Health Care Puts Progressives On the Verge of Changing the Power Dynamic

by: David Sirota

Tue Aug 25, 2009 at 09:15


So, here's the deal, folks: Looking at the current state of play on health care through the multicolored lenses I acquired working on Capitol Hill and then working in politics out here in the West, I'd say it's a good bet that the House will pass a health care bill with a solid public option in it, and the Senate will pass a health care bill without a solid public option in it. I'd say it's also a good bet that the major reason - though probably not the only reason - Obama has gone back and forth on the public option is because the administration is solely focused on getting bills - any bills - passed through each chamber and into one conference committee for a final negotiation.

Once that happens, the health care shit hits the legislative fan. We won't have to speculate anymore about whether the president is really committed to the public option, nor will we have to speculate about whether top senators and House members on the conference committee are committed to the public option. At that point, their actions will be far louder than their words.

Obama will be forced to take a position on the public option as he either draws a veto line in the sand, or doesn't - and if he doesn't on the public option, it means he's willing to sell out the public option. Similarly, conference committee lawmakers will either have to vote for a public option, or vote with the insurance industry against it.

A month ago, I would have said that the administration was planning to lay low while two templates got into a conference committee, and then sell out the public option in that committee, believing that ultimately, progressives will vote for a bad health care bill (ie. one sans public option but with a few regulatory goodies) rather than kill it outright. The White House is, after all, packed with staffers like Rahm Emanuel and Jim Messina who have made their careers coddling corporate lobbyists - and the president himself is a guy who has often chosen to seek common ground instead of confrontation with moneyed interests when an avenue is available to do that. That's why, for instance, this administration has exhibited two different standards for dealing with progressive and conservative Democrats - it tries to push progressives around while kissing the fat, mostly white and mostly southern asses of the so-called Blue Dogs.

A month ago, all of these forces might have made the "roll the progressives, sell out the public option" strategy a legislatively successful one, even as it would produce a bill that would likely be terrible public policy. I say that because let's be honest: the bloc of congressional progressives who the White House would be hoping to steamroll, while fighting the good fight in the lead up to key votes, has nonetheless capitulated on nearly every single do-or-die final-passage vote in recent memory (and I say that sadly, having served as an aide to Progressive Caucus leader - and dear friend - Bernie Sanders).

However, after the fantastic organizing/whipping/fundraising being done by Firedoglake, OpenLeft and Moveon and after the strong progressive media pressure on radio, TV and in newspapers, I believe the dynamic - and therefore the White House political calculus - could change.  

David Sirota :: Health Care Puts Progressives On the Verge of Changing the Power Dynamic
Indeed, all the forces seem to be coming into line: Polls show local Democratic dissatisfaction with easily primary-able Democrats, putting huge pressure on those Democrats to get in line; the Paul Krugmans of the liberal punditocracy, often offering up "on the one hand, on the other hand" dithering at the end of legislative fights, have now come out pretty strong for a public option; mainstream Republican editorial boards like the Denver Post are saying the public option is necessary; the decline in Obama's poll numbers are being fueled by progressive - not conservative - dissatisfaction on health care; fundraising for the public option campaign is intensifying; and the organizing work to support the public option is in full gear.

Taken all together, the aimed at A) forcing House Democrats to pledge to vote against a public-option-free health care bill and  B) getting Senate Democrats to state their support of a public option may be making the easier legislative path the one that squeezes the Blue Dog Democrats - not the progressive movement that got Obama elected.

Obviously, the pressure on the House Democrats is the most important. The Senate is basically a wholly owned subsidiary of the insurance industry - the best we're probably going to do is get enough members to say they support the public option, but it's probably too big a lift to hope to get many of them to pledge to  vote against an insurance-industry sop, if that's what the final bill ends up being. However, that's less significant because enough House members taking that pledge - and sticking to it, rather than publicly undermining it - creates a veto power all on its own. That is, it creates a Ben Nelson Effect for the progressive movement.

