Senate Finance/Baucus's Health Care Bill a complete disaster

[Duckie]

Here

Sources: Senators near bipartisan health deal
Compromise axes requirement for big businesses to offer coverage to staff

WASHINGTON - A bipartisan group of senators is closing in on a health care compromise that omits key Democratic priorities but seeks to hold down costs, as lawmakers on both sides of the Capitol labor to deliver sweeping health legislation to President Barack Obama.

After weeks of secretive talks, three Democrats and three Republicans on the Senate Finance Committee were edging closer to a compromise that excludes a requirement many congressional Democrats seek for large businesses to offer coverage to their workers. Nor would there be a provision for a government insurance option, despite Obama's support for such a plan, officials said.

The Finance senators were considering a tax of as much as 35 percent on very high-cost insurance policies, part of an attempt to rein in rapid escalation of costs. Also likely to be included in any deal was creation of a commission charged with slowing the growth of Medicare.

"We're going to get agreement here," Sen. Max Baucus, D-Mont., the Finance Committee chairman, said Monday. "The group of six really wants to get to 'yes.'"

Obama has outlined two broad goals for legislation he is struggling to win from Congress: expansion of health insurance coverage to millions who lack it, and reining in increases in costs. The president is participating in an AARP town-hall meeting on health care Tuesday.

Numerous setbacks
The president's top domestic priority has suffered numerous setbacks in recent weeks and a Senate vote has been postponed until September. Administration and Democratic leaders hope to show significant progress before lawmakers begin their monthlong August recess.

In the House, the Democratic leadership sought to allay concerns among the rank and file, holding a five-hour briefing on the House version of the legislation, which was written without Republican support. Democratic leaders are still holding out hope of floor passage before the summer break, and Majority Leader Steny Hoyer is looking at keeping the House in session some days past its scheduled Friday adjournment date.

A group of seven fiscally conservative House Democrats who have held up action in the Energy and Commerce Committee by demanding more cost savings and other changes negotiated late into the night Monday with the committee's chairman, Rep. Henry Waxman, D-Calif. Waxman's is the only one of three House panels with jurisdiction on the health bill that has yet to act.

Waxman made the so-called Blue Dog Democrats an offer intended to address their concerns, and they planned to meet Tuesday to decide how to answer, they said. Neither Waxman nor the leader of the rebel Democrats, Rep. Mike Ross, D-Ark., would give details on the offer. They said it touched on the 10 items in a list of demands the Blue Dogs have given Waxman, including increasing an exemption for small businesses from a requirement to provide insurance coverage, and decreasing the size of subsidies offered to poor people to help them buy care.

"We're going to review it and decide whether we feel it's something that we can accept, or whether we want to counter, or whether we believe that we should simply keep talking," Ross said.

The Blue Dogs have enough votes in the Energy and Commerce Committee to potentially block passage there, but time is running out for their negotiations with Waxman. The talks nearly broke down Friday after Waxman threatened to bypass his own committee and move the health bill straight to the floor, circumventing the Blue Dogs.

A voting session in Waxman's committee that has been on hold for a week must resume quickly, probably by Wednesday at latest, if there's any chance for the committee to pass a bill and send it to the full House for action before the summer recess. Bypassing the committee remains a last-ditch option if agreement can't be reached.

"If we're going to do the bill out of committee, this is the week," Waxman said.

In the Senate, officials stressed that no agreement has been reached on a bipartisan measure, and said there is no guarantee of one, with numerous key issues remaining to be settled.

The officials spoke on condition of anonymity, saying they were not authorized to discuss matters under private negotiations.

They said any legislation that emerges from the talks is expected to provide for a nonprofit cooperative to sell insurance in competition with private industry, rather than giving the federal government a role in the marketplace.

Obama and numerous Democrats in Congress have called for a government option to provide competition to private companies and hold down costs, and the House bill includes one — another concern for the Blue Dogs. But one of the senators involved in the talks, Olympia Snowe, R-Maine, confirmed that co-ops are the preferred approach of the Senate Finance Committee negotiators.

Officials also said a bipartisan compromise in the Senate would not subject large companies to a penalty if they declined to offer coverage to their workers. Instead, these businesses would be required to reimburse the government for part or all of any federal subsidies designed to help lower-income employees obtain insurance on their own.

