I think a number of assumptions (among other things) have fueled the insecurity on progressive blogs regarding health insurance reform. I think those assumptions are understandable based on what is commonly known about the players, but they're also based on various myths... and exist in part because there are other things that aren't common knowledge that I think would round out the picture.  In addition, sometimes when you're really following something closely, it's very easy to lose sight of the big picture. If you're operating on the wrong assumptions, then, your analysis is bound to be wrong, too.

It's understandable that bloggers would feel nervous or insecure about things, but it's no excuse for throwing out logic, common sense, and facts.

(Note this was mostly written prior to the leaks about the possibility of the bill being split up.)

Assumption 1: The WH Doesn't Really Want a Public Option
Assumption 2: The WH Isn't Involved in Writing the Bill
This is false. The WH really does want the public option. I've seen quite a bit on the blogs about talk v. action. So, let's look at the actions. If the Obama WH didn't want the public option, then, why did the WH (likely Rahm Emanuel b/c of his relationship with Schumer but it could be someone else, too) get Chuck Schumer to offer up the public option compromise several weeks ago as a way of getting more moderate Dems on board? Obama also wants to take care of Dodd politically, and last I checked, the HELP Cmte bill had a public option in it. While the WH is giving due respect to Congress as an institution, don't assume that they're not heavily involved. The Obama WH didn't write the legislation itself, but it did submit to Congress basic guidelines (that Obama campaigned on) which included the public option. In fact, on the stimulus and health care, the three versions of the House bill were crafted very closely to what Obama wanted. And for health care, guess what's in all bills that were crafted by the three House committees involved?

We may or may not get the public option in the end. I never thought the odds of it making it into the final bill were better than 50/50, but if we don't get it, it won't be because the WH didn't want it or fight for it. The only scenario where Obama signs a bill without a public option, is if there's no way that they can round up the votes in the Senate. And there are enough aspects of a bill without the public option that are not only good policy (even without the public option) and good politics, that Obama will have to sign it.

Assumption 3: The Hold up in the Senate Finance Committee is Solely About the Public Option
This is mostly true. The public option can't get out of the SFC, which is why co-ops became the issue. Still, even if the public option wasn't an issue, there'd still be something else for the WH and SFC to negotiate: MedPAC/IMAC and Medicare cost controls. The WH will accept a bill out of SFC if it doesn't have the public option but does have Medicare cost controls that the other committee bills don't have. Anything to get this into conference at this point.

Assumption 4: The Objections of Moderate-Conservative Democrats Is Solely Over the Public Option
Depends on which moderate-conservative Democrats we're talking about. It would be unsurprising if this were true for a few. Some will not be persuadable. Others will, but it will be because things that they wanted were put in the bill and because people (small business owners, doctors, nurses, etc. -- preferably from their district) that sat down with them to explain their reasoning -- not because of pitchforks. In the House, there weren't nearly enough moderate-conservative Democrats to kill the public option. As far as the Blue Dog caucus, what you saw was largely a split between representatives from urban/suburban districts (that voted for Obama) and representatives from rural districts (that voted for McCain). Even some of the representatives from rural districts weren't opposed to the public option per se. E&C Committee members did want a delay to make changes to the bill, but those changes made the bill stronger (according to Howard Dean). The delay was not just for policy reasons, but also for political ones. Democrats in red districts can't be seen as rubber stamps, and it's much easier to inoculate yourself form that charge if you impress upon their constituents that they've taken the time to consider everything and to extract concessions. The objections that some E&C members made was not over the public option itself.

Similar story in the Senate. Baucus and Conrad won't filibuster a bill that comes out of conference with the public option. They're even likely to vote for its passage. Co-ops came about because they realized that no amount of politicking was going to get the public option out of that committee.

That's not to say that Baucus and Conrad don't deserve some of the criticism that they've gotten. The lack of sharing of information and cutting out other Democrats on the committee was dumb. Conrad is being egotistical about his role. But they'll both probably end up supporting a final bill that includes a public option as long as there are no other sticking points for them.  The reason why there's so much heat on them is because there are other Democrats who really won't support a public option at this stage... and Baucus & Conrad are the ones tasked with figuring out a way around it.

