The DSCC needs a new sales pitch for health care reform

You don’t greet an historic achievement with a list of technocratic talking points.

Today’s blogosphere is full of posts pointing out what a huge achievement the health care bill will be, if it finally gets to the President’s desk.  Jonathan Chait, Ezra Klein, Jonathan Cohen, Mark Schmitt, Matthew Holt, and Kevin Drum are all singing in harmony. Here’s Kevin:

A trillion dollars in benefit for low and middle income workers. 95% of Americans insured. Medical bankruptcies on the verge of disappearing. And for the first time ever, an acknowledgement that decent healthcare ought to be universal in the United States. This is historic.

I think they’re right.  I also think that health care will be a defining issue for the 2010 elections, and that it matters enormously whether Democrats stand united and proud behind their achievement, or whether instead Blue Dog pols try to run away from it while activists dismiss it as a sell-out.  Harry Reid is no one’s idea of a great orator, but his speeches in the last couple of days at focused on the key point:  that the bill establishes as a principle that in the richest country in the history of the world no one should die because he can’t pay for medical treatment.

Someone needs to explain this to the folks at the DSCC.  A fundraising email from Bob Menendez this morning links to Common Ground, the DSCC blog. Instead of comparisons to Social Security and the Civil Rights Acts, the Common Ground post consists mostly of technocratic blah.

On December 24, 2009, the Senate passed (60-39) the Patient Protection and Affordable Care Act.  Against a wall of Republican opposition, Senate Democrats united to pass landmark health care legislation.

The Patient Protection and Affordable Care Act (PPACA) is the most sweeping health care reform package this country has ever seen. It will reduce costs, increase access, and provide critical insurance reforms that will put patients first. This legislation also makes Medicare more solvent and expands prescription drug coverage, all while reducing the deficit and reining in health care costs. The PPACA provides choice and competition and invests in the small businesses of this country.

Cost

  • The PPACA will reduce the federal deficit by $132 billion first ten years
  • In the second years, the bill will reduce the deficit by roughly $1.3 trillion.
  • This bill will result in a net tax cut for Americans.

Coverage

  • This legislation will cover over 94 percent of all Americans.
  • It will provide coverage to 31 million of America’s uninsured.
  • The bill will also expand rural and community health facilities.

Small Business

  • This legislation provides tax credits to small businesses, beginning in 2010.
  • These tax credits will health insurance more affordable for small businesses and their employees.

Insurance Reforms

  • Insurance companies will be held accountable, forced to spend more on care and less on padding their bottom line.
  • Insurers who excessively raise their rates will be barred from competing for your business in the Exchange.
  • Patients will have the right to appeal to an independent board if an insurance company denies a coverage claim.
  • Health insurers will offer national plans to Americans under the supervision of the Office of Personnel Management, the same entity that oversees health plans for Members of Congress.
Does this sound like the winning line to you?  Me neither.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

7 thoughts on “The DSCC needs a new sales pitch for health care reform”

  1. No one is more eloquent on the need to sell and explain Democratic policy preferences than digby at Hullabaloo.

    digby: "I think such pronouncements are as fatuous as those I heard just a year ago insisting that Barack Obama's election changed the face of politics as we know it. (It's funny to me that Chait condemns the liberals for being inappropriately cynical, when to me the problem is that they are almost always excessively ecstatic and prematurely triumphant — thus creating tremendous disillusionment when things inevitably don't turn out to be as wonderful as claimed. Different strokes, I guess.) If this bill turns out down the road to have been the greatest social schievement of our time, nobody will be happier than I am. But in the here and now, I wish everyone would be a little bit more cognizant of the political landmines that await and lower expectations just a tad."

    The process of collapsing collective choice, by means of a series of yes-no menus, sometimes makes it difficult for people to motivate themselves, and that results in too much motivational speechifying. RBC has been part of the "it's still a good bill, good enough to support and pass", and there's been a lot of shouting directed at we progressives and liberals, who support the bill, but also recognize that it isn't what we wanted, and — this is most important — doesn't look like it establishes the strategic high ground that's needed to survive in the subsequent back-and-forth of politics. For all we know, right-now is the zenith of liberal/progressive power, and this bill does NOT look to me like a policy designed to survive ten years of fighting with the Right. Authorizing subsidies isn't the same as appropriating the money, for example; enacting prohibitions on insurance company behavior isn't the same as enforcing them; containing costs isn't the same as hopeful pilot programs that might, or might not, be expanded upon.

    There's a disturbing pattern emerging across the board, on major policy issues: the People are losing to the Plutocracy. That's not crazy populism; that's an Obama foreclosure assistance program that assists almost no one; it's outrageous credit card interest rates; it's a vast military budget and a pointless war, and now it's a mandate for relatively poor people to buy high-deductible health insurance. It's a political scrum at midfield. If that scrum continues to move in the right direction, it will be fine.

