Of course this has nothing to do with the actual merits of the current health proposal in the Senate, but I see that some blogs think it is relevant that Howard Dean's position on the regulatory aspects of the Senate bill may have changed. In the spirit of comity, I would ask then that the President of the United States' change of position on the individual mandate from his stated position in his campaign for the Presidency be considered:

The argument about the evil of the individual mandate is all wrong. It was wrong during the primaries, when Obama unfortunately used it to demagogue his rivals [. . .]

Now that is from Paul Krugman arguing for passage of the Senate bill. Krugman does not consider Obama's flip flop on the issue relevant. Neither do I. (d-day does. He's wrong imo.) Some people apparently see Howard Dean's alleged change of position as relevant to the substance of the bill. I do not.

Speaking for me only

This time from David Axelrod:

“To defeat a bill that will bend the curve on this inexorable rise in health-care costs is insane,” Axelrod said on MSNBC’s “Morning Joe.” "I don’t think that you want this moment to pass. It will not come back."

Leaving aside the new fighting spirit out of the White House (apparently even the docile Obama likes punching DFHs), Axelrod's comment makes no sense. This bill's selling point to progressives is its cost cutting features? Really? Forget for a moment that Axelrod is FOS on the "cost cutting," I thought the more effective pitch was the provision of health insurance to the less well off. Moreover, if this is THE moment, as Axelrod states, this argues for fighting for more now, not accepting the lousy bill you have. The once vaunted No Drama Obama Team is really off its feed these days.

Speaking for me only

Last night, I mentioned this excellent post by Ed Kilgore. I want to delve into it a bit more and I will use Matt Yglesias's post on it as an entry point. Matt writes:

Kilgore writes that “sorting out these differences in ideology and perspective is, in my opinion, essential to the progressive political project.” I’m persuaded that acknowledging the existence and principled nature of this difference of opinion may be crucial. But I think the solution is less to sort them out, than to simply problematize the distinction. At the end of the day, no matter what people think they think, nobody remotely sensible actually holds a pure strain of either of these views.

This is absolutely true. Take health care for instance. No one who is for the public insurance program approach opposes the "regulatory reform model" because their ideology leads them there. They are skeptical that it will work. They believe that the government insurance model is the reform that will work for the U.S. Not the regulatory model (and certainly not the regulatory model proposed by the current bill.) More . ..

Ezra Klein cites Paul Starr arguing for some last minute bargaining on health care:

[T]here should be one last effort to incorporate some of the stronger provisions from the House in the final Senate bill.

Ha! You can not simultaneously scream at the top of your lungs that it would be crazy to not vote for the bill and then say we should go back and negotiate some more. I'm pretty sure the folks on the other side of the table have figured out that you are going to capitulate on the point by now.

Speaking for me only.

Ed Kilgore, who I am friendly with, writes a very good post that I want to riff off of in a post tomorrow (about the different conceptions of effective reform for health care). But I want to highlight now a key point he makes:

[I]deology, however muddled, is part of what makes most politically active people tick. And if we don't talk about it--and about differences in strategic thinking as well, which should be the subject of future discussions--then all we are left with to explain our differences on this issue or that is questions of character. And anyone paying attention must recognize there's far too much of that going on.

Ed's right. And I am as guilty as anyone. For now, I will stop it and will instead stick to the policy and the politics. More . .

Not surprisingly, Village blogger Ezra Klein recommends these 20 Questions from Nate Silver. I thought about answering them (though most of them showed a complete ignorance regarding the nature of the debate on health care reform this year (disingenuous too - Silver asks how insurance company profits MARGINS will grow instead of asking about profits)), even though I am undecided on the Lieberman Bill. Until I read Question 20:

20. How many of the arguments that you might be making against the bill are being made out of anger, frustration, or a desire to ring Joe Lieberman by his scruffy, no-good, backstabbing neck?

In the word of Ezra, sigh. That someone could insinuate today that the arguments made by rational, intelligent, thoughtful people are a result of anger about Lieberman instead of from firmly held, reasonable and LONG HELD views, demonstrates that that person is a dilettante who just started paying attention in the last few days. It tells you a lot about Silver and Klein that they think these are good questions.

Update below:

Glenn Greenwald on MSNBC this afternoon:

Good to have Glenn making some key arguments on this issue.

Ezra Klein writes:

The key to cost control is a politics that forces Congress to make the hard decisions that lead to cost control. Right now, the ranks of the uninsured grow, the cost of insurance rises, and Congress can pretty much ignore the whole thing. The individual mandate controls average premium costs, but more than that, it is the political mechanism for cost control. Kill it, and you've killed our best hope of making the next reform better than this one.

The next reform? Ha! Actually, Ezra has it precisely backwards.The mandate is the bargaining chip necessary for putting health care reform on the table. We are not getting reform in this bill and if you give up the mandate now you will NEVER get reform. [More...]

While something called "health care reform" will be passed, it's pretty clear now that there will be no real reform in the bill. If there is good remaining in the bill, it will be Medicaid expansion and subsidies for less well off person to purchase minimal insurance.

How can you get the good in this bill and still have a chance for health care reform in the future? The mandates are a sticking point of course. They are the lever for the political bargaining that might make health care reform possible in the future. But there are others. Ben Nelson is not done yet and Bart Stupak is still waiting in the House. The problem with the subsidies is that they are going to be channelled through exchanges which will be subject to a Stupak Amendment. The current bill makes that too bitter a pill to swallow I think.

There is a solution to these problems I think. Instead of channeling the subsidies through the exchanges, eliminate the exchanges and make all persons who would have been eligible for the exchanges able to use their subsidies to purchase Medicaid. More . . .

Greenwald mentions this in his article I posted on earlier, a WaPo poll:

Do you think the government should or should not expand Medicare to cover people between the ages of 55 and 64 who do not have health insurance? Do you feel that way strongly or somewhat?

The result is 63% favor, 33% oppose.

Ezra Klein:

[I]f I could construct a system in which insurers spent 90 percent of every premium dollar on medical care, never discriminated against another sick applicant, began exerting real pressure for providers to bring down costs, vastly simplified their billing systems, made it easier to compare plans and access consumer ratings, and generally worked more like companies in a competitive market rather than companies in a non-functional market, I would take that deal.

Me too. Call us when that deal is offered. Of course, Ezra is arguing that that is the deal being offered - "And that may be the exact deal we're getting." It isn't. More . .

"'Health Care Reform' has only suffered a flesh wound." - Village Bloggers (h/t KD commenter.)

As part of the Village Bloggers' attack on Howard Dean, I enjoyed our friend Kevin Drum's turn of phrase:

If healthcare reform dies this year, it dies for a good long time.

If? Oh. I see. The Senate bill is "health care reform" for Kevin. Let's count the reasons why: