not done that, I don't think the public would have been as appalled as they became ... Public opinion can change, but it is affected by what elected officials do. Our reaction to what they were doing had a lot to do with how the public felt about it. Republican unity in the House and Senate has been the major contributing factor to shifting American public

Democratic attempts to craft bipartisan legislation, by definition, cannot succeed as long as Republican opposition is unified. So Democrats could adopt RomneyCare or the 1993 Republican health care alternative, and Republicans who co-sponsored that earlier bill would still vote against it -- making it, by definition, a partisan Democratic bill. Or they could enact the largest two-year tax cut in US history, and every Repubolican would still vote against it -- making it partisan Democratic legislation. Or they could attempt to set up a bipartisan deficit reduction commission, and seven Republican co-sponsors would still vote to successfully filibuster it. And then Republicans accuse Democrats of enacting partisan legislation. Or, if the Demcrats are unable to overcome the opposition, they are accused of being ineffective. So far, that strategy seems to have been working for Republicans (if not the American people).

Senator Jim DeMint (R-SC)
famously said early in the health care process, "If we’re able to stop Obama on this it will be his Waterloo. It will break him." The goal was to "break" the Obama presidency. Had they succeeded in defeating health care reform, they would have done so.

On the other hand, if they had sought to get a bill more to their liking, they could have easily achieved that goal. President Obama was desperate for any Republican support. Senate Finance Committee chairman Baucus, with President Obama's encouragement, went to ridiculous lengths over months to get Republican support, even long after those with whom he was dealing, like Chuck Grassley, were picking up the "killing granny" and "free health care for illegal immigrants" themes and otherwise making it clear they weren't going to break with their party's obstruction. In return for even half a dozen Republican votes, Democrats almost certainly would have agreed to gut their bill.

That was especially true after the Massachusetts election when Congressional Democrats were running for the hills and even President Obama was making noises about a scaled down effort. Had Republicans come up some kind of pathetic, soggy, half a loaf, defeatist Democrats would have jumped at it. Even if it only succeeded in dividing the Democratic caucus, it would have killed the bill. But, as it turns out, Republican insistence on total defeat of the health care reform effort, with no compromises, ended up leaving Democrats with no option other than to go ahead with the bill that had passed the Senate with 60 votes on Christmas Eve.

Former Bush speechwriter, David Frum, has been among those faulting Republicans for their strategy on health care, saying (in a
widely cited blog post) that they ended up creating their own Waterloo. (Matthew Yglesias notes that the whole "Waterloo" metaphor is historically inapt.) But Frum makes the mistake of assuming the Republican goal was to come up with better health care reform legislation. Rather, the goal was to create partisan division and discredit the Democratic effort. And they largely succeeded at that.

Frum also makes the point that Republicans had worked their base into such a crazy rage over the last year that they couldn't back down. How do you compromise with "totalitarianism" or a "socialist takeover of the country" or "death panels"? The Glenn Beck/Rush Limbaugh/Sarah Palin crowd is now calling the shots. As Frum
observed, "Republicans originally thought that Fox worked for us, and now we are discovering we work for Fox."

Republicans now seem to be doubling down on the partisan division and obstruction. There is the whole phony "repeal" effort (Republicans would need 67 votes in the Senate to overcome a presidential veto which they couldn't achieve even if they won every Senate seat up this year). Then there is the frivilous litigation challenging the constitutionality of the act. But my favorite is John "Hey Kids Get Off My Grass!" McCain's
threat, "There will be no cooperation for the rest of the year." As opposed to all that Republican cooperation before. And what has made McCain more churlish than usual? Democrats overcame a Republican filibuster with 60 votes in the Senate. An OUTRAGE!

Jonathan Chait
makes a good point regarding McCain's threat:
[I]f we believe McCain [and other Republicans], they're saying that there are areas in public policy where Republicans would help make legislative changes that they believe would make the country a better place, but they are refusing to do so out of pique ... In other words, their own claim is that they are deliberately choosing to create suffering -- not merely preventing legislation the Democrats want, but preventing legislation they agree would help people and would otherwise support -- in order to punish the Democrats. This sounds like something the Democrats would accuse them of doing, not something they'd boast about.

This is the guy whose presidential campaign slogan was "Country First."

