Shape of the Real Deal on Health Care Reform

If you’re interested in the broad outlines of what House and Senate conferees will be grappling with in reconciling their health care reform bills, take a look at Paul Waldman’s American Prospect piece on the top ten conference issues.

What’s most interesting about the less visible but important issues at stake is that several have big implications for the future shape of health care in this country. One is pretty much settled: the bill if enacted will almost definitely put a final stake in the heart of Medicaid’s vast inequalities between states in eligibility (unless, of course, some sort of general state opt-out is authorized). Another is the collateral attack on the employer-based system of private health insurance via the Senate’s excise tax on high-cost plans, and its small opening to Sen. Ron Wyden’s proposal to let some employees covered by particularly bad employer plans to join the new health insurance exchanges. And still another is the principle, all but gutted in the Senate bill but still maintained by the House, that the health care system, beginning with Medicare, should finally begin separating the sheep from the goats in terms of effective and ineffective treatments.

It’s very likely that media coverage and public controversy over the conference will continue to focus on total public costs, new taxes, subsidy levels, the individual mandate, and the ghost of the public option. But in the long run, other deals may represent the real deal on health care reform.

This item is cross-posted at The Democratic Strategist.

Lessons From Flight 253

President Obama seems determined not to overreact to the narrowly failed attempt by Islamist terrorists to massacre Americans on Christmas Day. Three days passed before he issued a statement on the attack.

Obama clearly believes that a measured response is preferable to his predecessor’s bellicose bluster and call for an unrelenting U.S. “war on terror.” That’s probably right, but the plot by al Qaeda’s Yemen branch to blow up a U.S. airliner also demands urgent and resolute action from America’s commander in chief.

First, the White House must shake up America’s homeland security bureaucracy. The U.S. got a break when the father of Umar Farouk Abdulmutallab, the would-be suicide bomber aboard Northwest Flight 253, warned our embassy in Nigeria that his son had fallen under the spell of radical Islam. Inexplicably, however, Abdulmutallab’s name was not placed on the “no-fly” list, nor was he stripped of the U.S. visa he had previously acquired.

As Homeland Security chief Janet Napolitano admitted Sunday, the system emphatically did not work, and the White House must quickly find out why and hold those responsible for its failure strictly accountable.

It was also disturbing that Abdulmutallab had no trouble clearing airline security with explosive chemicals sewn into his underwear. But spending billions on millimeter-wave machines, and subjecting all passengers to even more time-consuming and invasive searches may not be the wisest response. Terrorists are inventive and will always find ways around screening regimes. A better use of transportation security resources is to identify high-risk passengers and subject them to higher levels of scrutiny.

Second, the White House clearly must give higher priority to preventing Yemen from becoming a haven for Islamist radicals. The plot was hatched by al Qaeda in the Arabian Peninsula, in retaliation for U.S. counterterrorism assistance to the Yemeni government. The U.S. must step up those efforts, but we should also consider investing more in counter-radicalization programs such as have been used in Saudi Arabia and Europe to dissuade young Muslims from embracing extremism.

Third, Obama needs to challenge Muslim spiritual and lay leaders to confront the scourge of jihadist fanaticism in their midst. The willingness of young men and women to slaughter innocents in Islam’s name is first and foremost a Muslim problem. Its victims – including the thousands of civilians randomly murdered in Iraq, Afghanistan, Pakistan, Nigeria and elsewhere — are chiefly Muslims.

Islamist radicalism is an ideology, one shaped by a particularly virulent and violent form of religio-ethnic identity politics. It feeds on myths of external oppression and cultivates a sense of victimhood. Only credible Muslim leaders can put the lie to these myths. Only credible Muslim religious authorities can discredit the cult of martyrdom that glamorizes suicide killers and terrorists.

President Obama is right to search for ways to protect Americans from Islamist terror without feeding the jihadist narrative of a U.S.-led war on Islam. But he and other world leaders should speak clearly to the Muslim world about its responsibility to confront those who kill and terrorize in Islam’s name.

Senate Passes Health Reform

The Senate today passed health care reform legislation by a 60-39 vote. It’s a historic achievement, the farthest health care reform has ever come. Progressives should cheer today’s news.

Yet because the legislative sausage-making occurred under the bright lights of the 24-hour news cycle and incessant blogorrhea, the sense of achievement is tempered by disillusionment — even disgust — with a political system that seems designed to chip away at bold reform. Horse-trading and bickering are hallmarks of the legislative process, but we experienced something different with this bill: because of its momentousness, and because of the media ecosystem, more Americans than ever saw more of the process than ever. And what they saw was a politics that seems horribly ill-suited to solving the public problems that face us today.

Even President Obama, who has shown remarkable faith in messy pluralism throughout the entire ordeal, indicated his frustration with the system, telling PBS:

I mean, if you look historically back in the ’50s, the ’60s, the ’70s, the ’80s – even when there was sharp political disagreements, when the Democrats were in control for example and Ronald Reagan was president – you didn’t see even routine items subject to the 60-vote rule.