What is the Ben Nelson Effect? Back in 2007 while reporting my book The Uprising, I wrote a post about progressives learning lessons from the Ben Nelsons of the world - about us learning to use the conservadem tactics of threatening to torpedo a bill to further progressive goals. Back then, Moveon and many other progressive groups as well as many congressional progressives refused to play this kind of hardball, and, as The Uprising showed, our nation paid for it in substantial blood and treasure. So I'm absolutely thrilled that it looks like we're finally embracing the kind of tactics that could force legislative change.

And that's the key word - "force." As Glenn Greenwald has said, this isn't about trust in Obama, or loyalty to Democrats or affinity for particular legislators because they happen to be nice people. This, like every political issue, is about raw power - something many of us on this site have been saying for years, something that many progressives in the throes of Democratic Party/Obama sycophancy have refused to consider (and, indeed, many of us who have been talking for years about changing from partisan to movement psychology have been the target of more than a little anger/vitriol/hate from the sycophants).

We will get only what we force both the Democrats and the Republicans in Congress to give us, taking into account exactly how the Congress works. This is, once again, the "Make Him Do It Dynamic" - and right now, that requires us to build the Progressive Block, as Chris Bowers calls it. We must focus laser-like efforts on constructing a group of House members who delivers on a promise to vote against a public-option-free health care bill. If we do that, we will change the power dynamic in the health care debate by forcing the administration to use its power to make the public option a reality in the final bill that is reported out of the conference committee. And even more broadly, it may change the power dynamic on every other issue by finally establishing the progressive majority in the Democratic caucus - and not the corporate whores - as the final "deciders" on other major bill.

These are the stakes, and they are high. While they aren't going to get us all the way to single payer (which I've long said was a huge missed opportunity), they may deliver us a public option that represents genuine progress. It all depends on us. If we can ignore the professional naysayers and power appeasers in the Washington Punditburo (especially the D.C. liberals who keep going back and forth with overwrought handwringing/bedwetting), if we can substitute real pressure for partisan apologism, if we can refrain from making our typical excuses for Democratic politicians, we can actually deliver this Progressive Block and have a real shot to be successful.

And remember, I don't say that very often.


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Good roundup! But what's also required is progressives... (4.00 / 2)
..becoming a much more visibal group. For instance, despite the changing view of the media, the reports about the townhall meetings still focus on the opponents of reform. Is this onesided reporting by the press and TV, or is it really true that not remotely enough progressives stomp for the public option there? I guess it's a bit of both, and that the left wing has to organize appearances at this meetings, and boost the number of signs demanding the public option. It simply isn't helpful if progressives are seen as a small Dem fraction applying strong pressure on lawmakers, instead of as a significant part of the population that wants to have the choice of governmental healthcare.

So, not only the lawmakers have to be won over to support the public option, but it has to be shown that there is strong public support for this, too. By strong presences at townhall meetings, the media has to be forced to acknoledge that there are lots of folks who don't trust the insurance companies anymore, and who would gladly pay for medicare. This could lead to more stories and columns focussing on the good arguments of the progressives, for instace the incredibly inreasing profits of the insurers, and the also incredibly increasing number of people being forced into bankruptcy, despite being insured.

I guess it's safe to say that the media won't pick up these arguments as long as they are seen to come from a fringe group. So, making a strong appearance at the townhalls is essential in changing that view. Just look at the reports about single "indepedent" protestors and the coverage of their "arguments". Don't leave that battlefield to the nutcases!


Don't forget to write those letters to the editors! (4.00 / 6)
Keep them rolling in. It's something we can all do to change the atmosphere of the debate, to keep our side visible.

Montani semper liberi

You forgot to mention Democracy for America (4.00 / 9)
However, after the fantastic organizing/whipping/fundraising being done by Firedoglake, OpenLeft and Moveon

They've been doing a hell of a job on this as well.  


