Thursday, March 18, 2010

An Inconvenient Truth

Yesterday, Ben Smith wrote an article suggesting that Rahm Emanuel was vindicated thanks to the vast progressive support for the final health care bill. While Chris Bowers made the valid point that Rahm lost the fight on the scope of the bill(wanting something less comprehensive), he was absolutely vindicated on one subject: Predicting that the left would cave and support the bill no matter what.

Glenn Greenwald:

For almost a full year, scores of progressive House members vowed -- publicly and unequivocally -- that they would never support a health care bill without a robust public option. They collectively accepted hundreds of thousands of dollars based on this pledge. Up until a few weeks ago, many progressive opinion leaders -- such as Moulitsas, Howard Dean, Keith Olbermann and many others -- were insisting that the Senate bill was worse than the status quo and should be defeated. But now? All of those progressives House members are doing exactly what they swore they would never do -- vote for a health care bill with no public option -- and virtually every progressive opinion leader is not only now supportive of the bill, but vehemently so. In other words, exactly what Rahm said would happen -- ignore the progressives, we don't need to give them anything because they'll get into line -- is exactly what happened. How is that not vindication?

Just consider what Nate Silver wrote yesterday in trying to understand why progressives have suddenly united behind this bill, in a post he entitled "Why Liberals (Suddenly) Love the Health Care Bill":

It has occurred in spite of the fact that the bill hasn't really gotten any more liberal. Whatever might come out of the reconciliation process will be marginally more liberal than what the Senate passed on its own, but still lacks a public option or a Medicare buy-in, and suffers from most of the same flaws that some liberals were critiquing in the first place. It might have helped a little bit to get the Senate bill off the front pages -- but the differences between the "Obama"/reconciliation bill and the Senate's December bill are fairly cosmetic.

In other words, the bill which many progressives were swearing just a couple months ago they could not and would not support (the Senate bill) is materially similar to the bill they're now vigorously supporting (the Obama/reconciliation bill). The differences are purely "cosmetic," as Silver says (it's even worse than that, since one of the few positive changes progressives could point to -- the Health Insurance Rate Authority, which would prevent large premium increases -- was just removed from the bill). Thus, from a purely strategic perspective, Emanuel was absolutely right not to take progressives seriously because he knew they would do exactly what they did: support the bill even if their demands were ignored.

It's hard to argue with that. As loathsome as that approach may be, if ideology was thrown out the window, it would be hard to argue that rolling the left wasn't the easiest way to pass any major legislation. Greenwald goes on to discuss how this approach is rooted in not understanding how negotiations work:

Moreover, everyone who has ever been involved in negotiations knows that those who did what most progressive DC pundits did here from the start -- namely, announce: we have certain things we'd like you to change in this bill, but we'll go along with this even if you give us nothing -- are making themselves completely irrelevant in the negotiating progress. People who signal in advance that they will accept a deal even if all of their demands are rejected will always be completely impotent, for reasons too obvious to explain. The loyal, Obama-revering pundits who acted as the bill's mindless cheerleaders from the start (this is the greatest achievement since FDR walked the Earth) were always going to be ignored; why would anyone listen to the demands of those doing nothing but waving pom-poms?

By contrast, progressives who originally threatened to oppose the bill unless their demands were met (such as Moulitsas, Howard Dean, Jane Hamsher, the Progressive House Caucus) absolutely did the right thing: that's the only way to wield power and to have one's demands be heard. And there's nothing necessarily wrong as a negotiating strategy with ultimately backing down from one's threats: it's normal and often effective in negotiations to insist that one won't accept a deal without X, Y and Z only, at the end, to accept a deal lacking some or even all of those elements on the ground that the deal on the table is the best one will ever get, and it's preferable to having no deal. The problem here is two-fold: (1) nobody (certainly not Emanuel) ever took the progressive threat seriously -- because nobody believed they would really oppose the bill even if they got nothing -- and it thus had no credibility and they were ignored; and worse: (2) nobody will ever, ever take progressive threats seriously again in the future, because they know that progressives will do what they did here: namely, get in line at the end and support what the Party wants even if none of their desired changes to a bill are made.

Talk Left's Armando, who is a long-time litigator and thus deals with these negotiation dynamics every day, has been making this point for months, and made a very insightful comment yesterday about all of this. He quoted Nate Silver pointing out that "at least five different parties effectively have veto power over the process, including the White House, the Blue Dogs (who cast the decisive votes in both chambers of Congress), and both the Floor and Committee Leadership," and then explained:

And there you have the progressive failure in political bargaining in a nutshell - no one EVER believed that progressive had veto power, or more accurately, no one ever believed progressives would ever EXERCISE veto power. That the progressives would be rolled was a given. Obviously that was an accurate view of the reality. . . .

