Wednesday, December 30, 2009

unhealthy politics

The continuing health care debate in Congress has highlighted some seriously dysfunctional elements in our nation’s politics. The inherently anti-Democratic features of the Senate (where the 500,000 residents of Wyoming have the same voting power as 36 million Californians) have been greatly exacerbated by the now routine invocation of the filibuster, preventing a bill from coming up for a vote. This is a relatively recent development. That would be bad enough if we had two functioning political parties. But the Republican Party has become essentially nihilistic, refusing altogether to engage in the formulation of policy or any other serious efforts at actual governance. When you combine these two developments – the need for 60 votes in the Senate for even the most routine matters along with party-line obstructionism by a caucus consisting of 40 Senators – you have come very close to producing the complete failure of governance that Republicans hope will further their electoral prospects – even if it prevents Congress from addressing the nation’s problems.

Paul Krugman had an excellent column in the New York Times last week (“
A Dangerous Dysfunction”) wherein he notes the filibuster problem:

Some people will say that it has always been this way, and that we’ve managed so
far. But it wasn’t always like this. Yes, there were filibusters in the past — most notably by segregationists trying to block civil rights legislation. But the modern system, in which the minority party uses the threat of a filibuster to block every bill it doesn’t like, is a recent creation.

The political scientist Barbara Sinclair has done the math. In the 1960s, she finds,
“extended-debate-related problems” — threatened or actual filibusters — affected
only 8 percent of major legislation. By the 1980s, that had risen to 27 percent.
But after Democrats retook control of Congress in 2006 and Republicans found
themselves in the minority, it soared to 70 percent.

Some conservatives argue that the Senate’s rules didn’t stop former President George W. Bush from getting things done. But this is misleading, on two levels.

First, Bush-era Democrats weren’t nearly as determined to frustrate the majority party, at any cost, as Obama-era Republicans. Certainly, Democrats never did anything like what Republicans did last week: G.O.P. senators held up spending for the Defense Department — which was on the verge of running out of money — in an
attempt to delay action on health care.

More important, however, Mr. Bush was a buy-now-pay-later president. He pushed through big tax cuts, but never tried to pass spending cuts to make up for the revenue loss. He rushed the nation into war, but never asked Congress to pay for it. He added an expensive drug benefit to Medicare, but left it completely unfunded. Yes, he had legislative victories; but he didn’t show that Congress can make hard choices and act responsibly, because he never asked it to.

James Fallows also has a good post on the filibuster (with a lot of good links -- as a prelude to “a gigantic article coming out soon in the Atlantic … which concerns America's ability to address big public problems”):

The significant thing about filibusters through most of U.S. history is that they hardly ever happened. But since roughly the early Clinton years, the threat of filibuster has gone from exception to routine, for legislation and appointments alike, with the result that doing practically anything takes not 51 but 60 votes. So taken for granted is the change that the nation's leading paper can offhandedly say that 60 votes are "needed to pass their bill." In practice that's correct, but the aberrational nature of this change should not be overlooked. …

[A]s the
chart below shows, the huge increase in threatened filibusters came from the Republican minority, after the Democrats took back the Senate in 2007. Since the time covered by this chart, the number of threatened (Republican) filibusters has shot up even more dramatically. Still, whoever is in control, this is a more basic and dangerous threat to the ability of any elected American government to address the big issues of its time. …

[You can view a better version of the same data on this

[Even as
Republicans are attempting to blame President Obama for the recent failed attempt to ignite an incendiary device on a US-bound airliner, the Transportation Security Administrator is without a leader because Republicans are holding up his nomination. Senate Majority Leader Reid announced yesterday that he would seek a cloture vote on that nomination – requiring 60 votes – as soon as the Senate reconvenes in January. Meanwhile, Cheney has slithered back out from under his rock to attack President Obama for actually using the criminal justice system established under the US Constitution to try the suspect in that case. You know, exactly like the Bush administration did back in 2001 under virtually identical circumstances with attempted shoe-bomber Richard Reid – now serving a life sentence not at Guantanamo but at the Super Max prison in Florence, Colorado – on US soil! I bet they even read the wannabe shoe-bomber his Miranda rights and gave him a lawyer. But I digress ….]