Blue Dogs and DeLay (4.00 / 1)
Tom De Lay would not let bills reach the floor unless they were supported by a majority of the Republican caucus.  That shut down GOP moderates as they were no longer swing votes unless they went into full rebellion.  The Blue Dogs represent 20% of House Democrats (51 of 256 with one vacant).  Why should they control everything?

Some other points.  A majority of Blue Dogs are non-southern (31 of 51).  Stunningly, 7 of these scum hail from the Northeast and 7 come from California.  Virtually all the Blue Dog growth is outside the south with 13 of the 16 members elected in the last 2 cycles coming from outside the south.

I still say we need a major push in these areas to disenroll non-southern Dogs.  Blue Dogs don't control spending and it is not cool.  We don't need suburban BDs from NY and CA in the mix.  No, BDs are just a problem, not the new moderate Republicans in canine disguise.  Yes, they are the major management problem and should be disenrolled or crushed in primaries.  They represent who?  Corporations?

That's my thought.  Obama meeting with Republicans before he met with Progressives?  Stunningly incoherent and way naive.  He should have known from his time on the Hill.  I think that;'s mostly ended.  Now we just have to neuter the Dogs.


Most LIkely Outcome: Fig Leaf Public Option (4.00 / 1)
There are articles saying the insurance companies are celebrating.  And Rep. Emanuel Cleaver, who took the FDL pledge not to vote for a healthcare bill without a public option, was also quoted recently as saying he would be OK with "starting over" even though he conceded that if that happened, a healthcare reform bill would not pass at all.  That is how squishy some of the "progressives" in the House are.

If the public option is only available to people who cannot get insurance through work, then the public option will be forced to take on all the people that the insurance companies do not want because they are too expensive.  If, in addition, we have a public option that does not use Medicare rates, which seems likely, we will have a public option that is not cheap.  The outcome, then, would be like Massachusetts, where people are forced by the mandate to pay high rates to get a policy with a high deductible.  

Given that the pressure from the Obama Administration and healthcare industry lobbyists will be intense, do you really think enough progressives will really stand for a public option that is strong enough to be meaningful?  I will do my part to fight for it, partly because I am one of the people who will be forced to pay high rates for bad insurance, but I am doubtful.


Don't give up yet (4.00 / 1)
There are 50,000 corporate lobbyists in DC backed up by hundreds of millions of dollars of campaign contributions and PR. Challenging all this is clearly not an easy fight. But look how well we are doing nonetheless. We've worked our butts off for decades to get progressives elected to Congress and to take leadership positions. We've lobbied them for years to stand up and fight for a decent healthcare system. And now, finally, we are not that far away from winning a major victory. The Progressive Caucus is actually standing up and fighting. What we end up with will not be Medicare-for-All as it should be. And the bill finally passed may not take effect until 2013 and may have several provisions that are not very progressive. But right now, we don't know what the final bill will look like, so right now, we should still be fighting hard and doing our best to make it as good as possible. The more we fight, the better it will be.

If, at the end of the day, what is up for passage is terrible, then we can get cynical and hopeless. But for now, we need to fight.


[ Parent ]
I think you should recognize the Progressive Caucus (4.00 / 5)
The whipping and PR of the advocacy groups you mention have been really great. But a big chunk of the progressive caucus went out on a limb with the letter and I think they deserve recognition too. We are following the insider-outsider combination strategy which got us abolition, suffrage, and civil rights, and both legs need to be on for that to work.

This is excellent analysis, David. (4.00 / 3)
I am so glad you stil write about politics.  We need you.

Won't Republicans undermine a house veto? (0.00 / 0)
If Congressman Weiner succeeds in whipping progressive Dems to vote against a bill without a public option, won't GOP reps just step up to the plate and help to pass it?

The insurers will be happy and Obama will have his much vaunted 'bipartisan bill'.


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