Assumption 5: Obama is Controlled by Bad Advisers
I've seen people who think that Obama can't do anything right (Obama just caves to his advisers and the establishment!) and people who think that Obama can't do anything wrong (Don't blame Obama, blame [insert admin member]!) trot out some form of this. This is completely illogical. If Obama just did whatever his advisers told him to or was that wedded to the establishment he wouldn't have run for president in the first place and wouldn't have budgeted hundreds of millions for health insurance reform in his budget. Not to mention, WH staffers work at the pleasure of the president. Advisers are encouraged to give differing opinions and sometimes are encouraged to argue against their personal advice on whatever topic is at hand. It is ultimately Obama who weighs everything (including factors that almost never come up in the blogosphere) and makes the decisions. It's Rahm Emanuel's job to deliver on what Obama wants (Rahm was hired because Obama is a do-er, and Rahm is a do-er above all else). It's Jim Messina's job to deliver on what Obama wants. It's Phil Schiliro's job to deliver on what Obama wants. Not the other way around.

Assumption 6: WH Never Arm-twists
Assumption 7: WH Only Arm-twists Progressives
So I guess no one saw them (and Pelosi's team) whip a vote on ACES in the House? Rahm was one of the people twisting the arms of moderate-conservative Dems, BTW.

The bulk of the arm-twisting will happen when there's a floor vote, and the WH will be even more involved once it gets to conference.

Assumption 8: Rahm Emanuel is the Only WH Senior Staffer Who Talks to the Press and Congress
Assumption 9: WH Takes Progressives For Granted
I get why people don't like Rahm Emanuel, and I'm not going to disabuse anyone of the notion that he can be an asshole. But that's only part of the story and if something doesn't go your way or if something mean was said about some progressives, it doesn't necessarily mean it's him. It could be, but there are other administration officials who talk to the press. And there are other administration officials heavily involved in shepherding legislation through Congress. It's like people forget who Jim Messina, Phil Schiliro, Pete Rouse, and others are or that they even exist.

There are also various Obama advisers in the WH and from the campaign who know that some portions of the progressive infrastructure do stupid things. This isn't the same as contempt for progressives in general; indeed, the most powerful (re: largest) progressive organizations (which doesn't necessarily mean that these are the ones that get the most publicity in the blogosphere) are working closely with the WH on various parts of the agenda. (They helped whip the House votes on ACES, and are expected to help whip the vote in both chambers on health care, education and immigration as well.) The objections and criticism of some progressive organizations and organizers is in reference to the fact that some have in the past f-ed up and are f-ing up now. They're not tailoring their message, tone, and tactics to specific members of Congress and their constituencies. In addition, it's not just about tactics or even strategy. To use an example from last cycle, one progressive figure who many of you know (and you definitely know of some of the people he has worked with in the past) opened his organization up to investigation of violating campaign finance laws. I don't want to get too into the weeds, but it was basically a result of not doing due diligence.  So, while I have no illusions that from time to time, some of the hits that some progressive activists and organizations have taken are ideologically based, there are also many if not more times when the objections and criticism is based on competence. I've sat in meetings where the people I was working with and said that we wanted to help a progressive organization, but the organization couldn't come up with a realistic, sophisticated, tailored campaign plan to work off of. In another case, a progressive organization had no reliable accountability mechanisms for their field organizers. The lack of professionalism was appalling. It's one thing to have good ideas, but it's another to implement them properly.

Assumption 10: The Public Will Go To The Mat Over The Public Option
You can quote 76% of the public want the public option all you want, but general support for something that sounds good is not the same as the public willing to throw out the whole thing if it's not in the final bill. The only people who want it that badly are a subset of the blogosphere and some progressive activists.

If you think that there's a huge swath of people who voted for Obama specifically for the public option, then, show me the ad and the campaign lit that emphasized the public option. It's one thing to talk about your plan as one that will "reduce health care costs."  I looked at campaign lit from last cycle, and I see bullet points on stopping denial of coverage b/c of pre-existing conditions. I see bullet points on covering children and closing the doughnut loophole. Nothing specific about the public option.  Sure it was a part of the plan, but it wasn't emphasized specifically. If there are other mechanisms that will contribute to the reduction of health care costs, then, many Americans will basically say that Obama fulfilled his general pledge to Americans.

