.

[Bull Moose Base]

.

[War on Want]

It should help Obama. America loves Moderate Heroes.

[You kip if you want to...]

He's gotta start thinking which is worse. Angering the left (the base) by passing a bill with no Public Option, or angering moderates and indepentants by making it look like he's not doing anything.

[War on Want]

I think passing the Healthy Americans Act or something similar wouldn't piss off leftists too much but it would really please indies and moderates. Basically it would be very politically smart to pass the bill, it would show Obama is bipartisan and it would make the government look "efficent" by saving billions of dollars. In the long run it wouldn't reform the Healthcare system.

[Democratic Hawk]

Depends on whether or not it achieves its objectives expanding insurance for those uninsured and reducing costs

Where can a Democrat realistically govern from? I don't think its from the left. My advice would be to stear clear of cultural wedge issues (especially, gun control and abortion rights) for as long as he is president beyond repealing DOTA at some stage and don't raise taxes on the middle class. Rein in spending as soon as feasibly possible (emphasis, on feasibly)

Many editorials endorsed pragmatism in 2008 (especially those which swtiched from Republican to Democrat) and when he was elected opined that that was what Americans voted for. That could mean a desire for genuine bi-partisanship on major issues. There will be Democrats who want no compromises with Republicans. As for the myriad of Democrats in Congress, it's time they focused on what unites them instead of what divides them; while not all Republicans in Congress are dogmatoid arthritics

Larry Sabato, on BBC Election Night, commented that Americans are surprisingly non-ideological and that the center is pragmatic moderate

He'll be judged on his record. If the economy has rebounded nicely; there are no unpopular foreign wars or major scandals directly involving him - he wins. In the meantime, will the economy show tangible signs of improvement before the mid-terms? Will unemployment have fallen from where it is now? [And we all know that is a lagging indicator]

Obama's goal seems to be a realignment that is essentially center-left but, when all is said and done, he can only please some of the people some of time and not all of the people all of the time

Don't expect too much too soon - if you want to avoid disappointment

[Person Man]

I think we will be fine on Health Care and Abortion for the next few years. I don't care about or for Gun Control...at all...so I think this is the best thing Obama can do now and with his Congress beginning to go "my way or the highway", I think we can pull this off without much in the way of crippling comprimise.

[Padfoot]

As long as "mild healthcare reform" isn't perceived as a "do nothing" gesture I think Obama will still have the support of most Americans come 2012.  Average Americans just need to be able to see how the reform works.  It doesn't necessarily have to affect them on an individual basis but it is essential that they be able to understand what was accomplished.  Right now, I think the public is far more concerned with reducing costs than they are with covering the currently uninsured.  Whatever bill ends up coming out of Congress, Obama needs to be able to easily pinpoint and explain how it will reduce the cost of health care. 

This is why I think the health care debate has spun so wildly out of control.  Most Americans are unconvinced that Obama's plan is going to save any money while still providing quality care.  Plus, the Republicans have incited a panic by spreading dangerous and unfounded rumors about "death panels" and restricted access to those deemed "unworthy of care."  This brilliant political tactic on their part has made it nearly impossible for Obama to hold the kind of civil nationwide debate on the issue that he was hoping to have.

The president is going to have to show some backbone on this issue soon or risk losing this battle.  He needs to clearly articulate some specific policy changes in a compelling enough manner to seize the microphone back from the fear-mongering lunatics.  If he can't regain control over the media's attention without seeming flippant with regards to people's concerns this is going to end badly for him.

[GLPman]

At this point, given the recent reception of the plan among both the public and politicians (Democrat and Republican alike), I think that a moderate healthcare bill would be best.

[anvi]

A "mild" health care bill would work for the president.  Something with
the insurance reforms and co-ops will allow Obama to have some bragging
rights to expanded and enhanced coverage at relatively low government
expense.  It's a win, it's better than anything anyone else has done in
decades, it can sell to voters in the middle.  Plus, he can pledge to keep working
on it and garner further improvements in the future.  If the bill has effects
that people like in the short term, a plege for further reform will go over
better.  Furthermore, if the Senate passes such a bill, the House Democrats
have to let it pass too, otherwise they would be handing their own president a
defeat and that's not a winning formula for the midterms or a '12 reelect.
I understand completely why House Dems are pissed; I support a public
option and I'm not happy either, but if they are stupid enough not to let a
"mild" bill go through, losing their seats in the midterms would be the
appropriate reward.