Making matters worse, there no longer seems to be any distinction being made on a cloture vote (i.e., the vote ending debate and proceeding to a vote on the bill) and the vote on the substance of the underlying bill. In the past, a Senator might vote to allow a matter to come up for an up-or-down vote while voting against the bill itself. Indeed, that was the rule not the exception. For example, back in 2003 when Republicans enacted the Medicare Part D prescription drug benefit (which according to the Medicare trustees created a
$9.4 trillion unfunded liability) the cloture vote pass by a 70 to 29 margin while the bill itself passed by a narrower 55 to 44 margin. In the case of both the stimulus bill and the health care bill, however, the cloture vote and the vote on the underlying bill were the same. Despite all their demands for a “up-or-down vote” when they controlled the Senate, Republican Senators it seems are no longer willing to permit an up-or-down vote on legislation they oppose as used to commonly be the case.

This new de facto requirement of 60 votes for anything to pass the Senate would not be so bad if there were actually something approaching 100 votes in play. But if 40 votes are committed to obstruction from the outset, it’s pretty hard for the system to work.

Jonathan Chait has a good article in The New Republic on
The Rise of Republican Nihilism. He does a good job analyzing the nature of Republican opposition to each of President Obama’s three areas of policy priority:

Whatever the merits of President Obama’s agenda, it is clearly a response to
objectively large problems facing the country. The administration has selected
three main issues as the focus of its domestic agenda: the economic crisis, climate change, and health care reform. … In all three areas, the Republican Party has adopted a stance of total opposition, not merely because it disagrees with aspects of Obama’s solutions, but because it cannot come to grips with the very nature of the problems of modern American politics.

Take the stimulus. At the peak of the worst economic crisis since the Great Depression, recently inherited from a Republican administration, the stimulus package was able to attract not a single Republican in the House and only three in the Senate (one of whom – Arlen Specter – was subsequently drummed out of the party as a result). In order to attract the bipartisan support it desperately sought, the Obama administration had made the package
about half the size that its own Council of Economic Advisors calculated was necessary and tilted much of its composition toward tax cuts (which have little stimulative effect in a liquidity trap when people are likely to save any windfall). The resulting package was almost certainly similar in its general contours to what a President McCain would have proposed. Indeed, one of McCain’s top economic advisors, Mark Zandi (now chief economist of Moody’s, recently acknowledged the positive effects of the stimulus:

… “there was a considerable amount of hand-wringing that [the stimulus] was too small, and I sympathized with that argument,” said Mark Zandi, … Even so, “the stimulus is doing what it was supposed to do — it is contributing to ending the recession,” he added, citing the economy’s third-quarter expansion by a 3.5 percent seasonally adjusted annual rate. “In my view, without the stimulus, G.D.P. would still be negative and unemployment would be firmly over 11 percent. And there are a little over 1.1 million more jobs out there as of October than would have been out there without the stimulus.”

But even the worst economic crisis in 70 years thrust into the lap of a new president seeking bipartisanship wasn’t enough to elicit constructive engagement from Republicans in Congress. Their calculation was that a bad economy would be good for them. The American people be damned.

But the area where Republican obstructionism has been most conspicuously on display has been health care reform. To put this in perspective, the basic approach to health care reform that Democrats adopted was one of Republican origin. David Warsh (who publishes the
Economic Principals Web site) recounts that history (a MUST READ piece, especially for Republicans):
Consider how a bipartisan approach devised by middle-of-the-road technocrats for an entrepreneurial Republican became a winning issue for the Democrats and provoked a crisis in the Republican Party.... In November 2004, on the op-ed page of The Boston Globe, [Massachusetts governor Mitt] Romney announced "My plan for Massachusetts health insurance reform.” He was, he wrote, adopting a bipartisan approach. His plan would require no employer mandate or “single-payer” government takeover of the system. Nor would any new taxes be required. But by restraining medical expenses, the measure would lower the cost of health insurance for all....

[The plan] took advantage of a considerable head start, relative to all other states: Massachusetts already put aside as much as $1 billion annually for emergency care of the uninsured. …. And Romney persuaded the Bush Administration to preserve $400 million in annual Medicare funding....