Senate Republicans are already acting on their threat of total obstruction by invoking an
obscure Senate rule to prevent any Senate committee meetings from taking place after 2pm. (In sympathy with their cause, I call on all Americans to join Senate Republicans by heading home from work every day at 2pm.) Seriously.

You couldn't come up with better material for a Gail Collins column if you tried -- and she has a
great one today. As she reminds us:
[F]eel free to remind Rush Limbaugh that he promised to move to Costa Rica if health care reform gets implemented. Once you’re done, you can go back and remind him that Costa Rica has national health care.

For that alone, we should all be grateful that health care reform was finally signed into law.

Wednesday, March 24, 2010

Tuesday, March 16, 2010

president romney's first year

In early 2008, the presidential front runner for the Republican presidential nomination, John McCain, suffered a heart attack. Although he recovered fully, he had to drop his presidential bid, leaving the field to former Massachusetts governor Mitt Romney. As it turns out, that was a lucky break for the GOP. When the financial crisis exploded less than two months before the fall election, Romney's business background was just what the country was looking for. While the charismatic young Barack Obama offered change, what the country really sought at that time of great uncertainty was stability and a return to some kind of normalcy. Romney was someone they were confident could handle the economy. They certainly were in no mood for inexperience (let alone some unhinged ideologue like that crazy Alaska governor -- what's-her-name -- who didn't even last one term in a state known for tolerating eccentrics).

Even the most bizarre storyline of the long campaign ended up as something of a blessing in disguise for Romney. His first choice for VP, South Carolina governor Mark Sanford, was an attempt to reassure the Christian right, which never had much love for the Mormon Romney. But when Sanford's scandalous affair with an Argentine woman broke only days before the Republican convention, Romney quickly pivoted to Indiana governor Mitch Daniels, who had been budget director during the first couple of years of the Bush/Cheney administration. The result was the Republican economic "A team" cued up just in time for the worst economic crisis since the Great Depression.

Republicans were fighting a strong headwind after the disastrous Bush/Cheney years, and Democrats increased their Congressional majorities. But the Romney/Daniels team managed to eek out a narrow win based on their perceived economic strengths.

And, as things turned out, it's hard to argue with the judgment of the American people. (Although the inauguration wasn't the most thrilling ever -- with the highlight being The Osmonds fresh off their
50th anniversary tour.)

A confident President Romney demonstrated his executive decisiveness by
swinging into action even before he had been sworn into office, proposing a large economic stimulus package. The centerpiece of that package was the biggest two-year tax cut in US history, with the rest roughly equally divided between support for state and local governments and more traditional public works spending. Some Democrats complained that the $787 billion measure was too small and too tilted toward tax cuts, and some Republicans complained that it was too big and didn't include enough tax cuts. President Romney's economic advisors defended the size of the stimulus by noting that it largely just countered the "anti-stimulus" resulting from state and local tax hikes and spending cuts required to offset the effects of the Great Recession on their budgets (with the net combined fiscal effect of government actions at all levels close to zero). But the need for urgent action during a national crisis muted criticism, as it had after 9-11, and the parties came together quickly in the spirit of national unity. President Romney had been in office for less than a month when the stimulus passed both houses of Congress with overwhelming bipartisan majorities.

President Romney's strong leadership reassured the financial markets and the crisis, which had threatened to bring down the global financial system, quickly receded. The nations' Gross Domestic Product, which had
declined at the staggering rate of 6.4% in the fourth quarter of 2008 turned around and only a year later was increasing at a 5.9% rate.

Unemployment continued to rise during President Romney's first year in office, peaking at 10% in December of 2009. Some Democrats tried to make an issue of it, but without much success -- and for good reason. The economy lost 779,000 jobs the month President Romney took office and at similar rates for his first couple of months, before his policies kicked in. But the rate of job loss soon began a steady decline. By February of 2009, it had fallen to 36,000 and headed into positive territory thereafter. Everyone agreed that President Romney's economic policies had been a huge success.