The legislation in the House includes both a penalty and a requirement for large companies to share in the cost of covering employees.

Let's see:

-Large and Small Businesses alike not required to cover employees
-No public insurance plan
-Subsidies for said insurance slashed
-Requires all individuals to buy health care.
-Costs a trillion dollars anyhow, but is a few billion cheaper than a public option or similar solution

That's a .... great bill you've got there. Baucus's post-name tag should read something like ("D"-Insurance Companies) considering how excited this bill will make them.

I'm actually struggling to understand how this works.

The government pays money for businesses to help cover their employees, but the businesses don't have to give them the money, instead they can just refuse and repay the money to the government if they think it'll cost too much. If your employer doesn't give you health care, you're required by the government to then buy private health care with little (if poor) or no (if middle class) help from the government, regardless of whether you can afford it or not?

So it's basically what we have right now except that the unemployed or uninsured are ordered to buy private insurance, so that the Senate can brag that now nobody is uninsured?

What.

[SirNitram]

I'm not surprised. He was fully briefing Republicans and giving them closed-door hearings so he could get their input. Democrats? 'A deal is soon.' repeated ad nauseum.

[PeZook]

Heh. That's a clasiic example of solving a lack of shoes by ordering people to walk on their hands. You're guaranteed it will be mostly ignored, or the newly-insured people will buy cheap, crappy coverage just to comply with new regulation. Of course, the giant companies will be overjoyed to sell those shitty policies...

There's so many ways to do it, and they just had to pick the least sensible one

[The Spartan]

Come on. It's not like we didn't see this coming. This was inevitable because the Republicans were going to do anything they could to sabotage it, the Blue Dogs were going to only going to do enough to make it look like they were doing something and everyone else was either too spineless to accomplish something useful or just plain outnumbered.

[Duckie]

Come on. It's not like we didn't see this coming. This was inevitable because the Republicans were going to do anything they could to sabotage it, the Blue Dogs were going to only going to do enough to make it look like they were doing something and everyone else was either too spineless to accomplish something useful or just plain outnumbered.

It's not entirely hopeless, though. The bill might be fixed in reconciliation- I heard the house passed or is passing an actually palatable bill with public health care and sufficient subsidies in addition to a mandate for employer health care, so the Democrats might be passing a shitty senate bill and an okay house bill and fixing the senate one in Reconciliation in order to dodge the fillibuster. It would be ballsy and partisan, but it could work. I doubt they'll do it though- the Democrats don't give a shit and are willing to sacrifice 20 years of single-party rule they could milk off of a successful health care bill in order to not spend a dime more than necessary.

Note also that Baucus's isn't the official health care plan of the democrats yet, it just has wide support among republicans and among blue dogs, so something else might step up.

Incidentally where the hell is Obama? He's making youtube videos on the importance of this and holding town halls, but how come he's letting the senate do its own thing and pass a bill that doesn't have anything he wants in it and just makes it worse for everyone save the insurance companies who get the government to legally compel millions of people to be customers to their products? Shouldn't he be leveraging his political capital?

Either he's got some crazy-long term plan for rushing in and saving this, there's something we're not being told like that there's another viable bill he's going to support, he really believes the Republican "don't fix it it's fine, just make more people buy the existing insurance" view should get 50% of the bill like the stimulus due to his bipartisanship fetish, or he's so conflict averse and sparing about spending political capital that he's not going to use any on the most important issue in his presidency that will make or break 2010 and indeed the Democrats for the next decade or more because he wants things incremental and slow.

Somehow no matter how enthused I was in November, with what we've seen on him on the DADT and DOMA fronts, I'm now leaning towards saying it's options 3 and/or 4.

[The Spartan]

It's not entirely hopeless, though. The bill might be fixed in reconciliation- *snip*

Honestly, I don't have that much faith in the American political system. It's not so much the basic structure that will fail, it's the idiots we put into the offices set up as part of that structure. There's too many sheep and too many devious shepherds who convince the sheep to do what they want and too many wolves who know how to manipulate the sheep and shepherds.

