Kausfiles: A mostly political weblog.

Our Whippersnappers Is Learning

Something is Killing the President's Approval Numbers (especially on Rasmussen):  Is it his budget? Or the failure to pass health care reform, his #1 priority, and the ensuing strategic flailing, which is creating the impression that he's ... well, a loser? Nice guy. Knows all the arguments. Can't get it done. In other words, the numbers might vindicate the argument of health care reform supporters--that not passing the bill is extremely damaging to Obama and the Dems. What are they good for, anyway? ... 11:21 P.M.

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First Time Farce, Second Tragedy: Fire Mickey Kaus talks about how

old new leftists ...see tension and perhaps hypocrisy in a political philosophy devoted to a just and equal society that is dependent on groups formed around fragmentation and selfishness for its electoral success.

Well put. ... You might even speculate that--after a few decades of pursuing a more ideal society through fragmented, selfish interest group/constituency politics--liberals would have accomplished what there is to be accomplished via that route, and that the remaining problems would be those raised or perpetuated by interest group/constituency politics itself. ... The one exception would seem to be health care reform, which really should have been achieved in the last century. Yet now it appears to have foundered once again on the rocks of ....interest group/constituency politics. ... Hmm. I always wondered what "exception that proves the rule" means. ...  3:28 P.M.

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The scales have fallen from young Ezra Klein's eyes. He's not writing the surface health care "ego" story (e.g. procedural wrangling) when the underlying "id" story (e.g. they do or they don't want the bill) is the key:

There's been a lot about procedural impediments to moving forward on health-care reform: Can the Senate can pass a reconciliation bill before the House passes the Senate bill? Can Republicans delay reconciliation with amendments? Who should go first, House or Senate?

You all know I'm big on procedure. You've also noticed I'm not writing about this. I don't buy it. What Democrats can do is a lot less important than what they want to do. If 51 Democratic senators and 218 Democratic congresspeople are dead-serious about passing a bill, they can, and will, pass a bill.

Too bad most of the blogosphere's health care reform spirit squad didn't notice that the bill was failing the "id" test--and that this failure would be dispositive--until it was seemingly too late. ... 12:31 A.M.

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Are there really 1,690 people in the federal Department of Transportation making $170,000 or more a year? ...

Update: An alert reader who once worked at the DOT emails--

If this is true, I sort of know why. ... The simple answer is that DOT is, first of all, a collection of agencies that existed in other forms and were simply gathered together when the Department was formed -- the FAA, and the Federal Highway Administration are the big ones, but there are also NHTSA, the Federal Transit Administration, and I think eight others.  All of these have their own administrators, chief counsels, press offices, and so on.  They each have all the bureaucratic facilities they's need if they were independent agencies.  (It was done this way probably to preserve Congressional committee jurisdiction over these functions.  This is a far more significant factor in Washington than is  generally recognized -- the topic of transportation is rationalized in the executive branch by putting all of those agencies together, but they are still left separate within the department so that Congressional oversight can be left unrationalized.  ...)  

Then, spread over all of these there is an enormous Office of the Secretary, with another full complement of policy, legal, and Congressional-relations functions.   The result is that there's a huge number of presidential appointments and high level executive functions, many more than if the separate agencies had been destroyed when the department was created.

Then, on top of that, a number of these agencies have enormous presences around the country. ...  Take a look at http://www.dot.gov/DOTagencies.htm , start clicking on its links, and you will get the picture.  In  the way that bureaucracies work, all of those local offices have people at the top.  The number of top level people mentioned in your blog does not surprise me.   [E.A.]

12:31 A.M.

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The Left Takes a Powder

Here's a twitter exchange I had today with Josh Marshall of Talking Points Memo (I've reversed the order so read from top down):

 joshtpm I hear official DC is agreed: just wouldn't be right to pass HC reform post Scott brown victory. Welcome to Broder-Brooks-ocracy. about 5 hours ago from Tweetie

@joshtpm but my impression is that it's the left (Weiner, Grijalva) and not the evil centrists who are abandoning hcr on Hill. No? about 5 hours ago from web in reply to joshtpm

@kausmickey many shoes still to drop. But that is our impression. The real story of the last week has been the silence of the centrist dems about 5 hours ago from Tweetie in reply to kausmickey

@kausmickey but "official dc" resides in the commentariat not the right flank of the Dem caucus about 5 hours ago from Tweetie in reply to kausmickey

a) Fair enough. Just don't ever saddle us New Dems and moderates with Broder again, OK? b) Let the record show that, in the crunch, it was the "progressive" left that bailed on health care reform. Arianna bailed too! c) I'm sure many progressives have talked themselves into thinking that the Senate bill is just so awful--no public option, keeps the insurance companies in business, the Pharma deal, etc.--that doing nothing is better. If so, they are deluded. When do they ever think they are going to get this close again? Do they think a bigger, better, lefter Obama is going to sweep America off its feet anytime soon?

The argument that the Senate's scheme would be such a disaster that it would poison the public on reform--made explicitly by local Double-A League radical Robert Scheer--is a special stretch, calling out for a semi-Freudian excavation of progressives' subconscious impulses. After all, isn't it much more likely that, if the Senate scheme fails for lack of a public option, then a public option, or Medicare buy-in, could be added later? Maybe the real fear on the left is that the Senate bill might work. (Then the public option would be in trouble.)