Certainly the financial markets cast their votes for the president. Rather than risk the disruption that might result from bringing in new, inexperienced players in the midst of a global financial crisis, President Romney reassured the markets by reappointing Bush's Federal Reserve Chairman, Ben Bernanke. And, in a bipartisan gesture, he named as Treasury Secretary former New York Fed Chief Timothy Geithner, who along with Bernanke had acted swiftly and decisively to help rescue the global financial system during the 2008 crisis. President Romney's choice of Geithner was not as odd as it first seemed to many. Geithner got his start working for Kissinger Associates, founded by establishment Republicans like Brent Scowcroft and Lawrence Eagleburger -- and, of course, the Big K himself. (And, truth be told, is these kinds of establishment Republicans, not the radical religious right, with whom President Romney is really most comfortable.) Geithner's formative government experience was at Treasury in the '90's working to contain financial crises in places like Mexico, Thailand, Indonesia and Russia -- valuable experience at a time when a global financial crisis was threatening another Great Depression in this country. (Excellent profiles of Geithner in
The New Yorker and The Atlantic.)

"Don't change horses in the middle of a stream," President Romney said, and the markets agreed. They bottomed out less than two months after he took office, just as his policies began to kick in.

By March of 2010, the S&P 500 had risen almost 70 percent from its low and more than 40 percent since President Romney took office.
As Republicans kept reminding us, markets represent the ultimate "spin-free zone" -- where politics and ideology get shoved aside and money talks (check out this video clip).

Rather than nationalizing the most problematic of the "too-big-to-fail" banks like Citigroup and Bank of America, as a growing consensus of economists seemed to favor at the time, President Romney chose instead to minimize the role of the federal government. His bank "stress tests" succeeded in reassuring private investors and allowed the banking system to attract $140 billion of private capital. As a result, the federal government was able to largely exit from its rescue effort much sooner and at less cost than most experts thought would be possible at the time President Romney took office. A year later, most of the TARP money put into the banks as part of the Bush Bailout had been repaid with interest and it appeared that
the ultimate cost of the financial rescue would be less than $150 billion -- about the same as the much smaller savings-and-loan crisis of the 1980's (our last experiment in financial deregulation gone awry). Some optimists (e.g., here, here and here) even believe the effort could eventually turn a profit. And, as Republicans are quick to emphasize, President Romney was able to spare the federal government any continuing role in the management of the banks as nationalization would have entailed.

Bloomberg story from March 10, 2010, provided a typical summary of the president's economic success:

The judgment of money in all its forms has been overwhelmingly positive [in its appraisal of the president's economic performance].

One year after U.S stocks hit their post-financial-crisis low on March 9, 2009, the benchmark Standard & Poor’s 500 Index has risen more than 68 percent, and it’s up more than 41 percent since [the president] took office. Credit spreads have narrowed. Commodity prices have surged. Housing prices have stabilized.

“We’ve had a phenomenal run in asset classes across the board,” said Dan Greenhaus, chief economic strategist for Miller Tabak & Co. in New York. “It's not surprising that we've had a never-ending drumbeat of news stories about markets voting in favor of the president.”

The economy has also strengthened beyond expectations at the time [the president] took office. The gross domestic product grew at a 5.9 percent annual pace in the fourth quarter, compared with a median forecast of 2.0 percent in a Bloomberg survey of economists a week before [the president]’s Jan. 20, 2009, inauguration. The median forecast for GDP growth this year is 3.0 percent, according to Bloomberg’s February survey of economists, versus 2.1 percent for 2010 in the
survey taken 13 months earlier.

“You have to give them -- along with the Federal Reserve - - a lot of credit,” said Joseph Carson, director of economic research at AllianceBernstein LP in New York. “A year ago, there was panic, as well as concern. And a lot of the expectations were not only that we were going to have declines in activity but they would stretch all the way to 2010, if not 2011.”

Since then, monthly job losses have abated, from 779,000 during the month [the president] took office to 36,000 last month. Corporate profits have grown; among 491 companies in the S&P 500 that reported fourth-quarter earnings,profits rose 180 percent from a year ago, according to Bloomberg data. Durable goods orders in January were up 9.3 percent from a year earlier. Inflation is tame, and long-term interest rates remain low. ...

Mark Zandi, chief economist at Moody's Economy.com, said the public’s opinion of the economy is likely to improve as the gains companies have made begin to translate into more jobs and higher wages.

Zandi said the economic rebound is largely a result of the policies of the White House and Federal Reserve. He cited the bank bailout, the Fed’s low-interest-rate policy and support for credit markets, and the ... administration’s stimulus plan, bank stress tests and backing of Fannie Mae and Freddie Mac.

