From Firedoglake: Obama is using his bully pulpit in the health care debate as might be expected of a weak Democrat – he’s going after MoveOn for running an ad campaign against Senator Mary Landrieu (D-LA). Apparently the ads have been quite effective, forcing Obama’s hand. He wants progressive groups to unite around Democrats, presumably facing outwards and bent over.

I listened to John S. Adams’ last interview (listen here and here) with Senator Max Baucus. I mean “last” not in the sense of “most recent”, but rather that he’ll never get another, having broken the journalists’ code, which works something like this:

Wait in line. Do not take cuts. Enter the office looking down. Do not attempt to make eye contact. Step sideways two steps, forward two steps. Ask your question. Do not be confrontational lest you hear the words ending your tenure in journalism: “No access for you!”

There were some interesting highlights in the interview, many actually. At one point an aid cuts in, telling the Senator he had another call. (Apparently Baucus has an elaborate call-waiting system that kicks in when he is in a dangerous interview.) Again, later in the interview, the aid simply tells the Senator he has to move on. (Adams named the aide who was interrupting in his post, but that post is now gone.)

Adams grilled the Senator about his treatment of single payer advocates. Baucus said he was planning to meet with some advocates in Montana. Adams asked who he would be meeting with and Baucus got testy. He told Adams not to get “confrontational”. Adams reminded him that it was a worthy question, and the Senator said that it was his tone that was “telling”.

Baucus didn’t answer the question, by the way. That was the whole point of the maneuver. It was a dodge. The single payer people he is going to meet with are your aunt and her dog, and the meeting will be held on the tenth of Never, 5:00 sharp.

Later, the senator said that there was no bill in the senate for single payer. He’s wrong – Senator Bernie Sanders introduced S. 703: The American Health Security Act of 2009 way back in March. Baucus doesn’t know this. That’s … how would you phrase it … telling?

Adams then raised the matter of money … campaign contributions from health insurance companies and pharmaceuticals. Baucus seemed indignant. He said money means nothing to him, that he pays no attention to it.

He’s raising a worthy point. We who advocate campaign finance reform dwell too much on the money aspect. It’s much more than that – it’s power. Many times if a politician does not take money from one side of an issue, he’ll get it from the other. Money can be neutered.

But with the Senator and single payer, there is only one money tap, so it does matter. But power factors in – it is revealing how Baucus dealt with single payer advocates at his health insurance “hearing”. He had them arrested, holding them in literal and figurative contempt. That’s … how would you phrase it … telling?

Baucus understands power – who has it, who doesn’t. He acts accordingly.

Money is but one tool of power, and perhaps not even the most important one. Powerful people have many means at their disposal: They can threaten to finance opponents in either primary of general elections. They can generate bad publicity through newspapers they own or advertise in. (Right wing newspaper publishers abound, after all.) (Baucus has a cozy relationship with most Montana newspapers, the Great Falls Tribune apparently an exception at this time. Journalists ought to look into that.)

More tools: powerful people can lure politicians into compromising situations involving women or drugs or back-door sex. They can offer privileged flights on private jets to exotic locations or to sporting events. (Baucus’s staff members once watched the Super Bowl from a private box.) They can hire relatives to lucrative jobs for which they are not qualified – think Wendy Graham or Beau Biden, or Elizabeth Dole running the Red Cross for $700, 000. Perhaps most importantly, powerful people can offer delayed bribes – jobs and riches after politicians leave office. Tom Daschle has made $220,000 in health care doing “consulting” work since his electoral defeat. His wife pulls down a lucrative salary for lobbying for defense contractors. And of course former Senator Conrad Burns immediately went into lobbying after his 2006 defeat.

Powerful people can also use wiretaps and spying. We are probably seeing only the tip of that iceberg. And then there are prostitutes and seductresses who are as common around power as plastic phasers at a Star Trek convention. Here’s an interesting anomaly: Elliot Spitzer was actively challenging corporate power. He was exposed for using high-priced hookers. That’s not something that I can afford approve of – the question is, why him, and not the countless others who are likely sampling the expensive candy?

Senator Max Baucus is corrupt*, but to say that it is due to taking money from a certain industry for legislative favors is to give that industry far too little credit. It’s more than money – it’s both positive and negative incentives. It’s not something applied haphazardly – these are serious people who want serious favors, and who know how to get their way. It’s not a game – it’s a business. High-priced talent does persuasion for a living. So when Baucus says “Money means nothing to me”, he may be right in a narrow sense. He merely left out the last part of the sentence: “… but power owns me”.