Eighteen months later, Romney declared that the problem had been solved. A combination of a series of new no-frills insurance plans and a requirement that even healthy young adults purchase one, plus government subsidies for those unable to afford those basic policies, and increased emphasis on Medicaid for those who qualified under current law would accomplish the goal with no new taxes....

He didn’t like to call it a plan for “universal coverage,” Romney told Time’s Joe Klein;
to him it was a “personal responsibility system;” but the net effect would be the same: all Massachusetts citizens would be covered. … “It’s a goal that Democrats and Republicans share, and it has been achieved by a bipartisan effort, through market reforms,” he wrote [
in the Wall Street Journal]…

So a contagious Republican proposal which quickly spread to the Democratic primaries proved to be the proximate cause of landmark legislation... by extending somewhat the principle of federal regulation, it changes the geometry of the medical industrial complex in fundamental ways. As [Jonathan] Chait puts it, the proposed statute “prods the system” in myriad ways. It directs money away from wasteful and ineffective treatment in emergency rooms and towards routine care for the previously uninsured. It launches many experiments, large and small, designed to discover effective ways of doing things – everything from computerizing medical records to penalizing hospitals with high infection rates. … [T]he current bill is not the kind of plan that liberals wish they could design from scratch. “Rather, it is a centrist compromise of the best variety, combining the ideas of the now nearly extinct moderate wing of the Republican Party with the smartest bipartisan technocratic reforms.”

... The Wall Street Journal fulminated [against President Obama’s heath care reform plan]... the editors wrote. “A popular president might have crafted a durable compromise that blended the best ideas from both parties.” That, of course, is exactly what Romney attempted and Obama accomplished. Sufficiently clouded by defeat is the editors’ judgment, however, that they no longer seem to recall that they themselves showcased Romney’s “Healthcare for Everyone? We’ve Found a Way” proposal in 2006...

By most accounts the Massachusetts plan, on which the current Democratic health care reform plan was modeled, has been a big success. The plan has resulted in 97% of Massachusetts residents having health care coverage (vs. something like 83% at the national level). And the real test politically: It is popular. A poll in October showed that 79% of Massachusetts residents want to keep their reform plan; only 11% of voters there support repeal.

So Democrats in Congress forgo the reforms preferred by a strong majority of their base, like a single-payer system, and instead adopt a popular, successful Republican plan as their model for health care reform. It attracts large bipartisan majorities in Congress, right? Just kidding, of course. The only Republican vote for health care reform garnered in either house of Congress was Rep. Joseph Cao of Louisiana, who is not likely to get reelected in his heavily Democratic New Orleans district where President Obama captured 75% of the vote (Cao only narrowly defeated the indicted – subsequently convicted – incumbent, William Jefferson, infamous for the $90,000 in cash found in his freezer).

It would be one thing if Republicans engaged in a serious debate about the actual merits of Congressional proposals. But they have chosen to remain apart from the policy debate altogether, instead spewing lies about things like “death panels” and coverage for illegal immigrants. As Steve Benen noted in the Huffington Post (“
The Long Overdue Debate”) the real policy debate has been among Democrats, not between Democrats and Republicans:

The United States was supposed to have had a great debate this year about one of the most important domestic policies of them all. With a once-in-a-generation opportunity to address a dysfunctional health care system, the left and right,
Democrats and Republicans, would bring their A games, and the public would
benefit from the discussion.

We now know, of course, that Americans were denied that debate, not because of the proposals, but because the right didn't have an A game to bring. Intellectual bankruptcy left conservatives with empty rhetorical quivers.

But as it turns out, it wasn't too late for the debate, we were just looking in the wrong place. We expected the fight of the generation to occur between the right and left, when the more relevant dispute was between the left and left.

It's easy to overlook right now, but the quality of the policy debate between competing progressive contingents is infinitely better and more interesting than the policy debate between Democrats and Republicans, which has unfolded in depressing ways over the last eight or nine months. …

[N]otice the quality of the arguments conservatives and Republicans have offered -- and continue to offer -- in this debate. Death panels. Socialism. Hitler. Government takeover. Socialized medicine. Incomprehensible charts. Incessant whining about the number of pages in a proposal.

… [R]egardless what side of the dispute you're on, it's worth appreciating the vibrancy, energy, and seriousness with which progressives are engaging in the debate, as compared to the incoherent, ridiculous, and dull qualities our friends on the right have brought to the table.

