Albuquerque, a fairly Democratic town, just elected a Republican mayor because of low Democratic voter turnout. Democrats are in danger in both of the big gubernatorial races coming up in New Jersey and Virginia. The generic congressional polling numbers are in a statistical dead heat, and Democratic base voter enthusiasm is trending down.
There is no reason for Democrats to panic, as demographics are still trending in our favor and the Republican brand is still in tatters, but the warning signs for my party are out there and should not be ignored. What Democrats need to be extremely well focused on is short term deliverables for real people. On health care, on jobs, on banking legislation, on immigration reform, on climate legislation - on all of these major initiatives and more, they of course should be thinking about what's best in the long term, but better damn well be focused on delivering real and tangible benefits to voters before the next election, or Democrats will suffer a bruising defeat in November 2010.
Let's start with health care. When you are working to re-structure 17% of the American economy - and probably the most byzantinely-structured 17% there is - there are a lot of complications, and it is obviously going to take some time. Some of the features of the plan will need time to phase in, which is understandable. But some of the benefits need to be apparent to Americans right away too. If we spend a year and a trillion dollars passing health care reform, and no one sees any benefits to them by November 2010, we Democrats have a really big problem in the next election.
Another key point on this issue: if a public option doesn't go into effect for a while, say until 2013, insurance companies better not be free to raise their rates at will until they finally have competition, when the public option enters the scene. There is nothing that will guarantee voters turning away quickly from health reform, and the politicians who voted for it, more than letting insurance companies hike up their insurance costs over the next four years, and we know they would have because they already promised to do it.
Health care reform needs to have immediate benefits - no pre-existing conditions, no lifetime caps, all of those insurance regulations we've been hearing about need to kick in immediately. But even more importantly, if a public option gets delayed, there has to be a short term way to keep insurance company greed and power in check. To leave the public utterly at the mercy of the arrogant insurers who have already promised they would raise their rates after this is passed - like consumers were left at the mercy of credit card companies for many months after the consumer protection bill passed - is not only unfair to people but is truly terrible politics. If you think these insurers won't jack rates through the roof, and then blame the rate increases on reform, you are truly naïve. Don't make voters feel like it was a bad idea to pass health reform because they are seeing only the downside in the short term.
On the economy, the macro-economists in the administration like Larry Summers love to say that, "jobs are a lagging indicator", that eventually in the long run, that jobs will start getting created. Even if they are right (and I tend to be skeptical when economists tell me that in the long run, things will eventually trickle down to working people), neither the economy nor the Democratic Party can afford for there to be another year where no jobs are being produced. To have that many people in trouble exacerbates the foreclosure crisis, weakens the housing market, forces more cuts in the state and local budgets, and a higher federal deficit: and it is a complete political disaster for Democrats. Jobs need to be created ASAP, lots of jobs, not a few here and there, and should not be seen as the lagging indicator that will take care of itself someday. In the long run, as John Maynard Keynes liked to say, we are all dead, but the Democrats will be dead in the short term unless we start producing lots of jobs quickly. The stimulus is certainly helping, and Obama deserves credit for that, but it is not enough. Democrats need to think bigger on creating jobs.
On financial reform, as with health care, much of what needs to be reformed will take a long time to kick in, and in fact much of the goal will be to keep disaster from happening in the future - a harder thing to get credit for. (Which by the way, is the main thing the Obama White House is claiming about the economy - that we would have had a disaster if not for the US. It's a hard thing to win votes on.) But a strong policy of consumer safety in financial products will be noticed by people who went through the outrages of being ripped off over the last few years, and there are other things that could be done that voters would notice and cheer. How about a tax on financial transactions, structure to cost the most for the biggest traders, where the proceeds would go to new job creation? Based on private polling I was shown recently, that would get about 85% support. How about anti-trust actions against the biggest banks? How about throwing some of the worst violators of the financial system in jail, and returning their ill-gotten gains to the people they ripped off? There are plenty of things to do in the financial sector that would get voter attention and would be seen as an immediate benefit.
On climate change, the first item of business should be dramatically expanding green jobs. On immigration, families ought to be reunited right away. On issue after issue, we need to get things done, and make sure that what we get done has immediate benefits to regular people.
George W. Bush was a disastrous President, rated by many historians as the worst President of all time, and he handed Democrats a terrible mess that we will be digging our way out of for years. But blaming the other guys for bad times doesn't cut it in American politics, and it shouldn't: we need to deliver real things to real people. Trying to convince voters that it would have been so much worse if it wasn't for us, and that our policies will help them someday in the long run, is not a winning strategy. We need to deliver things that make a difference in voters' lives now.
The insurance industry inadvertently gave health reformers the best argument we ever could have had to pass a public option and the strongest possible regulations on insurers. Declaring that rates will go up dramatically if reform passes, insurers launched a full-scale open assault on the idea of any reform at all yesterday, except I guess a reform plan especially tailored to them and their profitability. What they left out of their little study is that they are the ones who decide when rates go up because the biggest companies have very little competition in most of the markets they are in. There is no federal rate regulation, there is no anti-trust enforcement in insurance (they are specifically exempted from it in the McCarran-Ferguson Act), and unless there is a public option, there will be little competition. They will be the ones who decide if the rates go up, and they have just guaranteed they would raise those rates if we don't stop them from doing it.
