Progressive Breakfast: Is Health Care Reform a "Done Deal"?

"Deal" Is Announced, And Congress is "Gone 'Til September"

Call it a call it a breakthrough, or call it a betrayal (and it will be called many things during the next month or so), but a deal has been made on Capitol Hill, concerning health care reform. Whether it's a "done deal" or not depends on what happens between now and September. NY Times: Efforts to pass sweeping health care legislation took a big step forward on Wednesday as House Democratic leaders reached an agreement with fiscally conservative party members that would cut the bill’s cost and exempt many small businesses from having to provide health benefits to workers. Under the House agreement, the federal government would still establish a public insurance plan to compete with private insurers, but the public plan would not use Medicare fee schedules to pay doctors and hospitals, as envisioned in the original House bill. Instead, the public plan would negotiate rates with health care providers, as private insurers often do. Representative Mike Ross of Arkansas, the chief negotiator for the fiscally conservative Democrats known as Blue Dogs, said the changes were “a huge win for us.” Meanwhile the Senate is pushing the health care exchange model.

The Times also reported that a Texas Hospital that also happens to be "one of the largest sources of campaign contributions to Senate Democrats" flexed considerable muscle in the health care reform debate this week: "One of the largest sources of campaign contributions to Senate Democrats during this year’s health care debate is a physician-owned hospital in one of the country’s poorest regions that has sought to soften measures that could choke its rapid growth. The Democratic Senatorial Campaign Committee collected nearly $500,000 at a reception here on March 30, mostly from physicians and others affiliated with Doctors Hospital at Renaissance, financial disclosure records show. ... The hospital, which is in Edinburg, adjacent to McAllen, is working both sides of the aisle. Its political action committee, Border Health PAC, split $120,000 last year among House and Senate candidates, including Republicans. Although Congressional negotiations over health care legislation are continuing, Doctors Hospital seems to be getting much of what it wants. Thus far, physician-owned hospitals have been insulated from some of the most onerous potential restrictions in the health care legislation moving through Congress."

The deal has, predictably, sparked criticism from progressives who deem it a betrayal. Politico: "House Speaker Nancy Pelosi spent half of Wednesday finalizing a deal with the Blue Dogs — and the other half quelling a brewing rebellion among progressives who think conservatives have hijacked health care reform. Liberals, Hispanics and African-American members — Pelosi’s most loyal base of support — are feeling betrayed after House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) reached an agreement with four of seven Blue Dogs on his committee who had been bottling up the bill over concerns about cost. 'Waxman made a deal that is unacceptable,' said Rep. Jerrold Nadler (D-N.Y.), one of about 10 progressives who met repeatedly with Pelosi and Majority Leader Steny Hoyer (D-Md.) on Wednesday. 'We signed a pledge to reject any plan that doesn’t include a robust public option, and this plan doesn’t have a robust public option,' he added. By sundown Wednesday, the outcry from the left had become so loud that Waxman was forced to scrap a scheduled markup of the compromise measure. He rescheduled the meeting for Thursday morning and convened a mass question-and-answer session for a deeply divided Democratic Caucus — a meeting that is expected to be extremely contentious."

The deal and today's raucous caucus among the Democrats may stem from the Republicans plans for what Politico called an "August health blitz" — in which the opening shot may have been the $700 billion health care plan introduced by House Repulicans — amid what Politico (again) called "mounting danger" for Democrats in 2010: "Democrats giddy with possibilities only six months ago now confront a perilous 2010 landscape signaled by troublesome signs of President Barack Obama’s political mortality, the plunging popularity of many governors and rising disquiet among many vulnerable House Democrats. The issue advantage has shifted as well, with Democrats facing the brunt of criticism about the pace of stimulus package spending, anxiety over rising unemployment rates and widespread uneasiness over the twin pillars of Obama’s legislative agenda: his cap-and-trade approach to climate change and the emerging health care bill. Bolstered by historical trends that work in the GOP’s favor — midterm elections are typically hostile to the party in power — and the prospect of the first election in a decade without former President George W. Bush either on the ballot or in office, Republicans find themselves on the offensive for the first time since 2004."

In the meatime, both the House and the Senate have agreed that nothing will happen until after their vacation recess. So, as Sen. Durbin said, the president and the Democrats have the recess to sell us on this "new deal" on health care: “I say this as a member of Congress who’s been an observer: The president is in the driver’s seat in August,”Durbin, a close ally of Obama’s, told reporters Wednesday. “Congress is gone and scattered to the winds with personal family and constituent service. And the White House is still there, generating a message and activity. So I think the president will have a chance to tell the American people a little bit more about why this process is so important.” Durbin said it’s critical that the Senate Finance Committee approve its bill before Aug. 7 in order to have a big piece of their plan to sell to voters. “I think it’s very important, and I hope we get it done,” Durbin said. “I still have my fingers crossed and feel good about it. And there are some members of the House who were waiting on that to see that the Senate Finance Committee can actually produce a bill.”

