Don Davis

On Understanding Your Market, Or, Mr. Obama, We Need To Talk

Filed By Don Davis | September 09, 2009 1:00 PM | comments

Filed in: Living
Tags: health care reform, joint session of Congress, Obama's big speech, political strategy, Republicans vs Democrats

So it's the day of the big speech, Mr. President, health_care_access_manual_logo.gifand we got trouble with a capital "T" right here in Health Care City.

What are you gonna do? Do we follow the traditional Democratic Party legislative process of passing something at any cost, assuming the entire time that the Left and the Netroots will "go along with the program", or is there a risk that the calculus doesn't work as well today as it did in 1994 and 1996?

Well, lucky for you, I'm a fake consultant, and I know a few things about your "target market", so before you answer that question... we need to talk.

So the common sense approach to handling this situation is to make any deal required to get a bill passed, because otherwise your entire Presidency will be tagged as "strong on oratory but unable to govern". healthcare.jpgSince the Far Left supports Democrats today and won't be supporting the Republican Party under any circumstances, they'll have no choice but to follow the "centrist" (read: "bluedog") Democratic lead.

What you don't want to do, common sense tells us, is demand that reform contain elements that simply are too tough to get through Congress. Insisting on a public option is absolutely out of the question, the new "pre-existing conditions" requirements would be too onerous on the insurance companies - and requiring everyone to purchase insurance, with no public option competition at all to moderate the prices private insurers charge, or, for that matter, a guarantee of universal coverage, somehow makes perfect sense.

To mollify those who will object, we can hold out "triggers" as a compromise: in other words, government says "Hey, let's wait a few years, and if the insurance companies still haven't changed their ways, then we'll do something."

If you decide upon this approach, then the speech you want to give is to remind the Far Left and those pesky bloggers that political progress is incremental, you take what you can get, and that we can always come back later and make this whole stew of compromise better than what we propose to cook today.

While that's a pretty good approach most of the time. It won't be this time.

It's A New Political Day

There are two major reasons why, and, ironically, they're both derived from your success in 2008.

Right off the bat, this strategy assumes the millions of new voters - and even more importantly, donors - that you attracted in 2008 are Democrats, and that, no matter what, they will continue to support Democrats. The problem is, they're not and they won't.

Why? Because the vast majority of those new voters weren't "redirected" from another Democratic candidate. Instead, they were "political non-participants" who had previously held no political affiliation whatsoever. Other than supporting you personally, the vast majority of those new voters have no long-term political affiliation now, other than, perhaps, "Progressive".

The only reason they voted for you in the first place was because you were out promoting that whole "change you can believe in" thing. They saw you on TV telling people that universal access to care " a moral responsibility and a right for our country", and saying you would:

"...set up a government plan that would allow people who otherwise don't have health insurance because of a preexisting condition, like my mother had, or at least what the insurance said was a preexisting condition, let them get health insurance".

At that same evening's event (the Democratic Presidential Debate of January 31, 2008), they also saw you say this:

"...because my view is that the reason people don't have health care... [w]hat they're struggling with is they can't afford the health care. And so I emphasize reducing costs. My belief is that if we make it affordable, if we provide subsidies to those who can't afford it, they will buy it.

Senator Clinton...believes that we have to force people who don't have health insurance to buy it. Otherwise, there will be a lot of people who don't get it.

...I think that it is important for us to recognize that if, in fact, you are going to mandate the purchase of insurance and it's not affordable, then there's going to have to be some enforcement mechanism that the government uses. And they may charge people who already don't have health care fines, or have to take it out of their paychecks. And that, I don't think, is helping those without health insurance."

"Help! I've Been YouTubed!"

The fact that you said all those things brings us to problem number two: if you don't live up to your exceptionally public campaign promises, you're gonna get YouTubed.

Forget about the Republicans. The Netroots will dig these quotes up in about two seconds - in multi-part harmony, I suspect - and all of a sudden, all those "new voters" who helped put you over the top last time, instead of seeing change they can believe in, are going to start seeing you as the "same old same old" If that happens, they won't be voting Democratic again (or for anyone else, for that matter) for years to come.

political banquet.jpgAnd if they won't vote for you they most assuredly won't be giving money to Democratic causes and candidates - including you in 2012.

You have to understand, it's a question of trust. We want to believe that you'll do the right thing, but we have been lied to for eight years straight and we now fundamentally mistrust our elected representatives - including you.