Silver can not imagine a progressive bargaining position that threatened the passage of the health bills. No one could imagine it, even progressives. Until they can not only imagine it, but in fact project it in a political negotiation, progressives will remain irrelevant outside of Democratic primaries, when they will receive a plethora of campaign promises sure to be abandoned by pols. Cuz that is what pols do.

I think there is actually a counter example that anyone interested in bargaining can look to for a better result - the unions and the excise tax. The unions were willing to "kill the bill" unless they received major concessions on the excise tax issue. The White House wanted an excuse tax and serious and tough negotiations ensued, with the unions gaining major concessions.

The only reason why the unions were able to garner those concessions was because they were willing to, and were perceived as willing to, "kill the bill." They knew Obama wanted this health bill more than they did and that Obama would find a way to accommodate the unions' concerns on the excise tax.

The unions took the risk of killing the bill and were rewarded with major concessions on their key issue. That is how bargaining works.

Reasonable people can disagree on whether passing this bill advances or hinders the quest for real health care reform, but the what can't be debated is the progressive movement's failure to achieve any of their major goals throughout the process. That hasn't stopped the vast majority of the left from supporting the bill, strongly advocating for its passages and vilifying those who continue to criticize it from the left, even though some of them were making the exact same argument only 2 months ago.

Until we learns to negotiate, it would be foolish to expect the administration to start listening to any of our demands with any seriousness. Throughout the health care debate, they've made it clear that they value "winning" legislative battles more than just about anything else. If we'll fight like hell to help them get their win no matter substance of the bill, why should they take any of our demands seriously?


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  2. I think you're kind of missing the forest for the trees when you talk about the "progressive movement's failure to achieve any of their major goals throughout the process" Giving every American access to dependable and affordable health insurance not only qualifies as a "major progressive policy goal" but, at least I thought, one of the most basic progressive policy goals.

    The fact that we're 48 hours away from a bill that achieves universal access to health insurance is a HUGE progressive policy win. Serioiusly, do you think Blue dog dems and republicans give a shit about uninsured Americans?

  3. Maybe if the bill included a public option, it would guarantee every American access to affordable health insurance, but the current version of the bill does no such thing. If you're poor, you can qualify for government subsidies, but the middle class, which won't qualify, is screwed again. Insurance prices are not going to drop as a result of this bill.

  4. I had no idea that Republican talking point were good enough to convince even liberals.

    The senate bill has federal subsidies for families up to 400% of the federal poverty line (which would be something like over $70,000 a year for a family of three). It also limits out of pocket expenses on all health care plans sold on the individual market.

    The CBO says that, after these subsidies, people buying coverage in the individual market can expect to pay 55% less on premiums, 8% less in the small group market, and even without subsidies and tax breaks people in large group market would pay the same or slightly less than they do now. And that's before the reconcilliation changes, which improved the subsidies.

    I'm pretty sure the target is that no one should ever have to spend more than 10% of their income on health care. (It might be 15%, I can't remember now) Compare that with now, when people lose their homes and go bankrupt due to health care costs.

    The poor (up to 133% of FPL) won't qualify for subsidies but will instead be eligible for medicaid coverage.

    Its true that the regulation on insurers (insurers have to accept all applicants regardless of pre-existing conditions, limits on premium ratios based on age or gender) will cause premiums to rise intially. But there are actually really good efforts at long term cost control.

  5. @Dan:
    On the failure to achieve any of it's goals, let me expand a bit:
    Not that universal coverage wasn't a goal, it just seemed like it was lowest hanging fruit.

    Progressive Goals:
    -Universal Coverage
    -No pre-existing conditions/other reforms that would pass senate with 70 votes
    -Public option
    -Employer mandate
    -No tax increase on the middle class to pay for it.
    -End Insurance company monopoly
    -National exchanges

    Those were loosely the goals of the progressive movement going into this fight.

    By far, the two easiest goals there are the mandate (because no opposition from the insurance cos) and the changes in regulation (cause bipartisan Sens support it). The progressives got a few good things in the bill (Sanders' health clinics) but got rolled on all the other major goals.

    I've come around that this improves the status quo, and is worth passing, but considering what was possible I'm not going to be partying in the streets for a Democratic president and a Democratic congress passing Mitt Romney's health care bill.