[Duckie]

It's not entirely hopeless, though. The bill might be fixed in reconciliation- *snip*

Honestly, I don't have that much faith in the American political system. It's not so much the basic structure that will fail, it's the idiots we put into the offices set up as part of that structure. There's too many sheep and too many devious shepherds who convince the sheep to do what they want and too many wolves who know how to manipulate the sheep and shepherds.

That may be in the Senate, which mostly has the problem of entrenched conservativism (even among Democrats, thus Blue Dogs, who are an almost entirely Senate phenominon), but the House passed a perfectly serviceable bill. I'm not that down on the entire process yet. It's just that the Senate is for now a den of vipers in regards to Blue Dogs and other "Bipartisans".

That said, if Olympia Snowe isn't supporting a public option, it looks pretty doomed in the senate, but the bills are going to have to reconcile. Even if every single democrat and republican unanimously passed the Baucus Bill (which isn't close, there's still a half-dozen competing plans), they'd have to compromise the two since the House has already passed a public health care plan and a mandate for employers to provide healthcare. Hell, I think it might even eliminate denials based on pre-existing conditions, which is one of the number-one problems.

It just comes down to exactly how hard liberal democrats will fight in the Senate and in Reconciliation against the senate shitty version triumphing over the House tolerable version.

Nate Silver also noted several times that the two moderate republicans and the conservative democrats like Ben Nelson don't have to vote for the bill, they can vote against a republican fillibuster and against the bill, meaning that the most conservative 15% or so of the democrats could split their votes and it'd still pass. Apparantly on many things this is common in Congress, although I don't have any proof of it, and it would be convenient if half the blue dogs and all the republicans could allow public health care to pass but still vote against it so as not to taint their records in their home races (where commercials about LIBERAL SOCIALIST [blue dog's name here] from a republican challenger would destroy them)

[The Spartan]

Well, servicable is better than nothing. Fingers crossed.

To be fair, I'm in a rather negative state of mind for the time being and that may be coloring my already cynical and unflattering thoughts on politics.

[Duckie]

oh, a point that needs to be made:

GO. WRITE YOUR SENATOR.

YES YOU.

NO NOT YOU YOU'RE NOT AN AMERICAN.

YOU THE AMERICAN.

yeah you. Even if you've got two republican senators who aren't named Snowe and Collins, especially if you have a non-republican or Snowe and Collins.

Write some senators and tell them how you don't want bullshit like the Baucus Bill, you want a subsidized public health care option, removal of 'preexisting condition' denials, etc. It's better than nothing and can't hurt. Senators are cowards, the only reason conservatives think nobody wants health care reform is because the elite echo chamber has told conservative voters they don't want it. If you mail them and show them there's people in their constituency who do, you tip the "maybe I should not kill this thing with a fillibuster" or even "maybe I should vote for this public thing" scale.

No not Obama, either, don't bother. He's got a snazzy website with a convenient email button to use but he's already either on the side of health care reform and/or determined not to do anything. Senators are easier to influence and matter more.

[incidentally is it any surprise- Baucus has taken 140k dollars from the health care industry over the past 5 years. In fact, Nate Silver did a probabilistic account and found that the following graph applies:


If I'm reading that right, you can tank any possibility of reform in the senate for less than a million US dollars by buying the blue dogs and maybe a mainline democrat or two. That's insane.]

[The Spartan]

That actually is a good point. I'll have time this weekend and I'll draft up a letter.

[Straha]

Actually, don't. I've talked to a number of lobbyists on how constituents can influence voting and the best advice I got was from Lori Lippman Brown who essentially said that letters are a waste of time. They'll be skimmed, the gist of it noted down and then it'll be filed away with no real consequence except for, maybe, them sending a form letter in response. Instead call the Senator's office (and your congressman's office also) and politely tell the person who answers the phone you're a constituent and you'd like the Senator to do X on Y bill. They'll ask for some personal information to confirm you're a constituent, and that's it. All of the offices keep a running tally on those calls, and they can apparently do a lot to sway some of them, while being quicker, cheaper and easier than writing a letter.



Also, the reason this is failing isn't the Blue Dogs, it's the Democratic Leadership. If they'd cracked the whip on this, with the support of Obama, they could have run this through congress so fast it'd have made heads spin. But they don't want to waste political capital on this because it'll make all the reps and senators from swing districts/states nervous and less likely to follow the leadership in the future out of fears for job security. Instead they squander their majority by letting the members act to cover their own backsides just so they can get as many people as possible re-elected. Spineless cowards.

