First I should probably talk about my overall thoughts on the health insurance debate, since I think it'll help to clarify my reaction to the entire forum. Overall, I am not too fond of either bill, mostly because I think that they won't do much to lower healthcare costs going forward. I think certain parts of the bill(s) are good, most notably the stuff on pre-existing conditions. My biggest gripe though is with the individual mandates without a public option. I'm always a bit queasy about mandates of any kind, but it would be far more palatable (and much easier to philosophically defend) if the mandate came with an option to buy publicly rather than being forced to buy from a private insurance company.
Personally, I would like to see a system with universal catastrophic coverage, vouchers for preventative care, and an increase in community health clinics that serve poor and working class people.
I also think that we need to be honest about what accounts for the majority of healthcare costs- end of life treatment and chronic conditions. Those are the two real problems, and they're the ones that are the hardest to do anything about. I would just as soon put chronic conditions in with the catastrophic coverage, with either a deductible or yearly cap, although admittedly each would have their own problems.
Overall, I don't think the health summit got much accomplished as each side stuck to their guns pretty hard. Talking to my brother about this earlier today he had a very good point- our system makes it so that no side can ever admit that they're wrong, not even for a moment. And that makes people dig in their heels, even in untenable positions, The calcification of our political process is probably the biggest impediment to solving any problems in our country and there's really no way to fix it.
President Obama- Came off as the smartest guy in the room as he usually does. He's really the ace for the Democratic party and is pretty much the only person in leadership that is able to easily and effectively explain the parties position. At times he got a bit agitated, sometimes even snapping at members of his own party (Biden, Waxman, and Rockefeller). Even with his agitation though, I do think he enjoys these kind of debates. In a way, descriptions of Thomas Jefferson come to mind. Jefferson was someone who enjoyed debate and enjoyed mashing out legislation in committee moreso than being President. Obama is probably a much better orator than Jefferson was (at least from contemporary accounts) but I often times think his natural role is Senator rather than President. Or if we had a parliamentary system he'd make a great prime minister. Back on topic though- he's generally a great salesman for his ideas even though I don't agree with all of them and I echo both the Atlantic and Salon that he should do more talking while the rest of the party leadership just shuts the hell up.
Harry Reid (D-Nevada) and Nancy Pelosi (D-California)- Doing them together since I only watched a bit of their opening and only Pelosi's closing. The biggest problem with both of them, and the Democratic leadership (besides Obama and Durbin) in general is that they don't actually talk much about their bills and instead just spout platitudes about expanding coverage and bending cost curves. Okay, that's fine, but why should we use this bill to do it? They have a hard time being able to defend their respective bills because it's convoluted. That being said, it's very easy to sell healthcare reform broadly and very hard to sell specific legislation of this magnitude and those two just don't have it in them
Lamar Alexander(R-Tennessee)- A bit frustrating but mostly harmless as the Republican standard bearer. Couldn't get much of the talking points and was outsmarted by Obama during their back and forth.
John Boehner-(R-Ohio) The tan-man was terrible, easily the worst speaker of the day. Had the gall to say that medical malpractice was the key driver of healthcare costs- Boehner's never met a fact he couldn't completely misconstrue . I think it was Moynihan that said that people are entitled to their opinions but not their own facts. He was talking about you Boehner.
Charles Boustany(R-Louisiana)- Good points in the beginning, boilerplate at the end. Mostly inconsequential though.
George Miller(D-California)- Also mostly boilerplate- although I faded in and out of his speech because he was kind of boring.
Jon Kyl (R-Arizona)- Just an all around jerk, went on rambling about costs control but government takeovers and really had new clue what he was talking about. Absolutely awful.
James Clyburn(D-South Carolina)- Liked his point about community health centers, which I'm glad he brought up because for a second I thought his speech was going nowhere.
John McCain(R-Arizona)- Came across as petty and petulant like he has ever since he lost the election and Obama rightly smacked him for it. Did have a point about Obama's promise though, and I would have loved to see the entire debate on C-Span from the get go.
Secretary Kathleen Sebelius- I've had the opportunity to hear her twice now, once for a conference call at work and now here. I find her unimpressive and although I know she knows her stuff, I had a hard time focusing when she spoke. Maybe I just needed a second cup of coffee.
Eric Cantor (R-Virginia)- My brother and I both did debate in high school and while talking to him on the phone during the intermission, my brother described Cantor perfectly. He's the rich conservative kid at the debate tournament who comes dressed in a nice blue blazer, has way too many files for the competition, is cavalier and snide to anyone who is not his intellectual equal (which to him is pretty much everyone), and is really just an all-around asshole. But the kid also really knows his stuff, practices everyday, is abreast on all political issues, is engaging and speaks with a confidence that at it's best is engrossing, and is always the most formidable opponent you'll face during the tournament. Man I hated that kid but always respected the effort. Cantor is like that and he played up to the role- not as intellectually rigorous nor as formidable as Paul Ryan, but amongst the best of the GOP. Which is pretty sad.
