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The Real Debate Over What Is To Be Done

by Elias Isquith on May 7, 2012

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Ed Kilgore makes an argument I haven’t heard before, one in service of swatting down some liberal convention wisdom. And, in a roundabout way, his post helps explain why I write so much more about the Left than I do the Right.

Kilgore’s target on this one is the oft-repeated truism that as the Republican Party has moved to the right, it’s dragged the center — and Democrats — along with it. Usually you hear this in the context of left-of-center folks contesting the article of faith among Americans Elect-styled “centrists” that Democrats and Republicans have shifted toward their respective bases. Kilgore doesn’t deny Republican have gone hard-right; but he thinks the Dems’ trajectory hasn’t been quite as linear (be it to the right or the left) as many seem to believe. He focuses on the two frequently cited pieces of evidence, Clinton’s TANF and Obama’s PPACA.

Kilgore’s emphasis:

On some issues, notably welfare reform, Democrats “moved right,” if that’s what you want to call it, for a combination of reasons that initially had little to do with cutting deals with Republicans: the existing system wasn’t working very well to accomplish its own stated goals, and was massively unpopular with voters of every persuasion. Yes, Bill Clinton wound up compromising with Republicans on actual welfare reform legislation in 1996 (after vetoing two significantly more draconian bills), but was pursuing his own version of welfare reform before Republicans gained the power to force him to the table.

On health care, it’s not accurate to say that Barack Obama embraced the framework for what became the Affordable Care Act strictly because Republicans had supported something similar. A private-sector-based “managed competition” proposal was in the mix earlier, back during the ClintonCare debate, and was supported by a lot of fairly conventional Democrats, such as Sen. Daniel Patrick Moynihan. In the 2004 and 2008 Democratic presidential primaries, every candidate other than Dennis Kucinich proposed a “hybrid” system as well, and not because they were anticipating negotiations with congressional Republicans. A single-payer system, while popular among many liberal Democrats, was never some party-wide policy preference that was later “abandoned” by Clinton or Obama, and the polling on it never showed it to be a world-beater, either. Maybe these two Democratic presidents should have pursued it anyway, but again, it’s not so clear that a craving for Republican approval was the key, much less the only, factor.

Concerning welfare reform, I’ll have to defer to Kilgore. At the time of its implementation, I was focused more on T-rex than TANF; and although I think the current policy has proven itself to be woefully inadequate — and to represent a fundamental shirking of the social responsibility that ostensibly defined the Democratic Party — I can’t speak to the virtues, if there were any, of what it replaced. In general, I think those who want to help the  economically oppressed empower themselves do better focusing on health care, education, and labor rights rather than the traditional wealth redistribution of welfare. Beyond fulfilling the most basic economic needs, direct payments don’t do much to combat systemic forces bearing down on the poor. And as we all know, they’re politically toxic, arguably even counterproductive.

On Obamacare, Kilgore’s point — that there never was a decisive contingent among Democrats in favor of single-payer — should be all too clear to anyone who remembered the ignominious end of the Public Option. It’s always worth remembering: the Democratic Party is home to most of America’s liberals, but is not itself a liberal Party. This unwavering fact of the country’s political life can be enormously frustrating and, what’s more, makes comprehending US politics even more difficult than it is already. But it’s the reality that the President, Speaker Pelosi, and Majority Leader Reid in 2009, and they tailored the ultimately passed bill accordingly. There was a real political value in Democrats touting their plan’s similarity to earlier Republican ideas; but that wasn’t the reason why Obama went with the PPACA model rather than something more clearly resembling the New Deal.

All right: so the past two Democratic Presidents probably get more blame for moving the Party to the right than they deserve. At the same time, there’s no doubting that, by and large, the Democratic Party today is more interested than it was previously in using markets, rather than the state, as a first resort. Liberals could get all worked up and search for villains to blame, but keep in mind that this process has occurred throughout the West. There’s really no leftwing Party in the developed world that hasn’t embraced markets more than it had before; the problem — if indeed there is one — is not one of bad actors. Ideas mattered too.

People tend to focus on their perceived adversaries’ ideas, and most understandably think the other Party is where they’ll find their adversaries. True enough — but it’s not the only place. Although this isn’t so much the case today with the GOP, there are plenty of ideologically adversarial relationships within the two major Parties; and in some ways, the result of intra-Party conflict is more important than what happens on election day. Republicans were likely to win big in 2010, no matter what. But it wasn’t inevitable that they’d do so advocating the Tea Party line. A Republicanism of compassionate conservatism might have rocketed to the fore in 2011. It didn’t. Why? Because the Tea Party types, by and large, won their internecine squabbles.