The right-wing is really stupid to assume that the public isn't open to the public option or that it's dead in the water with the public. Much of the current opposition is largely because the public has been sold misinformation by the right and much of the mainstream media.  It's also driven in part because Americans always get nervous when big change is being considered.  Approval when Americans realize what actually makes the final cut and after implementation. Bill Clinton, who is pretty good at politics when he's not wrapped in the bubble of his wife's presidential campaign:

"I'm telling you no matter how low they drive support for this with misinformation, the minute the president signs a health care reform bill his approval will go up. Secondly, within a year, when all those bad things they say will happen don't happen, and all the good things happen, approval will explode."

(DemFromCT is one of the very few bloggers who has emphasized that the polling on health insurance reform is conflicting and who has also tried to illuminate what the numbers are telling us.)

Assumption 11: Bipartisanship is a Fool's Errand
Bipartisanship for bipartisanship's sake is stupid. IA with that. This next section isn't directed at those who think that the WH has gotten all it can politically out of being bipartisan and should stop now; at least these folks understand that there is something to be gained with at least trying bipartisanship. This is directed at those who don't think the WH should bother to try and see no political value in it.

Many voters, especially swing voters, really do want bipartisanship, but when voters talk about bipartisanship, it doesn't necessarily mean that there is one Republican vote on every piece of legislation that Obama signs. (In other words, they don't mean what the traditional media thinks it should mean.) Many independents, especially, believe that one of the reasons why things don't get done in Washington, D.C. is because the two political parties don't at least talk to each other or take into consideration the other side. This actually is one way Obama won over swing voters. These voters don't necessarily believe that Obama himself will change the tone, but they do appreciate that he's thoughtful and tries to be considerate. It gives him leeway with the electorate. One of the reasons why Bush's disapproval ratings hardened (people didn't just disapprove of the job he was doing, they strongly disapproved... and his personal unfavorability ratings hardened, too) was because people thought he was just an asshole. Voters won't hear you out ever if they can't come up with any reason to like you.  While 30% of Americans are dead enders who hate Obama no matter what, the vast majority of Americans are at least open to hearing him out. And that is dependent on him projecting the image that he projects. It also political cover to enough moderate-conservative Democrats in Congress so that we have enough votes in the end.

There's one other reason why the WH works with and not against Congress. There will be many tough legislative battles after health care, and you don't burn your bridges unnecessarily.

So in sum, you might as well get used to it. The Obama WH always says that they're open to any good ideas. ALWAYS. Obama gets to look reasonable. If there are other ideas that are genuinely good ones that fulfill his broad goals and don't impede his other goals, then, he'll gladly accept them. It doesn't automatically mean that the WH is going to change their position. They'll only make as many concessions if Maybe they they have to. The WH wants to win. Remember, there's no one more competitive than Barack Obama.

Assumption 12: It Was So Easy For Other Presidents
George W. Bush didn't make any major institutional changes through legislation. The only thing comparable in scale and difficulty to what Obama is attempting to do on health care was Social Security privatization, and that died an early death.

LBJ mythology straightened out here. If you judge based on time, the Obama WH has worked at record speed in getting HCR to this point. That's not to say that there haven't been hiccups or delays (there have, of course), but anyone calling their entire strategy a dismal failure is simply ignorant or unwilling to give the Obama WH (and some Dems in Congress) any credit for anything. I mean if this passes, we're talking about the most significant piece of domestic legislation in decades. The idea that this wouldn't take some time, that there would be ups and downs, that there wouldn't be compromises that had to be made no matter how much no one wanted to make them and that we wouldn't get everything we wanted is ludicrous, given that no one has ever been able to pass universal health care. I also haven't seen any suggestions that haven't been tried in the past and haven't already failed miserably. Maybe those old, failed strategies and tactics would work now, but at least acknowledge that these old, failed strategies and tactics are not a silver bullet. Criticize soberly and realistically, but don't go off without considering everything. Speaking of strategy...

