Health Care: The Permanent Campaign

The Democratic National Committee, through the Organizing for America operation that it imported from the Obama presidential campaign, has put up a new website that attempts to translate some of the internet-fueled grassroots tactics of the 2008 campaign into a governing tool for the Obama presidency. In that toolbox: Everything from 21st century social networking to techniques as old-fashioned as writing a letter to the editor or calling your congressional representative.

This is not a bad idea. The opposition is organizing, and one thing the failed Clinton health care reform effort lacked in 1993 and 1994 was an effective pushback. But I’m not sure it is going to be possible to capture the kind of energy and unity you can generate in a presidential campaign for something that is, at its essence, legislative sausagemaking. For instance, many Obama supporters who favor a single-payer system are feeling alienated and shut out because they are seeing no serious consideration being given to that idea. And while the website cites a “public insurance option” as one of Obama’s core principles, it is not specific on what that means. Would it be one that operates like (and is tied to) Medicare, or one of the significantly weaker versions now being floated as a possible compromise? Right now, I’d bet the ultimate version that emerges is going to be a lot less ambitious than many liberals are hoping.

In that sense, the Obama message machine is facing a challenge on two fronts. One will be against the inevitable opposition that will be coming from the right. The other one is convincing the President’s own base that some health care reform is better than none at all.

UPDATE: And speaking of the need to be precise in what we are talking about, here’s an explanation of how the same words can mean very different things in the wonky health care debate. Jargon can paper over a lot of big differences.

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  • vastwastelander

    Am I paranoid, or does it seem like the incredibly pansy-a$$ed version that many Dems are espousing is a set up to intentionally undermine a universal system? WORST. IDEA. EVER.
    .
    Are they really sooooooo scared of the insurance lobby that they’re willing to set up a crappy, straw-man public option that will fail miserably and end up scuttling any chance of a single payer/ universal system in the future? I mean, how stupid can you get!?! I’d rather just stick with our current crappy system . . . but that’s their plan anyway, apparently.

  • Paul-no not that one

    “I’d bet the ultimate version that emerges is going to be a lot less ambitious than many liberals are hoping.”
    .
    Is there a single piece of legislation that you wouldn’t say that about?
    .
    BHO getting pushed from the left is a good and necessary thing, which he likely recognizes.

  • http://phd9.blogspot.com Paul Dirks

    But I’m not sure it is going to be possible to capture the kind of energy and unity you can generate for a presidential campaign for something that is, at its essence, legislative sausagemaking.
    .
    I don’t know about anybody else, but I’ve been routinely deleting my Obamabot e-mails for months now.

  • vastwastelander

    @Paul Dirks –
    Same here . . . I guess I feel that he, the House Dems, the Senate Dems, and the Gubernatorial Dem majority should have enough clout to move the agenda forward without bothering me every fews days. If they’re not able to push their policies with that kind of manpower, they deserve to lose.

  • darius3

    In that sense, the Obama message machine is facing a challenge on two fronts. One will be against the inevitable opposition that will be coming from the right. The other one is convincing the President’s own base that some health care reform is better than none at all.
    .
    I’d say that’s a pretty accurate assessment. I doubt Obama’s ever going to be able to placate the right, but he could easily shore up the support of his own base by providing a concrete set of reform proposals, including a strong public option.

  • FlownOver

    Hey, what was that? Gunshots? Here in the Village? Whassup?

  • afguy

    I don’t know about anybody else, but I’ve been routinely deleting my Obamabot e-mails for months now.
    .
    PD,
    .
    Haven’t been getting any myself. Color me lucky. Right now, I don’t give a rat’s a$$ about about the public proclamations from WH PR because I KNOW the crap that’s being done behind the scenes.
    .
    When I see something that shows that the Pres is pushing for a good healthcare program that benefits all of us, then I’ll start to take what I’m reading seriously. Otherwise, it’s just spin that I’m totally sick of seeing.
    .
    Read somewhere that someone called Sen. Landrieu’s office and suggested that she and others cancel their own govt-provided health care programs until they could pass something like that for the rest of us. Suffice to say that her staff was not amused by that suggestion, but their reaction does seem to indicate that they are at least aware of the hypocrisy of their position.

  • shepherdwong

    Another problem: voting for a particular politician is always simply the choice of the lesser of two evils (as best one can figure) and the outcome is temporary, even reversible. Choosing a policy among many possibilities determining something like the health care system of the US for generations to come is entirely different.