    In health care, that will mean delivering generous subsidies, and mandating as "preventive care" (to which no deductible applies) a variety of necessary, social-welfare enhancing services. But, it also might mean yielding Lindsay Graham, who is worried about mandated increases in Medicaid spending in his State, which he notes, has a high unemployment rate and a 31% African-American population. (What Graham's concern about the proportion of his constituents, who form the darker race, in this context, might mean, is left to idle speculation.)

    I've had CNN on as background noise over the last few days. The Dem rhetoric aside, the CNN referee voice, over and over, has not been reporting Republican opposition. CNN's line is that the Republicans claim that the whole process has been rushed; Republicans, apparently, acknowledge the need for reform, just not this reform. And, that line is given the force, as I say, of the referee's voice, CNN's voice. Along with the repeated assertion, again in CNN's voice, that polls show that this particular policy reform is unpopular in the country. And, that's just the beginning. A News Media, which has never explained either the problem or the legislation itself, will also not report on Republican opposition to reform. It's two against one, so to speak, and the Democrats have not given themselves the strong fortress of a policy, simple in design or soon in execution.

    Democrats and progressives and liberals — none of us — can afford to be throwing temper tantrums, or blaming each other. That said, I think it hard to say whether or not our leadership is, in fact, doing the best it can in difficult circumstances, or throwing the game. Obama needs the support of a significant slice of the corporate plutocracy to govern — or apparently he thinks so. It is not clear that the either the Democrats or the country can survive and prosper under the policy design that results. Our coalition will have to manage that uncertainty about the trustworthiness and wisdom of our own leadership, as long as Larry Summers populism rules the day. A dark view is well-justified, on the facts, and optimism from folks, many of whom didn't think GWB all that bad, back in the day, bodes ill.

  2. " * The PPACA will reduce the federal deficit by $132 billion first ten years

    * In the second years, the bill will reduce the deficit by roughly $1.3 trillion.

    * This bill will result in a net tax cut for Americans."

    And you claim to belong to a "reality based community". What a joke.

    Congress taxes to the extent they think they can get away with, and spends to the extent they can get away with, and the difference is the federal deficit. The PPACA does nothing to alter either limit, and so will do nothing to alter the deficit. Kind of like that boost to SS taxes, which was supposed to be saved up for future SS expenses, but, predictably, got spent as it came in.

    Anybody who thinks it would work out differently this time has no claim to be "reality" based.

  3. Strange world. I have Cadillac coverage in two separate countries. I have enough in liquid assets to buy and pay cash for Cadillac care almost anywhere,

    yet I seem to be the only one that sees this as a piece of crap legislation. Unless you walk out of a hospital with more money than you had going in, the medical care system sucks. A hospital stay is not a fun and jolly time. The bills at home don't stop piling up while you are hospitalized. The taxes accumulate. A sudden cessation of income destroys a family. No one can predict when their turn in the barrel is coming.

    What I read about this legislation, mixed with what I know of insurance companies from the times that I worked for them as a temp, is this is some of the sleaziest pieces of crap since Ronald Reagan and his Secretary of Defense rebuilt the 5 battleships in the 80s.

    Anyone who can think and will stand up with a straight face and say that this is not a welfare for the rich bill needs to be locked up as insane.

  4. Well, this is thrilling: Apparently it's not enough that they're going to outlaw high deductible policies like I have, (So much for the promise I'd be able to keep the insurance I have now!) the new health care bill no longer permits health savings accounts to be used for over the counter medical purchases. It's prescription, or nothing.

    I eagerly await the explanation as to how this is really for my own good, and if I think otherwise, it's just false consciousness.

  5. "There’s a disturbing pattern emerging across the board, on major policy issues: the People are losing to the Plutocracy. That’s not crazy populism; that’s an Obama foreclosure assistance program that assists almost no one; it’s outrageous credit card interest rates; it’s a vast military budget and a pointless war, and now it’s a mandate for relatively poor people to buy high-deductible health insurance."

    Very well said.

    Also don't forget the subsidies are income-tested, not means tested.

    So a young person with $50,000 in income, no assets, and $120,000 in student loans will be subsidizing 55-year-olds living off the dividends of their $1 million stock portfolio, or their unearned home equity that exists in large part because of the gigantic housing subsidies that Obama has only made larger.

    I'll be looking at ways to resist the individual mandate any way I can. After having had insurance before, I will never deal with those slimy companies again.

    Mark's faith that passing a regulation means the insurance companies will actually follow all these new regulations is touching and child-like.

    "This legislation provides tax credits to small businesses, beginning in 2010."

    Just what small businesses need, more paperwork and hoop-jumping! Also: being forced to do business with big insurance companies. The bill sounds great for CPAs.

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