Not all the news here, however, is bad news.

Let's Play Leapfrog

There is a way to turn all this to your advantage, and it basically involves "leapfrogging" the opposition.

Here's what you do:

In the speech tonight, you look America in the eye and you tell us that you said all along that we must have a public option if we hope to control costs, you tell us that insurers can't continue to "exclude" us out of insurance, and that universal coverage is, indeed, a moral obligation for our Nation - and a smart investment to boot.

Tell America that you will fight for them and against the special interests that are trying to hustle us once again. Most importantly - and this will be The Tough Part - tell us that a bad bill is a bill you won't sign.

You have to tell America that if we don't get it this year, we'll have to come back next year and try again. And if we have to, the year after that, and the next, and the next.

You also get to remind America exactly what kind of methods Republicans were wiling to use to advance their position over this past month, and whose interests they're representing when they do it.

To put it another way, you gave 'em enough rope, and now it's time for some noose-tightenin'.

The best part: not only does this approach lay to waste Republican opposition, it reels in the wavering Democrats - and it allows them to go home and tell their constituents that "Barack Obama and I are fighting for people and businesses and jobs while Republicans fight for fat cat insurance companies".

If it's done correctly, the 2010 midterms will be y'all's to lose. But as I said earlier, if you are seen as selling a political product everyone's seen far too many times before, the cost could be brutal - maybe even "President Palin" brutal.

We all have a busy day today, especially you, Mr. President, so let's wrap it all up:

  • You made a lot of campaign promises about public options and universal coverage and ending exclusion abuses, and now it's come time to make good.
  • A lot of the people who supported you didn't do it because you're a Democrat - and not because they are, either. If you don't make good, you got a problem, and so do the Democrats, possibly for years to come.
  • YouTube was a fantastic tool for you and the seed of trouble for many Republicans in '06 and '08. If you're not careful, the tables will turn, and a lot of the people doing the turning will be to your left.

Do it right and you and the Democrats have a superb opportunity to pivot on the opposition and imprint the Democratic "brand" for a new generation of voters - and donors - and an aggressive approach tonight could be the opening salvo of a message barrage that either forces Republicans to become more moderate, or turns them into a crazier political movement that loses seats and Governors in 2010 and carries even fewer states in the 2012 Presidential than they did in 2008.

Screw it up, and even Tina Fey might not be able to save us from the wrath of "Palin/Gingrich 2012".

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I agree wholeheartedly, Don.

Especially with the we'll have to come back again and again and again to the health care issue.

and you know what?

if we do have to have this fight again--and obama is perceived as leading the fight--he gains enormously.

on the other hand, if he's seen as selling out, things will go badly for him--and congressional approval ratings will basically fall off a cliff (a short cliff, i admit, as there is not much distance left for congressional approval to fall).

Out of everything I've read about health care, Don, your post rings the most true. I found myself agreeing with you completely. You hit it out of the park.

thanks so much--and let's hope the obama folks understand just how fragile their coalition really might be.

in roughly 90 minutes, i guess we'll begin to find out.

The only viable option is socialized medicine and to get that we have to break the back of insurance companies, Big Pharma and HMOs monopolies, put them out of the business, and reopen them as publically owned, worker controlled institutions. The money being wasted on profits will more than pay for the costs of socialized medicine.

Needless to say that won’t happen while Obama is conducting his secret meetings (27 so far) with the owners and CEOs of criminally liable health care providers. He accepted $18.5 in contributions from them to seal the deal he’s making now.

The LGBT community has no real friends in either party. The debates between Republicans and Democrats are none of our business. Who cares what they call each other? They’re dancing the same dance and the music is provided by AIG, Humana, Pfizer and GlaxoSmithKline. Dosey-do and Allemande Right (centrist, that is).

The exclusion of imported and immigrant workers is an inexcusable and inhumane act of racism.

That’s exactly what you’d expect from the government that escalating the murder, under the guise of military action, of civilians from Palestine to Pakistan and that wantonly sentences GIs to death to increase the profits of Haliburton and Chevron-Exxon.

What we need is socialized medicine, not a few pissant crumbs.