[LMSx]

The noise I heard was that Obama is saving his big push for the congressional reconciliation where they can present the final bill to both houses, take it or leave it.

You know, trust him. He'll get around to doing the right thing one day.

In theory it should be very simple- tell the Senate Blue Dogs they can bitch, moan, complain, and even vote against the final bill, but all they need to do is support a majority vote and stop the Republican fillibuster. In practice of course, Harry Reid's going to water it down. I hope the Progressive Caucus votes against it if they're going to try and sell something without the public option. Otherwise, the leadership's just going to take their future votes for granted.

[The Duchess of Zeon]

The sheer insanity of forcing people to buy insurance while not providing a government option would be about in line for our current system of corporate socialism that the Republicans gleefully implemented and the democrats have gleefully continued... Not merely choosing socialism on the way down to cushion the lives of capitalists who made it rich working the system but proved idiots unable to preserve their profits, who in a real capitalist society should be begging in the streets, we've made sure they keep up their toga parties in the Mediterranean... And now, rather than either preserve choice and capitalism in the system or go ahead to a full universal healthcare system, these fuckheads are hellbent on combining the worst aspects of both to create a system in which the government forces everyone to buy private insurance with no effects whatsoever on cost except to make health insurance execs and investors That Much Richer. The programme as presently proposed by the Senate is nothing less than government mandated income redistribution from the poor to the rich.

[Androsphinx]

I hope the Progressive Caucus votes against it if they're going to try and sell something without the public option. Otherwise, the leadership's just going to take their future votes for granted.

Also, the reason this is failing isn't the Blue Dogs, it's the Democratic Leadership. If they'd cracked the whip on this, with the support of Obama, they could have run this through congress so fast it'd have made heads spin. But they don't want to waste political capital on this because it'll make all the reps and senators from swing districts/states nervous and less likely to follow the leadership in the future out of fears for job security. Instead they squander their majority by letting the members act to cover their own backsides just so they can get as many people as possible re-elected. Spineless cowards.

The last time healthcare reform was mooted seriously in 1993/4, the Blue Dogs killed it. H.W. Bush gave it a half-hearted try in 1991, but before that there was Nixon's attempts in the early 1970s. Despite his supreme cynicism (or perhaps because of it - discuss) Nixon's plan was better than anything likely to get passed this year. Ted Kennedy and the progressives thought it wasn't good enough, and killed it. In both cases, healthcare reform failed. While the public option is important, it's not the be-all-and-end-all of legislation - Clinton's plan didn't have one, nor did Kerry's. Remember also that the Senate HELP committee's bill, with which Baucus' will have to compromise, does have a public option.

On the other hand, Obama needs every vote in the Democratic caucus to stop a filibuster. That means he needs Baucus and Nelson and everyone else, no matter how despicably in-the-pocket-of-insurance-companies they are. He also needs to avoid alienating any of them, because he'll need them all again for climate change legislation, and another stimulus package, and everything in his legislative agenda that isn't in response to a looming disaster. Needless to say, a defeat on healthcare reform will have a catastrophic effect on the rest of Obama's aims.

Reid isn't a coward, and Obama isn't spineless. They're up again an immensely broken political system, with counter-majoritarian structures, enormous vested interests and a wholly disproportionate distribution of power. They'll push for the best deal they can get without risking the ruination of the other critically important things they need to do.

[Bellator]

The sheer insanity of forcing people to buy insurance while not providing a government option

Which I think it what Holland has. It's working there.

[PeZook]

Which I think it what Holland has. It's working there.

Uh, no.

Holland has a rather complicated hybrid system: expensive long-term care is covered by a state-run program, while for short-term routine care, people are required to buy their own insurance, with an allowance for the poorest so that they can afford it.

Also, the key issue: Holland has a tight system of premium price controls, as well as a package of procedures that insurers are required to cover by law. Things like exclusions and co-pays are also illegal in Holland.

The proposed American plan doesn't look anything like it.

[Vympel]

Matt Taibbi on this travesty:-

Link

Well, as the French would say… Quelle surprise!