“When you take it all together, the response was massive and unprecedented and ultimately successful,” Zandi said.

The federal budget deficit exploded as a result of the Great Recession, but no one blamed President Romney for that. In January of 2009, even before President Romney took office, the non-partisan Congressional Budget Office
forecast a $1.2 trillion deficit for fiscal 2009 (which began almost four months before Romney took office). As it turns out, the 2009 deficit came in at $1.4 trillion, but that was primarily the result of a plunge in tax revenue (which, at 14.8% of GDP was the lowest it had been since 1950 -- before Medicare, Medicaid and much of the federal government as we know it today). Federal spending actually came in slightly lower than the January 2009 CBO estimate. Indeed, President Romney's biggest battles to control the deficit were with his fellow Republicans who pushed hard for further massive tax cuts. For example, 36 Senate Republicans voted for Jim DeMint's plan to permanently cut taxes by more than $3 trillion over the next decade. As President Romney pointed out, those tax cuts would have exacerbated the shortfall in revenue that had already been decimated by the recession. They would have done little to stimulate the economy in the short term while massively increasing the long-term structural budget deficit.

President Romney showed his resolve to reduce the deficit by imposing a
three-year freeze on non-military discretionary spending. And he even had the courage to begin tackling some of the wasteful military spending that Congress had been insisting on against the wishes of the Pentagon. For example, he supported the recommendation of his Secretary of Defense and Joint Chiefs of Staff to cut off all further funding for the $65 billion F-22 fighter program after producing 187 aircraft (none of which had ever been used in either Iraq or Afghanistan). Despite the fact that a majority of Senate Republicans voted to continue that funding, President Romney prevailed with the support of a majority of Democrats. He was also tough on NASA, canceling Bush's feckless Moon project and proposing to privatize launch services, relying instead on commercial launch providers for future missions. And he established a deficit reduction commission headed by Vice President Daniels to address the long-term deficit. (Pundits joked that it was a form of penance for Daniels, who as Bush's budget director had been one of the principle salesmen for Bush's budget-busting tax cuts and had famously predicted that the Iraq war would cost between $50 billion and $60 billion. "Putting Mitch Daniels in charge of deficit reduction is like making Rush Limbaugh drug czar," quipped Senator Al Franken.)

Although the Great Recession had driven up spending on the "automatic stabilizers" like unemployment compensation and Medicaid, President Romney's
budget had spending coming back down to 23.2% of GDP by fiscal 2012 (despite unemployment forecast to persist over 8%) and 22.8% by 2013 (with unemployment still over 7%). As the Wall Street Journal noted in an editorial defending the Romney budget, "By 2012, spending as a percentage of the economy will be back down to the levels we enjoyed under President Reagan thirty years ago. Six of the eight Reagan years saw spending over 22% of GDP and for two years it exceeded 23%. President Romney is to be commended for his spending restraint despite inheriting the worst economy in 70 years. If he can deliver on those budgets, it will constitute a remarkable achievement. If it was good enough for Reagan, it's good enough for Romney."

It's hard to say which was better, President Romney's economic leadership or his performance as commander-in-chief. Just as he did with his economic team, President Romney sought continuity in his national security team. At his urging, Defense Secretary Robert Gates stayed on. And reflecting the fact that the country was fighting two wars, he named as his national security advisor a four-star Marine general,
James Jones. (Bill O'Reilly followed his praise for that appointment by observing, "Can you imagine who a President Obama might have named? Michael Moore, probably. And maybe Jane Fonda as Secretary of Defense. But only because Barbra Streisand had already taken the CIA post.") President Romney also kept on General David Petraeus as the head of the US Central Command, overseeing the wars in Iraq and Afghanistan, and General Ray Odierno as the top commander of US forces in Iraq.

Bush like to call himself a "war president" but he was better at starting wars than successfully concluding them. President Romney was left with the task of finishing what Bush started. So far, he has kept to Bush's withdrawal timetable in Iraq,
withdrawing all US troops from Iraqi cities as scheduled by the end of June 2009. After the Iraqi elections of March 2010 went off with minimal violence, he appears to be on track to keep his goal of having all US combat troops out of Iraq by the end of August 2010 and all remaining troops out of Iraq by the end of 2011.