“I am not interested in picking up crumbs of compassion thrown from the table of someone who considers himself my master. I want the full menu of rights.”
African nationalist Desmond Tutu

Obama is a Republican in drag. He’ll drag his supporters down with him just like Bush and the real Republicans.

there's a lot here, but let me see what i can do.

by "socialized medicine", i presume you mean something closer to the uk's model of care delivery--with the significant addition of the "worker controlled" element of the idea.

to be blunt, i'm not sure that there's any evidence that suggests such an approach is inherently superior in terms of delivering care at an affordable price.

that said, there is evidence to suggest that a uk-style system could be as effective and efficient as a single-payer system such as canada's, and either would be vastly superior to the system we employ here today. (there are "hybrid" systems as well, such as australia's, that are also superior to the us model.)

in terms of implementation, i suspect single-payer would be easier to establish in the us than the uk model.

the reason i say that is because the medicare system is already up and running, and single-payer could be established simply by making every citizen medicare-eligible. this would be much easier than taking ownership of every american medical facility and putting all those workers on government payrolls.

the medical facilities also have equity value, and the fifth amendment's "takings clause" would probably require us to pay market rates to acquire that equity, so such a takeover would be substantially more expensive than expanding medicare eligibility.

i have no evidence to suggest, one way or the other, that worker ownership would impact either the effectiveness or affordability of health care delivery. i don't want to offer speculation as analysis, so i'll back away from commenting on that aspect of the proposal.

i would also tell you (and you can expect a story in the next few days that does tell you) that every system in the world is struggling to find the money to keep up with the cost of care.

no matter what system is in place here, there will be an ongoing, yearly, battle to fund that system.

that won't be a presidential battle as much as it is a legislative battle--and if i were you, i'd be thinking about how to exert pressure on congress to see these as issues of the highest national important, in fact, that from time to time we may have to raise taxes to make things happen.

and finally: will obama turn out to be a republican in disguise?

from where i sit, it's too soon to tell.

but i will tell you this: obama does not seem to be anti-science, he seems to be pursuing (up to a point) a more respectful foreign policy, and, lots of borrowing notwithstanding, things like housing starts and job losses and the price of homes are in far better shape today than they were 12 months ago.

i'll also tell you this: there are a lot of people who project onto obama liberal positions that he does not hold. support for same-sex marriage is one of those, and in regards to that particular issue there are a lot of people who are surprised and disappointed today who should have known what was coming.

As you say Don, lots of stuff. You can't take up these questions with a few sound bites.

Our future is at state.

to be blunt, i'm not sure that there's any evidence that suggests such an approach is inherently superior in terms of delivering care at an affordable price.

The English, well, with the exception of the rich, like their system, which is similar to that of several other nations, including Cuba. Allowing doctors, med techs and nurses a say in running things cannot but help improve care. Obviously the Democrats, as the party of choice for union busting laws like NAFTA, deregulation and TARP will draw a line in the sand on workers control. We'll just have to cross it.

the medical facilities also have equity value, and the fifth amendment's "takings clause" would probably require us to pay market rates I'm for changing the law to allow us to confiscate the wealth of HMOs, insurance companies, Big Phamra and other criminal elements: the cults, the looter rich and predatory lenders - without compensation.

and if i were you, i'd be thinking about how to exert pressure on congress I'm all for that but it requires a clean break from the parties of the rich and a mass action campaign to compel them and the sellout in the White House to do the right thing.

things like housing starts and job losses and the price of homes are in far better shape today than they were 12 months ago.

Not so fast. Unemployment is at levels comparable to the Great Depression. The Labor Day figure stood at 9.7%. According to the BLS the real rate, including the compensated unemployed, plus discouraged and uncompensated persons and temp or part-time workers who want full-time regular jobs-is 16.3% . The average work week is about 33 hours, 7% of the workforce holds down two or more part-time jobs and unemployment in some areas is catastrophic. Detroit’s is close to 30%.

And you can’t pass over the TARP bailouts with a ”lots of borrowing notwithstanding”. In his book The Looting of America Les Leopold commented that:

"At least a trillion dollars was handed to big bankers in 2008 and 2009, with very little debate. This is borrowed money that we, the taxpayers and our children, are on the hook for. It's an immediate transfer of wealth from present and future generations to the largest financial institutions in the world. It may well be the largest wealth transfer since African-Americans built the South. We went along because the financial markets had a gun to our heads. No bailout, no lending. No lending, no economy."

According to KC Labor’s annual Labor Day Report there are no causes for optimism.