Assumption 13: There Is No WH Strategy, Or At Least No One Can Tell What It Is, Or It's Not Consistent
Obama WH's Broad Strategy (heavily modified from what AZDem posted):

  1. Co-opt the industries that killed previous bills, and work with progressive allies to build support for health insurance reform.  The AMA has fought EVERY health insurance reform bill from 1948 through 1994, and the hospital associations killed health care with "Harry & Louise" in 1994. Both organizations are on board with the WH.  PHRMA has teamed up with SEIU and Families USA to form "Americans for Stable Quality Care" to fund ads in support of health insurance reform. I've seen articles that say they'll spend up to $150 million, but in the past, I've seen various organizations claim that they were going to spend big money only to see actual spending come underneath that.  Even if it doesn't add up to $150 million, we should see several tens of millions of dollars spent. Patriot Majority has also gotten into the act in running radio ads in support. AARP also has a campaign in place to build support. Obama just did a conference call with faith groups. In addition, buy in from unions like SEIU and AFL-CIO as well as other progressive organizations has been key; they've been launching earned media campaigns and meeting with members of Congress. We've seen OFA2.0 recruit doctors and small business owners to the cause. This was all the first step in his health care campaign. Note that none of the stuff coming from these organizations are explicitly attacking reluctant Democrats. These ads are either general information ads designed to build support for the key planks in the plan, or are attacking insurance companies, Republicans, and conservative groups.
  1.  Get a House bill with real insurance reform, dual mandates, and a public option.
  1.  Get a Senate bill with real Medicare cost containment.
  1.  Go to conference.  This is where the White House really gets involved in shaping the bill.
  1.  Get enough votes in the Senate.  This is why it was essential not to alienate Republicans and Blue Dog Democrats.  That's what "bipartisanship" was about.

The basics of this isn't new for Obama. If you go all the way back to Obama's efforts on videotaping police interrogations, he worked to get buy in from interested parties (like the police unions and prosecutors and civic groups). He worked with legislators on both sides of the aisle to get the bill through committees and on to the floor. The bill ended up not facing any opposition which will not be the same case with health insurance reform, but the basic strategy is the same.

Barack Obama has a basic modus operandi. You don't have to like it. But if you understand the way the guy works, you'll be in a better position to figure out what the WH is aiming for and not get caught in the weeds and assigning random motives to actions that are fairly typical and expected. It's not selling out and it's not 11-dimensional chess. A lot of times it's just basic politics.

The Obama team's mistakes have largely centered on messaging. The WH really has been consistent on the public option. They do want the public option and have not wavered on their stance. The WH and surrogates have made the mistake of using different wording to describe the same stance. This creates confusion and makes it easy for the media to manipulate and take words out of context. Consistent wording would be helpful. Where the Dubya WH didn't care about policy, the Obama WH tends to get too wonkish for its own good. (But that's what happens when you have a president who actually reads and understands his briefings!) The talking points can sometimes sound too wonky and aren't easily digestible. Tweaking wording to take the wonk out of the messaging will clarify things for everyone.

Assumption 14: Obama Doesn't Get It Or Isn't Tough Enough
Obama is one "tough motherfucker" -- Democratic consultant to me.  He worked w/ the Obama campaign. The people who know the man will tell you that he's someone who "will make the call." Continual portrayals of him as 'naive' or not "getting it" or puppet of his advisers, are not based in reality. We already know that he's overruled advisers on various issues. On almost all of the big issues, Obama is with us and gets it. On almost all of the big issues, the problem is in Congress or some other institutional actor that makes the political reality more complicated than portrayed in the blogosphere. On almost all of the big issues, the focus should be on building support in the public and on the Hill for what we want... too much handwringing with regard to the administration and the usual back and forth is a waste of time, in most cases. If you're worrying about 'toughness,' then, you've misread Obama and you're wasting your time. I mean, there were people who didn't even vote for Obama who thought he was tough enough by virtue of him defeating Clinton in the primary. Even some of his former Senate colleagues grew to respect him (more) and his toughness throughout the campaign and this process.

None of this means that Obama and his team are infallible or that there aren't other agendas at work. Mistakes will be made. Missteps are inevitable no matter how talented anyone is. No one is asking people to stop being skeptical.  But there is a point, where cynicism overtakes logic and rationality.  There are a lot of people who take every bit of information that conforms to their viewpoint but ignore everything else that contradicts it. That's not the clear-eyed, comprehensive thinking that we need to get us through this and future legislative battles. If we're worried about things that we shouldn't be worried about or get sidetracked by things that are ultimately inconsequential, then, it makes us less credible, less coherent and less effective.

Originally posted to Newsie8200 on Thu Aug 20, 2009 at 07:06 AM PDT.

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