Health Care Reform and the Political Outlook for Congressional Democrats in 2010

[Time for change]

No sooner did the U.S. House of Representatives pass the long-awaited historic health care reform bill last Sunday, without a single Republican vote, than the Party of NO started in with predictions of doom for those who supported the bill:

The Republicans said Tuesday that those Democratic lawmakers would pay dearly in this November's elections…

The core of the massive law is the extension of health care coverage to 32 million who now lack it, a goal to be achieved through a complex cocktail of … subsidies for people who can't afford to buy coverage on their own, consumer-friendly rules clamped on insurers….

It’s not totally clear which aspect of the bill Republicans hate more. Is it the fact that millions of Americans who previously could not afford health care will be given government subsidies to help them afford it? Or is it the fact that private health insurance corporations will no longer have unlimited “freedom” to profit from selling their product to the American people in the complete absence of government regulation? Republicans have made it abundantly clear that either of those aspects of the health care reform bill is likely to lead to a totalitarian Communist state – just as they predicted the same results from Medicare several decades ago.

Before I go further with this, let me say that I too, as well as millions of other liberals/progressives, have serious concerns about the bill – specifically with the idea that millions of Americans will be mandated to buy their health insurance from private insurance companies, given that there will be no option to obtain it instead from our government. We believe that this massive giveaway to the insurance industry is likely to have far-reaching and severe ill effects, as did the massive bailout of Wall Street.

Nevertheless, there are many who believe that this historic bill could serve as a first step towards more substantive health care reform – of the type that puts the American people ahead of the insurance and pharmaceutical industries.

And therein lies our hope – a hope that the insurance industry and its lackeys in the Republican Party (and some in the Democratic Party as well) will do everything they can to snuff out. Snuffing out that hope will depend in large part on convincing our elected officials that their pursuance of health care reform spells political suicide for them, and therefore that pursuance of further health care reform will put the final nails in their coffins. So let’s take a look at the political effects thus far of pursuing the insufficient amount of health care reform contained in the current bill.


Current political fortunes of the Democratic Party

Before attempting to analyze the effect of health care reform on national political party fortunes we need to look at the relative current status of the two major political parties. Late last year I described, in a post titled “Democratic Party on Downhill Slide for 2010 Elections If they Don’t Change Course”, how following a high point for the Democratic Party around the time of the 2008 national elections, Democratic Party fortunes declined substantially since that time. Currently, polling on the generic national congressional ballot, perhaps the best predictor of the results of nation-wide U.S. House elections, shows a slight advantage to the Republican Party – an advantage that has existed since late last year. If that advantage persists, since all House members are up for reelection in 2010, it could easily mean that Republicans retake control of the House in that election. The outlook in the Senate is not much better, though it is highly unlikely that the Democratic Party will lose the Senate in 2010, given their current 18 seat margin and the fact that only about one third of the Senate is up for reelection.

The Republican Party and the masters whom they serve want us to believe that that these declining fortunes of the Democratic Party are due largely to its support of health care reform. But it’s not. The reasons are very different. The party with the power of the presidency usually loses Congressional seats in mid-term elections; the Obama administration inherited a severe recession from the Bush administration; and perhaps most important of all is – far from being too aggressive on health care reform – neither the Obama administration nor our Democratic Congress has been progressive enough on most issues of importance to the American people, including health care reform. Consider the following:


The political fortunes of Democratic Congresspersons who voted yes on health care reform in November 2009

An article written in June 2009 – a time when the great health care reform debate was red hot – identified 23 House Democrats as being highly vulnerable to losing their seats in the 2010 election. As it turned out in a House vote on health care reform in November 2009, 11 of those Democrats voted yes and 12 of them voted no.

Assuming that this vote approximately reflected the positions on health care reform held earlier in the year, if Republicans are correct that support for health care reform spells political suicide, that should have meant that the 23 highly vulnerable House Democrats should have been characterized by a very high proportion of yes votes on health care reform compared to those Democrats who were not highly vulnerable.