  • 53_3

    KT:
    .
    Forgive me, but in a way, it seems to me that the tail is wagging the dog. The right will never go for any government sponsored health care plan, and the one’s I’ve seen so far are frankly, gilded excreta.
    .
    I’m becoming rather disappointed in Obama for trying to be inclusive towards those who will never see single payer as a solution.
    .
    I think the time is for boldness, not timidity in the face of an unreasonable, and rather weak opponent. The reconciliation clause can be invoked at any time.
    .
    This is really more of a stage play than real reform. Everyone is going through the motions trying to pretend that they are really looking for workable solutions when in fact they are only looking for politically workable solutions…

  • vastwastelander

    53 – All I can figure (and hope) is that Obama is offering the weakest, most basic options to Republicans to prove that they won’t move an inch towards reform, and then steamroll them with a good “the American people desperately want this, but Republicans won’t risk angering the insurance lobby” argument, and then push his agenda through.

  • afguy

    …voting for a particular politician is always simply the choice of the lesser of two evils (as best one can figure) and the outcome is temporary, even reversible.
    .
    shepherdwong,
    .
    Agree with you on that. It’s often a matter of “holding your nose”. I’m not from RI but see signs that Sheldon Whitehouse may be an exception to that observation and am hoping that he is what he appears to be.
    .
    SC justices are another of those long-term choices that can’t be undone. In theory, health care can be improved in the future if you are able to get the right framework passed now. From a point of practicality, if you don’t get it right the first time, many of those living now will be gone before you can get the votes to get it right (or even make the attempt to try to improve it).

  • shepherdwong

    “And while the website cites a “public insurance option” as one of Obama’s core principles, it is not specific on what that means.”
    .
    Anyway, I agree that the Administration must outline specifically what it is asking the public to support, assuming that it really wants to build public pressure to help it try to pass a truly progressive solution, rather than simply making a pretense for political cover.

  • shepherdwong

    “I’m not from RI but see signs that Sheldon Whitehouse may be an exception to that observation and am hoping that he is what he appears to be.”
    .
    afguy: I don’t mean that in derogatory way relative to good public servants like Whitehouse (Feingold, Sanders, etc.), just an operating principle when choosing whom to vote for.

  • afguy

    I don’t mean that in derogatory way relative to good public servants like Whitehouse (Feingold, Sanders, etc.), just an operating principle when choosing whom to vote for.
    .
    shepherdwong,
    .
    Don’t worry. We’re on the same page on this. Just ever so often you actually get to pick “really good” over “very poor to pi$$ poor”.

  • shepherdwong

    “Just ever so often you actually get to pick “really good” over “very poor to pi$$ poor”.”
    .
    Perhaps that’s one thing that makes general elections so much more popular than primaries. Too bad half the voting public can’t tell sh*t from Shinola.

  • Paul-no not that one

    I haven’t been here constantly so I may have missed it but did KT or anyone comment on the NYT Sunday Magazine cover story about the administration’s wooing of Congress?
    As it relates to healthcare I came away a little more encouraged with their strategy.

  • afguy

    Perhaps that’s one thing that makes general elections so much more popular than primaries.
    .
    I’ve had this theory for some time that, at the national level, you can’t be a truly honest person and be a very successful politician (with exceptions already noted). At the local level, your job performance can be at least a little separated from party politics because you have to be competent to make the garbage pickup run on schedule.
    .
    A local politician with higher aspirations is a different animal though. At that point, ambition dictates that you have to serve the party masters, wherever that decision takes you.

  • afguy

    …about the administration’s wooing of Congress
    .
    P-NNTO,
    .
    I hope this wooing doesn’t come at the cost of a really good public healthcare option when all of the “sausage-making” behind closed doors is completed.
    .
    The search for “bi-partisanship” could also be called “wooing” (and we all know what a crock that is turning out to be).

  • Paul-no not that one

    afguy-I take a back seat to no one in my suspicion of things DC but their strategy seemed sound.
    .
    For anyone with both the time and inclination here it is-
    .
    http://www.nytimes.com/2009/06/07/magazine/07congress-t.html?_r=1&ref=magazine

  • pobo1

    Health care is an issue I’ve really gotten involved with and it’s discouraging, to say the least. This is an outgrowth from the Obama campaign (which I was not involved with). I am sick of getting all of these emails – sometimes several times a day. Based on FISA and torture investigation, I feel that petitions and phone calls do nothing. I send emails with links to Bill Moyers and good articles. I have hosted discussions where I invited friends to come and hear from an expert about what is happening – the few republicans who came left early. We are trying to get people to fill out postcards and will gather and deliver to our legislatures, but I feel extremely discouraged. I expect whatever is passed will be so watered down that it won’t make a real difference in both cost or coverage. And then the republicans will say “told you so”. And nothing will change, at least for the better.

