Cohen in WaPo suggests that Obama should ram away with the pending health plan, despite all the noise about a socialist plot to damn the poor citizens to a blundering bureaucracy with nothing going for it but losses for all. It is not perfect by any means, but it is a long overdue attempt to overhaul a severely broken system. BP

In our poll-driven culture it might seem strange for a president to attempt something that's somewhat unpopular but merely right. After all, the health-care bill has almost no near-term benefit for anyone who votes. Its immediate beneficiaries are the uninsured, consisting of the poor and vulnerable, and the young and delusionally invincible. As a voting bloc, they largely don't.

The rest of America looks at the bill and shudders. It seems to promise nothing but hardship. The aged have Medicare, and most workers have insurance of some sort. Sure, many fear losing what they have and rightly hate insurance companies, but they seem to prefer their existing plans to what they have been told will be a program run by sullen former Soviet bureaucrats. Opt out and you will be liquidated.

As with almost everything else the Obama administration has attempted, the benefits of health insurance reform either are invisible to the monumentally important television camera or are promised for a future time. No one can see savings -- either to the health system or the economy in general -- not because they are fictitious but because they are unfilmable.

It is the same with auto companies that did not disappear, a financial system that did not crater, and jobs that were retained along with a rate of joblessness that recently has been reduced.

As anyone in TV can tell you, it is impossible to film a reduction in the joblessness rate or a bank that's saved -- "before" and "after" look identical -- or, for that matter, teachers who were not laid off because their school system got stimulus funds. These are the visual equivalent of the sound made by the tree that falls in the forest but that no one hears. There's nothing to show. The Iraq war will not end with Obama on the deck of an aircraft carrier, wallowing in patriotic kitsch. The picture will simply go dark. This is a PR dilemma and, for Obama, a political catastrophe.

Great presidents lead. In a sense, Lincoln "rammed" through the Emancipation Proclamation just as FDR "rammed" through Lend-Lease, Truman "rammed" through desegregation of the military, and Lyndon Johnson "rammed" the Civil Rights Act down the throat of a gagging South. These might be considered more dramatic issues than mundane health care, I grant you -- but grant me an exception for someone putting off doctor visits because he or she can't afford to be sick. To that person, this bill is as dramatic as the difference between sickness and health -- the great divide of mankind.

The baleful fact is that the country suffers from a surfeit of democracy -- a gazillion interest groups, a gazillion blogs, a gazillion talk shows and all of them insisting on transparency so a gazillion eyes peer over the shoulders of politicians. The black but necessary art of politics shies from the sun. Little gets done. Backrooms have been turned into rec rooms and meetings are seminars. We are doomed. Worse, we are bored.

Google does not tell the whole story. It fails to answer what's wrong with the old belief -- a virtual childhood mantra -- that "majority rules"? It was never "supermajority rules," and the presidency was never intended as a weather vane, turning this way and that on the slight breeze of the latest poll. Lead and the people will -- or will not -- follow. Either way, ram the damn thing, Mr. President. Ram it!

cohenr@washpost.com

His new book, "Courage and Consequence," promises to "pull back the curtain on my journey to the White House and my years there." What he divulges nearly made me choke on a pretzel.

That business about President George W. Bush misleading the nation about Iraq? Didn't happen. "Did Bush lie us into war? Absolutely not," Rove writes.

Condoning torture? Wrong! "The president never authorized torture. He did just the opposite."

Foot-dragging on global warming? Au contraire. "He was aggressive and smart on this front."

Dana Milbank

WaPo 3-8-10

The health reform bill can actually be accomplished with a little political will on the part of the skittish Democrats in Congress. Our RRR position has long been that this is a necessity long overdue and that with a little shove the whole show can come to completion, and with benefits that will be palpable. Yes, it may cost some seats in November,  and it unfortunately leaves insurance companies in variably strong positions; there should be a public option and in many opinions, something like Medicare for all. But it also may be the signature accomplishment of this generation of leaders who have been complicit in unnecessary wars and tax cuts for people who don't need them. Let us just hope something worthwhile will pass. We shall see.  BP

The most straightforward way to enact reform would be for the House — which only needs a majority — to approve the bill passed by the Senate and send it straight to the president for his signature. Unfortunately, House Democrats appear unwilling to do that.