Sarah Palin, Rush Limbaugh and Glenn Beck have come to define the acceptable terms of the debate among Republicans. (Even Mitt Romney has disowned his own successful reforms in Massachusetts – just as he had earlier disavowed his support for reproductive freedom and gay rights.)

Recall last spring … and summer … and fall, when the Senate finance committee chairman Max Baucus held up the legislation for months trying to craft a bipartisan compromise that would attract Republican votes. That outreach didn’t prevent so-called Republican moderates like Charles Grassley from going out on the stump during the summer’s Teabagger protests and repeating lies that he knew perfectly well to be untrue. As I
wrote in September:

This lie about health reform extending subsidized coverage to illegal immigrants is official Republican party-line doctrine, being repeated even by supposed "moderates” like Chuck Grassley, who is part of the “Gang of Six” on the Senate Finance Committee that has kept legislation bottled up for months. Grassley said, “The bill passed by the House committees is so poorly cobbled together that it will have all kinds of unintended consequences, including making taxpayers fund health care subsidies for illegal immigrants.” (The “moderate” Grassley also piled on to the “Obama is going to kill granny” lie, saying, “You have every right to fear. You shouldn't have counseling at the end of life, you should have done that 20 years before. You should not have a government run plan to decide when to pull the plug on grandma.” But … Grassley previously voted to extend Medicare funding to “counseling … with respect to end-of-life issues and care options, and … advanced care planning.” In other words, Grassley was “for Death Panels before he was against them.”)

Despite abandoning the public option, the employer mandate and just about anything else that might offend a Republican, Baucus was able to attract only a single Republican vote in committee – that of Maine Senator Olympia Snowe. But despite the fact that the bill did not change in any respect of concern to Snowe as it proceeded to the full Senate, she subsequently voted against the final bill. She was able to offer no substantive policy reason for her change of heart, saying only that the bill was being “
rushed” – despite the fact that it had been held up for months to secure the changes she demanded. The pressure from her party to toe the obstructionist line was just too much for her to resist.

The debate in the Senate was the second longest debate in that body’s history. Republicans even filibustered the filibuster vote, forcing the 92-year old wheelchair-bound Senator Byrd to vote at one in the morning … not once but twice. It was the first time in over 110 years that the Senate voted on Christmas Eve. At the end of all that, the bill that started as a centrist Republican plan did not garner a single Republican vote. This is a bill that managed the unprecedented feat of securing the endorsements of both
the AMA (historically opposed to all health care reform) and the AARP (representing all those “grannies” that President Obama is allegedly intent upon finishing off) – hardly a radical coalition. But not a single Republican.

If I could recommend only one article on the health care bill as it stands now it would be “
And The Rest Is Just Noise” by Jonathan Chait in The New Republic. There is too much to excerpt, especially in its description of the best features of the bill and its refutation of some of the most common attacks on it, so just READ IT. But especially for disappointed progressives, I would note these parts:

American liberals have a habit of withdrawing into cynicism and ennui at the most inopportune moments. The 2000 presidential election, and subsequent recount, was one such moment. The most die-hard reaches of the left, deeming the Democratic Party hopelessly corrupt, rallied to Ralph Nader’s fulsome populist denunciation of Al Gore’s subservience to the corporate agenda. …

At some level, it is possible to understand the roots of liberal frustration. The
machinery of Congress has ground away at the health care bill, as it does to almost any bill. … What has emerged from that machinery is not merely “better than nothing” or “a good start.” It is the most significant American legislative triumph in at least four decades. …

…If we want to understand why a bill that embodies the best of moderate Republican ideas has attracted zero support from the Republican Party, it is because moderation has disappeared from the party. The takeover of ideological conservatives, implacably opposed to the expansion of government, has rendered impossible any bipartisan solution.

But what about the left? Why has the rhetoric from progressives increasingly come to mirror the uninformed ranting of the right? … The defeat of the public plan, largely at the behest of insurance companies that don’t want competition, does weaken the reform plan. Yet liberals have responded out of all proportion to the scale of the setback. Left-of-center economists and policy wonks—including Yale political scientist Jacob Hacker, who created the public option—have endorsed the Senate bill. …

…The bizarre convergence of left-wing and right-wing paranoia echoes the forces that brought down the moderate consensus of the postwar era. The GOP retreat into Palinism represents one half of this collapse. The left’s revolt against health care reform represents the other. What has re-emerged in recent weeks is the spirit of the New Left--distrustful of evolutionary change, compromise between business and
labor, and the practical tools of progressive reform. It is the spirit that rejected Hubert Humphrey in 1968 and Al Gore in 2000.