Looking at the Democrats, Kilgore makes the same point:

[N]ow that everyone agrees “bipartisan compromise” on most vital issues has been made simply impossible by the devolution of the GOP into a rigid ideological cult, Democrats still have to decide what policies to propose, and still must, to the limited extent possible, try to govern. And there’s still not an automatic, default-drive “true progressive” position on many national priorities other than resistance to conservative assaults on the New Deal, the Great Society, corporate regulation, environmental protection, civil rights, and peaceful international cooperation.

Once the specter of feckless bipartisanship is banished, there will remain internal disagreements among progressives, so we might as well get used to it and stop pretending it’s a simple choice between courage and cowardice.

Among those left-of-center, the internal disagreement has understandably quieted down as we’ve gotten closer and closer to the election. But once November’s in the rearview mirror, it’ll pick back up again — especially if the President loses. So for those who still believe the Democratic Party can still be a vehicle for progress and improvement, the next few years are much more important than you may think.

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SCOTUS Expert Predicts Obamacare Will Survive

by Elias Isquith on April 5, 2012

Kennedy

Linda Greenhouse, a Pulitzer Prize winner has written on the Supreme Court for more than 30 years, has a must-read piece up at The New York Times on Obamacare before the Court. She thinks it’s going to survive:

Nothing in the Supreme Court arguments in the health care case last week, or in the subsequent commentary, has changed my opinion that this is an easy case. It’s the court that made it look hard.

I don’t mean the torrent of wisecracks at the government lawyers’ expense from Justice Antonin Scalia, who despite his clownish behavior in channeling the Tea Party from the bench is surely smart enough to know the difference between broccoli and health care. Rather, I mean the tough but fair questions from the members of the court who actually seemed to be wrestling with the issues: Justices Anthony M. Kennedy and Samuel A. Alito Jr. and Chief Justice John G. Roberts Jr. The Affordable Care Act will be upheld if least one of these justices is satisfied that the briefs, the arguments, and his own judicial perspective provide sufficient answers to the questions.

By the end of the arguments, Chief Justice Roberts and, to a lesser extent, Justice Kennedy were heading in that direction, it seemed to me. While they might have initially seen the government’s defense of the law as a slippery slope, leading from hospital emergency rooms to the vegetable bin, they appeared increasingly concerned by the implications of the plaintiffs’ arguments as well. They seemed particularly alarmed by the categorical position put forward by Michael A. Carvin, the lawyer representing the small-business plaintiffs, who argued that a victory for the government would mean that Congress could “regulate every human activity from cradle to grave.”

The chief justice’s responses to Mr. Carvin included such rejoinders as “I don’t think that’s fair” and “I don’t think you’re addressing their main point, which is that they are not creating commerce in health care. It’s already there.” Justice Kennedy, suggesting that “most questions in life are matters of degree” – as opposed to the plaintiffs’ all or nothing position – seemed to endorse the government’s argument that the market for health care has unique features that separate it from the various hypotheticals and analogies buzzing around the courtroom.

There’s plenty more, including a fascinating digression on the recent strip-search ruling and what it might tell us about internal strife within the Court — strife that could impact the eventual Obamacare ruling.

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If The Supreme Court Kills Obamacare, You Can Keep Your Silver Lining

by Elias Isquith on March 29, 2012

SCOTUS

Ed Kilgore, playing one my least favorite versions of What If since “Vice President Palin” was a less-than-remote possibility, guesses at how a nixing of Obamacare by the SCOTUS would affect this year’s elections:

I’d argue, however, that on the margins at least, a decision invalidating the individual mandate would change thedynamicsof the general election in ways that might prove uncomfortable to the GOP. Currently the Republicans “Repeal!” position is attractive, or at least not repellent, to a wide range of people with a wide range of concerns about ObamaCare, including those who would strongly support for more aggressive federal efforts to expand health care coverage or ban discrimination by private health insurers. If the individual mandate goes down, and with it prospective prohibitions on prexisting condition exclusions, the health care debate during the general election campaign will shift from scrutiny of ObamaCare from what, if anything, Republicans are prepared to offer. In effect, the much-dreaded and highly divisive intra-GOP debate on the “Replace” part of its “Repeal-and-Replace” agenda will be accelerated into the present tense. And at the same time, Republicans will be denied the base-energizing power of the passionate desire to repeal ObamaCare, which has become the default-drive unifying force among conservatives of every hue.

