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Posted by on Aug 28, 2009 in Health, Politics | 20 comments

Jonathan Chait On Who, Or What, Is Really to Blame for the Whole Health-Care Debacle

Well, the Republicans are to blame, of course. But, for Democrats, here’s some much-needed perspective from TNR’s Jon Chait:

The Senate is what controls the process. That’s the chokepoint for any health care bill. The question isn’t how badly Obama wants a public plan, or how much he cares about bipartisanship. It’s whether moderate to conservative Democrats in the Senate will filibuster a bill that has a public plan or lacks GOP support. Everything else is details.

In other words, it’s not all Obama’s, or even primarily Obama’s fault. And if Democrats, and especially the more progressive ones, want to lay some blame, they should look no further than the Senate.

I sort of buy this and sort of don’t. Obama certainly could have done more — and should do more — to promote meaningful health-care reform with a robust public option. But he’s also a realist, and there’s only so much he can do, not just given these structural/institutional limitations but given how much political capital he’s already spent on the stimulus package and the bank and auto bailouts.

And the key is not so much to secure the support of obstructionist Republicans opposed to reform, including the three in the Gang of Six, but to keep moderate/centrist Democrats in the fold. Which is easier said than done, of course, what with the likes of Joe Lieberman, Mary Landrieu, Max Baucus, Kent Conrad, and Ben Nelson now doing their best Republican impressions. (It’s also a bit rich for the generally moderate/centrist Chait to be calling upon liberals in the party to try to oust these more right-leaning Democrats. For more on this, see Greenwald.)

There is still hope for reform, of course. With Republicans looking more and more like the obstructionists they are, and showing more and more that what they really want is not compromise but no reform at all, Democrats are slowly but surely turning away from the possibility of a bipartisan bill, realizing that, if reform is to get done, they’ll have to go it alone. Whether they’ll be able to or not, given the Republican-lite positions of Lieberman et al., remains to be seen, just as it remains to be seen whether Obama will put a stop to the phony “post-partisan” niceties and lead the fight for meaningful reform. Which may be his plan, after all: Make a show of reaching out, genuinely, to Republicans, allow Republicans to expend their energy refusing to negotiate in good faith, move in and promote a Democratic bill while Republicans are relegated to the sidelines, blamed for their obstructionism, and emerge with what he wanted all along.

Once again, I fear I’m being naively optimistic. Regardless, I think Chait is right that it’s hardly all Obama’s fault. He can only do so much, after all, and there is only so much that can be done with members of his own party blocking the way.

(Cross-posted from The Reaction.)

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  • DLS

    “Well, the Republicans are to blame, of course.”

    All blame No brains

    Oh, that pathological angst.

  • DLS

    Here’s a wiser example of a foreign observation of what’s happening. (Note the obvious “wedge.”)

  • shannonlee

    “I think Chait is right that it’s hardly all Obama’s fault”

    True, it isn’t like Obama is the leader of the free world or the Dem party.

    Obama IS the leader of the Dem party. Leader of a party that controls both houses…he is the WH exec….He IS responsible and to blame.

  • DLS

    Where Obama shares the blame with the lib Dems (notably in the House) is when he has allied himself with the worst of their behavior, and collaborated, and has chosen publicly to put himself on record to that effect. We saw this earlier, with the climate bill that the public opposed, before the current health care effort. (Note that with health care, finally there actually is a real, honest “crisis” happening, but it’s the crisis the Dems face of desperation from growing opposition to what indeed has been developing into a debacle.)

    Obama’s misbehavior (and that which it encouraged by others on the Left) over Gates also hurt him.

    It’s old news, just getting worse now than it already was before.

  • elrod

    Obama made a decision not to repeat the experience of Clinton – he would let Congress do the sausage-making. As DLS likes to point out, that means the farthest left of the House (though a truly left proposal from the House would be HR676, not HR3200). The Senate is a different matter because many people with power on committees want to water these bills down to please their financiers. They should be able to vote as they please, but to have such power over the drafting of the bills is a sign of poor committee management in the Senate.

    Reconciliation seems almost certain for now, unless MA gets a new Senator right away. Hopefully the Dems will do to the parliamentarian what the Republicans did in 2003 when they rammed through their tax cuts and Medicare Part D bill under reconciliation and against the wishes of the current parliamentarian – let the majority rule or get out of the way.

    • Lit3Bolt

      However, elrod, Obama is not avoiding any flak in the healthcare debate. No matter what is in the bill, it’s still going to be dumped into his lap since it happened on his watch. And Chait’s analysis is almost worthless, because perception turns into reality so much in politics, therefore, it doesn’t matter what the real, objective truth is, because the subjective truth is what all politicians and their media sycophants create/follow. And I think I just summed up what is wrong with the media and our current political system in a nutshell.

    • $199537

      Obama made a decision not to repeat the experience of Clinton – he would let Congress do the sausage-making.

      Obama swung too far the other direction though, letting politicians much less popular than he run the show, not to mention providing them with guidelines that were almost impossible to follow. He deserves a fair amount of the blame, and in ten years most people won’t remember the Blue Dogs but they will remember him.

      Chait seems foolish to me, suggesting the Democrats should get rid of everyone that doesn’t toe the party line even if it mean losing power for decades.