But President Romney's bigger challenge was in Afghanistan, which had been all but ignored by the Bush/Cheney team.

By the time President Romney took office, the US war effort in that country was going badly and getting worse. The Taliban had been allowed to reconstitute themselves. They controlled large parts of Afghanistan and increasingly threatened neighboring Pakistan, even controlling the Swat Valley only 100 miles from the capital of Islamabad. President Romney doubled US troops in Afghanistan during his first year in office, from less than 35,000 to over 70,000, and
announced that he would increase those forces by another 30,000 in 2010 -- tripling the force Bush/Cheney left behind. He was also able finally to enlist the aid of Pakistan in that effort, which paid off in February 2010 with the capture of the Taliban's top military commander (second only to Mullah Omar in the Taliban hierarchy). By 2010, it was estimated that there were fewer than 100 al Qaeda members in Afghanistan and there were increasing signs of a rift between them and their former hosts, the Taliban. Certainly it was too early to declare that President Romney had turned around the Bush/Cheney administration's failing effort in Afghanistan. But at least he was making a go of it.

Needless to say, Republicans were effusive in their praise of President Romney's performance. They were exultant that he had largely erased memories of the Bush/Cheney years and had given new luster to the Republican brand. His pragmatic, centrist policies made it difficult for Democratic opposition to gain traction. The result was an increase in bipartisan cooperation in Washington. Nowhere was that more true than with perhaps the greatest triumph of President Romney's first year -- the popular health care reform bill
modeled on his successful effort in Massachusetts. No only did it pass Congress with large bipartisan majorities but it gave Republicans ownership of a key issue that had long been a Democratic strength.

As President Romney
said, "What we did, I think, is the ultimate conservative plan. We said people have to take responsibility for getting insurance, if they can afford it, or paying their own way. No more free riders" RomneyCare, as some people called it, was based on three key elements: 1/ Insurance reforms that required insurance companies to cover everyone with certain minimum standards for coverage and without being able to reject people with pre-existing conditions, 2/ to prevent people from "gaming the system" and waiting until they get sick to buy insurance, the plan included an individual mandate to purchase insurance (the core of Romney's "Personal Responsibility Plan"), and 3/ refundable tax credits, based on ability to pay, to help those who couldn't otherwise afford insurance. To increase competition, the plan created government-run insurance exchanges where consumers can choose among private insurance plans.

Unlike Democratic single-payer plans (or "Medicare for all") that Republicans said would have entailed a "government takeover of health care," President Romney's plan worked entirely through private insurance providers, for care delivered through private doctors, private hospitals and other private providers. For the 80% or so of American who get their health insurance through their employers there would be essentially no change in how they receive their health care. But his plan extended coverage to 30 million or so Americans who previous lacked it and instituted reforms to market for individual coverage that ensured Americans wouldn't lose their health care if they lost or changed their jobs. And all that was based on conservative principles of personal responsibility and free markets that had previously been proven effective and popular in Massachusetts. The plan was virtually identical in its
key elements to the Republican alternative to Clinton's health care reform proposed in 1993.

The one major partisan battle in the health care overhaul effort was the push by Congressional Democrats for a "public option" -- a government-run insurance plan that would compete with private plans. Democrats argued that it would provide additional competition, with consumers having a free choice among public and private plans (the way public and private colleges compete today), and with all health care still delivered though private providers (as with Medicare and Medicaid today). But President Romney threatened to veto any bill with a public option and Democrats eventually backed down. That standoff ultimately cost President Romney some Democratic votes, but with virtually all Republicans supporting the bill it had no trouble passing both houses of Congress with large bipartisan majorities.

Among the benefits of President Romney's health care plan was the elimination of "
job lock" where employees of large companies with health care insurance are unwilling or unable to leave their current jobs because they would lose their health insurance and wouldn't be able to obtain it on their own because of pre-existing conditions or for other reasons. Elimination of job lock is expected to benefit entrepreneurs and small businesses (most of which don't provide health care coverage) and make the economy more efficient and dynamic.

Not surprisingly, President Romney's health care plan was enormously popular and provided a big boost to his presidency. Republicans crowed about finally delivering on near-universal health care coverage without reliance on big government solutions.