So I think that if this pattern continues, you’re going to see an inability on the part of America to deal with big problems in a very competitive world, and other countries are going to start running circles around us. We’re going to have to return to some sense that governance is more important than politics inside the Senate. We’re not there right now.

Meanwhile, that up-close view of lawmaking no doubt contributed to the backlash that has emerged in the netroots over the bill. Dissent was not unexpected, but mutiny? That’s what the president faces on the left. On Firedoglake, one the left’s leading blogs, Jon Walker called the bill’s passage “a loss for the country.” Jane Hamsher accused President Obama of throwing progressives under the bus, calling his deal-making “the move of a deeply cynical politician who believes in nothing but shameless manipulation for political convenience.”

The netroots’ disdain for the president seems at odds with the messianic powers they ascribe to him. Apparently, all the president need do is give a speech or sweet-talk a legislator or two and he can get the left whatever it wants. You make laws, however, with the system you have, not the one you wish you had. Navigate the process — the only one we have — is what the president did. The wonder is that this legislation passed at all. Facing a fractious Democratic caucus, a phalanx of industry stakeholders, and — the biggest factor of them all — a Republican Party that has placed its bet on sinking this presidency, the president is close to notching, in the words of The New Republic‘s Jonathan Chait, “the most significant American legislative triumph in at least four decades.”

It’s not over yet. Anguished negotiations in conference will follow. Continued pressure from Republicans and interest groups, the conservative base and progressive blogs, will try to erode the resolve of congressional Democrats. The Republicans in Congress are a hopeless cause — a fact that, more than any other political consideration, should dominate progressive thinking about tactics and strategy. Seek to improve the bill in conference by all means. But attacking the bill with talking points that could easily come from Republicans (A “deeply cynical politician”? Really?) does the progressive cause no good.

Last year’s campaign showed Obama to be a really good closer. An even bigger test now awaits.

The Use of Force and International Law — The Void in American Discourse

President Obama, in accepting his Nobel Prize, spoke in lofty terms about the requirement that all nations, weak and strong, must adhere to the legal standards that govern the use of force. He noted that the U.S. had played a leading role in creating that legal framework. And he went on to underline that the U.S. too must respect international law: “America cannot insist that others follow the rules of the road if we refuse to follow them ourselves. For when we don’t, our action can appear arbitrary, and undercut the legitimacy of future intervention — no matter how justified.”

And yet the absence of any public discussion or analysis of the legal issues raised by America’s efforts against terrorism is striking. Whether it be torture and extraordinary rendition, military commissions, the targeted killing by drone attacks in Pakistan, the planning of CIA assassination squads, the large number of civilian deaths in air strikes in Afghanistan, or even the prospect of military strikes in Iran, all of these raise significant and complex international law issues. But you will not find any meaningful discussion of those issues in the media, or indeed in the talking points, blogs, or analysis produced by most liberal or progressive organizations.

Consider the contrast between the media coverage of such topics and the analysis of the issues surrounding the Israeli operations in Gaza earlier this year. There were countless articles examining the legal significance of the claims that the Israeli use of force was disproportionate, that civilians and civilian structures had been targeted, and that Israeli forces were using illegitimate munitions. The coverage was often sympathetic to the Israeli position, but there was nonetheless an examination of the legal issues involved. In contrast, when in the same month American forces killed Afghani civilians in air strikes, there was no such analysis – the entire discussion revolved around the strategic and political ramifications of killing civilians.

Liberal advocates say in private that they did not want to raise the international law arguments against torture, because such arguments “do not play well” in middle America. So the focus of the debate in this country was on the ineffectiveness of torture, and how counterproductive it could be. That is a dangerous argument to stake one’s entire position on. The fact is that the prohibition of torture is one of the very few peremptory norms in international law (known as jus cogens norms) – meaning it is one of the most bedrock principles of international law that nations may not derogate from under any circumstance. The other such norms include the prohibitions on slavery, genocide, and piracy. Yet in America, the debate was over when and under what circumstances we might derogate from the norm, and liberals were afraid to raise the law, because it does not “play well.”

The danger in all of this is that if liberals and progressives are afraid to make the argument for international law and the rule of law, then the argument will not get made. Progressives, afraid of looking weak, abandon the defense of the rule of law in favor of functional arguments. And so the country lurches ever rightward, in a one-way ratchet effect, with crucial principles being left by the side of the road as political liabilities.
Yet this country is supposed to be a “nation of laws” that preaches to the world the importance of the rule of law. These principles are supposed to be foundational, part of the constitutional DNA of the nation. They are part of the identity that is presented to the rest of the world. It cannot reject international law without doing violence to its own notions of the importance of law and the rule of law.

Moreover, as President Obama said, if the U.S. does not respect and observe the international legal standards, then it will lose its legitimacy and moral authority in the world. And that means that the extent to which American policy conforms to international law, from military commissions to targeted killings in Pakistan, must be part of the national discourse. So progressives have to engage the legal issues more, both to help preserve the country’s identity as a nation of laws, and to help ensure that we at least understand whether policy complies with the law.

