Tuesday, January 26, 2010

Think About It Really, Really Hard

Caption: The Thinker. Rodin's ironic work seems somehow appropriate here.

Image credit: CJ/Wikimedia Commons

It's appalling how divorced from reality the debate on health care has become. There is this idea that somehow the Senate bill will be fixed later, and that the House should just pass it so that we can continue to have momentum. Nate Silver thinks that a bunch of little attaboys is worth more than a few huge "aw shits" when it comes to the features of the Senate bill. One blogger seems to think that not passing this bill is a sign of lack of courage. Steve Benen thinks that the House just has to trust the Senate to fix things later. I think passing it shows a sign of a lack of a functioning brain. Here's why, via Jon Walker:

According to Politico, the potential reconciliation measure contains six major components:

1. An increase in the Medicare payroll tax for the rich
2. More cuts to Medicare Advantage
3. The special excise tax deal for unions
4. Small increases in affordability tax credits
5. A fix for the Nebraska Medicaid deal
6. Closing the Medicare Part D donut hole by 2019

There will also be some other small, technical fixes and, ideally, a national exchange instead of state-based exchanges. The national exchange could easily run afoul of the Byrd rule, and might not be possible.

Tax Increases, Medicare Cuts, And Special Give-Aways To Unions: Are Democrats Actively Trying To Lose The House?

Do you see a public option in there? Do you see any way of enforcing all those marvelous insurance regulations that are supposed to make insurance so much fairer (in other words, many of Nate's "attaboys")? Do you see any added funding for Medicaid, so the burden of increased qualification doesn't fall on cash-strapped states? See anything about allowing drug purchases from Canada?

I don't either.

This is the plain truth about the Senate bill - it sucks. It cannot be fixed without utterly changing what it is. It was written by people who are completely compromised, and passed by people who will not have to deal with its effects. The House bill may be redeemable, but that's "off the table".

There will be no health care bill worth passing.

Ian Welsh's first rules of thumb for thinking is "don't trust liars." That seems like such a fundamentally simple thing that it's barely worth mentioning. I never would have thought to. Yet people seem to think that you can trust liars when they are saying what you want to hear. You can only trust liars when they have no choice but to do what they say, and even then, only if they are smart enough to know what they can't do. The Senate leadership lied when it said it needed sixty votes to pass a health care bill. They lied when they said they couldn't get sixty votes. Trusting the Senate to fix things is absurd on that basis alone.

It's also quite apparent that none of these people is thinking about what happens after the bill is passed and signed. How will the insurance "reforms" be enforced? There will be hundreds of thousands, maybe millions, of complaints annually. Many of them will be valid, and some will not. Just sorting through those complaints will take hundreds of man-years. Does anyone think there's a federal law enforcement agency that can deal with that additional load without funding? Does anyone really think that in a thousand-plus page bill they just forgot about enforcement? If you think either of those things, or didn't think about it at all, count yourself as someone whose opinion on this matter isn't worth listening to.

I still have yet to encounter an intelligent answer to those issues.

We should get used to the idea that no health care reform worth passing will emerge from this session. Before that can happen, we need to change Congress. Until the current herd of prostitutes is thinned, nothing better will ever come of this process.

UPDATE: Added some evidence for why I wrote that the Senate leadership are liars. Memories can be conveniently short, and I should know better than to let those memories fade.


One Fly said...

Then I hear from our side that we should accept the unacceptable so later we can build on it. What stupid ass logic is that given what we have in DC now. We need to fix DC as you say but that ain't happening either. People did what they were supposed to do in'08 and did it well. We're screwed and have been. We're seeing the hideous part now because the other side pretty much knows they got it the bag.

Anyone on our side that thinks you're going to get anything of any significa are fucking nuts. Not being nice to the nutters and the same holds true for those on our side who are stupid enough to think so.

Somebody tell me what we got in the last nine years and Obama don't count.

Cujo359 said...

Funny thing is, One Fly, I'm only talking about people on our side here. The really ridiculous stuff that conservatives peddle doesn't matter right now, because they've taken themselves out of the conversation.

Change is going to take a long time, if it happens at all. That's certain. The only alternative to trying to change things is to live elsewhere. For me, that just doesn't seem like an option.

I think I can sum up what we got this way: the two thirds of the stimulus bill that wasn't tax cuts. Everything else is something the Republicans probably would have done had they been in power.

lawguy said...

I'd have to agree, unfortunately. I would further suggest that Obama has been lying from probably the beginning of his campaign. So you've got that.

People on our side seem to want to give him the benefit of the doubt which was understandable a year ago, but not so much now.

Cujo359 said...

Agreed, lawguy. I was onto Obama from the git-go, so it's a bit hard for me to see things from the perspective of his supporters. Still, at some point even the most credulous would have to catch on, provided they've been paying attention. I think we have reached that point by now.

In the end, peoples' real priorities are defined by their actions. Now that we have a set of actions, and non-actions, to evaluate him with, Obama's priorities should be fairly obvious.

Lex said...

Isn't there a DC maxim that it's easier to pass good legislation than to fix bad legislation? The "starter home/fixer-upper" meme has killed me from its first trotting out. If i can't trust these people to put together the best legislation possible the first time, how can i trust them to fix it later?

lawguy said...

Lex I'd have to agree with you. Particularly since everything says that if this legislation passes the democrats will be decimated (not that they are good for much as they are, alright, nothing come to think about it).

I backed Obama because I figured he had to be better than Clinton. Boy was I wrong.

Cujo359 said...

I don't know if there is such a maxim, Lex, but there ought to be. Once bureaucracies and contracts are created to implement a law, they tend to take on a life of their own. They become part of the status quo, which is something that most folks in national politics seem to favor at the expense of everything else these days.

As a commenter over at FDL wrote today, has anyone fixed the Patriot Act, the Military Commissions Act?

Cujo359 said...

I don't know if Clinton would have been better, Lawguy (I voted for her in the primary, since Edwards had dropped out), but she definitely wouldn't have been any worse. You knew what you were getting with Clinton, where Obama was a mystery with, for me at least, some pretty disturbing clues.