The New Left rejection of “corporate liberalism” came at what we now regard as the historical apex of American liberalism. At the moment of another historical triumph,
liberals are retreating from politics into languor, rage, and other incarnations of anti-politics. One day they may look back upon this time with longing.

For disappointed progressives, I also recommend these two pieces:
Rich Poor by TIME’s Joe Klein; and this excellent blog post (“Simulating Single Payer”) by Paul Krugman explaining the economics of the individual mandate. For Democrats or Republicans, I recommend this response to a Wall Street Journal editorial by OMB director Peter Orzag (“No Illusions”)

Meanwhile, count me among those progressives who whole-heartedly support the current health care plan.

Only three years ago Republicans still controlled both houses of Congress and Bush/Cheney were running the executive branch. If you had described this legislation then and the progress it has made through Congress, I think progressives would have been overwhelmed with delight. The filibuster, which used to be reserved for extraordinary things like denying civil rights to black people, now has to be overcome to enact any business in the Senate. You combine that with 40 Republicans (Snowe has now apparently fallen in line with the rest of her caucus in their blind obstructionism) who will vote against any Democratic initiative no matter what, and President Obama and Leader Reid have to hold together 100% of their caucus. (And that is giving Lieberman credit for being a Democrat.) Given the egos and independence of Senators that is extraordinarily tough to achieve – even if Democrats didn’t have an ideologically diverse caucus (in any other era, Ben Nelson would be considered a conservative Republican). I don’t understand where progressives who are complaining about the loss of the public option think they would have gotten their 59th or 60th votes – or will get them if this version of reform dies. Do any of them really in their hearts believe that Lieberman would have voted against all the insurance interests in Hartford to which he is beholden? It was never going to happen no matter how much the Democratic leadership threatened him. It wouldn’t take much for him to pull a Jeffords or Specter and bolt to the other side – in which case we would lose him on even fairly routine votes. As much as I dislike Lieberman, he still votes with the majority 85% to 90% of the time, which is a lot better than Snowe. In other words, the WORST member of the Democratic caucus is still much better than the BEST member of the Republican caucus.

In that light, the fact that President Obama and Leader Reid have managed to corral 100% of their caucus behind the most progressive piece of major legislation in a generation is extraordinary. Bear in mind, the public option was not even a topic of debate during the election. It arose as the cause célèbre of progressives only after the election. This bill is almost everything that President Obama and Hillary Clinton advocated during the primaries. And to achieve it in an environment requiring 100% support of a 60 vote caucus that Democrats didn’t even have a year ago (and only obtained when Specter was driven out of the Republican Party) is extraordinarily impressive.

At the end of the day, Democrats still needed the votes of Lieberman and Nelson. While it is always possible to fault tactical decisions along the way, I don’t think the result would have been better. (I think ultimately Baucus did more harm than Lieberman or Nelson by keeping legislation bottled up for months over the summer while the opposition mobilized and drove the poll numbers for reform down.) In fact, had Republicans actually participated constructively in the process I think Democrats would have given major concessions (as they did with the stimulus bill) in order to bring in even a few Republicans, resulting in a much weaker bill. As it turns out, Republican obstructionism probably helped unite the Democratic caucus and resulted in a stronger bill than anyone would have expected even a year ago.

I’m hopeful that the Senate bill will be improved modestly in conference and will eventually be signed into law. That will be a remarkable achievement. But this process has revealed serious dysfunction in our political process. It is not realistic to expect 100% support of a 60-member caucus to address any of our country’s problems. And if that 60-vote super-majority is lost in the next election, the result is likely to be political paralysis. The Senate is already undemocratic enough by its very nature. Ultimately, it must be possible for a majority in the Senate to govern and be held accountable for the results. It would be nice if we actually had two political parties serious about governance. But for the time being that just isn’t the case. So in the meantime, let the majority govern.

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