Some observers would argue "progressives" are simply more comfortable staying angry and on the outside. It helps them stoke their followings, or raise funds, or get on MSNBC. I'd say it's more likely that recalcitrant House members like Raul Grijalva are simply advancing their left objections as a handy cover for the universal trans-ideological self-interested Congressional political survival instinct: they don't want to pass a bill and lose in 2010 in a wave of independent, swing-voter displeasure.  ...

In any case, it's revealing, as Marshall said, that the "center" hasn't been playing this covertly self-preservationist game, at least in public. Not that they have to do it when Anthony Weiner is doing it for them. ...

Update: When the most plausible, optimistic scenario for passing health care reform is outlined by .... Dick Morris, you know you're in trouble:

Nancy Pelosi’s strategy is to delay and let the impact of the Brown win in Massachusetts be blunted by time. Meanwhile, she will propose amendments to the Senate bill and submit her proposed changes to the upper chamber. Harry Reid will tell her that such a bill is dead on arrival but she will demand a vote. When the measure is rejected (or fails of closure), she will go back to her caucus and say, “I tried, but the Senate would not accept any of our amendments.”

More: Sen. Sherrod Brown of Ohio tells TPM he's been meeting with House "progressives" who don't want to pass the Senate bill in part because "it really writes them out of having any impact." Pathetic, no?  Is it that they want to show lobbyists they can deliver, they want to impress voters with Kabuki,, they're just juvenile--or they really don't want to pass a bill? ... 8:26 P.M.

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Game Change Outtakes: Left on the cutting room floor when New York magazine excerpted the juicy Edwards bits from Game Change were these rather forceful sentences from the book itself, about St. Elizabeth:

What the world saw in Elizabeth: a valiant, determined, heroic everywoman. What the Edwards insiders saw: an abusive, intrusive, paranoid, condescending crazywoman.

They said it! I don't know the truth. I don't think any of the embarrassing, wacky incidents recounted in the book quite add up to that last word. But it would still explain a lot. ... 9:23 P.M.

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I dont thnk I've seen an uglier mass-market sedan than the new Mercedes E-Class. A pretentious pile of dreck. Makes Chris Bangle look like Pininfarina. ....9:30 P.M.

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Groopman 1, Orszag 0

If you didn't want Obama to fire Peter Orszag already,** you might after reading Jerome Groopman's piece in the New York Review of Books. Groopman notes that "comparative effectiveness" research on which treatments work and which don't--research Orszag would back up with financial incentives and other semi-coercive measures, and which he and Obama think will cut costs--is often a four card flush:

Over the past decade, federal "choice architects"—i.e., doctors and other experts acting for the government and making use of research on comparative effectiveness—have repeatedly identified "best practices," only to have them shown to be ineffective or even deleterious.

Plus, declaring one course of action a "best practice" often involves a value judgment that experts aren't in a much beter position to make than individual physicians or patients. When a federal panel recommended against mammograms for women in their forties--allegedly without considering cost--it implicitly decided that the anxiety and pain of false positives (resulting in biopsies and sometimes surgery) outweighed the saving of nearly 12,000 lives over 10 years. Maybe that's not an unreasonable weighing--seems crazy to me, and Groopman doesn't buy it--but it's not a "scientific" finding to be imposed through financial penalties.

P.S.: Obama, who (Groopman notes) consistently portrays "comparative effectiveness as equivalent to cost effectiveness," either a) has an average President's shallow understanding of the subject, or else b) is conveniently trying to make "bending the cost curve" look painless (by pretending cost-cutting will never require denying treatments that have some benefit).  ... Or else c) he knows that if he knew more--enough to second-guess Orszag--he couldn't do the pretending, so he doesn't want to know more. (And Ron Brownstein and Dave Leonhardt love his position the way it is! ) (C) would be my guess.

P.P.S.: I think Groopman pretty clearly demonstrates why Bob Wright was wrong, so wrong, in our latest bloggingheads debate about what was and wasn't in the health care bill. But at least Wright wasn't smug about it. Oh wait, he was! ...

**--The latest humiliation to the Obama/Orszag/Pelosi/Reid health care effort: Dems are apparently floating the idea that the ban on excluding pre-existing conditions will apply only to children (who are of course the least likely to have them). That would be a pathetically small achievement designed mainly to preserve the careers of Dem Congresspersons by allowing them to hype a tiny, face-saving accomplishment. Kabuki wins! Or, as Charlie Peters calls it, Washington Make-Believe. ... 11:40 P.M.

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Would Voters Punish Dem Health Care Backsliders?

Jonathan Cohn, and SEIU head Andy Stern, among others, argue that there's no turning back on health care for House Dems who've already voted for it once. If they now claim to have changed their minds, they'll still be attacked for their earlier vote, or else they'll be pilloried as Kerryesque flip-floppers. 

I'd like to think this is true. But in my experience voters are all too reluctant to punish politicians who've had timely conversions to the winning side after a drubbing at the polls.** Voters may even value those pols more than their colleagues who were on the "right" side all along--the post-defeat change of heart a) pays respect to the voters' power and b) suggests that the pol knows who is in charge and will be easy to control from now on (unlike an annoying principled true believer who might not take orders). ... Pols who have followed electoral repudiations with seemingly opportunistic turnabouts--but have survived thanks to this perverse rewards system--include Jerry Brown (who flipped after losing on Prop. 13) Arnold Schwarzenegger (who started looking a lot like a Democrat after his 2005 "year of reform" flopped in a special election). ...

All this suggests, unfortunately, that many wavering House Dems may decide that declaring they've 'gotten the message' and changed their position on health care reform could, in fact, help protect them from being effectively attacked for their earlier support. ... P.S.: This doesn't mean they won't be effectively attacked for having failed to accomplish much, a slightly different question.. ...