Liberal members of the caucus think the Senate bill should spend more money to cover more people and provide more generous subsidies. Fiscal hawks are nervous about the projected costs of either bill. And legislators who strongly oppose abortion think the restrictions on coverage for abortion in the Senate’s bill are too weak.

The multiple sniping has forced the Democrats to consider amending the Senate bill by “reconciliation,” a procedure that can sidestep a Republican filibuster.

Don’t be misled by Republican charges that the president is planning to “ram through” reform with a rarely used maneuver. The Senate already has approved its bill with a 60-vote majority. Both parties have used reconciliation in the past. The Republicans happily used it to approve the Bush tax cuts in 2001 and 2003.

Senate Democrats should be able to muster the 51 votes needed. So what will it take to win over the House?

Liberal Democrats are right that the Senate bill is too stingy. More money should be added to make subsidized insurance affordable and to help states pay for expanding their Medicaid rolls. That would drive up the cost somewhat and make fiscal conservatives even more nervous. Yet there is much in the Senate bill for them.

The two most important points they — and all Americans — need to remember is that the Senate and House bills are fully paid for by tax revenues and budget savings, and both would reduce future deficits.

The Senate bill also has two additional cost-control mechanisms: a tax on high-cost insurance plans designed to push people toward cheaper plans, and an independent board to push cost-cutting measures into the Medicare program. Both could probably be strengthened in reconciliation.

Neither the liberals nor the fiscal hawks will be able to get everything they want. Mr. Obama and Congressional leaders will have to persuade both camps that failure is the worst option of all.

Do House liberals really want to deny 30 million uninsured Americans the chance at coverage? Do House deficit hawks want the deficit to rise even more? Because without reform, there are no plans to rein in the relentless rise of medical costs and the Medicare obligation.

The issue of abortion coverage can’t be addressed in a reconciliation bill that must deal only with budgetary matters. The Senate bill already has onerous provisions that would likely discourage insurers on new exchanges from offering policies that cover abortions. The House bill is even more restrictive. Both are outrageous intrusions on a woman’s right to make health care decisions.

House Democrats who say they cannot accept the Senate’s abortion provisions must ask themselves a fundamental question: Are they willing to scuttle their party’s signature domestic issue and a reform that this country desperately needs, rather than accept the almost-as-tough language of the Senate bill?

NY Times Editorial, 2-4-10

Watched again some Altman, Prairie Home Companion & The Player, amazed at the spontaneous comic and serious themes, death with the Keillor homage, and the viciousness of Hollywood in The Player. Been reading an oral bio (Mitchell Zuckoff, Knopf) of Robert Altman, just out. Altman hated his chosen world as much as he loved it and each piece is a loving/macabre stew of stories and acting by almost always capable players. Something radically funny about Altman and his capacity for storytelling, Nashville pretty close to a masterwork. But he worked his beat with a stealth unmatched by others. Was planning new projects at the end. Worked in TV too; I worked for a protege of Altman,  Riza Badiyi, on Falcon Crest. Meryl Streep finally got to work with Big Bob on Prairie Home, playing singing sister Yolanda Johnson (with Lily Tomlin as another sis) and she obviously had a great time. Death haunts Prairie, Virginia Madsen plays the Angel of Death. Altman took on death as one of his special subjects, and in the Player you can see how much suffering went into what looks like the death of American filmmaking: it's all unreal this Hollywood world of grotesque relationships, phony stories pitched by nimrods, distortions of humanity at every level. The improvisational feel of the piece, and the departures from the Michael Tolkin script make it one of Altman's best. He makes it up as he goes along, you can feel the savage power of his intention when he is working at his best.

Altman: Making a film is like painting a mural. You've got this big wall to fill and you've got a subject, and the only difference is, as you go up there and you're painting it, you've got living pigment...You have to control it, but you're dealing with a living thing that's really forming itself. So you're sitting up there doing damage control all the time. But the style in which one paints these films is...their personality, it's what they do, it's their artistry.