There were 258 Democrats who voted on the November bill. Given that 11 of 23 highly vulnerable voted yes on the bill, which comes to 48% of highly vulnerable Democrats, considerably less than 48% of non-vulnerable House Democrats would have been expected to have voted yes on the bill – if the Republicans are correct about the suicidal consequences of supporting health care reform. Instead, much to the contrary, 219 of the 258 Democratic House members – 85% -- voted yes on health care reform in November. Far from political suicide, it appears that political suicide was committed by those Democrats who voted no, not by those who voted yes on health care reform. Could have such a large difference in political fortunes between those Democrats who supported and those who did not support health care reform have occurred by chance? Statistical analysis of the differential showed that the probability of having such an uneven distribution occur on the basis of chance alone was about one in one hundred thousand.


What became of the political fortunes of the 12 vulnerable Democrats in 2009 by 2010?

It is also instructive to consider how the political fortunes of the 12 vulnerable Democrats in 2009 who voted no on health care reform changed over time. A more recent assessment of vulnerable Democrats, the Cook Political report from March 2010, evaluated in conjunction with the more recent March 21, 2010 House vote on health care reform makes the point. Of those 12 House Democrats who were considered highly vulnerable in June 2009 who voted no on health care reform in November 2009:

6 maintained their “No” vote in March 2010: 4 of those 6 continued to be rated as highly vulnerable in March 2010.

4 had the good sense to change their vote to “yes”. Of those, only one of them remained highly vulnerable by 2010.

One (Eric Massa) resigned from the House prior to the March, 2010 vote.

And one resigned from the Democratic Party to join the Republican Party.

The numbers are small, but none of this provides any evidence for the idea that support of health care reform constitutes political suicide. To the contrary, it reinforces the idea that one’s political fortunes are improved by supporting health care reform.


The political fortunes of Senate Democrats

Last month I posted an article on DU discussing the 5 most vulnerable Senate Democrats in the 2010 elections – Blanch Lincoln, Harry Reid, Arlen Specter, Michael Bennet, and Evan Bayh. As with the House, the problem with vulnerable Democrats is not that they are too far left, but that they are too far right.

I wrote in that article that according to a frequently cited political analysis of US Senators, only one of the five most highly vulnerable Senators (Reid) was ranked among the 33 most liberal Senators of the 110th Congress, and one other (Bennet) was not a US Senator in 2008 when the analysis was performed.

Reid is rightly judged by different standards because of his role as Majority Leader – and many liberals see him as lacking in leadership with regard to issues of crucial importance, as exemplified by his failure to take any stand at all in support of the public option being included in the health care reform bill. Bennet was rated by Nate Silver as the second most conservative of the ten current Democratic freshman US Senators. Blanche Lincoln and Evan Bayh were two of the 9 Democratic Senators who made an active (and successful) effort to ensure that the public option was left out of any health care reform passed by Congress. Arlen Specter had 44 years as a loyal elected Republican behind him. Evan Bayh was the initiator of the Blue Dog Democratic caucus in the Senate. And he has been one of the 9 most obstructive Democratic Senators on health care reform, as he even opposed getting around Republican filibusters through the reconciliation process.

Since that time, things have remained much the same. Bayh has announced his retirement from the Senate. The outlook for Bennet has improved substantially, undoubtedly a result of his leadership in pressuring Senator Reid to support the public option.


Support for the public option in the United States

The apoplexy that the Republican Party is exhibiting over the passage of this very weak health care reform bill is incredible to behold. Considering the degree of rage they exhibit over some subsidies to help low income Americans afford health insurance and a few federal regulations placed on the insurance industry, imagine what they would do if Americans were actually given the option to purchase health insurance from the federal government, instead of being mandated to purchase it from the insurance industry.

Actually, I doubt that there outrage would be any worse than it now is. Because the fact of the matter is that they ramp up their outrage to the max in response to ANY bill passed by Democrats. So they really can’t go any further with their fake outrage without appearing to be rabid. The whole motivation is political, and any truth that emerges from their lips is pure accident. Most important, the oft repeated accusation that the American people don’t support health care reform, and more specifically that they don’t support an option to purchase health care insurance from the federal government is pure bunk.

When asked a straight-forward question about the public option in a way that describes what it actually is, Americans routinely demonstrate overwhelming support for it. Here is a question that measures actual support for the public option because it asks about what people actually want, without giving it a label:

In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance – extremely important, quite important, not that important, or not at all important?

When asked that question in an August 2009 poll, 77% of Americans answered that it is either “extremely important” (58%) or “quite important” (19%). All demographic groups in the United States support the public option. Both genders, all races, all age groups, and all regions of the country support it. Americans support it regardless of religion, income level, or educational attainment. Even 71% of Republicans support it!


