Palliative Care

The more being said about health care by members of Congress, the less likely it looks like anything at all will pass.

At the Atlantic, Marc Ambinder notes the alarm bells from Klein and Cohn, and can’t resist pointing out the irony that “the honest numbers [from the CBO] — and maybe the tougher-than-expected numbers — are the result of Orszag’s determination to get health care financing right — from the POV of the legislative branch.”

That would be Peter Orszag, previous head of the CBO, now the president’s budget director.

According to a report by Kaiser Health News quoted by Ambinder, Orszag did some heavy lifting at CBO to insure it was ready for the health care debate:

Orszag, anticipating the big push by the new president for health care legislation, beefed up the agency’s staff with health care economists and ordered a new, high-speed computer to run a complex health insurance microsimulation model that analyzes health care proposals and their budget impact.

All of which apparently means CBO can deliver numbers that have inspired another run at the plan to use reconciliation process for passing reform. As Ambinder reports, “a group of centrist House Democrats and Republicans will hold a joint press conference today to formally oppose using budget reconciliation rules to pass the financing portion of reform.”

Once the president’s reputed allies in Congress are teaming up with his opponents, it brings the conversation back around to the usual question: What’s Obama going to do now?

At the Democratic Strategist, Ed Kilgore says, “It’s becoming increasingly obvious that the President will need to spend some serious political capital in convincing both Congress (especially nervous Democrats) and the public that we can’t afford to put off health care reform any longer.”

In another post at the Democratic Strategist, former Clinton pollster Stan Greenberg concurs:

At the moment, the country is tilting toward enacting Obama’s reforms, and it will do so more enthusiastically if Obama learns from the Clinton experience and rises to the educative role that he relishes. He must respect the thoughts, feelings and calculations of ordinary citizens who are not easily spun on important issues. People will take out their calculators when he lays out his plan, and he can’t avoid speaking candidly about its costs and consequences. And he can’t forget that he has a big story to tell about a changed America, one in which health care is but a pile of bricks in the new foundation he is laying.

Obama has scheduled a nationally televised town hall on health care next Wednesday, June 24. And as Nate Silver at Fivethirtyeight notes, the public is still with him on reform. But it is going to take a bigger effort, says Silver, than just one meeting:

So far, there is no sign of erosion in the public’s support for health care reform. And the Administration appears poised to begin doing some more explicit advocacy for the legislation, beginning with a one-hour national forum on June 24th. But it had better be prepared for that town hall meeting to be a start of a trend, because history suggests that leaving a health care bill unattended before Congress is just about the worst place for it to be. . . .

This has been an extremely cautious White House to date; they have scrupulously avoided doing anything that might ruffle Congressional or public feathers and they are probably afraid of gambling on a specific plan and losing. But as Neville Chamberlain learned long ago, and Spock learned in the latest version of Star Trek, caution does not always equate with safety. It is time for the White House to take hold of this debate and not let go.

And let's face it, Obama's record on getting Democrats to go along on things they are jumpy about is next to zilch...cramdown, Gitmo, DADT...all are stalled or dead. His record on actual reform so far, judging from his job on the financial sector? Equally disappointing.

Three quarters of Americans want a public health care option if only for the government to keep the insurers honest (and the insurers' profit motivation to keep the government plan honest.) But the insurance giants will never tolerate it, and the GOP knows if it passes, they're the minority party until 2032 or something.

It's increasingly looking like the Democrats don't want the plan either. 76% of Americans want a public insurance option. But what America wants doesn't matter...it's what the insurance companies and Big Pharma can get out of Congress. In the end, it's the Democrats who will kill health care reform, not the Republicans. We're seeing Obama lose control of the argument. Much like the stimulus package, he's going to have to throw everything he has and more at his own party to get them to do America's business.

[UPDATE] Bob Cesca nails it in one.

Another fascinating number from the NBC/WSJ poll. These are the people the Democrats appear to be afraid of:

25 percent hold a favorable view of the Republican Party, which is an all-time low for it in the poll. 45 percent hold a favorable view of the Democratic Party.

So here we have a public health insurance plan which 76 percent of the American people support. The Republicans, who are against the plan, have a 25 percent approval. And the Democrats, meanwhile, don't give a rip about the 76 percent who want it, they're afraid of the 25 who don't want it.

And that's just sad. If we can't pass health care with 60 Senate votes and a 70+ margin in the House and a President with a 60%+ approval rating, when Republicans are literally as unpopular as they have ever been, then there really is no hope for reform.

Big Pharma owns Congress. Big Finance owns Congress. What the American people overwhelmingly want does not matter to our elected representitives in Congress. It's up to Obama now, for whatever that's worth.