It’s funny, earlier this summer I was watching the Federer-Roddick Wimbledon Final. Great match in a way, final set was 30 games long, one of the all-time epic battles. And yet, as I watched it, I thought to myself, “This has to be the least suspenseful epic sporting event of all time.” Because there was never any doubt in my mind that Federer was going to win the match. I simply could not envision a scenario where anything else than a Federer victory could happen. I think I even turned it off at 7-7 in the final set, figuring I could catch Federer’s award ceremony later on.

It’s the same with this health care bill. Who among us did not know this would happen? It’s been clear from the start that the Democrats would make a great show of doing something real, then they would fold prematurely, ram through some piece-of-shit bill with some incremental/worthless change in it, and then in the end blame everything on Max Baucus and Bill Nelson, saying, “By golly, we tried our best!”

Make no mistake, this has nothing to do with Max Baucus, Bill Nelson, or anyone else. If the Obama administration wanted to pass a real health care bill, they would do what George Bush and Tom DeLay did in the first six-odd years of this decade whenever they wanted to pass some nightmare piece of legislation (ie the Prescription Drug Bill or CAFTA): they would take the recalcitrant legislators blocking their path into a back room at the Capitol, and beat them with rubber hoses until they changed their minds.

The reason a real health-care bill is not going to get passed is simple: because nobody in Washington really wants it. There is insufficient political will to get it done. It doesn’t matter that it’s an urgent national calamity, that it is plainly obvious to anyone with an IQ over 8 that our system could not possibly be worse and needs to be fixed very soon, and that, moreover, the only people opposing a real reform bill are a pitifully small number of executives in the insurance industry who stand to lose the chance for a fifth summer house if this thing passes.

It won’t get done, because that’s not the way our government works. Our government doesn’t exist to protect voters from interests, it exists to protect interests from voters. The situation we have here is an angry and desperate population that at long last has voted in a majority that it believes should be able to pass a health care bill. It expects something to be done. The task of the lawmakers on the Hill, at least as they see things, is to create the appearance of having done something. And that’s what they’re doing. Personally, I think they’re doing a lousy job even of that. I lauded Roddick for playing out the string with heart, and giving a good show. But these Democrats aren’t even pretending to give a shit, not really. I mean, they’re not even willing to give up their vacations.

This whole business, it was a litmus test for whether or not we even have a functioning government. Here we had a political majority in congress and a popular president armed with oodles of political capital and backed by the overwhelming sentiment of perhaps 150 million Americans, and this government could not bring itself to offend ten thousand insurance men in order to pass a bill that addresses an urgent emergency. What’s left? Third-party politics?

[Frank Hipper]

Years ago I was taken to task here for saying that we have a single party system masquerading as a two party system.

I'm still asking where's the substantial difference between Democrat and Republican?
Government's chief concern is preserving the status quo. Everything else is window dressing with no substance; distraction, a cheap farce, pablum for brain-dead consumers.

Perhaps when the day comes that the consumer base is too impoverished to buy their Feces Helper, we'll see substantive change...by that point we'll probably see livers skewered on sticks being marched through the streets, too.

[Vaporous]

it's strategic masterstroke if you're an insurance lobbyist.

take the bill that could ruin your extortion based industry, and use it to have the government force millions of people to pay you rates that you set and they can't afford without assistance or regulation.

At least you can't say that "no one has read this bill!. It's been read over and over again- by the insurance agents who wrote it and handed it to their stooges in the senate.

[Straha]

At the risk of necroing:

On the other hand, Obama needs every vote in the Democratic caucus to stop a filibuster. That means he needs Baucus and Nelson and everyone else, no matter how despicably in-the-pocket-of-insurance-companies they are. He also needs to avoid alienating any of them, because he'll need them all again for climate change legislation, and another stimulus package, and everything in his legislative agenda that isn't in response to a looming disaster. Needless to say, a defeat on healthcare reform will have a catastrophic effect on the rest of Obama's aims.

Reid isn't a coward, and Obama isn't spineless. They're up again an immensely broken political system, with counter-majoritarian structures, enormous vested interests and a wholly disproportionate distribution of power. They'll push for the best deal they can get without risking the ruination of the other critically important things they need to do.

