Psyche, Science, and Society

Paul Starr and Paul Krugman support healthcare bill

Meanwhile healthcare expert Paul Starr and economist Paul Krugman argue that even this eviscerated healthcare bill is worth supporting. Here is Krugman:

Illusions and bitterness

By Paul Krugman

There’s enormous disappointment among progressives about the emerging health care bill — and rightly so. That said, even as it stands it would take a big step toward greater security for Americans and greater social justice; it would also save many lives over the decade ahead. That’s why progressive health policy wonks — the people who have campaigned for health reform for years — are almost all in favor of voting for the thing.

The argument about the evil of the individual mandate is,as Jon Cohn says, all wrong. It was wrong during the primaries, when Obama unfortunately used it to demagogue his rivals — helping set the stage for problems now. And it’s still wrong.

And the truth is that health care reform was probably doomed to be deeply imperfect. As Ezra Klein pointed out a few weeks ago, we’re basically in a hostage situation: progressives really, really want to cover the uninsured, while centrists whose votes are needed can take it or leave it. So the centrists have a lot of power — which in the case of Joe Lieberman means the power to double-cross and indulge his pettiness.

Now, in a hostage situation there are times when you have to just say no — when giving in, by encouraging future hostage-takers, would be worse than letting the hostages perish. So the question has to be, is this one of those times? I don’t think so, given the history: as Kevin Drum points out, health reform has come back weaker after each defeat. I’d also point out that highly imperfect insurance reforms, like Social Security and Medicare in their initial incarnations, have gotten more comprehensive over time. This suggests that the priority is to get something passed.

But what’s happening, I think, goes beyond health care; what we’re seeing is disillusionment with Obama among some of the people who were his most enthusiastic supporters. A lot of people seem shocked to find that he’s not the transformative figure of their imaginations. Can I say I told you so? If you paid attention to what he said, not how he said it, it was obvious from the beginning — and I’m talking about 2007 — that he was going to be much less aggressive about change than one could have hoped. And this has done a lot of damage: I believe he could have taken a tougher line on economic policy and the banks, and was tearing my hair out over his caution early this year. I also believe that if he had been tougher on those issues, he’d be better able to weather disappointment over his health care compromises.

So there’s a lot of bitterness out there. But please, keep your priorities straight.

By all means denounce Obama for his failed bipartisan gestures. By all means criticize the administration. But don’t take it out on the tens of millions of Americans who will have health insurance if this bill passes, but will be out of luck — and, in some cases, dead — if it doesn’t.

December 17th, 2009

AFL-CIO opposes current Senate bill

The conflict over the Senate healthcare cave-in intensified today as the AFL_CIO said it would not support the current version of the bill and the SEIU leader Andy Stern criticized President Obama by name. And Senator Byron Dorgan accused the White House of using the FDA to kill his provision allowing drug re-importaion from Canada to reduce cost:

Over at Open Left, David Sirota points us to this Wall Street Journal interview with Senator Byron Dorgan about the White House role in killing the drug importation bill:

Last week, [Dorgan] said he heard rumors that the FDA was going to send a letter objecting to drug importation on safety grounds, which he has said is a bogus reason. He said he called FDA Commissioner Margaret Hamburg, who said she knew nothing about such a letter.

He said his timeline shows that a letter, signed by Hamburg questioning the safety of drug imports, was sent 24 hours later to a few senators who opposed importation. That piece of paper became a rallying cry for other senators who voted down Dorgan’s amendment.

“I think the letter was prompted, probably drafted somewhere else,” like “the White House” Dorgan said.

The context for this is that the White House cut a secret deal with the drug industry to get its support for the health care bill.

Sirota explains the importance of this development about the FDA:

So Hamburg, who is supposed to be concerned only with science, first says she has no idea what Dorgan is talking about. Then, suddenly, 24 hours later, she’s signed onto a headline-grabbing letter saying Dorgan’s bill would threaten American consumers. Something smells here – something smells really bad.

Hamburg is an Obama appointee, so the FDA isn’t fully removed from politics. However, its declarations about safety are supposed to be science-based – not political. And by this Wall Street Journal account, Dorgan is asserting that, in fact, its declaration that imports are unsafe – a dishonest declaration that provides zero empirical scientific evidence – may have been written by political staffers in the White House.

If this is true, it’s a genuine scandal. It’s one thing for the White House to oppose a measure, make arguments against a measure on any grounds it wants. But if the White House political staff played ventriloquist for a science/safety declaration from the FDA, that’s a huge problem.

Sam Stein reports from Huffington Post on the unions’ attitude:

Nation’s Largest Union: Change Health Care Bill Or Else

By Sam Stein

The nation’s largest union group said Thursday that it will not support the Democratic health-care bill unless “substantial changes” are made to the current Senate version.

AFL-CIO President Richard Trumka said in a statement to reporters that without a public option for insurance coverage or an employer mandate – and with a tax on high-end insurance plans that some union members get – the health care legislation supported by Senate Democrats falls far short of meeting his group’s standards.

“[For] this health care bill to be worthy of the support of working men and women, substantial changes must be made,” said Trumka. “The AFL-CIO intends to fight on behalf of all working families to make those changes and win health care reform that is deserving of the name.”

The remarks are a strong indication that the coalition of pro-health-care-reform groups has begun to fray. Earlier in the day, Service Employees International Union President Andy Stern penned a letter to his fellow union members in which he called out President Barack Obama for abandoning his own principles of reform.

“President Obama must remember his own words from the campaign. His call of ‘Yes We Can’ was not just to us, not just to the millions of people who voted for him, but to himself. We all stood shoulder to shoulder with the President during his hard fought campaign. And, we will continue to stand with him but he must fight for the reform we all know is possible,” Stern wrote.

“Our challenge to you, to the President, to the Senate and to the House of Representatives is to fight,” Stern continued. “Now, more than ever, all of us must stand up, remember what health insurance reform is all about, and fight like hell to deliver real and meaningful reform to the American people.”

Stern, like Trumka, called for Democrats to make changes to the legislation as the process moves forward. And his rebuke of Obama – a staunch personal ally – was a telling sign of the growing frustration within the labor movement.

Both labor leaders were particularly incensed over the concessions made by the Senate’s Democratic leadership to Sen. Joseph Lieberman (I-Conn.), the 60th member of their caucus. “The public option is declared impossible. Americans cannot purchase Medicare at an earlier age. The health insurance reform effort we have needed for a century is at risk,” Stern wrote.

Officials at both unions met late into the night on Wednesday in emergency sessions to discuss the Senate bill. Aides say the conversations were lengthy and, at times, emotional. The labor community, while privately angry with the White House and Democrats in Congress, still needs the support of these lawmakers on other legislative priorities. Meanwhile, having poured millions into advertisement and man-hours in order to get health care passed, they have watched in horror as the principles they worked for were abandoned in a matter of days.

Officials are also aware of how much would be lost by simply scrapping the bill altogether. Stern noted that under the Senate’s bill 30 million additional people would be covered, pre-existing conditions would no longer be an excuse to deny coverage, and people who get sick would no longer lose their insurance. Trumka, likewise, pointed to “good things” in the Senate bill, including the fact that “insurance companies will no longer be able to deny coverage based on pre-existing conditions or impose lifetime or unreasonable annual limits.”

December 17th, 2009