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The Boston Massacre

Robert Laszewski Tuesday’s Republican victory in Massachusetts means the current Democratic health care bills will not be on the President’s desk in 2010.

Forget the crazy talk of ramming something through—including just having the House pass the pending Senate bill.

I’ve talked to lots of people in the past few months that didn’t like the Democratic effort but conceded that the Dems won the 2008 election on a platform to do health care their way. They would say, “elections matter” and could, albeit begrudgingly, understand Democratic attempts to pass their brand of health care.

But losing Ted Kennedy’s former seat in Massachusetts with the singular issue being health care?

The game has changed. Democrats just can’t any longer spin the polls that for months have been so negative on the Democratic health care efforts.

The conclusion is now crystal clear—the people don’t want this. For goodness sakes—they rejected it in Massachusetts! On the political shocker scale this rivals “Dewey Defeats Truman” and the ’94 elections.

When Bill Clinton lost the ’94 elections, he went before the press the next day and took responsibility for what happened and then spent the next two years successfully rebuilding his presidency.

Obama and the Democratic leadership really only have that course in front of them now.

Defying the American people at this point with these foolish hypotheticals about how they could still thwart the obvious will of the people and pass their bill would only result in their digging themselves into an exponentially deeper political hole.

I am not sure Reid, Pelosi, and Emanuel understand this—they have proven to be incredibly politically tone deaf all winter.

But I will tell you something you can take to the bank—a lot of their House and Senate moderate Democrats do understand what this means and you can expect them to begin moving off these bills in the next 24 to 72 hours.
A trickle will lead to a stampede and that will be it.

There will be no interest in staying aboard the kamikaze flight Reid and Pelosi are now piloting straight into the 2010 elections.

In the end, this was 1994 all over again. The Democrats thought they could unilaterally do health care their way and blew it just the way they did 15 years ago–out of pure political arrogance.

Let me repeat something I must have said on this blog a hundred times—health care is too big an issue to be done in any way other than a bipartisan fashion. One side simply can’t move something this big, complex, and controversial without lots of political cover from the other side. This bunch, to their peril, never understood the lesson that both Social Security and Medicare were passed by comfortable bipartisan margins.

There is no doubt in my mind that there were at least 10 Republican Senators that were ready to deal in good faith on this issue—the “gang of six” plus the Republicans who had signed on to the Wyden-Bennett bill, for example.

But when Max Baucus was given the opportunity to try for a bipartisan solution, his hands were tied—bipartisanship was defined as Republicans having to sign-on to the Democratic bills their leadership and the left wing of the party were overly confident they could pass on their own.

Health care is an easy issue to demagogue. The opposition will always do it. Republicans, including these ten Senators, did a lot of it the past few weeks. That is why the opposition needed to be neutralized in the first place with real bipartisan support.

As readers of this blog know, I have been pessimistic about this effort for more than a year. But, today I also believe there is a way to pass a substantial bipartisan health care bill that would cover at least 30 million people, reform the insurance markets very much like the Democratic bills would have, and begin a process of real systemic change. I also believe that can happen in the next couple of years. It could all be in place by the same 2014 date the Democrats had in their bill.

But for now, the overly confident and unwilling to compromise Democrats blew it again.

With their solid majorities and popular new President, whom else do they have to blame?

The only way for them to make this election-year mess worse would be to ram their bill through. There are lots of Republicans in this town secretly hoping they will!

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Red ChalktonRomelPrivate CitizenMargalit Gur-Arierbar Recent comment authors
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Red Chalkton
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Red Chalkton

This is one of the more thoughtful pieces I’ve seen online, though the notion of “providing healthcare for 30 million people” in some cost effective way that doesn’t destroy the current system is naive, especially when you factor in illegal immigrants who don’t pay in to the system. This video sums it up for me:
http://www.youtube.com/watch?v=G4B4ry1pSjs

Romel
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Romel

The recent debate around how to best control health insurance and the cost, has pushed the issue of prevention to the front. Why is prevention so important? Everyone is complaining about the cost but the cost would not be as high if everyone took the time to properly take care of themselves. I know prevention is only a part of it but it is an important part of health. It is important because the average person is overweight and running up the medial cost. If you look at the generations before us they were in much better shape and took… Read more »

MD as HELL
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MD as HELL

I want the government to decide not to pay for the PEG tube, blondie. I never said I want them to decide to put it in or not. Futile end of life care must be a topic of healthcare reform. Without it, there is no way any money will ever be saved. After that comes cataract surgery for nursing home patients. After that comes dialysis for demented people. Where is the point where the government no longer pays for stupid care? Why did the nursing home send me a resident having a minor allergic reaction at 3:00 AM? Bacause they… Read more »

Margalit Gur-Arie
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Margalit Gur-Arie

MD as HELL,
So you want the government to decide when the PEG tubes go in, but are opposed to government structuring and subsidizing insurance plans.
What exactly is it that you want government to keep their paws off? Money?