Rush Limbaugh was among the conservatives who expressed their relief at finally having a Republican president whose performance they could defend. Speaking of his past support for Republicans,
Limbaugh said, "I feel liberated... I no longer have to carry water for people who don't deserve it."

It makes you wonder how a liberal Democrat like Barack Obama would have responded to the combination of the worst economic crisis since the Great Depression, trillion dollar deficits and two wars going badly. It's a question most Americans are glad they don't have to answer in light of the stellar executive performance of President Romney during his first year. Americans seem to be united in the conclusion that the experienced conservative was the right choice for America at a time of crisis.

Note: Tom Tomorrow has noted how difficult political satire is in our current political climate. Even the most ridiculous fictions often fail to match the absurdities of the daily headlines. I have found in my own experience that political satire tends to fall flat. So at the risk of stating the obvious, let me explain that the foregoing was an attempt to imagine how Republicans would react to the policies and performance of President Obama had they been those of one of their own. It is not necessarily my own reaction to those policies or even the elements of President Obama's performance that I might emphasize. All the facts and figures are real (with links, for the most part). Although there is obviously a satirical element to this summary, I think the partisan perspective it portrays is reasonable accurate.

Tuesday, March 9, 2010

reconciling ridiculous rhetoric

I have to give Republicans credit. They, and their right-wing noise machine, sure do a great job of OUTRAGE!!!! They can get OUTRAGED over all kinds of things, from the absurdly trivial and unobjectionable (e.g., President Obama giving a speech to school children telling them to work hard and stay in school) to things that were common practice when they were running the show (e.g., trying terrorism suspects in the American courts: under President Bush more than 300 individuals were convicted on terrorism-related charges in regular civil courts vs. only three terrorism suspects convicted in military commissions, two of whom were subsequently released).

The latest OUTRAGE is the prospect of an “up-or-down” vote in the Senate on a package of amendments to the health care reform bill that passed that body with 60 votes last December. In the current Republican parlance this is referred to as either “ramming”, “cramming” or “jamming” health care reform “down the throats” of the American people. As Richard Cohen
writes in the Washington Post today:

Googling to my heart's content on a recent eve, I decided to match "health care" with "ram" to see what would happen. What I got was about 9.8 million hits, some of them right on the nose and reflecting the current conservative meme that after more than a year, several votes, countless presidential speeches and having to look upon the face of Harry Reid some 10,000 times, the health-care bill is being "rammed" through Congress -- an absurdity that now has currency through sheer repetition. It is not exactly the renowned vaunted Big Lie, just a miserable little one.
Check out
this segment from last night’s Colbert Report (especially the series of clips at around the 2:00 mark). As Colbert notes, “The American people don’t want anything jammed down their throats … unless it is first battered and deep-fat fried.”

The point of this exercise in OUTRAGE, of course, is to convince the American people that there is something illegitimate about passing a measure in the Senate on the basis of a mere… majority of Senators. The notion that a supermajority is required to pass anything in the Senate is even being portrayed as the will of the Founding Fathers.
Here is Senator Judd Gregg (R-NH):

[U]nder the Senate rules, anything that comes across the floor of the Senate requires 60 votes to pass. It’s called the filibuster. That’s the way the Senate was structured. … The Founding Fathers realized when they structured this they wanted checks and balances. They didn’t want things rushed through. They saw the parliamentary system. They knew it didn’t work. … That’s why we have the 60-vote situation over here in the Senate to require that things get full consideration.
(And to think President Obama, in a fit of delusional bipartisanship, actually nominated this clown to become Secretary of Commerce.)

There are several things wrong with this passage. Matthew Yglesias
notes one:

“[J]ust to point out that Gregg is an idiot, where on earth has he gotten the idea that the Founding Fathers “saw the parliamentary system” and “knew it didn’t work?” There were no countries operating on a modern parliamentary system when the constitution was written. And why doesn’t it work? It seems to work in Australia, Belgium, Canada, Denmark, Finland, Germany, Hungary, India, Japan, Korea, etc.”
The more important point is that the filibuster is not in the Constitution. As a constitutional expert who wrote a book on the filibuster notes,
the filibuster is actually something of a historical accident that came into being after the Constitution was ratified and only discovered as a tool of obstructionism long after that. The Founders considered the idea of supermajority requirement and rejected it except for a few purposes specified in the Constitution like overriding presidential vetoes, ratifying treaties and impeachment. As I’ve noted a couple of times previously, it was rarely used prior to the 1970’s. But in the year since President Obama took office there have been more GOP filibusters than there were in the twenty years between 1963 and 1983. Republican use of the filibuster in the current Congress is on pace to triple the previous record. This isn’t a matter of seeking greater deliberation. It is an attempt by Senate Republicans to thwart any successful action by Senate Democrats – who despite losing the Massachusetts Senate seat still have the largest Senate majority in over 30 years (the last time either party had Senate majority larger than 59 was in 1979). Republicans are even filibustering measures that they co-sponsored.

As is typically the case, once the right-wing noise machine kicks into gear with its bogus narrative, the “mainstream” media dutifully report on the “controversy” using the Republican framing.

As Andrew Romano writes in an
excellent piece at Newsweek:
On Wednesday, President Barack Obama announced at a White House gathering of health-care professionals that he wants Congress to schedule "an up-or-down vote" on health-care reform "in the next few weeks." A few minutes later The Washington Post sent out a political news alert translating his remarks for laypeople. In "a move intended to bypass a Republican caucus that remains united in its opposition to the legislation," the paper wrote, "Obama [just] endorsed the controversial legislative tactic known as reconciliation."

“The controversial legislative tactic known as reconciliation": Republicans must have been delighted to read in the Post that they'd won the framing war and redefined reconciliation as some sort of abomination. The fact is, reconciliation has been around since 1974, when it was created to help lawmakers avoid filibusters on politically difficult budget legislation by allowing a simple majority vote. For the past 35 years, no one has made much of a stink about it. But last month, in a preemptive effort to sour the public on the procedure, Republicans decided to start describing it as something dirty and dishonorable. Sen. Orrin Hatch of Utah suddenly began tossing around the phrase "highly partisan nuclear option"; Sen. Lamar Alexander warned that it would lead to "the end of the Senate" as we know it. Pretty soon, what had long been considered standard Senate operating procedure began to sound downright apocalyptic.

editorial in The New Republic gives more examples of the mainstream acceptance of the Republican framing:

As the filibuster has evolved from a rarely used signal of unusually strong dissent into a routine requirement for a supermajority, reconciliation has become a vital legislative tool, embraced by both parties. And it has come into play now because Democrats need it to make health care reform palatable to both chambers of Congress. Their plan is to have the House pass the Senate bill, and then to have both the House and Senate amend the bill through reconciliation. The amendments, Democrats agree, would be limited to questions of tax and spending levels--the very sorts of issues for which reconciliation was designed.

In response, Republicans have exploded in indignation, and their complaints have found a sympathetic hearing in the Washington media. Here are a few select samples of the coverage--all from straight-news reporters: “Democrats have not ruled out the possibility of using a strong-arm tactic, called ‘budget reconciliation,’" (Associated Press); “Obama may be ready to play hardball and lean on filibuster-busting reconciliation rules” (Roll Call); “the hardball strategy would worsen partisan friction” (Congressional Quarterly). The New York Times, as if seized by a tic, has used the term “muscle” on at least three occasions to describe reconciliation.

This hackishness was most recently on display in a thunderous Washington Post op-ed by Senator Orrin Hatch. Lamenting the haste of simple majority votes, the great elder statesman railed that “the Constitution intends the opposite process,” a claim that is utterly ahistorical--the Constitution makes no mention of the filibuster. Indeed, the Constitution prescribes a supermajority vote for a mere handful of select purposes, ordinary legislation not among them.
So let’s clear up some of the confusion over this radical tool of majority rule known as “reconciliation.”

As the Newsweek piece quoted above notes, reconciliation has been around for over 35 years, and it has never been particularly controversial despite having been used for everything from the Bush tax cuts, to the 1996 welfare reform, and most of the health care measures enacted during that time. Republicans even used it in 2005 to try to open up the Arctic National Wildlife Refuge to oil drilling (fortunately the measure was
killed in the House). Depending on how you count, reconciliation has been used 19 times, 16 of those by Republicans.