Conversely, the invalidation of a landmark Obama administration accomplishment that virtually all progressives regard as historic if not entirely satisfactory will help Democrats energize their own party base. And you cannot imagine anything more likely to make the last-resort argument about the importance of Supreme Court appointments more tangible and immediate.

NPR’s Frank James is thinking along the same lines, citing recent electoral results as proof that there might be a silver lining to a SCOTUS drop-kick:

[T]he immediate reaction to the total trashing of the law is likely to be gleeful for the right and brutal for the administration. Imagine, too, the pain of Democrats who voted for the law in 2009 and 2010 and are now former members of Congress, at least partly as a consequence.

But in the longer run, there are ways in which the striking down of the law could help the president and his party.… major hit from the high court could create a bounce-back issue for outraged Democrats in 2012 and beyond. The Democrats have done well in recent decades when they could run on popular disaffection regarding health care, particularly in 1992 and 2008. A chance to rally against the tyranny of the court, striking down popular provisions as well as unpopular, could be potent. Consider how much ground the GOP gained running against the liberal court of Chief Justice Earl Warren a generation ago, or against the Roe v. Wade abortion decision since 1973.

Ugh. Maybe. But I’ll be honest: my first, second, and maybe third response to a SCOTUS nixing of Obamacare (which, for the record, I think is inferior to a single-payer system) will be intense enervation. The idea of kinda-sorta starting from scratch, after a torturous two years of debating this specific bill — and nearly a century of striving for universal health care in one form or another — towers so unappealingly, it summons thoughts of our political system as a late-imperial revamp of No Exit.

Full disclosure: I’m a cancer survivor. I had leukemia when I was very young, and I was lucky enough to have it purged from my blood relatively quickly and without the need for x-rays or more than a few bouts of chemotherapy. I’ve had health insurance all my life, either from my parent’s or my own employer’s plan. And it’s not clear that, even if I and the rest of the country were to be flung back into the dark ages of death (financial or literal) from preexisting condition, my history with cancer would brand me with a scarlet letter of outsized risk.

In other words, I’m far from the top of the list of those with the most to fear.

Still, the mix of weariness, fatalism, despondency, and sublimated anger that I feel when I imagine being, once again, merely one stroke of bad luck away from losing health insurance perhaps semi-permanently? When I think of the millions of people who, unlike myself, would immediately be thrown curbside by a 5-4 majority unable to keep its ideological zeal in-check? This must be the way the Yippies felt during the insidious time between the ’68 DNC flame-out and Rubin’s embrace of proto-Reaganite “self-improvement.” Or maybe it’s more like how Mookie felt as he grabbed threw off the lid and grabbed that trash can with both hands.

Which brings me to the other potential consequence of a bold move by the SCOTUS that’s worrisome — what this would do to the political culture in the United States. Yes, we’ve all heard how ugly, uncivil, uncouth, and unhealthy is our politics today. But anyone with passing familiarity with American history well knows that things could be, have been, far worse. What if the SCOTUS, by striking-down Obamacare, throws a lit match into a deceptively placid but in truth frightfully deep pool of kerosene? What if whatever pretenses toward comity that linger are extinguished and American politics enters into its most explicitly Hobbesian moment since at least the 1960s, if not earlier?

Staying in that romanticized but in reality quite unpleasant (at least it seems so to me) epoch, let’s remember that undergirding all of that tumult was perhaps the most robust and prosperous economy that human civilization had theretofore seen. Americans were only then beginning to truly distrust, even loathe, their bedrock civil institutions. The climate crisis was there, of course, but it wasn’t here the way it is today. There was no looming tidal wave of debt. The country could handle such a prolonged period of in-fighting and growing pains. Wading back into those choppy waters today, however, seems to me to be a much more foolhardy undertaking.

Because of all this and more, I still don’t think the Court will do something as rash as many liberals now fear they might. As Senator Blumenthal said yesterday, these Judges must know that their power is an almost miraculously ephemeral thing. They and their posterity live on little more than sentiment; the noble lie that politics ends at 1 First Street’s first stone step. If for no other reason than not wanting to be remembered by future Justices as the ones who threw it all away, I think the conservative majority will restrain itself. This may be one of those few instances in which the human obsession with the preservation of institutional power leads to a positive outcome.