The views expressed in this piece do not necessarily reflect those of the Progressive Policy Institute.

Shadi Hamid on the “Cairo Conundrum”

A great new piece from Shadi Hamid in the latest Democracy: A Journal of Ideas on “The Cairo Conundrum” — the seeming paradox between peace and stability in the Middle East. Hamid examines American policy towards Egypt, arguing convincingly:

[T]he pursuit of peace came to depend on prevailing authoritarian structures. Unless autocracy can be made permanent–and there is little reason to think that it can–this state of affairs is unsustainable. If Obama wishes to repair relationships with Middle Eastern governments, then he may, in the process, alienate the other key constituency he seemed to be speaking to [in Cairo] on June 4: the millions of everyday Arabs and Muslims hoping for more freedom and democracy.

He offers a dual-track approach to break the longstanding American mindset that democracy and stability in Egypt are a zero-sum game. The first track is “positive conditionality” — offering even more aid to Egypt, provided the government meets a series of democratization benchmarks. Should it fail in the first year, the money would be denied but rolled over into an accumulating fund. The entire amount would remain available once Egypt fulfilled the requirements; fail to do so, and the price of non-compliance would grow every year. The second track is “Islamic engagement” whereby the administration would facilitate political participation with moderate Islamist parties that renounce violence.

Hamid’s formula may not prove to be ultimately successful — after all it is quite possible that Egypt would be happy to accept ever-increasing American donations while feigning a reformist bent. But as long as the White House remains continually engaged across the spectrum of Egyptian politics, it is quite possible that Hamid’s formula of grassroots pressure married to large financial incentives could move Egypt along the path to democratic openness.

In Florida, the GOP at War with Itself

Greetings from Miami, where the weather is warm and the politics are positively scorching. Down in these parts, the talk has centered on the struggles of Gov. Charlie Crist in the Republican primary for the Senate against former House Speaker Marco Rubio, who is challenging him from the right.

Rubio was once considered a long shot. But a recent Rasmussen poll has pegged the race as a dead heat. As Ed Kilgore noted in these pages, Rubio has become a star in the national conservative movement, winning the endorsements of the right’s true believers eager to bag themselves another RINO in the moderate Crist.

Now comes word that Crist has lost the endorsement of two key backers:

Miami Republican Reps. Lincoln and Mario Diaz-Balart have pulled their endorsement of Gov. Charlie Crist for the U.S. Senate, dealing his campaign a significant blow in South Florida’s Hispanic community.

When asked by the Miami Herald the reason for pulling their support, Lincoln Diaz-Balart was cryptic, saying Crist “left us no alternative and he knows why.” The Herald reports that it might have something to do with Crist passing over a prosecutor recommended for a North Florida county judgeship by Lincoln Diaz-Balart.

Whatever the reason, it’s the latest round of bad news for Crist, whose moderate Republicanism has run afoul of a state party that — like the national conservative movement — has the urge to purge.

But that’s not all! Florida GOP Chairman Jim Greer has been facing calls for his resignation from state party leaders who have accused him of mismanaging the state GOP’s finances and mishandling its political operations. As Crist’s handpicked GOP chairman, Greer has been widely seen as devoting much of his efforts to Crist’s campaign. In fact, Greer had sought to snuff out Rubio’s primary challenge early on, a move that certainly did not endear him to the party’s restive base.

(Now, before you go and think that Greer is a reasonable, level-headed Republican being targeted by an inflamed rank-and-file, think again. Remember when President Obama gave that televised speech to students across the country at the beginning of the school year and caused a right-wing meltdown? Here was Greer’s Glenn Beck-ian response: “As the father of four children, I am absolutely appalled that taxpayer dollars are being used to spread President Obama’s socialist ideology.”)

Greer has responded by sending out a letter accusing his critics of being “bent on the destruction of the Republican Party.” He has also agreed to hold a special meeting to rescind his chairmanship, as his critics had demanded — but claimed in his letter that the rules do not allow for such a move at the special meeting.

One thing seems certain: with the well-funded Crist and his GOP chairman now fighting for their political lives, the Florida GOP civil war is only going to get uglier. After weeks of watching progressives duke it out over health care, it’s nice to be distracted by the internecine wars on the other side for a change.

Parker Griffith Can Change Parties, But Not History

As a Democrat from the South, the news that freshman Rep. Parker Griffith of Alabama was switching parties brought back bad memories from the 1990s, when a goodly number of elected officials from the region who had been Democrats for no particular reason other than political convenience became Republicans for no particular reason other than political convenience.

But the exodus of party-switchers back then was both natural and healthy, painful as it was. Jay Cost of RealClearPolitics seems to think, or hope, that Griffith’s flip-flop could touch off another wave of party-switching. I have two reactions to that: (a) if, as appears entirely possible, Griffith loses his seat anyway, then I doubt he’s going to be a major role model for others; and (b) Griffith is from the rare southern seat that is conservative but has never elected a Republican congressman. In other words, it’s like the venues of the party-switchers of the 1990s, when the realignment of the parties was reaching its peak. Most moderate-to-conservative Democrats in the South are from areas where genuine Democrats-In-Name-Only left the party years ago. The remainders are a pretty hardy bunch, even if more progressive Democrats don’t like their voting records.