It's sort of like the sheriff in Blazing Saddles holding the gun to his own head, and saying "back off or I'll shoot." The insurance industry is saying that if they don't like what's in the bill, they will just decide to arbitrarily raise the rates. But we can stop those rates from going up by checking the insurers' power. That's why a public option, real competition for an arrogant out-of-control, way-too-powerful industry, is so essential. Without it, we are left to their whims, and anytime, for my reason, they will just jack up their rates. If their stocks go down, if they just want more profits, if some regulation they don't like is passed, they will just raise their rates. With a strong, robust, nationwide public option, we can force insurers to the table, and give them real competition.
Personally, I think we ought to repeal McCarran-Ferguson and impose tough rate regulation as well. That would really open up competition and guarantee lower prices. But at the very minimum, we have to have a strong national public option. The insurance industry has just reminded us as to why that is. Thanks for the help in making our case, friends.
By the way, it's not just me who thinks this. Voters do not support being forced to buy health insurance unless there is a public option- at that point, as the polling clearly documents, voters are fine with an insurance mandate. As long as there is real competition with a public option, voters are fine with being asked to buy insurance. Sometimes I think regular voters are smarter than the politicians they elect to govern them.
You gotta love the industry guys who make millions (or tens of millions, or sometimes hundreds of millions) on the system as it currently exists who don't understand why anybody else has a problem with it. Like the health care CEO who vastly overpaid for Blue Dog Congressman Mike Ross' business who, in describing our health care system, said "If it ain't broke, don't fix it." Or the banker who said about Democratic banking reform proposals, "We don't think that as far as regulation of banks is concerned, that solves any problems we had. The checks and balances under the current system are pretty good."
Then there are the industry lobbyists who demand a major change in law without wanting to give up anything in return. One of the best examples from the health care fight is the AMA, which whines incessantly about curbing medical malpractice lawsuits while never being willing to do anything serious about the thing which would actually curb lawsuits, which is to clean up problems with bad doctors and inferior quality of care. There are 98,000 deaths a year from preventable medical accidents, and a great many of those are by doctors who have screwed up repeatedly. Maybe if the AMA had aggressive plans to shut down the medical practice of bad doctors and otherwise improve the quality of care, then all the complaints about those horrible juries and those nasty family members who sue doctors that kill their relatives could be taken a little more seriously.
Industry leaders oblivious to the harm people - and our economy, and our health care system - are suffering because of the messed up system should think a little more before they complain about attempts to reform the system for the better. Just because your industry is making a ton of money doesn't mean that the system is working peachy-keen for the rest of us.
Industry lobbyists need to learn what for most regular legislators and Hill staffers is what they live with every day: you have to give something real up to get a real benefit. Insurers, you are going to get 40 million or so new customers, subsidized by the federal government, but you're going to have to accept competition from a public plan. Bankers, we just saved your ass, so you're going to need to let us regulate you. Docs, we're giving you lots of new customers too, plus we're open to creative solutions on medical malpractice, but first get rid of your incompetent and alcoholic doctors.
See how this works? It's simple, it's easy, and everyone comes away with something in hand.
CNN interviewed me earlier this week for a story they were doing on the differences between this health care fight and the last one, during the Clinton years. The story Jim Acosta did is here, but I made a couple of points to them that they didn't put in the piece that I thought were worth sharing with you, namely about bipartisanship and the insurance industry, which are highly linked topics. I also want to highlight Bob Creamer's terrific new post on the same issue.
There are some similarities and lots of big differences between this health care fight and the last one. So far, Obama has shown that he has learned the lessons of the last fight well - he made it a top priority, he said he wanted to get it done in the first year, he put a down payment on reform into his budget. All of those are good strategic moves that Bill Clinton did not do. But the biggest difference by far is that Obama and the Democrats agreed to have the option to put health care reform into the reconciliation package, meaning we would only need 50 votes instead of 60.
So here's the point I made to CNN: Obama is doing a great job of including the insurance companies and their stalwart Republican defenders in the discussions, welcoming their ideas, etc. But this bill does not need to be bipartisan, and if the Republicans want to insist that the insurance industry gets what they want, we can do this without them. We will need 83% of the Democrats in the Senate, and 85% in the House, and an effective popular President can get that done.
And to those who worship at the alter of bipartisanship, who say we need a bipartisan bill for something to be "sustainable," I would suggest you check your history books: many of the greatest reforms in our nation's history - including ending slavery and most of the great New Deal reforms - came without much or any bipartisanship. So, look, if you Republicans want to stop carrying water for an insurance industry desperate to avoid legitimate competition from a public plan, you are welcome to the table, come on aboard. But if not - as I said to CNN - we will just roll you and muscle this one home.
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