So, they might want to shorten those vacations

Whether or not Democrats face "mounting danger" in 2010, they may face what Chris Bowers called a "Progressive Backlash" over the health care deal, that extends far beyond this morning's "raucus caucus.": The big health care news on Wednesday was that Blue Dogs and the Democratic House leadership apparently reached a deal on health care reform. In 2009, this has been the template for how legislative fights end in the House of Representatives. Blue Dogs hammering out the final details with Nancy Pelosi and the relevant committee chair, the rest of the Democratic caucus swallows whatever is served up, and the place of the Blue Dogs as overlords is cemented even further. This time, however, progressives appear ready to force the House down a different path. ..."

Progressives who are wondering "What happened?" should check in with Mike Lux, of OpenLeft: "With the dizzying twists and turns of these last several days on health care, we still don't know where things will lay once the dust settles after what promises to be a very high drama ending before the August recess. We shouldn't be giving up hope that a good bill can be achieved, because the drama has not played itself out yet, and the August recess period itself - with the question of whether strong health reform proponents or astroturf defenders of the status quo will win the passion and organizing battle - will be crucial in deciding this bill's fate. But one thing is absolutely clear from what has happened over the last week: fundamental change has not come to Washington, D.C. Big business lobbyists, in this case from the health insurance industry, still have more power than the President. The media establishment, for all their lost audience and credibility, still have the ability to drive a negative conventional wisdom story about how change is impossible. And Democratic leaders on Capitol Hill, out of a combination of caution and the fear of these aforementioned lobbyists, still don't have the ability to deliver transformational change. The kind of change Barack Obama based his campaign around is, so far, nowhere to be seen."

HCAN's Jason Rosenbaum, meanwhile, summed up the Republican plan thusly — "Taxes, Taxes, Taxes": Let's see here… Tax credits that don't add up? John McCain's plan. Cutting Medicaid and SCHIP? John McCain's plan. Insurance across state lines, blowing past consumer protections? John McCain's plan. Not outlawing denial for pre-existing conditions? John McCain's plan. Tort reform? John McCain's plan. The country voted on John McCain's health care plan. They didn't want it. It's good to see that Republicans still have no new ideas."

The Nation's John Nichols downgrades the compromise from "reform" to "consumer protection", that ultimately benefits insurance: Instead of the bold rhetoric of last year's campaign, or even of last month's press conferences, the president is now pitching reform as more of a consumer-protection gambit. ... Unfortunately, they tinker around the issue of affordability -- the great challenge for tens of millions of Americans who haveaccess to health care but lack the resources to pay for the coverage they need. For those who would seek to control costs in a responsible manner, the dangerous trend in the health-care debate at this point is toward schemes that would see the federal government providing money to low-income families so that they can buy care from high-income insurance companies. That's nothing more than a giveaway to insurance companies. And it will not control costs.

Economy, On The Side

Jobless claims are up 25,000 in a week, and Both Reuters and BusinessWeek report increasing unemployment is fueling forclosure crises across the country. Reuters: "With the unemployment rate near a 26-year high and many employers cutting wages, more consumers in areas that were initially spared in the foreclosure explosion are now behind in their home loan payments. More than 20 percent of areas with above-average foreclosure activity were in Oregon, Idaho, Utah, Arkansas, Illinois and South Carolina in the first half of the year. That shift points to growing unemployment more than to fallout from subprime and adjustable-rate loans, RealtyTrac said in its midyear metropolitan foreclosure market report.

Robbert Kuttner notes the irony of the recent economic dialogue between the U.S. and China: "Suddenly, it was U.S. officials who were promising deep reform to their disgraced economic system rather than demanding it from incompetent foreigners. President Barack Obama’s economic team of Clinton-era holdovers, who a decade ago had hectored China on the virtues of fiscal responsibility, now were falling over themselves to reassure the Chinese that their $1.5 trillion stake in U.S. government-issued securities is safe, and that they should buy more at this week’s $200 billion Treasury auction.  If they don’t, we’re in big trouble."

Huffington Post's Gilbert Kaplan suggests that the U.S. needs a Secretary of Manufacturing: "When we think about where to put stimulus funds or other United States investments, someone has to stand up for manufacturing. We have lost seven million manufacturing jobs in this country since 1969, and the manufacturing sector is close to a tipping point. Speak to any mid-level manager in an American manufacturing company and you will hear the same story. The effect of this off-shore movement of jobs is cascading."

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