But whether or not Parker Griffith is the wave of the future or the north end of a south-bound brontosaurus, one thing ought to be clear: his protestations that he had to change parties because of some shocking new ideological development in the Democratic Party is total, absolute, conscious b.s. Griffith’s not some crusty old long-time incumbent whose party changed without him; he was first elected in 2008, when Barack Obama was running on a platform promising climate change and health care reform legislation, and going along with George W. Bush’s decision to rescue the financial industry. Nancy Pelosi, whom Griffith is now attacking, wasn’t any less liberal then that she is today. Sure, he needs to play catch-up with his new party-mates in shrieking about socialism and the destruction of the U.S. Constitution, but nobody should be under any illusion that anything has changed since 2008 other than Parker Griffith’s assessment of his re-election prospects.

So however you assess the meaning of this development, nobody in either party should have any particular respect for Griffith–not because he’s a “turncoat,” but because he’s trying to disguise his opportunism as an act of principle, which it is not.

The item is cross-posted at The Democratic Strategist.

Death Panels the “Lie of the Year”

Sarah PalinDick Cheney may have won Human Events‘ “Conservative of the Year” award, but the Right’s more contemporary megastar, Sarah Palin, got her own big end of the year award. She’s the author of PolitiFact’s “Lie of the Year,” via her infamous Facebook post on health reform and “death panels.”

This was indeed an instant classic: completely fabricated, aimed at a particularly important constituency, and applying one of the favorite hallucinations of Palin’s buddies in the Right to Life movement (liberals want to extend their “holocaust” from the unborn to old folks) to the domestic policy issue of the day. And best of all, the lie was distributed not through some clunky and news-cycle-sensitive speech, but through Facebook!

TPM has a nice slide show illustrating how the “death panel” meme pre-developed before Palin invented the term and launched it into the national consciousness.

The Mayor Who Stole Christmas

The Whos down in Whoville might almost be jealous of Portici – a town of some 60,000 residents near Naples, Italy – whose mayor, Vincenzo Cuomo declared that Christmas decorations would be banned in public this year.

And why would Whoville be jealous of this decidedly anti-festive decree? Because at least the good mayor has a reason to justify his actions: In Whoville, the Grinch stole Christmas out of spite; in Portici, Mayor Cuomo’s policy is an attempt to break a Mafia funding scheme.

The crackdown on tinsel, Mr. Cuomo says, is the latest front in his battle against the Camorra, the Naples-based mob known for its brutality and economic savvy.

When the Christmas season comes around — and holiday shopping picks up — the town sees a spike in payments of the pizzo, or protection money. The “pizzo di Natale,” as Christmas-time payments are called, is commonly carried out through the forced sale of overpriced decorations — from Advent calendars to poinsettias — by the Camorra to shopkeepers.

So far, so good, though the Mafia aren’t usually ones to take such aggressive attempts to curb their power lightly. Two months ago, the mayor received a bullet from an AK-47 in the mail. And that’s not the only threat: No doubt if they ever get wind of it, Fox News viewers will also shower him with a deluge of War on Christmas hate mail.

Obama One Year On

PPI President Will Marshall joined a panel to discuss and assess President Obama’s performance on national security and domestic policy issues at the end of his first year in office.

The event was hosted by the New America Foundation/American Strategy Program and The American Interest.

Essays written by the panelist are featured in the current edition of The American Interest.

This event will run from 12:15pm – 1:45pm EST and will be featured on CSPAN later this week.

Panelist
Walter Russell Mead
Henry A. Kissinger Senior Fellow for U.S. Foreign Policy
Council on Foreign Relations

Richard Perle
Resident Fellow
American Enterprise Institute

G. John Ikenberry (via conference call)
Albert G. Milbank Professor of Politics and International Affairs
Woodrow Wilson School of Public and International Affairs
Princeton University

Steve Clemons
Director, American Strategy Program
New America Foundation
Publisher, The Washington Note

Will Marshall
President
Progressive Policy Institute

Stephen Krasner (via conference call)
Former Director of Policy Planning, US State Department
Graham H. Stuart Professor of International Relations, Stanford University

Ronald Steel
Professor Emeritus of International Affairs
University of Southern California

stage-setting remarks
Adam Garfinkle
Editor
The American Interest

moderator
Steve Coll
President
New America Foundation
Staff Writer, New Yorker

Where’s the Center? More on Polarization and the Parties

Here at P-Fix, the ever-energetic Scott Winship has pivoted from a debate with me and others about the advisability of limiting or killing off the Senate filibuster into an extended and scholarly discussion of the origins and nature of partisan polarization. He’s mainly doing battle with the 2005 book “Off-Center” by Jacob Hacker and Paul Pierson. I have no particular dog in that fight, other than to observe that Hacker and Pierson did usefully draw attention to the perils involved in allowing either party to unilaterally move “the center.”