The filibuster isn't a real roadblock to legislation, it's an excuse for the majority party to not pass something or a way for them to look like they were forced into compromise (like they did with the minimum wage bill two years back). When a majority party wants something passed, like LBJ and the Civil Rights Bill, or the Extradition Treaties in the 80s or any number of endless bills that can be pointed out, they can get it done. What Obama and Reid have now is massive public support and approval, a major financial crisis which lets a otherwise recalcitrant U.S. Government rush through massive amounts of public spending, and general public derision for the opposition party. If Obama stood up and declared that he wanted a comprehensive healthcare system established in America, with Reid rallying support in the Senate, and Tim Kaine (the DNC chair) threatening to revoke the 'D' and DNC money from the democrats who opposed the bill, the bill would be passed. Not only that but the Republicans who opposed it would be tarred and feathered by the mainstream American opinion and would suffer another electoral defeat in 2010 making the sort of opposition they're throwing up now a liability instead of an asset. Win-win for the Democracts, especially considering the political momentum they'd gain from a massive public victory like this.

The reason they don't is because the Democratic Party hasn't gotten over the 1994 election or the 2002 election. In both those they 'learned' that when they stand up and fight Republicans on issues they get massacred (horrifically so in 1994, where they lost the Houes of Representatives which they had gerrymandered to their desire). So, instead, they make themselves the least offensive as possible and wait until they get their turn in power on the platform of not being the other fellows.

[Androsphinx]

I don't know. Obama isn't quite as popular these days, and is polling pretty poorly on healthcare & the economy. There's still a long way to go on this & although more pessimistic than I used to be, I've not given up hope. Remember that whatever Baucus comes up with in his room will need to be approved by the rest of Senate Finance, the Senate as a whole (where it has a competing, public-option bill) and then reconcilled with the House bill.

I don't think you can reduce the Democrat lessons from 1994 (2002 is a very different case) to a fear of standing up to the Republicans. Rather, if just a single thing, that the most vulnerable members of the party to electoral swings are the Blue Dogs, who were decimated in 1994. Their caution is one part donor-based, one part ideological and one part fear that they're going to be the first up against the wall unless they have anti-Obama credentials. These, rather than the personal force of the White House, are their personal concerns.

It would be immensely better if we lived in a world where POTUS was like Green Lantern (things happen due to his willpower!), but I see the problems as primarily structural - the Senate is too counter-majoritarian, the Blue Dogs are too much of the Democratic party, too many old people who have Medicare aren't concerned about further reform.

Remember also the most basic lesson of politics - you win more support by going towards the centre. Obama was the 10th or so most liberal Senator when in office, but he needs to guide legislation which will be acceptable to the 60th most liberal. There's just no way that he's going to get his ideal programme, or anything like it.

The sad fact is that America's political system is broken, and has been for a long time. Things like the CRA and VRA passed because they had bipartisan support - a larger % Republicans in the Senate (I forget the House, but probably there too) supported them than Democrats. The increased polarisation of recent years as the parties have sorted themselves out ideologically, combined with the lock-step opposition of the GOP, has made that sort of voting coalition impossible.

Remember also that the great reformist administrations in the US' history only maintained their power through deals with the devil. FDR left civil rights broadly alone to keep Southern Democrats on board, LBJ needed the Vietnam War to keep cover on his right, and the less said about Reconstruction the better.

[Straha]

I don't know. Obama isn't quite as popular these days, and is polling pretty poorly on healthcare & the economy.

Largely because he came in with a truly impressive mandate, unprecedented popular support and a promise to bring Change to the United States and has done just about nothing to actually change things. If he'd actually used his popularity to bring about healthcare reform, actual economic stimulus or recognized Change then he'd probably be a lot more respected, and popular, than he is now.

There's still a long way to go on this & although more pessimistic than I used to be, I've not given up hope. Remember that whatever Baucus comes up with in his room will need to be approved by the rest of Senate Finance, the Senate as a whole (where it has a competing, public-option bill) and then reconcilled with the House bill.

Which means that the Democrats will probably do what they've done every time they've been stuck with an important issue so far, and bargain off something in every step of the legislative process. Leaving the populace with a worthless set of laws and a larger tax bill as a result.

I don't think you can reduce the Democrat lessons from 1994 (2002 is a very different case) to a fear of standing up to the Republicans. Rather, if just a single thing, that the most vulnerable members of the party to electoral swings are the Blue Dogs, who were decimated in 1994.