Frank Rich in Sunday Times (2-28-10) examines some of the elements of the IRS kamikaze mission and what it might mean in terms of current politics. It is beyond disturbing to see this kind of thing, which could have easily matched the Oklahoma City massacre with more luck on the side of the madness. Our politics have become more desperate and mad in these times, and it's hard to see how the two parties can actually govern in the midst of the derangements. BP

Frank Rich:

It is not glib or inaccurate to invoke Oklahoma City in this context, because the acrid stench of 1995 is back in the air. Two days before Stack’s suicide mission, The Times published David Barstow’s chilling, months-long investigation of the Tea Party movement. Anyone who was cognizant during the McVeigh firestorm would recognize the old warning signs re-emerging from the mists of history. The Patriot movement. “The New World Order,” with its shadowy conspiracies hatched by the Council on Foreign Relations and the Trilateral Commission. Sandpoint, Idaho. White supremacists. Militias.

Barstow confirmed what the Southern Poverty Law Center had found in its report last year: the unhinged and sometimes armed anti-government right that was thought to have vaporized after its Oklahoma apotheosis is making a comeback. And now it is finding common cause with some elements of the diverse, far-flung and still inchoate Tea Party movement. All it takes is a few self-styled “patriots” to sow havoc.

Equally significant is Barstow’s finding that most Tea Party groups have no affiliation with the G.O.P. despite the party’s ham-handed efforts to co-opt them. The more we learn about the Tea Partiers, the more we can see why. They loathe John McCain and the free-spending, TARP-tainted presidency of George W. Bush. They really do hate all of Washington, and if they hate Obama more than the Republican establishment, it’s only by a hair or two. (Were Obama not earning extra demerits in some circles for his race, it might be a dead heat.) The Tea Partiers want to eliminate most government agencies, starting with the Fed and the I.R.S., and end spending on entitlement programs. They are not to be confused with the Party of No holding forth in Washington — a party that, after all, is now positioning itself as a defender of Medicare spending. What we are talking about here is the Party of No Government at All.

The distinction between the Tea Party movement and the official G.O.P. is real, and we ignore it at our peril. While Washington is fixated on the natterings of Mitch McConnell, John Boehner, Michael Steele and the presumed 2012 Republican presidential front-runner, Mitt Romney, these and the other leaders of the Party of No are anathema or irrelevant to most Tea Partiers. Indeed, McConnell, Romney and company may prove largely irrelevant to the overall political dynamic taking hold in America right now. The old G.O.P. guard has no discernible national constituency beyond the scattered, often impotent remnants of aging country club Republicanism. The passion on the right has migrated almost entirely to the Tea Party’s counterconservatism.

The leaders embraced by the new grass roots right are a different slate entirely: Glenn Beck, Ron Paul and Sarah Palin. Simple math dictates that none of this trio can be elected president. As George F. Will recently pointed out, Palin will not even be the G.O.P. nominee “unless the party wants to lose at least 44 states” (as it did in Barry Goldwater’s 1964 Waterloo). But these leaders do have a consistent ideology, and that ideology plays to the lock-and-load nutcases out there, not just to the peaceable (if riled up) populist conservatives also attracted to Tea Partyism. This ideology is far more troubling than the boilerplate corporate conservatism and knee-jerk obstructionism of the anti-Obama G.O.P. Congressional minority.

In the days after Stack’s Austin attack, the gradually coalescing Tea Party dogma had its Washington coming out party at the annual Conservative Political Action Conference (CPAC), across town from Capitol Hill. The most rapturously received speaker was Beck, who likened the G.O.P. to an alcoholic in need of a 12-step program to recover from its “progressive-lite” collusion with federal government. Beck vilified an unnamed Republican whose favorite president was the progressive Theodore Roosevelt — that would be McCain — and ominously labeled progressivism a cancer that “must be cut out of the system.”

A co-sponsor of CPAC was the John Birch Society, another far-right organization that has re-emerged after years of hibernation. Its views, which William F. Buckley Jr. decried in the 1960s as an “idiotic” and “irrational” threat to true conservatism, remain unchanged. At the conference’s conclusion, a presidential straw poll was won by Congressman Paul, ending a three-year Romney winning streak. No less an establishment conservative observer than the Wall Street Journal editorialist Dorothy Rabinowitz describes Paul’s followers as “conspiracy theorists, anti-government zealots, 9/11 truthers, and assorted other cadres of the obsessed and deranged.”