**--Kerry's flip-flops were different--they smacked of instinctive "positioning," the attempt to insure that whatever happened Kerry could say he was on the more popular side. Not a one-time move from "yes" to "no," as it were, but a drumbeat of "yesnos." ...1:18 A.M.

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Democrats: Are You Ready for ... Victory?

Why Andrew Sullivan is not someone you'd want to follow into battle, Part XVIII: Andrew Sullivan declares, upon contemplating a possible Coakley loss:

Democrats can stop hoping at this point.

I can see no alternative scenario but a huge - staggeringly huge - victory for the FNC/RNC machine tomorrow.  ... [snip]

What comes next will be a real test for Obama. I suspect serious health insurance reform is over for yet another generation.

Even if Coakley wins - and my guess is she'll lose by a double digit margin - the bill is dead. The most Obama can hope for is a minimalist alternative that simply mandates that insurance companies accept people with pre-existing conditions and are barred from ejecting patients when they feel like it. That's all he can get now - and even that will be a stretch. [E.A.]

Later, Sullivan writes, about health care reform:

It's over. Rahm Emmanuel did such a great job, didn't he?

Excitable! ... Q: How do we know this is the real Andrew Sullivan, and not one of his ghostbloggers?**  A: The ghost would have been more level-headed.. ... 

It's not over, of course. There's a good chance of passing the Senate bill through the House, which would be a perfectly legitimate course of action. Nate Silver, for one, has a useful analysis free of theatrical overreactions.. ... Does Dennis Kucinich, in the crunch, really want to be the one who blocked coverage for the uninsured? ... P.S.: Jon Chait calls on Sullivan to keep his head. Never a good bet. ... But once he loses it he recovers quickly! Peer pressure works.  ...

**-- Sullivan's new name for them, apparently, is "under-bloggers." Flattering! ...12:31 P.M.

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Stop me before I curate again: Slate Overboss in Pre-Election Shock Tweet: Even the liberal Obamaphile Jacob Weisberg wouldn't vote for Coakley (because of her role in the Amirault case). .... Neg for Meg: Who is the mystery "celebrity" that conservative radio host John Phillips hears will jump into the California governor's race in about a week? Phillips doesn't specify that it's a Republican.... Lawrence O'Donnell thinks Senate GOP leader McConnell has been secretly trying to make sure Obama's health care reform passes. ... 2:53 P.M.

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Kf hears that if Coakley loses on Tuesday, the White House strategy will in fact be to try to pass the already passed Senate bill, word for word, through the House. Sudden Victory! **... Sorry about all the lost Kabuki! ... And Mr. Trumka, you'll have to get labor unions out from under the Senate's "Cadillac tax" later. ... P.S.: You didn't actually believe Speaker Pelosi when she dismissed this prospect, did you? ... P.P.S.: Always trust content from kausfiles. ...

Update: Keith Hennessy raises the question: Would it really be less controversial for the House to pass the already-passed Senate bill intact, as opposed to quickly ramming through a new House/Senate compromise before Brown is seated? A: Yes. One strategy requires blocking the result of the Mass. election. The "sudden victory" strategy does not. You could seat Brown promptly, and if the House passed the Senate bill it would still be Game Over. ... Of course, that assumes that spooked House lawmakers can be persuaded to pass the Senate bill (something Megan McArdle doubts).. ... [via 538]

**-- formerly known as "Pong."...1:29 P.M.

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Blame Orszag First, Part VIII: A friend emails: 

I think Mass. is validation of your take on Obama's stupid framing of insurance reform.  He has given people absolutely nothing to feel bad about if the bill is stopped.  "WHAT?  THEY TOOK AWAY MY COST CONTAINMENT?"

Coakley and all the Dems are bearing the burden of that stupidity.  It's not that people don't want insurance reform.  It's that they don't want what they have been hearing about it -- from Obama no less than the Republicans. 

Obama has let the respectable press nudge him into talking about vague or downright ominous-sounding Orszagist cost-controlling schemes at virtually every opportunity. Here he is being all-too-easily driven off-message on NPR recently:

SIEGEL: Mr. President, some people have faulted this whole process for not focusing enough on how medicine is practiced in the U.S. and our appetite for lots of tests and the like. I want to ask about a recent, coincidental event, which would be the new guidelines on mammography. They suggested that we've been testing too much and it would be better to get tested less. There was an outcry. ...

OBAMA: Well, I think what it says, No. 1, is that we still have a tendency to think that more medicine is often - is automatically better medicine. And that's just not the case. Inside this reform bill that I'm pushing is a provision that has a panel of experts - doctors, medical experts - who are going to look at all these practices to start changing how we think about medicine.

SIEGEL: Will politicians defer to their judgments - to their scientific judgments?

OBAMA: Well, one of my goals is to make sure that doctors and scientists are giving the best information possible to other doctors who are seeing patients. Look, if you talk to most health care economists right now, they will tell you that every good idea out there, when it comes to improving quality of care and reducing costs of care, are embedded in this bill. It's not going to happen overnight because we're going to have to change both how doctors think about health care and how patients think about health care.