But while I am not competent to joust with Scott on the proper exegesis of Poole-Rosenthal “scores,” I do find a couple of the assumptions he makes quite troubling.

The first is his understandable but still misleading reliance on self-identification of “liberals, moderates, and conservatives” (or some variation involving intensity) for defining the ideological character of the American electorate. Yes, polls of self-identification on this scale do show a very stable “center-right country” in which conservatives typically outnumber liberals three-to-two or even more. This is how Scott arrives at his fundamental argument that polarized elected officials don’t adequately represent the people who elected them, and also how he somehow concludes that the notable shift of Republican opinion to the right in recent years has made the system more, not less representative (that’s his major refutation of the Hacker-Pierson contention that the GOP has dragged the political center to the right).

Self-identification measurements are always iffy, as is made most evident by the vast gap between the number of voters who call themselves “independents” and the number who actually behave in an independent manner. But the hoary liberal-moderate-conservative scale is particularly influenced by the unpopularity of the “liberal” term, even among many voters who are “liberal” by the normal standards. This is what conservatives have bought with so many years and so many billions of dollars invested in the demonization of “liberalism,” compounded by the very different meanings the term has denoted here and abroad.

The distortion involved in using this term is made evident by many, many surveys that show millions of “non-liberal” voters agreeing with liberal values and policy goals, and by a few efforts to use a different typology. In the latter category, John Halpin and Karl Agne published a study earlier this year that found a significantly different spectrum of ideological self-identification simply by adding two other options — “progressive” and “libertarian” — to the usual three choices. The electorate broke down as 16% progressive, 15% liberal, 29% moderate, 34% conservative, and 2% libertarian — a much more equal distribution than the ancient three-to-two-or-higher advantage for the right.

It’s worth noting as well that the “center-right nation” meme has the perverse effect of holding Democrats to a higher standard of “bipartisanship” than Republicans, since “liberals” obviously have to move further to reach the actual political center than “conservatives.” And indeed, that’s pretty much what Scott suggests.

The second problematic feature of Scott’s analysis is that his data is (unavoidably, since you use what you can get) crucially out of date when it comes to profiling Republicans ideologically. Pre-2006 analyses of Republican elected official ideology may well be useful for a historical debate, but since this whole discussion began with the current partisan gridlock in Congress, the sharp movement of the GOP to the right following its defeat in the last two election cycles is more than a little relevant. To put it simply, the “moderate” wing of the Republican Party, at least in Congress, largely died after 2006 and 2008, partly because many moderates were defeated, and partly because party leaders and activists alike made a collective decision to blame both defeats on insufficient GOP conservatism. Few if any Republican “thinkers” are arguing for greater moderation or bipartisanship; more common are safaris to bag the increasingly rare species of the RINO. And most obviously, as Barack Obama seeks to implement the campaign platform (if not, as in health care, something to the right of his platform) he won on, Republicans in Congress are united against him while Democratic moderate dissenters are sometimes so thick you can’t stir them with a stick. This is not the picture Scott paints from his data of a political system where both parties have equally eschewed “the center.”

Getting back to the original discussion, Scott suggested that reforms to open up primary elections to independents might be a more fruitful approach to ending gridlock than restoring something like majority rule in the Senate. Though I favor open (or at least more open) primaries as a general proposition, the idea that this would have an immediate impact on polarization isn’t terribly compelling. It’s a subject that is complicated by definitions: some states with “closed” primaries allow very late changes in party registration, even on Election Day, which certainly gives independents every opportunity to participate. “Open” primaries range from the “jungle” primaries of Louisiana and Washington, to those in states with no party registration to begin with, to those who allow registered independents to vote in either party’s primary. But if you are looking in this direction for a cure-all, consider that the two most ideological senators, Jim DeMint of South Carolina and Bernie Sanders of Vermont, are both from open primary states. (Meanwhile, Ben Nelson, Joe Lieberman, and Olympia Snowe are products of closed primary states.) And remember, too, that registered “independents” are not always “centrists.”

In the immediate future, there are only two apparent routes to ending gridlock. One would be curbing the filibuster, either through intrapartisan pressure among Democrats to support cloture votes as a matter of course, or a change in the Senate rules. The other would be the revival of interest among Republicans in governing, either because they win elections and are forced to do so, or they lose so badly that today’s rightward stampede is reversed.

Conservative Crocodile Tears About “Corporatism”

TNR published a piece I did the other day examining the ideological underpinnings of the left/center split in the Democratic Party over the propriety of a universal health care system based on regulated and subsidized private health insurers. I suggested there was a burgeoning, if questionably workable, tactical alliance between “social-democratic” progressives and some conservatives to derail much of the Obama overall agenda. Then I made this observation:

[O]n a widening range of issues, Obama’s critics to the right say he’s engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. They can’t both be right, of course, and these critics would take the country in completely different directions if given a chance. But the tactical convergence is there if they choose to pursue it.