“Recent small increases in manufacturing output have not stopped the hemorrhaging of jobs much less created new ones. Labor productivity has increased as a result of squeezing more work out of existing workers. Even if orders for goods increase substantially there is much slack that can be taken up in returning to a normal work week-even overtime-and utilizing temp workers, before any new hiring can be expected. That's no where in sight at the present.”

“One more thing to keep in mind about the mass unemployment: the abrupt curtailment of payroll deductions poses a serious challenge to the functioning of Social Security and Medicare just as the "baby boomers" are ready to claim their benefits.”

As for the rest if you think Obama is more respectful from where you’re sitting you’re obviously not sitting in Baghdad, Gaza City, Kabul or Islamabad.

I’m glad he did the sane thing about stem cell research but he get’s an F for the rest of it. Denying health care to immigrant and imported workers is recipe for disaster in a time when yellow and dengue fevers are moving north with global warming. We need to end this abstinence bullshit, pass out gazillions of condoms, provide for massive needle exchanges, create a viable effective ‘the day after’ protocol for people who had unsafe sex, vaccinate every young woman and man in the country for HPV and launch massive campaigns against HIV/AIDS and breast cancer. That not gonna happen under the Obama administration.

On the question of global warming and creating jobs by greening the economy he gets an F minus.

I do agree with you about one thing, liberals are very, very gullible and project their own desires on candidates like Obama who don’t give a rats ass about GLBT folks. And yes they should have known but they listened to the lies of his supporters, apologists and shills.

so let me start with the comment on superior systems.

to put that comment in context requires you to include the next paragraph:

"...there is evidence to suggest that a uk-style system could be as effective and efficient as a single-payer system such as canada's, and either would be vastly superior to the system we employ here today..."

the point being that i'm supportive of either a single-payer or an nhs-like system (cnanadians like their system, too), and i have no evidence to suggest an nhs-style system is inherently superior to single-payer (or vice versa, for that matter). i still think it would be easier to implement single-payer, for reasons already discussed.

to overturn the fifth amendment requires a constitutional amending process, and if it makes the tough congressional voting hurdles it's almost certain to bog down in the state legislatures (37 of which must concur before the fifth amendment can be overturned); so as i noted before, i view that as among the toughest (and costliest) to implement of the changes that you seek.

you note the need to create mass actions to bring congress into line, and i'm inclined to agree--but i would also point out a practical political reality: because such a small number of citizens participate in local "ground game" politics, an especially active and vocal minority can exert disproportionate leverage on local officials...which means even if you can't create "mass actions politics" it is still possible to have great impact.

the (often overlapping) "christian" and "conservative" political activist communities in this country have been using this tactic to great effect for roughly three decades now on city and county councils and school boards and zoning commissions; and it's something progressives have failed to respond to for just as long, to our great detriment.

a quick example of this tactic in action can be seen in the battle between evolution and "intelligent design" in school texts and curricula.

should state governments be given responsibility to run these programs (as canadian provinces and the uk's "local councils" do) this will be important, and we would do ourselves a favor by beginning the process of getting familiar with those folks now.

is obama being viewed as more respectful in tehran or islamabad or baghdad...or cairo, or beirut?

my friend wa'el nawara thinks he is--and that this will continue as long as he sticks to his words, as presented in the cairo university speech.

i would tell you that it's too soon to tell if he'll meet that goal or not, and that it may take 18-24 months before we really know.

a few words are in order about unemployment: the reason unemployment is an economic "trailing indicator" is because employers are reluctant to rehire until they are convinced a recession is over.

the historical sequence of recovery usually starts with consumer confidence, which leads to greater consumer and business spending, followed by new hiring by business.

a variation of this theme can occur when product cycles drive business demand, creating demand, and then recovery. some might suggest that this occurred in late 2001, moderating the recession that began as the "internet bubble" burst in 2000-2001.

the bank bailouts are the largest transfer of wealth since slavery?

i think not.

health care profits and "administration costs" (advertising and promotion, wages, etc.) have been coming in at about 1/3 of us health care spending, and that should be about $800 billion this year alone, a number similar to last year's and 2007's.

my guess: you're looking at $3-5 trillion in wealth transfer to the "health industrial complex" over the past decade.

of course, the bush tax cuts represented nearly $1.9 trillion in wealth transfer, which also seems like it's going to be a larger number than the total of the bank bailouts.

so with all respect to mr. leopold, i'm thinking the bailouts are unlikely to get above number three on that "transfer of wealth hall of shame" list.

next, i'll run through a whole bunch of stuff real fast. it'll be me in italics.