All that having been said, what has happened to this reform effort this year
has been such a shame.  The Senate deal-maker Daschle is forced out of
the HHS nomination because he acted like a bonehead, Ted Kennedy's health declines,
making Baucus and Conrad the rulers of the roost on health care among Senate
Democrats, and then the provisions of the bill get intentionally distorted all to
hell and create a public fury.  Even the bill without the public option has some
good stuff in it, and if we can get that bill passed after all the terrible turns this
year, it will do politically.

[pragmatic liberal]

The problem is that the major Democratic proposals are pretty mild.

The American health care system is fundamentally broken. We pay far more than any other country on earth, while nearly 50 million are uninsured and tens of millions more are underinsured. We have far higher rates of medical errors and duplications than other countries. And our costs are skyrocketing. Add to that we have too few primary care physicians, there are arguably too few doctors, and existing doctors are being crushed by debt and medical malpractice insurance and you have a system that would ideally have radical change.

There are a few different ways you could do this. Single-payer is one, and contrary to rightist screams about "socialism" it tends to work very well. Or you could go even farther and, like Britain, have a single-payer/single-provider system (a true "socialized" system). However, you could also go the Wyden-Bennett route and, like The Netherlands and Switzerland, end the employer-based system and create a very heavily-regulated private insurance mandate. Another option would be to, like Singapore, create a universal catastrophic plan while creating universal HSAs with mandated savings and have most routine expenses paid for through those.

The problem is all of these options run into the problem that you're ending what people currently have. That has been the problem that has doomed all previous health care battles in the court of public opinion. Add to that the fact that major elements of these proposals are opposed by the insurance industry, the pharmaceutical industry, and portions of the medical establishment and combine that with the fact that our committee system and our election-funding mechanisms make many members of Congress tools of these lobbies and you have a system that is incapable of truly radical reform.

And that brings us to the current Democratic proposals. They start from the basic principle that if you like the insurance you have, you get to keep it - meaning you leave the employer-based system intact and do nothing to hurt it. Then you set two modest goals: expand coverage to the uninsured, and regulate the insurance companies.

The problem is that just to do those two things while preserving the employer-based system, you need to have other major elements. You can cover many of the uninsured by expanding Medicaid and SCHIP, but you need to cap their enrollment at some point because otherwise you'll get shifting from the employer-based system into Medicaid and SCHIP. (Besides, both programs are already taxing state budgets.) So you cap those but now you have a large group of people in the middle who are not eligible for Medicaid but don't get coverage through their employers. To provide for them, you (1) you need mandates - an individual mandate to prevent adverse selection and allow the insurance regulations (like community-rating) to work and an employer mandate to preserve the employer-based system such that people can keep their employer-based coverage. (2) You need some kind of risk-pooling for the individual market, because otherwise the individual mandate is going to be unaffordable - hence the "insurance exchange," a regulated market-place in a large pool (Mass. calls it "the connector"). And (3) you need subsidies because the costs will still be high.

That, essentially is exactly what the Democrats and Obama are proposing. Of course, there's the debate over the public plan, which is in some ways odd because Obama is correct that the public option has been so compromised already that it really isn't very significant at this point. And that doesn't get into the issue of financing. As for cost-control, this really does nothing more than begin a process whereby you can start controlling costs.

Ending the employer-based tax exclusion would be a start, but that has little support. The cynical reason is because unions oppose it. But the more honest reason is that it would probably result in many, many people having a short-to-medium term rise in costs. They may lose their employer-based coverage, and even with the exchange (the risk-pooling mechanism for the individual market), costs will probably not decline for sometime, meaning they may have to pay for a more expensive plan, and their income that goes to health coverage is now taxed.

And that's where the debate is. The Republicans' opposition to the proposal is completely out of proportion to what is actually being considered. I mean, as hysterical as Republican opposition to the Clinton health care proposal was in '93/'94, at least it was an actually radical plan. This plan leaves over 80% of Americans' health coverage completely untouched except making it more secure by banning abuses like rescission.

So I think liberals are right to draw a line in the sand and say that the House and HELP committee bills are as mild as can really be acceptable given how dire the health care situation really is. Both are pretty decent bills, but need to be understood as basically being quite moderate in the vast scheme of things.