Private Citizen
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Private Citizen

The democrats had to compromise so much on this bill that Howard Dean wanted the Bill to be scraped. What nonsense is the author talking? THE ONLY REASON SOCIAL SECURITY AND MEDICARE PASSED IS – politicans were not as partisan back then, there was no cable TV, no blogs post like to confuse people. No way would medicare pass today! AMA opposed medicare back then, this admin tried it’s hardest to keep negative campaign kill the bill, obviously something as huge and complex as this will be impossible for anyone, they were close… Medicare has such huge opposition when passed,… Read more »

Vikram C
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Vikram C

Md as Hell- Which entity do you propose will solve the problems that are faced? And stop owning all the people when you make sweeping comments. Obama has undertaken to fix economy & get universal health coverage. What was your solution to corporations tanking during the bust? If you don’t have solution then let him run the way he thinks is best. You had your way with GW Bush for 8 years and you will get your chance again. Economy clearly ain’t your sweet spot. So rather leave it at that. As for end of life care, talk to you… Read more »

MD as HELL
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MD as HELL

Margalit,
The only thing the President was elected to do is not be George W. Bush.
He was not elected to scrap the constitution, to take over GM, to hijack healthcare, or to make the dollar worthless.
He must have believed his own hype.
The recent special elections are clearly saying the people do not want him or the dems to run their lives.

MD as HELL
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MD as HELL

rbar, With controlling majorities in both houses and the White House all Democrat, the Republicans are responsible for absolutly nothing in this situation. You might contend that they should have supported something in this process, but there was nothing to support. I will be responsible for my hand washing. The governemt needs to be responsible for paying for rational end of life care. I say again; if they cannot/will not reform end of life care, then they can never cut any costs. I would send them all to GA (government anonymous) but they do not believe there is a power… Read more »

Peter
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Peter

“This is mind boggling.”
No, it’s the conservative agenda.

Margalit Gur-Arie
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Margalit Gur-Arie

I saw that, Peter. And I thought conservative justices are supposed to be strict constructionists…. This is mind boggling.

Peter
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Peter

“There is a fine line between seeking consensus and plain cowardice.”
Margalit, this bill WAS a result of cowardice, that’s why it lost my support. But you haven’t seen anything yet with the Supreme Court’s blessing to give corporations unlimited license to spend at will to give them the candidate they choose. Fox News must be salivating.

Margalit Gur-Arie
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Margalit Gur-Arie

Massacre??? This is as much a massacre as the original Boston Massacre was. Inconvenience? Yes, probably, even though Massachusetts is the last state in the Union to be qualified to express an opinion on health care reform. The facts are that Democrats have a President in place and a sizable majority in both houses. If they want to pass a bill, they should be able to pass a bill. So can we please stop making mountains out of ant hills and give in to every pressure and every veiled threat? This is not what the people voted for. We voted… Read more »

rbar
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rbar

MD,
I agree that there is an extent of overregulation, but OTOH, no propfession incl. ours functions completely self regulated … look at our collective inability to do proper hand hygiene, avoid unnecessary ABx, back sx and other procedures … we have regulate what matters in HC, that’s the difference between good and bad policy.
Re. end of life care: there were timid attempts in early drafts (compensate advanced directives etc.). This was destroyed by calculated GOP clowning about “death panels”. The dems may be corrupt and ineffective, the GOP appears to be either idiotic or, more likely, evil.

MD as HELL
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MD as HELL

Frank RN, Do you really need JCAHO and CMS telling you how to be a great nurse? Do you really need all those suits walking around, simply to compoly with regulations imposed by other suits? Do hands that do not touch patients need to multiply exponentially as they have in the last ten years just for regulations like HIPAA? Just wheat do you mean by “we can do better”. I don’t need them at all to take care of patients. Unfortunately the only thing government can do is put more people watching people actually work. There will be no reform… Read more »

Frank RN
Guest

As unpopular a concept as it is, I was (and am) for universal health care, including single payer. But, the way the Dembs (my own spelling!) went about this, I went from feeling a sense of sadness to one of relief that this is not going to get the rubber stamp this year. Having said that, the nay-saying, knee-jerk, over my dead body anti-universal health care crowd are really hard to take. Health care for all benefits us all. Just look at our health outcomes compared to the rest of the industrial world. Can’t both sides at least acknowledge that… Read more »