Republicans have been saying things like, reconciliation "has never been used for this kind of major systemic reform" (Mitch McConnell) and "there's never been anything of this size and magnitude and complexity run through the Senate in this way" (Lamar Alexander). In fact, health care reform has already passed both houses of Congress. It passed the Senate with 60 votes in December. If the House adopts the Senate bill and President Obama signs it, it becomes law. And that is the plan.

Although the House has already passed its own version of the health care bill, both houses have to pass identical versions. Since Democrats no longer have the 60 votes required to overcome a Republican filibuster, the Senate bill has to be the basic bill that both houses enact. But there are changes to that bill that the House and President Obama – and even the Senate itself – would like to make. It is only those changes that would be passed through reconciliation. Most of those changes are relatively minor and unobjectionable – like getting rid of the “Cornhusker Kickback”, a provision favoring Nebraska inserted in the Senate bill to secure the support of Ben Nelson (even Nelson no longer supports it). It would also include changes offered up by President Obama to Congressional Republicans like funding for state initiatives to reduce medical malpractice costs.

It’s also worth noting that most health care reforms enacted in recent decades have been passed using reconciliation. For example, COBRA, the law that allows you to keep your health insurance if you lose your job, was a reconciliation measure signed into law by President Reagan in 1985. (“COBRA” stands for Consolidated Omnibus Budge RECONCILATION Act.) Similarly, the State Children’s Health Insurance Program (SCHIP) was passed using reconciliation.

The one major health care measure that was NOT passed using reconciliation was the massive Medicare Part D prescription drug benefit passed by Republicans in 2003 which
created an unfunded liability of nearly $10 trillion dollars. Nonetheless, it passed the Senate with only 54 votes. In its initial House vote it passed by only one vote, 216-215. When it came up for a final vote at 3am, the measure was losing at the close of the standard voting period. At that point Republican leaders froze the clock and kept the vote open for over three hours as they bribed and threatened members until they reached the necessary majority. Never before or since have tactics like those been used to pass a measure in Congress. (You can read accounts of that whole sordid affair here and here.)

The most ambitious use of reconciliation was for the two major Bush tax cuts which have since added a couple of trillion dollars to the national debt. The original idea behind reconciliation was that it would be used to help reduce the deficit. The health care reform bill is consistent with that intent – the Congressional Budget Office
estimates that it would reduce the deficit by over $100 billion in its first decade and upwards of $1 trillion over the next decade.

compare the budgetary impact of the two major Bush tax cuts with the Senate health care reform bill as initially scored by the CBO:

[The first bar is the impact on the unified budget balance of the Economic Growth and Tax Relief Reconciliation Act (EGTRRA) of 2001. The second is the impact on the budget balance of the Jobs and Growth Tax Relief Reconciliation Act (JGTRRA) of 2003. The third bar is the CBO estimated impact on the deficit of the Patient Protection and Affordable Care Act proposed in the Senate on November 19, for 2010-2019.]

Which of these is consistent with the original intention of the reconciliation procedure? (The 2003 tax cut resulted in a 50-50 tie in the Senate – it was only “rammed through” with the vote of the
Dark One.)

The 2001 Bush tax cut entailed another twist. The arbiter of whether a measure can be passed using reconciliation is the Senate parliamentarian. In 2001, when the parliamentarian (who had been put in the job by Republicans when they gained control of the Senate in 1994) issued a series of rulings that complicated used of reconciliation to pass the Bush tax cuts, Republican Senate leaders
summarily fired him. (Talk about “ramming through” a measure.) The guy they put in his place remains the parliamentarian to this day. Nonetheless, Republicans are already laying the ground for attacks on him as being biased in favor of Senate Democrats. Expect to be hearing a lot about the Senate parliamentarian in next few weeks.

All of this is beside the point, really. The Republican objective in expressing OUTRAGE over reconciliation is to sow more FUD (fear, uncertainty and doubt) over health care reform. A
recent Pew poll found that 74% of Americans don’t understand what a filibuster is. They certainly aren’t going to immerse themselves in the details of the Senate’s procedural history. All they will know is that the angry guys they listen to on FOX News and talk radio are really OUTRAGED over how Democrats are going about passing health care reform. It will just join the list of apocryphal OUTRAGES like death panels, free health care for illegal aliens and government-subsidized abortions Republicans have been using to scare and anger the American people.

And the Washington media will continue to “report the controversy.”