  • afguy

    I take a back seat to no one in my suspicion of things DC but their strategy seemed sound.
    .
    P-NNTO,
    .
    I truly hope you’re right. If I interpret what I read correctly, Obama will get more of what he (and we) want if he takes the lead and both he and we can convince the Senate and House leadership that their backs are covered when the time comes to vote.
    .
    At a certain point, he’s going to have to tell the GOP (and, to a certain extent, centrist Dems) “We were listening to what you had to say, but you didn’t bring anything CONSTRUCTIVE to the table regarding a public option. Therefore, we’re going to vote on what was developed on its merits.”
    .
    I do wory about reports that he isn’t pressing very hard for that option, though.

  • Paul-no not that one

    afguy, I would agree with your take. I thought BHO’s hiring of those key aides will help with the sell to Congress which is being allowed to actually do their jobs and craft the bill.
    .
    But nothing will happen without BHO getting front and center when the time comes.
    .
    I use the word “encouraged” rather than “optimistic” for a reason.

  • iam5un5hin3

    i know i am not really part of this blogging community, but i generally read ya’lls comments most days. i read over this particular entry, and i got so upset, i really wanted to contribute. i can understand being upset with obama because he has not lived up to expectations, but the premise that some reform is better than none at all really makes a lot of sense of me when it comes to health care reform. Texas is a horrible place to be poor, and the way they have folks accessing free health care is bordering on barbaric. my mom has has had cataracts for several years now. she is diabetic, and it is slowly starting to eat away at her. she lost her job a really long time ago and has been trying her best to get another one. for a variety of reasons, she hasn’t been having a lot of success. the gold card thing that Texas has going is hard to become a part of and the services are really subpar and short lived. it took several years, using the gold card, to have surgery on her eyes, and the procedure still wasn’t complete. i won’t even talk about the whole diabetes thing. it is really important my mom, my sister and her kids, my aunts (all of whom do not have health care) have some type of access. to have it dependant on what type of job you have…it’s so unfair that it almost makes me want to vomit. i mean, this country says every single day that poor people are not deserving of the same quality of life as middle-class folks. so, suffice it to say, i NEED health care reform to be pushed through, watered down or no.

  • Cliff

    so, suffice it to say, i NEED health care reform to be pushed through, watered down or no.
    .
    That kind of goes along with this:
    And nothing will change, at least for the better.
    .
    We’re at the breaking point on a lot of levels. Things have to change, or they’re going to get real ugly.

  • iam5un5hin3

    i got a little carried away telling my little story and glossed over some stuff. My sister does not have health insurance, but her kids do through medicaid. so she treats her asthma with her kids’ prescriptions. my mom does not have health insurance and one of my aunts doesn’t i believe. my other aunt is on medicare. but that was the result of a stroke so bad that for a few weeks she sounded like a 5 yr old. before that, she did the gold card thing.

    we are at the breaking point. things do need to change. that’s why i voted for obama. he and his people are tring.

  • yutsano

    we are at the breaking point. things do need to change. that’s why i voted for obama. he and his people are tring.
    -
    He needs to try harder and now. I say turn Rahm loose and let the curse words echo through the Capitol.
    -
    KT: You mention in the article that Nancy Pelosi will have a greater say in the final bill in the reconciliation process. Has she made any statements one way or the other regarding the public option?

  • pirate wench (demwoman)

    B’fore th’ election, there were an ubiquitous presence in th’ news an’ online combattin’ th’ distortions an’ pushin’ th’ agenda o’ th’ democrats an’ candidate Obama. An’ I don’t be meanin’ “agenda” in a derogatory-like fashion :) .
    .
    So, th’ silence an’ lack o’ visibility now speaks volumes t’ me abou’ just how much my party an’ leaders really have invested in th’ health care access fight, an’ just how deep in th’ pockets o’ the corporate health industry th’ congress members o’ both parties be.
    .
    An’, when I were writin’ Patty, Maria, an’ Rick expressin’ me clear preference fer’ single-pay, an’ inquirin’ wha’, exactly, they be proposin’ an’ workin’ towards, only one o’ ‘em responded, and tha’ were wi’ a form email full o’ noncommittal gobble-di-gook tha’ means nothin’ t’ me.
    .
    Sausage makin’ indeed.
    .
    I be downhearted an’ suspicious, mates, right downhearted an’ suspicious.

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  • http://swampland.blogs.time.com/2009/06/11/update-the-ama-says-no-maybe-yes-whatever/ UPDATE: The AMA Says No. Maybe. Yes. Whatever. – Swampland – TIME.com

    [...] brings us back to what I will continue to emphasize: A "public plan" can mean many [...]

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