This statement has drawn considerable comment from people on both the Right and Left, mainly objecting to the argument that Obama’s critics can’t all be right.

Conservative theoretician Reihan Salam, writing for National Review, first argued that there’s not much substantive difference between the “New Democrat” deployment of private-sector entities in public initiatives and that favored by the privatizers of the Right. But then he pirouetted to make common cause with Obama’s critics on the Left:

It is entirely possible for both sets of critics to be correct. The concern from the right isn’t that the Obama approach will literally nationalize for-profit    health insurers. Rather, it is that for-profit health insurers will continue evolving into heavily subsidized firms that function as public utilities, and that seek advantage by gaming the political process. Profits, including profits governed by medical loss ratios, can and will then be cycled into political action, which leads to the anxiety concerning a “corporate takeover of the public sector.”

Salam’s friend Ross Douthat of The New York Times added an “amen” to this argument:

The point is that the more intertwined industry and government become, the harder it is to discern who’s “taking over” whom — and the less it matters, because the taxpayer is taking it on the chin either way.

But do conservatives really oppose this intertwining of industry and government? Rhetorically, yes, operationally — not so much.

Consider the default-drive Republican approach to health care reform, such as it is. It typically begins with federal preemption of state medical malpractice laws and health insurance regulation, the latter intended to produce a national market for private insurance (while also, not coincidentally, eliminating existing state provisions designed to prevent discriminatory practices). But the centerpiece is invariably large federal tax credits, accompanied by killing off the current tax deduction for employer-provided coverage, all designed to massively subsidize the purchase of private health insurance by individuals (with or without, depending on the proposal, any sort of group purchases for high-risk individuals). Another conservative pet rock is federal support for Health Savings Accounts, which encourage healthy people to pay cash for most medical services, perhaps supplemented by (very profitable) private catastrophic insurance policies. And most conservatives, when they aren’t “Medagoguing” Democratic proposals to rein in Medicare costs, favor “voucherizing” Medicare benefits—another gigantic subsidy for private health insurers.

Now some conservatives will privately tell you that all these subsidy-and-deregulation schemes are just an interim “solution” towards that great gettin’ up morning when tax rates can be massively lowered, all the tax credits, vouchers and other subsidies can be eliminated, and the government gets out of the health insurance business entirely. But don’t expect to see that on any campaign manifestos in the foreseeable future. In the meantime, Republicans generally support huge government subsidies to corporations without any public-spirited regulatory concessions in return.

Do anti-“corporatist” progressives really think they can make common cause with conservatives, beyond deep-sixing Obama’s agenda in the short term? Well, sorta kinda. Salon’s Glenn Greenwald, who rejected my “incompatibility” argument about left and right critics of “corporatism” as strongly as did Salam, is smart and honest enough to acknowledge there’s no real common ground with conventional conservatives or Republican pols. He instead offers a vision of an “outsider” coalition that includes anti-corporatist progressives and Tea Party types. This is, of course, the age-old “populist” dream (most famously articulated by Tom Frank inWhat’s the Matter With Kansas?) of a progressive takeover of the Democratic Party that attracts millions of current GOP voters (or nonvoters) who don’t share the economic interests of the Republican Party or the conservative movement but have seen little difference between the two parties.

All I can say is: Good luck with that, Glenn. Short of a complete and immediate revolution within one or both parties, complete with blood purges and electoral chaos, it’s hard to see any vehicle for a left-right “populist” alliance other than a Lou Dobbs presidential run. Barring that unlikely convergence, wrecking Obama’s “corporate” agenda would produce little more on the horizon than a return to the kind of governance we enjoyed during the Bush years, or maybe a bit worse given the current savage trajectory of the GOP.

Part of my intention in the original essay was to suggest that pro-Obama Democrats take seriously the views of intra-party rebels on health care and other issues, instead of insulting them as impractical and childish or obsessed with meaningless totems like the “public option” (which in the anti-corporatist context isn’t meaningless at all). But said rebels really do need to think through where they are going, and where they would take Democrats and the progressive coalition.

Meanwhile, conservatives need to be far less pious about their alleged objections to “corporatism.” Cheap rhetoric aside, their own agenda (when it’s not just preserving the status quo) is largely corporatism with any clear and enforceable public purpose cast aside whenever possible.

This item is cross-posted at The New Republic.

What Happened at Copenhagen?

Robert Stavins, who wrote us a dispatch from Copenhagen upon President Obama’s arrival there last week, has had a couple of days to mull over the outcome of the talks. His verdict: qualified approval, with a healthy dose of “too soon to tell.”

At the final hour in Copenhagen, the leaders of a small number of key countries worked creatively together to identify a politically feasible path forward.  I have previously argued (“Defining Success for Climate Negotiations in Copenhagen”) that the best goal for the Copenhagen climate talks was to make progress on a sound foundation for meaningful, long-term global action, not some notion of immediate, numerical triumph.  That has essentially been accomplished with the “Copenhagen Accord,” despite its flaws and despite overt challenges from five of some 193 countries represented (Bolivia, Cuba, Nicaragua, Sudan, and Venezuela).