"Denying health care to immigrant and imported workers is recipe for disaster in a time when yellow and dengue fevers are moving north with global warming." (while i feel you're factually correct here, there is no way this gets through congress, and you can't be too tough on obama for grasping that reality.)

"We need to end this abstinence bullshit" (i'm with you 100%),

"pass out gazillions of condoms" (again, 100%),

"provide for massive needle exchanges" (i would go a lot farther than you've suggested here. i would sell needles along with drugs to consenting adults, just as we do tobacco and pipes.),

"create a viable effective ‘the day after’ protocol for people who had unsafe sex" (again, 100% on board with you here),

"vaccinate every young woman and man in the country for HPV and launch massive campaigns against HIV/AIDS and breast cancer." (there are questions as to whether it would be a wise use of resources to vaccinate men against hpv, and in canada the decision about whether to offer the vaccine to men is awaiting the results of clinical trials. other than that, i'm, again, with you 100%.

i would add one additional point: a national "wellness and prevention" message would not necessarily be a "breast cancer campaign", but the spillover effect would be to help reduce cancer incidence, and in implementing your suggestion here i would consider the multiplier effect of a general wellness and prevention initiative running alongside a cancer initiative.)

finally, global warming: i find it hard to believe that you can't differentiate between the bush administration's hostility toward science and reason in dealing with this issue and the obama administration's efforts to move something (hr 2454).

will this turn out to be just window dressing, or a real effort to move forward? once again, i would suggest it's too soon to tell, that we'll know better by this time next budget cycle...and that an "f" might be too harsh of a grade just yet.

1) If single payer excludes the participation of profiteers like insurance companies, HMO's and Big Pharma it amounts to socialized medicine.

Any program, like Medicare, that permits their participation is just another way of making the rich richer at the expense of the health care needs of working people.

2) The promises of the Cairo University speech are worth as much as Obama's 'fierce' opposition to DADT and DOMA. Those promises, and $3.75 will get you a cup of coffee.

My friends are working people in Iraq. They want the US out now and a chance to settle accounts with the sunnis and shiites themselves. And they want to protect Iraqi sovereignty over their oil. They don't think that US sponsored mass murder from Palestine to Pakistan is particularly 'respectful'. They think it’s just old fashioned imperialism and brigandage. I agree.

In Iraq they're building a new trade union coalition to protect Iraqi oil resources and push the Americans out. Giving unqualified support to the efforts of the anti-US Iraqi unions, the US civilian antiwar movement and the GI antiwar movement is principled. Giving Obama a year to two or more to murder civilians and GI’s is not.

3) I'm willing to wait and see which of the following bipartisan efforts fed the greed of the looter rich the most.

• Clinton's championing of the bipartisan deregulation of banks, financial companies and insurance companies that unleashed predatory lenders.

• Clintons championing of NAFTA.

• Bush's tax cuts.

• Obama’s gifts of trillions via TARP - welfare for the rich – and his attacks on unions.

Historian Steven Deyle, in his book Carry Me Back: The Domestic Slave Trade in American Life, says that the estimated value of slaves was valued at from $3-4 billion (1860) dollars. The combined capital invested in manufacturing, railroads and banks totaled about $2.6 billion (1860) dollars. Clearly slavery was the driving factor in the creation of wealth in the US, not just the South. The gains of the Civil War were betrayed and Reconstruction ended so that slavery could be partially reinstituted by states based on the draconian enforcement of Jim Crow laws. African Americans were jailed and their labor was ‘rented’ by the states for chain gangs, etc.

4) “while i feel you're factually correct here, (I guess you mean about racism and the public health dangers of denying health care to imported and immigrant workers) there is no way this gets through congress, and you can't be too tough on obama for grasping that reality.”

That’s not an answer. It’s more of an excuse. No one expects Obama, the Congress or most reformist Democrats to take a principled stand on racism, but we can be adamant that people describing themselves as progressives at least be able to figure out that Obama’s health care ‘reforms’ are racist and an attack on the health care needs of working people.

We have to begin taking a class approach to these questions, an approach not hinged on partisan support for Democrats.