And there are going to be millions of small decisions all across the country and interactions between doctors and patients that, over time, change the trajectory of our health care system. The important point is that we're getting started in this process. And I'm actually very confident that the average person is going to say to themselves, if, right now, I'm taking and paying for five tests and my doctor tells me that I only need one, that person's going to want to take one - save some money and save some time. But they need some validation. They need somebody who's giving them the better information. And we have set up a system where, year after year, best practices are going to get disseminated across the country. [E.A.]

a) Obama says,"[W]e're going to have to change both how doctors think about health care and how patients think about health care." And here I just wanted to get covered! I'm not sure I want to change how I think about health care. ... I thought the genius of the President's health care strategy was that it told people who were happy about their current insurance not to worry. Now he's telling them that under his bill they will need to alter the whole way they look at not only insurance but medicine itself-- that they, and the doctors they like, have it all wrong. Bad voters! Thinking that "more" is better! That's so American. Get your heads re-programmed. b) As Peggy Noonan notes rather forcefully, Obama's making an inside,elite appeal here--to moderate swing members of Congress and respectable Ron Brownstein types:

He negotiates each day with Congress, not with the people. But the people hate Congress! Has he not noticed?

c) "I'm taking and paying for five tests and my doctor tells me that I only need one." Do you have any confidence that Obama knows what he's talking about here? I don't. I think he's read some New Yorker articles. ...

These don't seem like mistakes a pol like FDR or LBJ would make. The program we know as Social Security, for example, was not all that popular when it was enacted in 1935 (for one thing, it took years to get up to speed). But FDR and the Dems realized this--which is why they hid our current contributory pension scheme behind a straight, cash-dispensing program of Old Age Assistance for the elderly poor--a means-tested plan that was wildly popular because it promised to start sending out checks immediately. (It's still with us, having morphed into SSI, which sends checks to, among others, impoverished seniors.) .... 11:26 P.M.

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How Health Care Reform Could Crash

Poll watcher Sean Trende (if that really is his name) thinks Massachusetts GOP challenger Scott Brown may have peaked too soon. Hmm. Doesn't necessarily look like it. .... Mark Blumenthal has some guidance for reading and reconciling all the Mass. polls--it's not just that lower turnout (and tighter voting screens on polls) tend to favor Brown. Everybody knows that!  It's also a robo vs. human contest, especially when it comes to independents.

Perhaps it is harder for them to tell a live interviewer they are ready to vote Republican. Perhaps the more anonymous nature of the automated methodology better simulates the act of voting which will ultimately force a decision.

Plus the Incumbent Rule is on the line, yet again.  ...
 
P.S.--Shock Waves Rippling: Trende makes a good point about the possible effect of a Brown win on health care:

[P]eople are predicting that if Brown wins either (1) the Democrats will pass the Senate bill or (2) the Democrats will get the revised bill through the Senate before Brown is seated.

I guess this is possible, but you have to think that a few more Democrats in R-leaning districts or states will be spooked enough by this to resist voting for the bill.  Does Evan Bayh really think his seat is THAT safe?  If Scott Brown can win in Massachusetts, John Hostettler can sure as heck win in Indiana. [E.A.]

I suppose, if the Congressional id is screaming for a way not to pass health care, the most obvious way that's left would seem to be this: a Senator bails (Nelson, most obviously) or if Coakley is defeated they just can't pass the bill before Brown takes her place. (Darn!) So the bill can't go back to the Senate--any House-Senate compromise is doomed by the lack of a 60th vote. The only hope becomes getting the House to pass the already-approved Senate bill word-for-word (the Sudden Victory strategy). But just enough House liberals declare they can't stomach the Senate bill--on the grounds that the uncompromised Cadillac tax is unacceptable, perhaps, or the subsidies are too low, or that a public option is essential. Presto, a train wreck. Everyone gets to go home and claim they were fighting the good fight. ... P.P.S.: Jay Cost runs down the names of the House swing votes, although he's paying more attention to the moderates who might bail on a compromise, not the liberals who might balk at the Senate bill. ... 2:21 A.M.

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Health Care: Will Kabuki Kill Pong?

Why the Health Care Polls Are Tanking, Part XVIII:

At least some of the rising discontent with the Democrats' health care reform comes from the left, or from not-necessarily-left voters disappointed that the left's favorite ideas--the public option, the Medicare buy-in--are dropping out of the legislation. At least that's the conclusion the Wall Street Journal reaches after the latest NBC/WSJ poll, in which a 45% plurality of voters said it's "unacceptable" to drop the public option--and in which overall support for the bill fell by 10 points (since the previous poll, in October). I'm not sure just how impressive this evidence of pro-government discontent is--the "public option" always tests well, and only 13% of "Democratic liberals" now actually oppose the bill (up from 6%). 
 
Still, you have to wonder what this says about the left's overemphasis on the public option throughout 2009. I'd originally assumed the p.o. fixation would work to Obama's advantage, drawing conservative attacks that would then be defused if the option was dropped. (That's Jonathan Cohn's take.) But maybe it worked to Obama's disadvantage--promising Medicare-like advantages from the wondrous public option only to have voters turn against the bill as a whole when this fabulous feature was snatched away from them. If so, the left has inadvertently done Obama a huge disservice--not pushing the bill "to the left" but rather helping kill it even after it's inevitably been pushed back to the right.  If the left had fixated on a policy idea that wasn't so sensible and appealing, it wouldn't have been such a problem! (Then dropping it would have been a helpful pushing-off point for Obama.) Possible moral: Be crazier next time!
 