Vice President Joe Biden- Didn't get much of a chance to talk, but when he did was pretty good. When Obama is at his most arrogant, it's usually with regard to Biden- it seems like he just doesn't like the man and it shows up on camera. Maybe it's too many episodes of Biden sticking his foot in his mouth; but he's far from a liability and could have been utilized more effectively in the number two slot; he is much better than Reid or Pelosi. His best attribute is his ability to breakdown arguments to their essence; particularly on the issue of pre-existing conditions, which is really one of the fundamental agreements of the healthcare debate. Because really, once you agree that pre-existing conditions should not bar people from being able to buy into health insurance and that the amount they pay should be capped at a certain percentage above the normal rate, then you're suggesting that government get into healthcare all the way. I don't think that point was stressed enough.
Louise Slaughter (D-New York)- Pro- Very passionate. Con- A little crazy
Tom Harkin (D-Iowa)- Cornboys! Another example of someone who had trouble defending the bill on the table. Essentially, he made a case for single payer coverage, but then tried to tie it to the bill on the back-end. And I have no clue where he was going with that whole insurance/segregation thing.
Jay Rockefeller (D-West Virginia)- Such a flopper, one minute he's for the public option moral imperative, next he isn't. Rambled on and on to the point where Obama had to cut him off. Just not a very inspiring figure.
Marsha Blackburn (R-Tennessee)- Shame, I thought she'd bring a bit of Bachmann to the proceedings, instead it was just your standard government takeover rhetoric.
Paul Ryan (R-Wisconsin)- The star of the GOP right now; the man's got some chops. The only one who can stand up intellectually with Obama, at times he had him absolutely stumped. Last week I read over his long-term plan on entitlements, and while I do not agree with it, at the very least he's relatively honest in saying that benefits will have to be cut if taxes aren't raised. He's much stronger on the general deficit than he is on the However, he voted for Medicare Advantage and he needs to repudiate that as strong as he repudiates the current plan. One other note; one thing that I like about the Republican party is that they are a bit quicker in allowing young people to rise in the ranks of the party. Cantor is the whip, Ryan has become one of their top policy guys. I mean the cream usually rises to the top, so a man with the political talent of Obama can run for President, but if Obama had stayed in the Senate he'd be a back bencher for years before getting an opportunity to become a leader. Now, the actual leaders for both parties in the House and Senate are pretty weak (I'd rank them Pelosi, McConnell, Hoyer, Boehner, and Reid strictly on their leadership abilities), but I just think the Democrats would be better served if they had some of their young guns in more prominent roles.
Tom Coburn (R-Oklahoma)- And right back to the crazies. Coburn is another one of those big time entitlement champions, but never
Chuck Grassley (R-Iowa)- I can never figure him out. Sometimes he seems like he's part of the small intellectually honest Republican contingent and sometimes he's as demagogic and misleading as the worst of them. And sometimes he champions causes for some unknown reason (huge opposition to physician owned hospitals, opposition to tax-exemptions). One thing I do like about him is that he's genuinely intellectually curious; I smiled when he said he relished the opportunity to learn so much about our healthcare system. His speech was mostly a wash though.
Henry Waxman (D-California)- And another wasted opportunity for giving a coherent speech on the merits of the bill. Did the majority of the Democrats come unprepared? Now, that's different from saying that the Dems have better arguments than Republicans. But it just seems like they barely attempted to play any defense. Waxman was in-line with the rest of them, never getting into the meat of why this bill is a good thing.
Dick Durbin (D-Illinois)- Maybe it's the Chicago water or just the way they play politics there, but the two most impressive Democrats today were both from Illinois. I sincerely hope that Durbin beats Schumer for majority leader when Harry Reid finally gets ousted. He's strong and consistent and is very good at crafting narratives. Plus he's really one of the only top Dems that is a natural and charismatic speaker. Either him or Biden should have been the number 2, rather than Pelosi and Reid.
I faded out a bit after that, and only caught a little bit of the rest of the speeches and the closing. Overall my verdict is one of a slight Democratic win, which I guess is how it was supposed to end up in the first place. Insofar as the Democrats were trying to shame the Republicans in their recalcitrance they failed at that. And if the Republicans thought that they could slow the Democrats or force them away from going it alone I think they also failed. Insofar as it matters, the best Democrats (Obama, Durbin, Biden) were far better than the best Republicans (Ryan, Cantor, Grassley) and the worst Republicans were godawful(Boehner, Coburn, Alexander). It should be enough to give the Democrats cover for reconciliation, now the question is do they use it?
But that's the political calculus. From a policy perspective, the bills are better than the status quo and certainly better than the Republican package of ideas, but to me they're still logically incoherent and not going to be nearly enough in the long-term. You can't fully make the moral health care coverage argument because you're forcing people to buy coverage rather than creating a mechanism to provide it for them. The fiscal argument is their primary argument, but it feels logically convoluted and a bit like a sleight of hand (cutting Medicare to fund other entitlements). But we'll see what ends up happening and whether or not this political theater actually matters.