I would disagree there. Some of the blue dogs were chucked out, but the part lost representatives from all over the party (IIRC, at least two have since gone on to actively campaign for the Green Party) and the damage was in no way contained to Blue Dogs. I'd say that what sticks in the minds of the Democratic party is that they lost two committee chairs and the Speaker of the House because they couldn't decisively answer the "Contract with America". And you're right, I wasn't thinking of 2002, but the 2004 congressional elections, my apologies there.

Their caution is one part donor-based, one part ideological and one part fear that they're going to be the first up against the wall unless they have anti-Obama credentials. These, rather than the personal force of the White House, are their personal concerns.

Of course, and that's exactly what I mean. Because the Democratic Leadership hasn't taken a stand on healthcare the democrats in the Senate, and across the country, are more than willing to jettison any possible commitment on the issue for short-term personal convenience. If Obama, Reid and the others had made it clear that the Democratic Party was going to fight for serious healthcare reform then this wouldn't be happening.

It would be immensely better if we lived in a world where POTUS was like Green Lantern (things happen due to his willpower!), but I see the problems as primarily structural - the Senate is too counter-majoritarian, the Blue Dogs are too much of the Democratic party, too many old people who have Medicare aren't concerned about further reform.

The Senate isn't counter-majoritarian to the degree you imply, further by simply delaying the vote on healthcare until right before a recess (as it seemed they might be doing) the Senate Leadership could neuter a filibuster. A filibuster's power comes from making the majority party have to wait to pass all the other bills it wants to, by making it so there are no other bills in waiting the Senate leadership can simply say "Filibuster all you want, at the end of the month all we need is fifty votes to get this thing passed" and then follow through on the threat.

The idea that you need sixty members in the Senate to pass what you want is a very recent one, and it's one that's come out mainly because of Harry Reid and the Democratic Party's emphasis on compromise over conflict and ideology. When the Republicans, and the Democrats who feel antsy about their electoral majority, know that anything in a bill can be modified if they cajole the leadership a little everything becomes up for grabs. If, instead, the leadership actually leads the party (like the Republicans did from '94 to '06) and makes it clear that compromise is not the name of the game then majority party can pass what it damn well pleases, more or less.

Remember also the most basic lesson of politics - you win more support by going towards the centre. Obama was the 10th or so most liberal Senator when in office, but he needs to guide legislation which will be acceptable to the 60th most liberal. There's just no way that he's going to get his ideal programme, or anything like it.

Except he was elected on what was perceived to be the most liberal platform since the days of FDR, and what the American people wanted was a liberal president. By being willing to compromise on everything he stood for he's made the general populace think him at best disingenuous and at worst a liar, he's annoyed his base of support in the left, and the Republicans still hate his guts (and will until he leaves office) meaning that he's lost a lot and gained nothing by his lack of a backbone.

The sad fact is that America's political system is broken, and has been for a long time. Things like the CRA and VRA passed because they had bipartisan support - a larger % Republicans in the Senate (I forget the House, but probably there too) supported them than Democrats. The increased polarisation of recent years as the parties have sorted themselves out ideologically, combined with the lock-step opposition of the GOP, has made that sort of voting coalition impossible.

The fact that more Republicans supported the CRA and the VRA isn't surprising in the least given the context. Remember it was Eisenhower who first deployed soldiers to enforce integration, and it wasn't until after integration that the South went Republican.

That said, the reason why the bills passed with such large majorities was partly because LBJ twisted everyone's arm to ensure the bill would pass, partly because the Democratic leadership took up the gauntlet for a fight from Richard Russel, Robert Byrd and others and was willing to get dirty fighting it out, and partly because they launched a massive PR campaign. It's very hard to offer compromise or half measures on Civil/Voting Rights when you'll be tarred as being against people like Fannie Lou Hammer, Rosa Parks and Martin Luther King, and for the Klu Klux Klan, George Wallace and Jim Crow. (In fact, the final bill was a compromise bill but one which was significantly stronger than the bill JFK initially proposed.) If the Democratic Leadership was willing to put anywhere near the same resources fighting for health care as they did there then we wouldn't be having this conversation now.