Briefly viewed the so-called health summit on CNN and was amazed at the alacrity of the statistical bullshit the Republicans kept throwing out. It reminds you of some kind of debating society where the facts don't matter; it's how the dishonesty is revealed as gospel. David Gergen commented that Obama sitting down with bitter Repubs made him look unpresidential; I think it's a tribute to his humanity and modesty that he would take his place on a fairly even playing field and listen to the same old same old, such as 'the US has the best health system in the world' and the rest of the world can't wait to unisnsure 40 million citizens and have people without insurance going bankrupt and going to ERs with head colds. Krugman in today's NY Times 2-26-10 takes some of this on in his 'Afflicting the Afflicted' piece:

It was obvious how things would go as soon as the first Republican speaker, Senator Lamar Alexander, delivered his remarks. He was presumably chosen because he’s folksy and likable and could make his party’s position sound reasonable. But right off the bat he delivered a whopper, asserting that under the Democratic plan, “for millions of Americans, premiums will go up.”

Wow. I guess you could say that he wasn’t technically lying, since the Congressional Budget Office analysis of the Senate Democrats’ plan does say that average payments for insurance would go up. But it also makes it clear that this would happen only because people would buy more and better coverage. The “price of a given amount of insurance coverage” would fall, not rise — and the actual cost to many Americans would fall sharply thanks to federal aid.

His fib on premiums was quickly followed by a fib on process. Democrats, having already passed a health bill with 60 votes in the Senate, now plan to use a simple majority vote to modify some of the numbers, a process known as reconciliation. Mr. Alexander declared that reconciliation has “never been used for something like this.” Well, I don’t know what “like this” means, but reconciliation has, in fact, been used for previous health reforms — and was used to push through both of the Bush tax cuts at a budget cost of $1.8 trillion, twice the bill for health reform.

What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.

One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.

In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.

Don’t take my word for it. Look at the Congressional Budget Office analysis of the House G.O.P. plan. That analysis is discreetly worded, with the budget office declaring somewhat obscurely that while the number of uninsured Americans wouldn’t change much, “the pool of people without health insurance would end up being less healthy, on average, than under current law.” But here’s the translation: While some people would gain insurance, the people losing insurance would be those who need it most. Under the Republican plan, the American health care system would become even more brutal than it is now.

So what did we learn from the summit? What I took away was the arrogance that the success of things like the death-panel smear has obviously engendered in Republican politicians. At this point they obviously believe that they can blandly make utterly misleading assertions, saying things that can be easily refuted, and pay no price. And they may well be right.

But Democrats can have the last laugh. All they have to do — and they have the power to do it — is finish the job, and enact health reform.

Paul Krugman, NY Times Editorial 2-26-10

Roger Cohen in the 2-22-10 NY Times hits on what Otto Kernberg wrote so well about thirty years ago (pathological narcissism) which has become a central feature of American life. Everyone locked into his own privacy, unable to feel the existence of the other.

Community — a stable job, shared national experience, extended family, labor unions — has vanished or eroded. In its place have come a frenzied individualism, solipsistic screen-gazing, the disembodied pleasures of social networking and the à-la-carte life as defined by 600 TV channels and a gazillion blogs. Feelings of anxiety and inadequacy grow in the lonely chamber of self-absorption and projection.

These trends are common to all globalized modern democracies, ranging from those that prize individualism, like the United States, to those, like France, where social solidarity is a paramount value. Ehrenberg’s new book, “La Société du Malaise” (“The Malaise Society”) is full of insights into the impact of narcissistic neurosis.

Sometimes, it seems, we are as lonely as those little planes over the Atlantic in on-board video navigation maps.

I was thinking of this during a recent spell as a grand juror. Thrown together for two weeks at Brooklyn Supreme Court with 22 other jurors, I was struck by how rare it is now in American life to be gathered, physically, with an array of other folk of different ages, backgrounds, skin colors, beliefs, faiths, tastes, education levels and political convictions and be obliged to work out your differences in order to get the job done.