Conclusion

Given the overwhelming support of the American people for meaningful health care reform, including giving Americans the option to purchase their health insurance at a reasonable cost from the federal government rather than from the insurance industry, it is reasonable to ask why there was so much opposition to it in Congress that the public option wasn’t even brought to a vote – despite the campaign promises of all major Democratic candidates for President in 2008, including the now President of the United States, to pursue a public option as a core principle of meaningful health care reform.

So, what is the reason for the continuing willful efforts of our elected representatives to defy the needs and desires of the American people? Clearly, there are some very wealthy and powerful forces in our country that will spare no effort to block meaningful health care reform. Perhaps the death of the public option was the price that had to be paid to quiet some of those forces long enough to pass any health care reform.

But once that is done, the Democratic Party better take heed of what the American people need and want. They better not take seriously the ridiculous notion propagated by the health insurance industry and their lackeys – the Republican Party – that support for meaningful health care reform is political suicide and that the American people are just fine with the idea of being required to subsidize the insurance industry with their hard earned money.

A September 2009 article by the editorial board at The Nation magazine, titled “By any Means Necessary”, hit the nail on the head:

We hope the president, his Congressional allies and millions of Americans will be inspired to honor and do battle for Kennedy's lifelong cause. Surely Obama knows that the Senate's fighting liberal would not have put the fate of the nation's healthcare into the hands of private insurance companies, which increase their quarterly earnings by denying people care. Reform is not possible without a public alternative to the private companies, one based on coverage for all and quality care rather than profit…

If the Dems put forth a watered-down "bipartisan" bill with no public option, they will be justly blamed for its inevitable failure – and will see ugly results in the 2010 midterm elections. If, on the other hand, Republicans manage to defeat a good bill, let them try to explain themselves to midterm voters, who will still be at the mercy of Big Insurance and Big Pharma.

I hope that the Democratic Party takes heed of those words. Now is not the time to rest on their laurels or to “play it safe”. Now is the time to put the interests of the American people above the interests of the insurance and pharmaceutical industries. If they don’t they will likely suffer massive losses this November.

But if they do decide to continue the quest for meaningful health care reform, they will help to put our nation back on the right track and they will likely be well rewarded for that, as was the Party of Franklin Delano Roosevelt in the 1930s, which stood up to the ‘powers that be’ to push through the most impressive array of social programs in U.S. history. Those programs, which included Social Security, led to the longest sustained economic boom in U.S. history, while reducing income inequality in our country to the lowest levels in its history. They also led to Democratic control of the U.S. House of Representatives, over the next six decades, in 29 of the next 31 national elections.

[Time for change]

1. .

[the other one]

2. Well reasoned and well written. K n r

[kctim]

3. Yes

it is reasonable to ask why there was so much opposition to it in Congress that the public option wasn’t even brought to a vote and I believe it was because that while 77% voted yes, less than half of them were willing to pay for it. The question is worded as having a choice to pay for either one or the other and people like to have that choice. But when you take away that choice and tell them they have to pay higher taxes for one and have an option to pay for a private plan, they do not like that. Luckily, President Obama is a smart man.

The good news though, is that if you are right, Democrats should actually pick up a lot of seats this November.

[Time for change]

4. I'm not sure what you're saying

If you're implying that having a public option would be more expensive for the American people than the plan as it is now, I don't agree. Government insurance is a lot less expensive than private insurance for many reasons. The expense of the plan is in the subsidies, not in making a public option available to the American people on a sliding scale, depending upon their ability to pay.

[kctim]

5. Then you believe

this government program would be different than all others and not require all Americans pay for it with taxes? It may be able to live off subsidies for a little while, but a govt program this massive would require full participation by all Americans, just as SS and Medicare does.

I am not implying it will be more expensive. I am simply pointing out that less than half of those who support a public option plan are willing to pay for it.

[Time for change]

6. No, I didn't say that at all

I'm saying that the expense of the program is in the subsidies.