Towards the close of the interview, Baucus rattled off a list of things that he had done that had offended health insurance and pharmaceutical companies. There was no time for follow-up, of course, as the breaker was hovering. Given more time, Adams might have asked how many of these offensive initiatives actually came to fruition, how many Baucus actually took a leadership role on. Baucus has a display window voting record. Much of what he does has no effect, and is mere dressing for that window.

The Adams interview is rich, and John was courageous, confrontational and incisive. American journalism has long been in need of a compass – reporters long ago lost sight of the fact that they are often our only window to power. They are more than stenographers, and they need show only perfunctory courtesy to political and corporate office holders. Their role is to hold powerful people accountable. One can only speculate, but if Baucus had been annoyed by pesky journalists of Adams’ caliber from the day he took office, he’d probably be herding sheep right about now.

If current journalists hold true to form, John will get the tap. He will meet with his editor and advised to tone it down. He should not, he will be told, become “partisan” or “emotional”. Those are code words for “disrespectful of power”.

Footnote:Adams’ post and the interview are gone from his blog. Fortunately, a link to was put up at Left in the West by a commenter, and thus the YouTube links above. I hope they stay in place.

*The word “corrupt” is used here not to mean that Baucus is storing money in his freezer, but rather that he is corrupted as a computer file might be: No longer useful and in need of replacement.

Gregg put up an interesting link to The Dynamist regarding inefficiencies in the Medicare system. Gregg’s conclusion is that before we can fix the private system trains, the public system has to run on time.

But saying “Fix Medicare First” is odd reasoning, like saying that I cannot put out a fire in the garage while the house is burning. Medicare is attached at the hip to the larger care system, merely reimbursing doctors and hospitals and abiding by decisions made in the private sector. It is therefore subject to every inefficiency wrought by our health care system (except for the excessive overhead of private insurers). Every cost control feature, every protocol, every guideline for use of resources that we could build into the private structure will benefit Medicare.

The same expense doom and gloom forecasts that are applied to Medicare apply to the private sector as well. It’s not just Medicare’s problem – the program, like all large programs, has inherent managerial challenges, but is efficient given its subordination to private sector decisions. Future costs will eventually overwhelm our entire health care system. Eventually we will be able to cure almost everything, but at what cost?

My mother just underwent expensive treatment for non-malignant skin cancer tumors. She’s 92. A friend of ours was seriously considering knee replacement for her 90 year old mother – the doctor approved the procedure (!), so Medicare would have paid.

We’re not being realistic and are avoiding hard decisions. How do we establish protocol for these hard decisions? That’s what leaders are for. Unfortunately … all we have are Democrats and Republicans who are financed by wealthy individuals and corporations. Any guidelines and protocols would be written by these financiers, and so would be skewed to favor them.

Fix campaign finance first.

Private health insurance can only be profitable under certain circumstances:

1) Insurers must to avoid sick people. They do this by 1) denying coverage to people with preexisting conditions, and 2) by using the workplace as a market. Employers tend to hire mostly healthy people, so pre-selection is done for the insurers before the policies are sold. That’s why private health insurance sold through employers, though too expensive, is an otherwise effective system.

2) By definition, insurers have to avoid people who can’t afford premiums. They either do without coverage, or are dumped on government.

3) Wherever possible, insurers have to avoid paying claims. They have many weapons at their disposal – they write the policies and understand them. Consumers don’t. They have tremendous and unequal bargaining power. It’s very hard to fight a claim denied – first you have to appeal to the very people who denied the claim, and second to the courts.

4) If insurers are forced to offer coverage to everyone (the Dutch model), then all people must be forced to buy coverage. This ensures that the companies will he covering a mix of healthy and sick people, and costs will be kept down.

5) Insurers have to avoid competing with one another. They already do this – all companies follow the Dwayne Andreas maxim that competitors are friends, customers enemies. “Free markets” are kind of a sick joke, an illusion, as markets are cruel and destructive. The whole point of accumulating wealth and bribing government officials is to buy insulation from market forces. We all know this. We just don’t say it. (There are over 1,300 private health insurance companies – if one turns you down for a preexisting condition, all do. You’d think that in a free market, one of those companies would take a chance.)

6) If insurers are forced to cover sick people, and if they have to cover people who can’t afford their policies, they will not be profitable investments, and will have to be subsidized to survive.

Hence the Max Baucus plan: 1) Insurance companies must survive, at all costs; 2) The IRS will force us to buy policies; 3) Competition (a strong “public option”) is not allowed, and 4) subsidy, subsidy, subsidy. Baucus is an private insurance tool, so it should come as no surprise that his plan reflects insurance company needs, and not ours.