I would say Democrats just need to muscle something through along those lines. If it has to be on a purely party-line vote, so be it. Failure would be the worst option of all, and anything more watered-down does run the risk of dampening enthusiasm. You could, theoretically pass something similar to what Kerry ran on 2004 - expansion of SCHIP and Medicaid, fixing the Medicare donut hole, creating an exchange but no mandate, and allowing people 55+ to buy into Medicare, while also introducing some new regulations. That would reduce the number of uninsured but it would be at best a short-term fix, because it would do nothing to address the structural issues that are causing the problem of the uninsured, nor does it really do much to address health care costs. And without a mandate, the insurance regulations would be fairly weak.

If something weaker than the current House and HELP committee bills get through, I do think it would hurt Obama politically in the short-to-medium term. It would probably make the rest of his legislative agenda through 2010 much more difficult. Cap and trade would most certainly be dead, his financial regulatory proposals would face a more hostile climate, and his approval ratings would probably sag.

That being said, the 2010 midterms may depend more on the state of the economy, so if growth has rebounded and at least the initial effects of the "mild" health care reform proposals are okay, then the results may be adequate - perhaps only mild Democratic losses. And I suspect he'd be on track to win a 2012 reelection.

[Democratic Hawk]

Of course, as we all know, the most moderate of Democratic proposals are deamed radical by the dogmatoid Right, who are pretty ept when it comes to playing psychological warfare by tapping into peoples' anxieties of "change". Result: caution on the part of many Democrats. Democrats were bold in 1932 (the 'Great Depression' discredited Republicans) and 1964 to be sure. FDR and LBJ had thumping mandates and even then LBJ overreached with his 'Great Society', but what you have today is essentially a center-left Democrat (Obama is no radical) - a mainstream Democrat - leading what is pretty much a center-right nation, in so far conservatives outnumber liberals in the electorate

Among the worst things to have happened to the Democratic Party was their adherence to a model of welfarism that was perceived as rewarding "idleness over work" - and that drove the white working class (long the stalwarts of FDR's 'New Deal'), among other things, into the arms of the Republicans. FDR's vision of welfare was that of a safety net. Isn't the way forward for Democrats to bring the white working class back into the fold?

Indeed, realistically, there is no going back to pre-Reagan tax rates or a welfare state which rewarded 'idleness', or anything remotely reminiscent of a mixed economy

George W Bush's rampant fiscal favoritism towards the richest, partially, explains why the economy hit the crappers to the extent that it did given that median income households were not the major beneficiaries of economic growth. The Nixonian, Kevin Phillips, is very critical of both Bush presidencies on that score

No economy can be on secure foundations when those who form the backbone of it - the middle class - in, real terms, fall behind and severe as the 'Great Recession' is there has been no ideological realignment. Conservatism endures but bear in mind that conservative Democrats tend to be more socially, than economically, conservative; hence, another reason for caution on wedge issues, like guns and abortion, on the part of Obama and the Democrats in terms of their legislative agenda

Yet many feel Democrats need to drop the culture of caution. I recall Margaret Thatcher and the Conservative Party, in the early 1980s, at the height of the worst recession prior to this one, when they were languishing in 3rd place in the polls behind the then SDP/Liberal Alliance and a badly damaged Labour Party (riven by infighting with ineffective leadership), which prompted her to say at her party conference, in response to being urged by party "wets" to u-turn on major initiatives, "You turn if you want too, the lady's not for turning"

Of course, the American system is very different

[Obnoxiously Slutty Girly Girl]

But I think one can govern from the Left on specific issues where public opinion allows.  I think healthcare is (or was?) one of those.  A solid majority was in favor of an option for government insurance.  I guess the insurance lobby has seen dividends from their investment in trying to confuse and scare the public away from it, with big help from Republican fabrication of things like "death panels" that the media don't challenge.  Just as they did from their Harry and Louise ads from the 90s.  But if effectively countered, I think you could govern more to the Left on that particular issue without losing the middle of the country.

Likewise on abortion, the "center" is fairly left.  A strong majority favors preserving choice in most circumstances and opposes overturning Roe v Wade.  Stem cell research as well, one can govern from the Left with little cost.

A "strong majority" favors government insurance and abortion? What a joke.

Must be nice just making up bullsh**t as you go along.

http://chppr.iupui.edu/research/govtrolesurvey.html

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http://www.gallup.com/poll/118399/More-Americans-Pro-Life-Than-Pro-Choice-First-Time.aspx?version=print

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But I do hope Obama continues to push these policies- and thus continues to push Americans away from him in time for 2012.