Paying for government health insurance is a lot less expensive than paying for private insurance. So, adding a public option to a program that is currently based on private insurance will decrease costs, not increase them. It is well recognized that basing a health care program on private insurance results in huge and unnecessary expense. This is what the economist Dean Baker had to say about it:

The fight is over whether Congress will leave in place structures that will siphon an ever-larger amount of money out of taxpayers’ pockets and put this money in the hands of the insurance industry, the hospitals, the drug companies and the doctors…

Unless Congress creates a serious public plan, you can expect to be hit with the largest tax increase in the history of the world – all of it going into the pockets of the health care industry.

http://www.merinews.com/article/dean-baker-on-health-care-reforms/15774737.shtml

[kctim]

10. Ok

am just trying to understand you're point, not put words in your mouth. I apologize if it seemed that way.

Unless the number of people on govt health insurance plans stays the same, I disagree that it will decrease costs for the taxpayer enough to matter. That number will at least quadruple at the onset of the plan, and will quadruple again once people discover they are paying for two plans when they do not have to.

Now I'm not saying a PO would not be better than what we have now, but I don't believe 77% would embrace it because it must be paid for and less than half are willing to pay for it.
If we are going to pass it against the peoples will and just let them get used to it, we might as well go with a single payer plan so that everybody knows what they are getting from the very beginning, instead of drawing the uproar out.

[Time for change]

11. Let me put it this way

When you compare having a PO to the current bill, it doesn't make sense to say that the PO has to be paid for. The difference between the PO and the current bill is whether people are forced to buy private insurance or whether they have a choice between private insurance and federal insurance. In either case, taxpayers will have to pay for the subsidies that are given to the poor so that they can afford insurance. But in the case of the PO, far less subsidies will be needed to cover people because federal insurance is far cheaper than private insurance. So having a PO is cheaper compared to the current bill.

So when a poll question asks whether people agree that they should have a choice between federal and private insurance, saying yes to that question means that taxpayers will have to pay less, not more than they would if they had no choice.

[Overseas]

7. K&R.

I'm still thinking about your last OP and the discussion about the lack of empathy.

I wanted to comment at the time about how the lack of empathy was being encouraged on an informal level by all the "Survivor" and "Big Brother" type reality shows in which people form alliances with others merely to get the better of them and claim the grand prizes. And the shows that exalt meanness like Bad Girls' Club. And the way extremely self-centered demanding people are given a certain cachet for being so brazen. And cyber-bullying has become a new way to gain status.

The passage of the healthcare reform bill has been treated very differently by Democrats and Republicans. Progressive Democrats who were holding out for the public option were pushed to drop their opposition out of compassion for the people who would get some relief out of the weaker bill.

Republican legislators and former Republican legislators stirred up intense hatred devoid of empathy in the frightened Tea Party folk. They've been driven to make death threats against those who passed the bill without a single thought for the millions more people who would finally get insurance or coverage for their kids with pre-existing conditions.

The GOP leaders (and astroturf groups led by former leaders like Armey), and right wing TV stars were allowed to rile people up against any empathy for months and months without any really serious discussion of those consequences until the current flood of death threats against Democrats who dared to pass a bill to help our fellow citizens a bit.

I think the right wing dominance of our national discourse was encouraged to soar out of bounds by the GOP and right wing leaders because a Democrat won the election.

It does make me wish again that Democrats had taken their mandate to heart and pushed the most compassionate Medicare for All through right after the Bush Crash and Bush Bailout, without allowing the right wing Republicans to stir up more of the dangerous sentiments they were pushing during the campaign season.

[Time for change]

8. All very good points -- I have some thoughts on them

"The Man Who Sold the World – Ronald Reagan and the Betrayal of Main Street America" – by William Kleinknecht talks about how greed and selfishness became "respectable" in our society during the Reagan presidency. It didn't just happen accidentally. It was planned that way, to clear the way for those who could profit from it.

I think that the lack of empathy among Republicans in Congress is astounding. I don't doubt that more than 90% of them are out and out psychopaths. Of course there is a reason for this. The Republican Party exists only through massive "generosity" of their corporate donors. It's nearly impossible to become a high level Republican without playing that game. And what kind of person would even want to be a Republican Congressperson, given what that Party stands for? Of course, many Democrats have been bought off as well.

And then there's the corporate media monopoly, whose main purpose in life is to drive our nation to the right and prevent the American people from learning things that might cause them to reject society's leaders.

[Overseas]

9. It's too late to say all I wish to, but I agree with you and have been amazed

at how intricate the social engineering has been-- or how multi-pronged. Quite an intense push against compassion on so many fronts, using many methods.

Right wing control of our mass media has been a vital force in that effort, which has swept way into our supreme court even.