P.S.: Paul Krugman calls on the disappointed left to "[b]y all means denounce Obama for his failed bipartisan gestures," but to support the scaled-back health bill. But how did Obama's "failed bipartisan gestures" lead to the public option (and the Medicare buy-in) dying? What sort of non-bipartisan gesture would have preserved them? They didn't have the votes. They had all the votes on the left. That wasn't enough. No votes, no public option. The only hope of getting the necessary 60 was appealing to the center, which is where the votes were. ... But maybe Krugman is thinking about some other kind of "failed bipartisan gesture"--i.e. if only the stimulus had been bigger, then the economy would have recovered faster and Lieberman or Snowe would have been more amenable to government-run insurance. That last step seems implausible. [Was this written by you or Herman?--ed Does it matter? I basted him with the triangulating juices, and he knows more about health care than Mickey does I do]

Update: A TPM reader tries to explain the left's beef:

I think people are pissed right now less at the fact that they didn't get what they wanted, and more at the fact that they feel like their people didn't really fight for it. Leaders don't always get what they want. But people recognize when true leaders at least give it a shot. And people judge that leadership by what they say in public and how hard they see them publicly pushing for it. ... [snip]

They wanted to see news stories about how "staffers close to the majority leader" say that chaimanships and other perks were on the line for any Democrat who talked about filibustering this crucial bill.

In other words, they wanted more Kabuki before the inevitable defeat. ... Do you think public threats would have changed Lieberman or Nelson's mind (as opposed to feeding their adversarialism)? ... Some would say this is the essence of the left's Fight Club mindset! It's all about the drama, even if the results are the same (or, usually, worse). ... [via Ezra Klein, who thinks "grueling negotiations" before giving up the public option would have helped. This hasn't been grueling?] ... P.S.: Nobody knows how to stage empty Kabuki outrage more than labor unions. ... P.P.S.: Maybe this rumor will help. ...1:02 A.M.

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@kausfiles--Dick Morris prepares to lose on health care?

Based on a true Twitter feed: 

Wouldn't it have been better if Obama's task force had sacked all these GM execs back in June, when the bailout happened? It would have been clear--to them and everyone else--that they'd lost their jobs because they'd driven their giant firm into bankruptcy.  Now they (and those around them) may just think they're survivors who've been victimized by an a-hole board chairman. ... P.S.: We demand to hear from (fired Chevy boss) Brent Dewar's daughter. That "will work closely ... to ensure a smooth transition" press release stuff doesn't even work as boilerplate anymore. ...

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What Unz Done: RT walterolson Calif.’s electorate proved right: Hispanic test scores up since anti-bilingual Prop. 227 passed [HMD, @cityjournal] http://is.gd/5hn8o 24 minutes ago from web 

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A sign health care reform may actually pass: Dick Morris is getting desperate, reciting Tennyson, lamenting Obama's mystical powers ("Why does this pied piper have such power over you?") http://tinyurl.com/yzjlypd about 4 hours ago from web ... Plus he's claiming victory in anticipation of defeat ("congratulations to all on having "seemingly killled the public option") ....

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kf is Stupid:  The curve-bendin' economists latest letter says there's "great interest in bundling payments for medical services,"
Hmm. Doesn't "bundling" mean that when I maybe need a med procedure, my doc has an incentive NOT to give it to me? And this is different from the hated HMOs ... how? ... 8:28 PM Dec 7th from web

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Hardy kf Perennial: Best Xmas song: Wedding Present's hard version of "Step Into Christmas"  http://tiny.cc/KCdQB This year, the anguished delivery of inane B.Taupin lyrics seems hilarious and profound about 4 hours ago from web

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26 Economists 26: Save Orszagism! http://tinyurl.com/ykwdygf Guess they don't think it's Kabuki (i.e., pretend deficit-control to give moderates cover). That makes for the best Kabuki! 8:26 PM Dec 7th from web

6:52 P.M.

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Obama Demands Staff Go Cocoon Themselves

According to Politico's Mike Allen, President Obama made Ron Brownstein's non-naive-but-still-cheerleaderish party-line Orszagist praise for the Reid bill's cost-curve-bending "mandatory reading for all senior staff." TPM says Rahm Emanuel gave the homework assignment ...

1) Do they really believe in curve-bending, or do they just want us to think they really believe? Certainly the latter. But judging from Obama's earnest, respectable early David Leonhardt interview--where he easily equated curve-bending with denying grannies hip replacements--he really believes. Yikes.

2) Note that the best even the enthusiastic Brownstein can muster are sensible quotes from Robert Reischauer saying, in effect, "Hey, some of these ideas might work'. Take that to the bank! ... 

3) Are these people in a cocoon? Wouldn't Obama would want to assign articles that didn't reinforce his pre-existing world view? That maybe raised plausible criticisms? You have to wonder if the reason the White House didn't delay the recent incendiary mammogram-cutback report was because they thought it would actually help them? 

4) Is it a coincidence that ever since press secretary Gibbs announced a renewed emphasis on Orszag's "curve-bending" in early November support for health care reform has plunged downwards on an increasingly alarming slope? That's one curve they've bent! ... The pattern seems clear: They talk about curve-bending (in the spring) they get into trouble. They stop talking about curve-bending (in September), and health care is suddenly a fait accompli! They start again, and they're in trouble again. ... What was that about insanity being defined as doing the same thing over and over and expecting different results?

P.S.: At least Brownstein, unlike Ezra Klein or the first rough draft of kausfiles, got the basic mechanism of the "Independent Medicare Advisory Board" right. Except he didn't. Brownstein writes that the

board would be required to offer cost-saving proposals when Medicare spending rises too fast; Congress could not reject its proposals without substituting equivalent savings.

No. Congress could reject its proposals without substituting equivalent savings anytime it wanted to (and could obtain the President's approval or override his veto). The Reid bill simply says Congress would have to substitute equivalent savings if it wanted to use a 'fast track' filibuster proof legislative pathway it sets up (a pathway that still allows a presidential veto). Future Congress' don't have to use that fast-track and no law Congress passes this year can make them, as far as I can see.. ...