The illusion of the free market holds strong in this country, so that we will probably stick with the private insurance model. So we will be faced with mandates and subsidy. I doubt we will save any money. More people will be covered, but insurance companies will still operate as a barrier between the public and the health care system. It’s crazy, it doesn’t work, and is what happens when ideologues of the right rule Washington.

Single-payer works because it is not a “free market” concept – it undermines the illusions and bypasses the profit seekers. It provides care to sick people in one easy step. Every country that has tried it has kept it. Every country that has gone to a public system has kept that system with one exception: Iraq. Paul Bremer forced them into the U.S. model.

That appears to be the only way anyone else will buy our health care system. At the point of a gun.

My wife’s daughter flew in from Canada today. She’s working a temporary job, and it will end sometime this fall. My wife asked her what she would do about health coverage once her job ended. “Mom,” she was reminded. “it’s Canada. We all have health insurance all the time.”

Later in the conversation, she talked about a friend of hers who works in a laboratory of some sort. She gets fed up with her job on a regular basis, and takes off, this time for Africa.

Imagine such freedom, telling her boss to shove it. Health security is a big part of it. She doesn’t have to worry about health coverage, and so can save some money, leave her job at will, and take off. Do you know anyone down here in the states that has that much control of their own lives?

Universal health coverage is part of the essential freedom we say we love so much in this country, but practice so little. It gives us control of our own lives. This is an unspoken, but important part of the debate we are now having.

I’ve finally figured out what’s wrong with the Democrats’ position on health care, as exemplified by Matt and Jay: They think that they are merely playing politics, log rolling, compromising to get what they want. They think that if they do that, they’ll come away with part of what they want, and we’ll all be better off.

Problems with this approach:

1) If only one side is willing to compromise, then it’s not really compromise, is it. It’s more like, what’s the word – car salesmen have a word for this – they call them “marks”. Someone is being fleeced. It’s hard to watch.

2) If your own leadership is not with you, if your own leadership wants to sell you down the road, if your own leadership has taken millions of dollars from the very people you are supposed to be reining in, then it’s not really compromise, is it. It’s more like, what’s the word – Dick Morris had a word for it – triangulation.

Honestly, we are in deep trouble. The people who have appointed themselves the ‘fixers’ of our problem do not understand the rules of the game they are playing. The best we can hope for at this point is that it all blows up, and that we come away with nothing. That will be better than any of the “compromises” that are being worked out. The idea that we have to get “something” will be our undoing. The Republicans know how to play this game, the Democrat leadership knows how to play it. The followship? Not so much.

PS: In answer to the inevitable “What would you do in our shoes?”, I have two answers: 1) If the only possible outcome is a loss, do nothing. Die another day. 2) Listen closely, Democrats – I will only say this once: Try being clever. Giving up incrementally is not a strategy – it only slows down the losing process.

There is no question that Senator Max Baucus (D-MT) intends to sell out progressives on health care. His containment operation has been successful so far, but there is leakage. So-called “listening” sessions in Montana turned sour has people asked his staff questions the regular media doesn’t touch – what about single payer? What about all that insurance money? The sessions got coverage in the media, but not the usual kind that Max likes.

The latest angle the insurance industry is pulling is called the “trigger“, where the insurance industry would have to fail to meet certain targets before a public option would kick in. Baucus and other Democrats in Congress would give the industry years to meet the goals, in effect killing the public option.

And that would be the goal.

I rarely say this – write to Senator Baucus’s office, tell him that you want a real and viable public option. Just kidding! Max knows exactly what we want. The game plan is to dodge and sidestep like …

Vodpod videos no longer available.

Max can neither sing nor dance, nor does he leave many people wondering what he is about. He is sneaking around looking for a way to appease the insurance industry. For once his cards are on the table, for once he will not be able to fool people into thinking he’s doing their business.

George W. Bush, according to Mark Crispen Miller, lapsed into his famous verbal gaffes – food on the family, etc. – when he was trying to feign something he did not feel, like compassion. Baucus has a similar trait, I think – he stutters when he is being disingenuous. Public speaking is really hard for him because he seldom gets to say what he really believes.

But I did notice that when he kicked the single payer advocates our of his hearing room and had them arrested, his words were sharp and his meaning clear.

Jeff at Speedkill wrote a post in response to mine below which I liked – his traffic is way down right now, so I’m going to reprint the whole thing – his succinct comments and my no-so-succinct response.

Jeff: You can almost hear this blog dying, can’t you?