If it’s not, though, I’ll pass on the pep-talks. Maybe it’ll eventually lead to better things (at what cost is unclear); but it’ll be awful, terrible, very bad, and no good news just the same.

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On The Whole Catholic Conscience Exemption Brouhaha

by Elias Isquith on February 5, 2012

The conversation over the HHS’s recent decision to require Catholic institutions to pay for various contraceptive services in their employees’ health plans was pretty good; and I think MBD held up all right considering his rather pronounced numerical disadvantage. He was able to defend his position without coming off like a defensive jerk, for one thing, and I think that’s genuinely difficult to do when you know you’re in the lions’ den. Your mileage may vary, as they say.

I myself was late getting into this issue and had to do some catch up. Culturally or instinctually (either word works) my inclination would be to side with Secretary Sebelius and, in general, promote anything that effectively recognizes that a woman has a natural right to control her reproductive capacity. But I think it’s also a genuine problem, this mandating that religious institutions — even if, as the conscience exemption makes clear, this ruling only applies to institutions who are not primarily religious (e.g., hospitals) — act in accordance with a law that they find fundamentally wrong and contrary to their doctrine.

My first conclusion, which the panel eventually gets to (but not in the section I’ve clipped above) was that this is yet another reason why it would be ideal if the iron-bond between employment and health care was irrevocably severed. I mean, these Catholic institutions are really in a no-win situation, here, considering that they cannot get out of this mandate so long as they accept public funds — and the likelihood of a hospital being able to operate without accepting Medicare? Not high. But remember that the chances of separating employment from health care are perhaps even lower than for running a major hospital without taking public funding. Only in the most academic sense is this morsel of wisdom valuable.

Next, I looked up the cost of birth control without insurance. (I’m a male ensconced in my male privilege, so this is not something I knew offhand.) According to the evil abortion mill Planned Parenthood, it can be around $15–$50 per month; and that seems like a real financial burden to bear for someone who may be a single mother living on a nurse’s paycheck. That information confirmed my confidence in my initial, knee-jerk reaction (fancy that!); but I think it could reasonably be seen as a bit of a cop-out by others who would consider a woman’s right to contraception — and let’s not pretend that this issue doesn’t disproportionately effect women — to be a fundamental right on which such prosaic considerations should have no bearing.

Hypothetically, I wouldn’t take that stance, because it would strike me that a negligible cost (like $5 every-other month, hypothetically) would not be a sufficient burden upon the holders of one right to justify overriding the holders of another. Rights are very frequently in conflict, and an attempt to balance is, I believe, not just easier but also more fundamentally decent than any quest to determine some ironclad hierarchy. Yet a delicate balancing act is not, I don’t think, why the Obama Administration reached the conclusion that it did. Rather, I think the explanation is less idealistic, but perhaps more valuable for being unvarnished truth.

As a wise man once wrote, “Between equal rights force decides.” Powerful as the Catholic Church may be, it’s no US Federal Government. And, really, that’s that.

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Rational’s Not In It

by Elias Isquith on December 15, 2011

Paulwyden

On the new Medicare proposal from Paul Ryan and Ron Wyden, Digby writes:

One might have thought the prudent thing would be to wait and see how the health care reforms work before throwing the sickest population into the mix, but apparently we just “know” it’s the way to go.

That’s not to say that people won’t be able to “buy” what we know as Medicare with their “supported premium”, but because the spending will be capped for all, and almost assuredly subject to political exigencies, this is very likely to result in, at the very least, a more difficult system to navigate for the most ill and vulnerable adult citizens. My observation of the most elderly in the past few years is that they can’t competently pay their phone bills, so this should be interesting. I suppose some kindly insurance salesmen will come to the rescue.

What strikes me about this comment is how alien it is to mainstream discussions of health care reform — and public-private fusion plans in general. It’s rare that you hear a politician or a respectable wonk or a think tank spokesperson discuss these kinds of plans in terms that aren’t loaded-up with jargon, for one; but even if the conversation is being carried out with plain language, there’s rarely if ever a focus on how the actual plan would work for real human beings, rather than abstract Consumers.

The disconnect Digby’s pointing out here is born from a larger ideological blind-spot of this era’s political class: they cannot see the world without the language and logic of the market. The wide swathes of the population who may not be able — or may not want— to adopt the mindset of the holy Rational Consumer might as well not exist; they’re square circles. To say that people can be quite real and quite valuable while, at the same time, not really being Consumers? Imagine telling a Medieval monk that the world can’t be divided between saints and sinners. It just doesn’t register.

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