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Barack Obama Criticism Health care Politics The Opinionsphere

Draw Your Own Conclusions

Matthew Continetti:

Scott Brown’s victory exposes NY-23 as a fluke. The trend is clear. Independents have moved sharply right over the course of President Obama’s first year in office, even in Massachusetts.

Matt Bai:

The most prevalent ideology of the era seems to be not liberalism nor conservatism so much as anti-incumbency, a reflexive distrust of whoever has power and a constant rallying cry for systemic reform.

Mike Allen:

By these lights, impatience with the status quo — rather than any rightward turn in the mood of the electorate — is what would fuel a Brown victory.

Jonathan Chait:

But political analysts are more like drama critics. They follow the ins and outs of the tactical maneuverings of the players, and when the results come in, their job is to explain how the one led to the other. If you suggested to them that they should instead explain the public mood as a predictable consequence of economic conditions, rather than the outcome of one party’s strategic choices, they would look at you like you were crazy. They spend their time following every utterance and gesture of powerful politicians. Naturally, it must be those things that have the decisive effect…

Barack Obama:

Here’s my assessment of not just the vote in Massachusetts, but the mood around the country: the same thing that swept Scott Brown into office swept me into office. People are angry and they are frustrated. Not just because of what’s happened in the last year or two years, but what’s happened over the last eight years.

David Leonhardt:

The current versions of health reform are the product of decades of debate between Republicans and Democrats. The bills are more conservative than Bill Clinton’s 1993 proposal. For that matter, they’re more conservative than Richard Nixon’s 1971 plan, which would have had the federal government provide insurance to people who didn’t get it through their job.

Today’s Congressional Republicans have made the strategically reasonable decision to describe President Obama’s health care plan, like almost every other part of his agenda, as radical and left wing. And the message seems to be at least partly working, based on polls and the Massachusetts surprise. But a smart political strategy isn’t the same thing as accurate policy analysis.

Categories
Barack Obama Domestic issues Health care Politics The Opinionsphere

Are The Pieces Aligning on Health Care?

[digg-reddit-me]David Brooks’s column is quickly becoming one of the most insightful, inside looks at the larger plans of the Obama administration (which suggests a column kneecapping Obama is forthcoming so Brooks can maintain his conservative cred). His latest column is practically gushing – but it certainly paints a plausible picture of what the Obama administration sees as it’s game plan on health care. Brooks starts his piece with this half-jesting, half-admiring set-up:

Let’s say that you are President Obama. You’ve inherited a health care system that is the insane spawn of a team of evil geniuses from an alien power. Pay is divorced from performance. Users are separated from costs. Rising costs threaten to destroy your nation and everything you hold dear.

You also know that [the only] two approaches [to actually fixing this] have one thing in common. They are both currently politically unsellable. Others have tried and perished. There are vast (opposing) armies arrayed against them. The whole issue is a nightmare.

You are daunted by the challenges in front of you until you remember that by some great act of fortune, you happen to be Barack Obama. This calms you down.

He then goes on to describe a strategy which runs like this:

  1. Table-setting. Court everyone – get everyone to the table and agreeing on some basic meaningless “pablum.”
  2. Congress. Ask Congress to put something together, keeping your distance as they investigate and write many competing proposals.
  3. The Long Tease. Refuse to rule anything out or commit to anything – thus keeping all the interest groups at the table.
  4. The Scrum. At the end of the summer session, when Congress actually begins to assemble health care in a series of all-night sessions, take a stronger role. But be willing to compromise. This scrum needs to end quickly – and send the bill off to be passed before the interest groups have time to realize who has and hasn’t been taken care of.
  5. MedPAC. Include in the bill this medical equivalent of the Federal Reserve – an independent, technocratic body to oversee the industry. This is where the real reform will stem from.

This scenario sounds plausible – although a David Brooks column explaining it would seem to undermine the strategy itself.

So far, the Obama administration has been extremely impressive in how it has managed the health care debate. They make it seem as if things really are going according to plan so far – an extraordinary thing given the history of Washington and health care. For example, Ezra Klein provided some insight into why the American Medical Association quickly retracted it’s direct opposition to a public option in the health care debate, citing this Roll Call piece:

Top aides to Senate Finance Chairman Max Baucus (D-Mont.) called a last-minute, pre-emptive strike on Wednesday with a group of prominent Democratic lobbyists, warning them to advise their clients not to attend a meeting with Senate Republicans set for Thursday.

[Meeting] with a bloc of more than 20 contract lobbyists, including several former Baucus aides…“They said, ‘Republicans are having this meeting and you need to let all of your clients know if they have someone there, that will be viewed as a hostile act,’” said a Democratic lobbyist who attended the meeting.

“Going to the Republican meeting will say, ‘I’m interested in working with Republicans to stop health care reform,’” the lobbyist added.

Ezra Klein explains what this means:

They’re saying that you’re either with health reform, or you’re against it. And if you’re against it, you can’t expect to be taken care of in the final legislation. They’re not going to save your seat at the table while you’re trying to burn down the room. And the AMA, it seems, got the message.

This hardball strategy with interest groups plus the extraordinary wooing of legislators by the Obama administration that Matt Bai described in a piece this Sunday, the general agreement among most Americans including business interests that our health care system is broken, the impending deficit crisis, Obama’s mandate, and the unusual role ultra-conservative Orrin Hatch appears to be willing to play to help his good friend Teddy Kennedy achieve a dying wish (Suzy Khimm in The New Republic describes it as, “a particularly senatorial way to pay tribute to a dying friend.”) – with all of these pieces falling together, the Democrats may finally be able to achieve what Harry Truman started all those years ago.