P.P.S.: Brownstein does unearth what seems to be a second Broder-shaking delegation of sweeping rule-making power by Reid:

[I]n a little known provision, the bill authorizes the HHS Secretary to implement nationwide, without any congressional action, any reform that department actuaries certify will reduce long-term spending [E.A.]

Wow. So we've got the independent Medicare board slashing spending, subject to a formalized Congressional meddling process, and we've got the Secretary of HHS slashing spending, subject to ... any check at all?  ...What if the recommendations conflict? ... I smell a new Czar! ...

P.P.P.S.: Do we really think the "IMAB" board and a grant of equivalent power to HHS will survive in the final bill? Will Congressmen really give up their power over sensitive issues like ... mammograms ... and let bureaucrats deny popular Medicare treatments to their constituents? If they don't--and if they strip or water down the provisions-- will Obama regret having made independent, expert "curve bending" seem like such an essential part of his health bill? ... Or is the purpose of making a fuss about Brownsteinian reforms just to get the bill over the hump in the Senate? ...6:27 P.M.

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Does Harry Reid's Health Care Bill Create a "Fed" for Medicare?

[Update: This post has been corrected. New text has been underlined.***]

David Leonhardt, complaining that the House health care bill doesn't do enough to control costs, touts a particular model for imposing parsimonious changes on the nation's health care delivery system: 

Twice a year, an outside advisory board sends Congress a list of suggestions for Medicare payment rates, based on the available evidence. Congress generally ignores them, in deference to the various industry groups that oppose any cuts to their payments.
 
We already have a wonderful model for how to avoid such interference. It’s called the Federal Reserve. The Fed is charged with setting interest rates based on economic conditions, not politics. The Senate bill would create such a commission for Medicare.

But does the Senate bill really have a cost-cutting commission that's like the Fed? The Fed is a highly independent agency whose actions take effect without approval from Congress. Maybe Congress could overturn a Fed action, but it would require a new piece of legislation, passed by both houses and signed by the president. In contrast, the current cost-cutting "MedPAC" panel submits proposals that then have to be passed as new laws by Congress or else they don't take effect (which, as Leonhardt notes, is usually what happens).

The logical middle ground would be to have an independent panel whose recommendations take effect unless they are somehow vetoed by Congress without presidential involvement,** or whose recommendations must be affirmatively passed by Congress but get the benefit of a streamlined, limited-amendment up-or-down fast-track "base closing" type of legislative process.

I assumed that the second of these obvious middle ground alternatives--rather than a "Fed" approach--had been taken when I read this description of the Reid Senate bill on Ezra Klein's blog:

The idea isn't simply that a panel of experts gets to dream up interesting reforms to try out in Medicare. It's that they are charged with making sure that Medicare hits certain growth targets, and their package of reforms has to achieve that goal. Those reforms are then sent to Congress, where Senate debate is limited to 30 hours, and amendments must be both budget neutral and "germane." This report, in other words, is exempt from the filibuster. So far as anything is ever easy to pass, this is easy to pass.

Then I read the bill.  As far as I can see, it's actually a whole lot closer to Leonhardt's "Fed" model than I'd thought. In general, there is an independent panel ("IMAB"), and if Congress does nothing, its cost-cutting rules take effect.  What's more, the "fast track" process described by Klein would not allow Congress to simply stop the board's rules, only to substitute its own plan to save the same amount of money. This would be a very powerful unelected board. David Broder may explode.

**********

You can read the law yourself--the relevant provision (Sec. 3403) runs from page 1000 to page 1053 here. But what it seems to say, specifically, is:

--The new 15 member "IMAB" board makes cost-cutting recommendations if Medicare spending exceeds specific targets.

--Congress then 'considers' these changes in bill form. But like other legislation, the president can veto this bill (and his veto can be overridden).

--The "fast tracking" provisions Klein discusses apply to this bill. But they also sharply restrict what the 'fast track' bill can do. Congress can't, under the fast track, just block the IMAB board's decrees. It can change them, but if it changes them it has to meet the cost-reduction targets in some other way. It's not allowed to not save money, apparently (though the Senate is allowed to do some unspecified things by 2/3 vote that I don't quite understand). In other words, the 'fast track' isn't designed to enable Congress to swiftly pass the new IMAB board's rules. The IMAB board doesn't need Congress' OK (see next paragraph). The fast track is designed to allow Congress to tinker with the IMAB board's rules as long as it reaches the same result. In this sense, the Reid fast track isn't like base closing, where Congress votes a package of cuts up or down in a special procedure. Voting down is not an option here.

--Key point: If Congress doesn't pass the fast-tracked 'tinkering' bill, the Secretary of HHS must implement the IMAB panel's recommendations.

--And Congress loses even its fast-track tinkering power after 2020, unless, by a 60% supermajority, during a specific window in the first half of 2017, while standing on one leg and humming Battle Hymn of the Republic, it passes a joint resolution discontinuing the whole process. Correction: The part about standing on one leg and humming doesn't seem to be in the final bill.