It was not always easy, of course; not easy to deal with the fidgety paramedic chewing chips through murder testimony, the scattershot flirtations of the former rhythm-and-blues musician, the off-point ruminations of the old guy who knew he was always right, the intermittent tedium and incoherence.

I can still hear the juror next to me. “I work at 311” — the number New Yorkers dial with complaints or questions about the city. “Drives me nuts, been doing it five years. People treat you like idiots. Most of the time it’s water seeping into basements, sewage systems blocked. At least my job hasn’t been outsourced to Bangalore. People ask me, ‘You in New York?’ They ask me, ‘Are you a human being or a robot?’ Sometimes I say, “I ... AM ... A ... ROBOT.’ But we’ve got supervisors listening to calls. One thing that drives me crazy is all the people who speak slowly, as if I’m an idiot. I tell them, ‘You can speak faster, you know!’ Jury duty’s actually a relief!”

In a way, it was — a relief from being alone on a phone or in front of a screen. We got to know each other’s tics and, having dealt with killing and rape and assault and insurance fraud, we all embraced at the end. Oh unthinkable act, we’d done something selfless for the commonweal, learned to listen to each other, accepted differences and argued our way to decisions.

America could use more of that kind of experience. As it is, everyone’s shrieking their lonesome anger, burrowing deeper into stress, gazing at their own images — and generating paralysis.

Which brings me to health care: Crunch time has come on a question central to the nation’s future, where an acknowledgment is needed that, when it comes to health, we’re all in this together. Pooling the risk among everybody is the most efficient way to forge a healthier society. That’s what other developed societies do. And they don’t have 30 million plus uninsured.

Now, as I understand it, the Tea Party movement is angry about waste, bail-outs for the rich and spiraling debt. They detest big government. But if waste and debt are really what’s bothering them, how about the waste in the more than 1,800 daily health-care related personal bankruptcies, the 25 to 30 percent of some corporate insurers’ costs going on administration (versus 6 percent for Medicare), the sky-rocketing health premiums that are undermining U.S. corporations (and so taking jobs), the endless paperwork of private reimbursement procedures, and the needless deaths?

Americans don’t want a European nanny state — fine! But, as a lawyer friend, Manuel Wally, put it to me, “When it comes to health it makes sense to involve government, which is accountable to the people, rather than corporations, which are accountable to shareholders.”

All the fear-mongering talk of “nationalizing” 17 percent of the economy is nonsense. Government, through Medicare and Medicaid, is already administering almost half of American health care and doing so with less waste than the private sector. Per capita Medicare costs for common benefits grew 4.9 percent between 1998 and 2008, against 7.1 percent for private insurers. Why not offer Medicare as a choice — a choice — to everyone? Aren’t Republicans about choice?

The public option, not dead, would amount to recognition of shared interest in each other’s health and of the need to use America’s energies and resources better. It would involve 300 million people linking arms.

Or we can turn away from each other and, like Narcissus, perish in the contemplation of our own reflections.

Roger Cohen,

NYTimes

Warren Rudman in an op-ed in the WaPo comes through with what is probably the most intelligent ingredient that might pave the wave to an improved governanace in the Senate. But who knows if there is sanity enough to rely on such suggestions?

Time and again, I hear from my former colleagues in the Senate that fundraising is life, and an unhappy one at that. The average senator raised nearly $10 million to run for office in the last election -- $30,000 each and every week of a six-year term. And last month's Supreme Court ruling permitting unlimited corporate spending in elections only made matters worse.

In practical terms, that means endless hours of call time with major donors, often out-of-state interests with business before the committees on which the senator serves. It means having to face the rampant cynicism of a public that overwhelmingly equates accepting money from private interests with compromises in personal and institutional integrity. It means time away from the real business of governing our country.

To restore the public's trust and put senators back to work, we need to end their reliance on special-interest money. The best solution I know is citizen-funded elections: a system of small donations from constituents and matching public funds for qualifying candidates who forgo large donations. Sen. Richard Durbin (D-Ill.) has made a fine start with the Fair Elections Now Act, which caps donations at $100 apiece and provides competitive matching dollars out of a deficit-neutral fund raised through fees on large-scale government contracts. It would be a welcome change for senators and the American people

Warren Rudman (R-NH) 1980-1993