[Image by JonathanHannpberger licensed under Creative Commons.]

Categories
Barack Obama Economics Financial Crisis Politics The Bush Legacy The Opinionsphere

Obama’s Grand Bargain (as a necessary response to the deficit problem)

[digg-reddit-me]David Leonhardt has a typically excellent piece in the Times with a helpful graph explaining the deficit problem. Leonhardt tells the story of how the $800 billion surpluses left by Bill Clinton have turned into $1.2 trillion deficits – or what he calls the “$2 trillion swing.” He identifies four categories of spending accounting for the swing in descending order of significance:

the business cycle, President George W. Bush’s policies, policies from the Bush years that are scheduled to expire but that Mr. Obama has chosen to extend, and new policies proposed by Mr. Obama.

Leonhardt identifies only 10% of the current deficit as resulting from either Obama’s stimulus package or new spending (which is only 3%). 20% of the deficit is traced to Bush policies set to expire that Obama is continuing – for example, a large portion of Bush’s tax cuts and the Iraq war. 33% comes from legislation signed by Bush – like the Medicare prescription act. And Leonhardt attributes 37% of these enormous deficits – the single largest factor – to the combination of increased counter-cyclical spending (on food stamps, unemployment, etc.) and a decrease in government revenues resulting from the downturn.

This math is a large part of what made those Tea Parties – as well as so much of the Republican opposition – ridiculous. First, these Tea Parties – and most of the opposition – was silent while George W. Bush pushed through legislation account for 53% of the current deficit – but suddenly was up in arms once a Democrat proposed 10% in spending to stimulate the economy and fix some significant problems. At the same time, many of those conservatives who were strong opponents of Bush continue to propose more tax cuts. In fact, during the debate over the stimulus bill, Republicans denounced the deficits being caused by government spending while proposing a tax cut bill that would create even large deficits.

What Leonhardt describes is a nation that has been subjected to the conservative “starve the beast” strategy of cutting taxes and increasing spending. This deliberate policy has brought us to the brink of disaster – as George Will describes:

For years, many conservatives advocated a “starve the beast” approach to limiting government. They supported any tax cut, of any size, at any time, for any purpose, assuming that, deprived of revenue, government spending would stop growing. But spending continued, and government borrowing encouraged government’s growth by making big government cheap: People were given $1 worth of government but were charged less than that, the balance being shifted, through debt, to future generations. In 2003, Republicans fattened the beast with the Medicare prescription drug benefit (Cooper opposed it), which added almost $8 trillion in the present value of benefits scheduled, but unfunded, over the next 75 years.

Liberalism’s signature achievement — the welfare state’s entitlement buffet — will, unless radically reduced, starve government of resources needed for everything on liberalism’s agenda for people not elderly. Conservatives want government limited, but not this way.

Leonhardt quotes Alan Auerbach, an economist at the University of California, Berkeley,

Bush behaved incredibly irresponsibly for eight years. On the one hand, it might seem unfair for people to blame Obama for not fixing it. On the other hand, he’s not fixing it.

And not fixing it is, in a sense, making it worse.

I think Andrew Sullivan has the right tack on this:

I don’t blame Obama for failing to turn all this around in five months, and for running a debt this big right now. I willblame him if he does nothing serious to tackle this in the next year.

Leonhardt has been a reporter with good access to the White House in these early days of the presidency. Which suggests that this article is not coming out of the blue for this administration. In fact, shortly before taking office, Obama talked about the “Grand Bargain” he would need to negotiate to deal with precisely this issue. It seems to me that this piece begins to set the stage for what Obama is looking to do after cap-and-trade and health care are passed – to tackle the issues of tax reform and entitlement reform.

All this makes his continued and extraordinary attempts to woo members of the House and Senate – and his efforts to give them a role in determining policy (as described in Matt Bai’s new article) – essential. As Bai describes:

“One of the mistakes of the past is that when presidents arrive on Capitol Hill with legislation chiseled into stone, it’s not well received,” says David Axelrod, one of Obama’s most influential advisers. “You have to give people a sense of ownership.”

Obama seems to have decided early on that his model for pursuing legislation would be something closer to Ronald Reagan, a president whose political savvy he has often expressed admiration for. Partly by necessity, because he had to work with a Democratic Congress, Reagan was known for providing broad policy frameworks while delegating the details to lawmakers. In this way, he managed to fundamentally reform the tax code and shore up Social Security during his first year in office — achievements for which he gladly took credit, even if Congress didn’t give him precisely what he wanted. To this end, Obama’s chief health care adviser, Nancy-Ann DeParle, has been all over Capitol Hill, consulting with various members and soliciting their advice, but the administration has been careful not to weigh in with too much authority or to make any public pronouncements on the negotiations.

Obama may have been able to push through health care and cap-and-trade with his Democratic majorities and personal popularity. But he needs the Congress and Senate to work with him on tax reform and entitlement reform once the financial crisis has been dealt with. Or perhaps sooner – as the bond market pressures the administration to set a clear path which involves a return to fiscal sanity.

To do this, Obama needs the trust and support of a large majority of Congressmen and Senators. And he needs to mobilize public and elite opinion to support a significant change in our tax and spending policies. This article by David Leonhardt strikes me as an attempt to set the stage for this soon-to-be debate.

[Picture by Peter Souza courtesy of the White House.]