Stavins calls the deal “a potentially very important third step” (the Rio Earth Summit in ’92 and Kyoto in ’97 being the first two), noting the improvement it makes over the Kyoto Protocol. The accord “expand[s] the coalition of the willing” by including rapidly growing developing countries that were left out in the Kyoto agreement, a crucial move if the world really is to make a concerted effort to mitigate greenhouse gas emissions.

Underscoring the immense difficulty of getting the whole world to sign on to one agreement, Stavins argues that while the Copenhagen accord may fall short of people’s expectations, it nonetheless was much better than what most people anticipated days before the conference’s end, when talks seemed hopelessly stuck in neutral. Stavins singles out President Obama’s late-game intervention as key to hammering out an accord. But as Stavins’ item-by-item breakdown of the deal suggests, there are simply too many details that have yet to be hammered out to fully determine the accord’s merits. The jury is still out.

One point that Stavins does make stands out: pointing the way forward, he suggests that bilateral and multilateral talks might be the more effective path as we proceed from here. I’ve been wondering about this, too. Considering how unwieldy it is to get nearly 200 nations on the same page, and that only 17 countries in the world account for some 90 percent of its emissions, wouldn’t scaling down agreements to the bilateral and multilateral level have a better chance of getting results?

Of course, it will all go for naught if the U.S. doesn’t act. Although China is now the world’s largest GHG emitter, it is still doing more on the renewable energy front than the U.S. And let’s face it: the average Chinese citizen is still nowhere near the polluter the average American is. The fact is that the U.S. needs to now do its part and enact a cap-and-trade bill. Senators, the world is watching — and waiting.

The Improbable Vote

So: at about one o’clock this morning, the United States Senate, or at least the 60 members of its Democratic Caucus, passed the long-awaited cloture vote to proceed to a final consideration of a health care reform bill.

As one who has had an irrational faith that the Senate would get to this point somehow or other, I have to say it was still an improbable accomplishment.

As recently as a few days ago, Joe Lieberman looked all but unreachable for this vote. Then Ben Nelson looked unreachable, even as Republicans Olympia Snowe and Susan Collins made it clear they had decided that nearly a year of begging from the White House and Senate Democrats wasn’t enough to overcome the right-wing heat they were experiencing. Then Democrats like Sherrod Brown and Bernie Sanders came under intense pressure to hold up the bill from progressives determined to derail the latest deal and force a recourse to a 2010 reconciliation strategy.

More fundamentally, a 60-vote Democratic Caucus was an exceptionally improbable achievement. It took (a) a near-sweep by Democrats of winnable seats in 2008; (b) a complex deal to keep arch-apostate Lieberman in the Caucus; (c) a favorable resolution of the near-tie vote in Minnesota after months of GOP legal obstruction; and (d) swift action by the Massachusetts legislature to provide for an interim Senator to replace the late Ted Kennedy.

It all came down to a one a.m. vote after a rare Washington snow storm, with Republicans openly praying that someone (i.e., the infirm Robert Byrd of West Virginia) wouldn’t be physically present.

The current conservative caterwauling about a “rushed” vote is pretty hilarious, given the endless delays undertaken by Senate Democrats all summer and early fall in an effort to engage Republicans, the open and notorious GOP strategy of running out the clock (reminiscent of the Bush strategy for securing the presidency nine years ago), and the front-page status of every detail of the legislation since last spring. Does anyone doubt for a moment that if Democrats had gone along and delayed final Senate action until after the holidays, the same people whining about their spoiled Christmas would be demanding the legislation be put off until after the 2010 elections? Indeed, that’s what we will in fact be hearing in January when a House-Senate conference committee completes its work.

That conference committee, and the House and Senate votes necessary to ratify its report, is far from a slam dunk, given House Democratic resentment of Senate deal-making, and substantive disputes on issues ranging from the public option to abortion. But the struggle to get to 60 votes in the Senate makes the endgame of health care reform look manageable by contrast.

This item is cross-posted at The Democratic Strategist.

Big Bite, Tough Chew

The following is an excerpt from Will Marshall’s piece in the latest issue of American Interest magazine:

President ObamaHow to grade President Obama’s first year in office? As Zhou Enlai replied when asked his opinion of the French Revolution, “It’s too soon to say.” Obama has set in motion a host of bold reforms that could break some of America’s deepest political impasses, or cause massive disillusionment if they fail. The big question now is whether his tenacity matches his audacity.

The string of “incompletes” on the Obama report card, however, hasn’t kept partisans and ideologues from rushing to judgment. To Charles Krauthammer, the President is “a man of perpetual promise” who has “achieved nothing.” That must be a relief, since the conservative columnist also maintains that Obama is a European-style social democrat bent on expanding government at home and appeasing America’s foes abroad. The backbone issue also arises on the Left. Many liberals fret that Obama isn’t tough enough to face down Republican obstructionists, or keep balky Democratic moderates in line. They also worry that his pragmatism and coolly logical approach to governing lacks the power to stir progressive souls. At this stage, though, all such judgments seem as premature as the Nobel Committee’s risible decision to award him a Peace Prize.