Complicated! (If I got it wrong, let me know.) The most obvious flaw seems to be this: Under the Reid bill, the way Congress react to the "IMAB" board's rules is by passing a law, subject to presidential veto, on a carefully-circumscribed "fast track." But Congress can pass a new law, subject to veto, anytime it wants on any subject, using its traditional "slow track" (or any faster track it feels like creating). The Reid bill can't stop future Congresses from doing that--passing a law simply throwing out an IMAB board recommendation, for example, without offering an alternative way to save money. Or killing the IMAB board completely (whether or not it passes this law in the first half of 2017). All the Reid reform can hope to do is prevent Congress from doing this via the specified "fast track." A meddling Congress, faced with constituents angry at Medicare cuts, might well say, in effect, 'take your fast track and shove it--we'll show you fast'.

Suppose, say, the "expert" IMAB board decrees that the feds won't pay for routine mammograms for women in their forties. How do you think Congress would react? ... 

**--Several readers suggest that this "legislative veto" middle ground would be unconstitutional under the principles of INS v. Chadha. They may be right--which could be why the Reid bill envisions a fast-track legislative process that requires the President's signature, as with any regular law. But the Reid bill appears to rely on a legislative veto of its own--allowing Congress, by joint resolution, without the President's approval, to terminate the whole IMAB board in 2017. Why would it be unconstitutional to let Congress, acting alone, kill the IMAB board's rules, but not unconstitutional to let it kill the IMAB board? ...  Paranoid thought: It's a trap. Proponents of a strong, Fed-like panel would love to sucker opponents into attacking it via a "joint resolution" mechanism that's later held unconstitutional and void. ...

***--Correction: Underlined words and sentences reflect a second, and I hope more accurate, reading of the bill. The "fast track" resolution is not designed to let Congress nix the board's rules, as I initially thought. It apparently only lets Congress substitute other ways to save the same amount of money. All the more reason Congress is likely to simply skip the 'fast track' entirely.

Cynical view: This entire "Fed for Medicare" provision, with its nanny-like restrictions on what Congress can do on the 'fast track,' isn't going to pass, and if it passes it won't last. It's mainly Kabuki designed to convince the CBO to "score" the whole health bill as a deficit-reducer. ... 10:40 P.M.

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Murder in the White House: I've read the Lloyd Grove's account and Steve Clemons' account and  Elizabeth Drew's account--and I still don't have a clue as to why Greg Craig was forced out as White House Counsel--just that it was a bad, bad thing and was done by leaks. ... If you could force someone out merely by leaks, wouldn't Rahm Emanuel have been forced out of the Clinton White House in 1993? ... There's something here we don't know, no? Someone Craig pissed off, maybe. Someone unfireable from Chicago? (I'm just speculating, but that is the sort of thing that would fill the role of ninth planet here.) ... 

Update: Time's account fills much of the void, portraying Craig as a politically tone-deaf civil liberties purist. Maybe there is another side to the story. But if Craig really did want to release photos of detainee abuse, that's enough for me. ... 11:49 P.M.

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Suckers of the Week

Explainer Wanted: Why would a politician ever concede a non-blowout race until every last ballot is counted? The momentary frisson of good will can't be worth the possibility that the concession will turn out to have been a mistake--as it was for Jimmy Carter in 1980, Al Gore in 2000, and now conservative Doug Hoffman in the NY-23 congressional race. ... Hoffman will probably still lose when all the ballots are in, but his concession has already had real world consequences--it allowed Nancy Pelosi to swear in Hoffman's Democratic opponent in time to give health care reform its narrow House majority. I'm assuming the people who voted for Hoffman aren't happy with that. ... P.S.: Dick Morris claims, plausibly, that Pelosi had many Dem votes in reserve. Still, thanks to Hoffman's concession she didn't have to use them. ...

Update: Mystery Pollster answers.

One answer: They remember Ellen Sauerbrey http://tr.im/EToC Hoffman wants to run again next year, also counted right http://tr.im/EToX 

I'm not convinced. You don't have to be nasty about it. Just say "Let's see how it turns out" and don't concede. ... 9:48 P.M.

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Things you thought you were getting in the auto bailout. ... Chrysler's showy electric and hybrid cars? Forget them. Now that Chrysler has your money, they're dead. ... GM's 2010 IPO? The one that was going to raise money to repay taxpayers? It's receding rapidly into the future. "It depends on how quickly we become profitable. ... I can’t promise a date," says GM Chairman Ed Whitacre. Translation: Not going to happen. ... Suckers! ... 9:40 P.M.

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Am I the only one who smells Kabuki in the reports that President Obama has dramatically rejected all the Afghan war options with which he was presented, demanding to know where the "off ramps" are? If you were about to recommend a troop increase that was unpopular, especially with your Democratic base, wouldn't you precede it with some drama like this to demonstrate that you are a) in charge, b) not being conned, and c) insistent on a withdrawal as quickly as possible? Just asking. ... 10:54 P.M.

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What's wrong with the upcoming Chevy Cruze? Production of the new compact has been delayed three months. The New York Times says the problem is "engine performance and the quietness of the Cruze's ride." AP, quoting the same GM executive, says the problem is the transmission ("No one was thrilled with where it shifted, how it shifted.") What if they're both right? ... P.S.: It's fine that GM postpones a launch for a car that's not yet up to snuff. But the NYT's Bill Vlasic is a sucker for buying the line that this sort of delay represents a dramatic "culture" shift: 

In the past, G.M. rarely held back a product to add the extra touches that would improve its chances in a fiercely competitive market.

Please. GM's been peddling this line for years. See, for example, this U.S. News report:

Concerns over quality have substantially altered the way Detroit launches new models. A case in point is the line of luxury midsized cars planned for this fall by Cadillac, Buick and Oldsmobile. Transaxle problems with these front-wheel-drive C-body models caused GM to delay their introduction until at least January, and possibly spring. ''The car will have to tell us when it's ready," says Robert Burger, Cadillac's general manager. Notes a longtime industry observer: ''In the old days, that would be unheard of. They'd move the cars in the fall, whether they were right or not.''