  • casualobserver

    I agree with the professor…..the Dems should go “hardball”…..would be curious to see if they actually have the guts and the party discipline to pull it off. Besides, that might “send a tingle up Chris Matthews’ leg”.

    But, I won’t be holding my breath.

  • DLS

    “Reconciliation seems almost certain for now”

    If they do it, they only lower their reputation more.

  • DLS

    “let the majority rule or get out of the way”

    Yes, Dem bi-partisanship at its essence. [grin]

  • What I’d like to see is a slim bill that does one thing. “Allow any American to buy into Medicare before age 65.” That’s a public option that requires no new bureaucracy, no new mandates that only those who can’t afford private insurance are eligible etc. Pure and simple. Opt in to Medicare if you want it instead of whatever you have now. Of course those who can’t afford it should receive a tax credit that allows them to buy public or private insurance plan at some basic level.

    • Agreed. That’s always been the most elegant solution to universal coverage in my opinion. But longer term, we really do need to think about how to manage health care spending, unless we’re simply willing to pay at any price.

    • superdestroyer

      But how much tax dollar support goes into supporting Medicare. I guess people would want to purchase Medicare insurance since the tax payers will subsidize it.

      • Wrong again, SD. ZERO general revenue funds have gone into Medicare. Just the opposite. The GOP raided the Medicare trust fund, and that of Social Security, to give a tax break, $1.6 trillion, to the rich. Then the GOP inserted into it’s Medicare drug plan (part D) a provision that prevented Medicare from negotiating lower drug prices. Now the drug benefit –surprise– is increasing the Medicare deficit. Still, until at least 2017, Medicare has not cost more than we taxpaying workers have paid into it. And excusing rich people from paying into Medicare and Social Security like the rest of us, is another way to cripple the program, then claim it doesn’t work. You guys are a real piece of work.

        By the way, everyone who gets pretax employer paid health insurance ACTUALLY IS using our tax dollars for their private insurance company profit and their medical expenses. I guess people (like you) “would want to purchase” private insurance, “since the taxpayers will subsidize it.”

        • superdestroyer


          Medicare only functions by taxing people who do not benefit from the program. So it is not a true insurance program but a wealth transfer program.

          If you look at,

          it states: s was true in 2008, Medicare’s Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures this year than it receives in taxes and other dedicated revenues So the revenues received from the beneficiaries do not cover the costs. Even the tax revenue from non-beneficiaries do not cover the costs.

          If the U.S. went to a Medicare for all, the real quesiton is what would the costs be to those under 65. The costs would quickly get out of control.

  • JSpencer

    God forbid any legislation should pass that might actually work in the best interest of the lowly citizens, rather than special interests! Seriously GC, that makes far too much sense to ever become a reality.

  • TheMagicalSkyFather

    I shall predict the future with my magic hat. The blue dogs will fight and scream but allow the dems to pass the bill with a public option/a link in to medicaid or muscular co-ops. The blue dogs that look like they could lose an election will vote against but will not block it and the rest will vote for it and the divisions in the dem party will be forgotten until needed again. The following year of coverage will be about Obama passing health care reform which has been a dream since Truman. The poll numbers will head back the other direction with this and a raising economy(its hard for it to go down much further). Those that watched the sausage making will be horrified(if they are reps or rep light and did not want this to happen) pleased as punch(those that voted for it but never believed it could have happened) or amused that they guy they thought was obambi seems to have just rope a doped the entire health care industry. Those who were not watching the sausage making will love it if they wanted it and hate it if they did not. 2010 the reps will gain seats but not near enough to gain any power short of obstruction and Obama will not landslide but easily walk away with the 2012 election if for no other reason than the coverage of how HE gave us health care that 60-70 yrs of dems could not. Have fun winning against him if this passes.

  • MSF, I agree. Obama doesn’t need to get the blue dogs on board with a public option. He just has to get them to agree not to allow the GOP to filibuster it. Dem Senators can help too, by pressuring the blue dogs to “let us vote up or down on it.” If 60 Senators agree to let the bill come to the floor, 51 can pass it.

  • Leonidas

    Well, the Republicans are to blame, of course.

    Yes its the Republicans fault for not controlling the Presidency, and both Houses of Congress with a filibuster proof (till Teddy croaked) majority.You can take your head out of the sand whenever you like.

    I guess liberals are sore that Sarah Palin outsmarted them.

    No Palin fan here, but she seems to have done it.

  • casualobserver

    Harry Reid says the left can have their own co-ops………

    “But there are many ways we can do it,” he said. “One would be to have an entity like Medicare. I really don’t favor that. I think what we should have is a private entity that has direction from the federal government.”

    Reid did not elaborate further on what that would look like.

    A Reid spokesman explained to TalkingPointsMemo that Reid is expressing his support for a co-op, an idea proposed by Sen. Kent Conrad (D-ND) that is finding support in the Senate Finance Committee. Reid “is willing to consider a co-op if he is shown it works to make insurers honest,” spokesman Jim Manley said.

    Ok, the left can form its own co-ops and then you don’t have to pay premiums to evil insurance companies. You can show us how eliminating operating for profit eliminates all that is wrong. Let’s move on to cap and trade………..

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