The President does have one big accomplishment under his belt: preventing the U.S. economy from sliding into the abyss. As Alan Blinder notes, the Administration managed to rescue the nation’s largest banks and get a hefty stimulus bill through Congress with impressive dispatch. That vigorous response, buttressed by an open-handed Fed, surely played a part in the stock market’s healthy gains since the Inauguration, as well as the economy’s return to growth (3.5 percent in the third quarter). But even if the recession is technically over, millions of working families are hurting. White House economists say unemployment will hit double digits soon and stay high well into next year. Consumer confidence is low, credit is still scarce, and there will likely be more foreclosures next year as mortgage rates reset.

Washington’s hyperactivity, moreover, seems to have awakened fears of “big government”, especially among independent voters who hold the balance in U.S. politics. There’s simmering anger in Middle America over taxpayer bailouts of greedy speculators and inept auto companies, reinforced by a sense that the government has intruded too deeply into the workings of private companies. None of this has led Obama to temper his ambitions. He is also trying to fix the health care system, create a new regulatory framework for finance, pass a complicated “cap and trade” scheme for carbon emissions, and turn around failing public schools. He’s promised to take on the highly combustible issues of entitlements and immigration reform just as soon as he can.

On the security front, he is attempting to check a spreading insurgency in Afghanistan, abet Pakistan’s struggle against extremists, and withdraw U.S. troops without destabilizing Iraq; shut down nuclear programs in Iran and North Korea en route to a “world free of nuclear weapons”; rekindle Middle East peace talks; and meet his one-year deadline for closing the Guantánamo Bay prison. Give the man his due: He’s not dodging the tough ones.

But by taking so many challenges on at once, Obama risks diluting his focus and making a themeless pudding of his presidency. His determination to solve stubborn public problems seems commendable, but his frenetic activity has yet to gel into a coherent story about the kind of society he wants America to be. The narrative of Obama’s presidency so far is more about him than us.

Read the rest of the piece at American Interest.

Pakistan Just Ain’t That Easy

It seems almost elementary that the governments of Pakistan and the U.S. both have a vested interest in extending Islamabad’s authority over the whole of its country, a point David Ignatius makes today:

Here’s the cold, hard truth: U.S. success in Afghanistan depends on Pakistan gaining sovereignty over the tribal belt. If the insurgents can continue to maintain their havens in North Waziristan and other tribal areas, then President Obama’s surge of troops in Afghanistan will fail. It’s that simple.

Extending the Pakistani government’s writ is certainly a core element to any hope of securing Afghanistan. A safe base of operation across the border in Pakistan would allow al Qaeda’s senior leadership room to incubate in hopes of re-spreading its wings in a larger Taliban-protected region. Points for identifying the problem, but it’s not that simple.

But just a handful of pages away from Ignatius is a reminder of just how difficult that challenge will be:

Pakistan’s Supreme Court nullified on Wednesday a controversial deal that had given President Asif Ali Zardari and thousands of other government officials amnesty from prosecution on corruption charges, a decision likely to further weaken Zardari’s shaky hold on power.

The ruling could open the door to additional legal challenges against Zardari. Although he still has immunity from prosecution under the constitution, opponents plan to contest that by arguing that Zardari is technically ineligible for the presidency. …

But Zardari’s ability to make decisions about the level of Pakistani cooperation with the United States has been compromised by his struggle to simply hold on to his job — a task likely to be made more difficult by the court ruling.

There are essentially three legs of power in the Pakistani government — the military and intelligence services are the largest center of gravity, followed by the courts and then the civilian leadership. Rivalries between all three are intense to say the least, a dissection of which could take up an entire encyclopedic volume. And even though the military isn’t mentioned in the WaPo’s article, it almost goes without saying that the generals would be fine if Zardari fell from power.

The point is that as long as these communities’ main focus is a struggle for power, the White House will never get them to pay primary attention to internal security. And even if you could, each power base has reasons (some better than others) to turn a blind eye to the Taliban lodged in Pakistan’s hinterland.

The situation isn’t hopeless…yet. Despite long-standing suspicions of civilian President Zardari’s corruption (hey, the guy wasn’t called “Mr. 10 Percent” for nothing), he is the legitimately elected leader and was allowed to return to Pakistan — with his late-wife Benazir Bhutto — in an amnesty deal reached with ex-President Pervez Musharraf. Therefore, the U.S. should stand by Pakistan’s nascent democracy and support Zardari, without making him look like an American puppet.

Then the U.S. government should work on aligning the military under Pakistan’s civilian leadership. Congress tried this by conditioning aid on just such a goal in October. Guess what? It didn’t go over so well with Pakistan’s generals. Back to the drawing board.