That paragraph was published in 1983. ... 10:56 P.M.

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"CNN doesn't have a brand.  It has a bland.  It just got blander." -- Alert reader T. ...  11:36 P.M.

Did Fox Win the War?

Obama aide Anita Dunn, who started the White House war against Fox, is leaving her post. ... Meanwhile, Obama will give an interview to Fox's Major Garrett. ... Did Fox win? ... Or was it an October fundraising ploy all along? ... If Obama won, his communications shop certainly knows how to magnanimously make it look like he lost. ... Is that what Sun Tzu would do? ... 11/13 Update: Dunn a) declares victory on her way out the door("People took a step back and said, ‘Hmm, am I really wanting to go chase those stories?’”) b) lobs a few more shells  c) suggests she had a White House pre-clearance to launch the war ("White House chief of staff Rahm Emanuel, Press Secretary Robert Gibbs and perhaps even the president himself gave her the green light," says Sam Stein.) d) says “There are no confirmed television interviews in China," where the Major Garrett interview was reported to be planned. Won't that make it a bit embarrassing if it happens? ... P.S.: Still looks like a retreat to me, even if I agree with Dunn's underlying premise--that Fox News is in essence a different sort of animal from even MSNBC. ...  6:20 P.M.

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BriarPatch.org: From ABC's Note:

MoveOn.org is launching a round of TV ads this week targeting Democratic House members who voted against the health care bill over the weekend.

Thirty-nine Democrats voted against the bill, though MoveOn is starting by targeting only six fiscally conservative "Blue Dog" Democrats: Rep. Mike Ross, [D-Ark.]; Rep. Jason Atlmire, D-Pa.; Rep. Glenn Nye, D-Va.; Rep. Rick Boucher, D-Va.; Rep. Larry Kissell, D-N.C..; and Rep. Heath Shuler, D-N.C. ...[snip]

A spokesman for the group said MoveOn plans to spend $500,000 on the ads, which come as liberals seek to pressure moderate Democrats in the Senate to support President Obama in his quest for health care reform.

 Alert reader T. emails:

If you were a Democratic House Member from a relatively conservative district (especially if you've already taken a bad vote on cap and trade) how much would you pay MoveOn to come into your district and publicize your vote where you stood up to Pelosi and Obama on government-run health care?

True. But doesn't MoveOn know this? They still get to look tough, and raise money. Conservative Dems get to triangulate. It's win-win. ... 7:41 P.M.

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A very pretty mid-50s FIAT with a body by the late Elio Zagato. Note subtle grille graphics. ... 7:41 P.M.

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PATCO in Reverse?

Tuesday, December 9, 2008

An early version of the New York Times story on the auto bailout deal said

[T]he bill seemed likely to stop short of authorizing the broad powers that some lawmakers had urged to allow what could have amounted to an out-of-court bankruptcy proceeding, in which the automakers’ creditors could be forced to accept reduced payments, labor contracts could be rewritten and executives could be summarily dismissed. [E.A.]

Hmm. Why shouldn't the bailout deal include an explicit reopening of labor contracts? If the new "auto czar" can order the companies to restructure, tell them to build smaller cars and veto any expenditure over $25 million, shouldn't he or she be able to require the UAW to give up the precious work rules that have rendered the domestically-owned industry inflexible and inefficient for decades? To be really effective, the bailout deal would have to "restructure" the UAW itself, so that union locals don't have an effective veto over productive labor practices proven in, say, the GM-Toyota NUMMI joint venture in San Jose, California.

I don't know what the actual deal contains (later NYT and other stories are vague), but this seems like a useful** bright line for opponents of corporatist bailout-creep to draw: If the taxpayers are going to foot the bill, then the goal has to be a successful industry in the long run--not a Congressional fix designed to protect the UAW from what it would face in a normal bankruptcy. That means rewritten contracts. If the UAW members didn't want that, they shouldn't have let their firms go broke--that is, they should have made the concessions they're making now, and more, years ago, when it would have made the difference.

Requiring painful, bankruptcy-style reopening would set a cautionary precedent. Just as Rick Wagoner's removal will warn timid management, it would warn unions that their function isn't to squeeze the absolute maximum possible from their companies every moment. They need to leave enough of a margin of error so that in a downturn their industry doesn't have to come running to the taxpayers.

It would also be a useful precedent for Obama. Does he really want to have to bailout every slow-adapting union that's contributed to the Democratic party's victory? When Reagan came into office, he was lucky enough to be presented with the air traffic controllers' (PATCO) strike. It was a lucky chance to demonstrate dramatically--at relatively little economic or human cost--that labor doesn't automatically win every strike. (In the PATCO case, the union not only lost, it ceased to exist--an even more effective precedent.) If Obama lets his fellow Democrats structure a deal that saves the inefficiencies in the UAW contracts, it will be PATCO in reverse--a signal to the Democrats labor backers that under Obama they can't lose. Even if they bankrupt their industry. ...

P.S.: I'm heavily influenced in these views by this article. Now if only the type were big enough to read. ...

**--By "useful" I mean sound policy. But wringing a big concession from the union (as well as management) would also be sound political theater, given the public opposition to the bailout deal. If you're a GOP senator sitting on the fence, don't you want to loudly and successfully demand a painful concession at this point? Then you'll have cover for a "yes" vote when it counts. ...  2:50 A.M.

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