Anyway, I was thinking about this post by Mark, which is post 93 in his long running anti-hope series.

Progressives like to claim the public is supportive of their agenda based on single issue polling. It seems to me that once public opinion collides with an opposition campaign, things look different. Public opinion is also contradictory. People like more services and they like lower taxes. They can’t have both. California is trying it and it’s not working. Opinion polls show that if you pay income taxes, you think you’re paying too much. So despite the fact that polls also show people will trade taxes for services, they don’t think they’re getting a good deal. That’s ripe territory for conservatives. And if we’re talking about single-payer, it’s hard to see how anything gets past “the government is taking away your health care for some brand new thing that sucks for various reasons.” Even if the various reasons themselves suck, losing your health care is scary.

That’s all obvious, isn’t it?

So single-payer organizing is pointless right now. If we get a public plan, that changes. Are we going to get a public plan? Beats me.

Mark:

You are one of the better writers and thinkers in the Montana blog world, along with maybe Crisp and Budge. I hope you hang in there – you just don’t write enough to keep up traffic.

I keep getting this single payer stuff – as if I did not understand practical politics and the power of propaganda campaigns and the public relations industry. I have said repeatedly that if we are going to have single payer, it is going to be in Canadian fashion, where the barriers were first broken down in Saskatchewan by a dynamic leader, Tommy Douglas, and where it then spread due to its unquestionable success. Perhaps the PR industry and health insurance companies in Canada were not as powerful then as they are now in this country – I don’t know. But I see our best laboratory as being post-Arnold California.

You did not address the central theme of my post – the emergence of the Democratic Party as a mere containment vehicle for opposition movements. Take 2000 – there is absolutely nothing – nothing! wrong with mounting a third party campaign. I don’t give a rat’s ass how effective or smart you think it is. But the Democrats have demonized Nader now, and very wisely so – it’s a message to anyone else who wants to try it – prepare to be ostracized.

That is now the role of the Democratic Party – to geld third party movements, to contain all popular movements and minimize their impact. The practical politicians tell us that we must keep our expectations low, and Democrats like Matt and Jay are perfectly happy with that concept. It’s a distressing situation. Screw your hope comment – let’s talk reality.

The bottom line is that we do not live in a functioning democracy. The Russian people were able to change aspiration to reality. Maybe they aren’t happy with the outcome now, but the point is that they wanted change and got it. Whose system is more democratic?

Regarding polling and health insurance, it seems contradictory that people are both happy with their current coverage and want single payer. Most people aren’t sick, and have not been exposed to how shitty their coverage is. Those that have want something better. Enough information about the 47 million has spread around that people also understand that while they might be OK, many others aren’t. It seems to fit.

And pollsters aren’t stupid – they know how to ferret out information in a sly manner. That’s the object of much polling – to get information that the person being questioned does not know he is after. So they hide their objectives, riddle the survey with protrait and contrait questions – the professionals, anyway. The bottom line: Most people favor a single payer system even if it would cost them more in taxes.

Odds are it won’t – we are ridiculously expensive right now, spending twice what Canadians do per capita. Overhead runs 10% in a good not-for-profit plan, as high as 50% in some for-profit plans. Emergency room care is incredibly inefficient. I doubt it could cost more than we spend now.

And anyway, watch out. When the Democrat leadership embraces a concept, the odds are that they, like pollsters are really after something else. Beware Baucus. He’s not even a good actor or an appealing persona – I don’t know how he fools so many people other than that they want to be fooled.

Sorry to take up so much space. I have my own blog. And I love writing – I am one of those who thinks with his fingers.

Republicans have proposed their own health care package. I doubt that the Democrats can muster forty votes to stop it.

Democrats are putting together their own health care package, but Republicans (and some usual-suspect Democrats) will easily defeat anything they do. Baucus has made it clear he wants sixty votes for his package, another way of saying in advance that he is willing to give away the store.

So the outlook at this time is bleak – Republicans hold all the cards, Democrats have no leaders. Republcans will insist on certain provisions for passage of a bill, such as no public option, or a horribly weak one, and perhaps no negotiating allowed on policy prices when government subsidizes insurance companies. The Democrats will give them what they want, supposedly just to get a bill passed, but in reality because this is what they want too.

I think it is important to focus on two aspects of the Baucus plan – one, his plan to tax benefits, and two, his intent to use the IRS to force people to buy private policies. In that, many of us can find common cause in opposing him. There aren’t enough progressives in the Democratic Party to stop him, but maybe we could do the odd bedfellow thing.

“Die another day” appears to be our only hope.