5) In terms of HPV it should go to women first, but if there’s not enough vaccine we can always buy some from the Cubans, who have socialized medicine and one of the most advanced pharmaceutical industries in the world. And hopefully they’ll sweeten the deal with some cigars.

6)In no case should any for-profit pharmaceutical company be allowed to make another penny off the medical miseries of working people. I know it means a fundamental change in how we conduct the government to promote the nationalization of for profits without compensation. That’s why I support it.

7) As to pollution and global warming, the Big Crunch is expected sooner than anyone imagined, in roughly 30, not 100 years. Every year for the last decades there have been horrific fires in Australia, Mexico, around the Mediterranean and across the western United States and Canada. The poles and Greenland are melting for the first time in about 8,000 years and ocean tempertures are the highest ever recorded. Desertification, severe weather and agricultural failures are things that children in grade school now will have to deal with.

The only solution is a huge effort to end burning of fossil fuels while allocating trillions to green industry and transportation (which has the added advantage of creating a huge number of jobs.)

It’s all about science and neither Bush nor Obama embrace an end to fossil fuel consumption or greening the economy. In fact they support the opposite – a genocidal war for oil. No science there, just good old fashioned murderous greed. Sitting Bull would take one look at Iraq and immediately know what was what. The Sioux had gold, the Iraqi’s have liquid gold.

Bush and Cheney deserve some of the blame for that but so does every US president and Congress since the warnings began about 3 decades ago. The Republicans continue to deny the rapid onset of a global warming crisis and want more oil from US Arctic and offshore drilling. "Drill baby, drill!"

The centerpiece of the Democrats bill HR 2454 is the bogus cap-and-trade scam that will make it easy for corporate polluters to continue wrecking the environment for the next decade. We don’t have any decades left to play with. Obama also promotes nuclear power, a disaster in waiting, hoaxes like biofuels and the idiocy of “clean coal".

The Democrats, like the Republicans before them deserve their F. Thinking they’re capable of solving the crises we face is plainly delusional. Giving them more time to trade the blood of GI’s for oil, pollute, screw up health care, bust unions and feed the rich will just make things worse.

You can give them all the time you want but I’ll wager that unemployed workers, people screwed by fake heath care reforms, GI’s, Iraqis, and victims of the next wave of foreclosures (because of growing and intractable unemployment) won’t be quite as generous as you are with that hustler in the White House.

Hopey-Changey is turning to rage.

so let's start with me pointing out that we actually agree about about a lot here, and while it's fair to say that i'm not yet ready to assign failure to the degree you have...i'm not willing to say you're wrong, either.

but i would also point out that a lot of what neither of us likes about "the gubmint" transcends presidents and is rooted in the legislative branch.

the cave in on single-payer in the current healthcare debate is a good example: did obama cave because he was giving up too much too early (or because he was bought off, or whatever), or did he correctly understand that the congress would not, under any circumstances, allow it to happen?

the debate over political aspiration and achievable reality is not gonna be settled here, but i tend to come down on the side of realpolitik because of people like kucinich.

here's a guy that was, for all intents and purposes, right about all the things he talked to us about during his presidential campaign...but where did it get him--or us?

and how effective is he at getting legislation he (and we) would like to see passed actually passed?

we could really fill space going over this ground, but i'm going to leave this thread of thought by saying that i often don't know how to bridge the gap between the possible and the "i want", a situation i suspect we both find maddening.

more on this tomorrow...

by the way...and just to keep this on a note of humor...have a peek here.

Ok. The discusssion is just about played out, but it did get the heart of things.

" did obama cave because he was giving up too much too early (or because he was bought off, or whatever), or did he correctly understand that the congress would not, under any circumstances, allow it to happen?

I think that's the wrong question. The correct question is do reforms work or, in decisive terms, can political democracy exist when the economy is controlled by an overwhelmingly powerful and very tiny oligarchy who call the plays and assign the players.

It translates to questions like “can health care reform be achieved without nationalizing, without compensation, the insurance industry, HMO's and Big Pharma.” And the same for ending the war, putting down bigots and racists, promoting unions, preparing for the effects of global warming (because it’s way to late to prevent it).

Put another way, the question is “Can the Democrat Party, which is owned by the looter rich and their agents, be reformed to become an instrument of fundamental change.” (Keeping in mind that the last fundamental change was the 13th Amendment, which Democrats, then called the Confederacy, fought tooth and nail.)

I say no to all of the above and you're not so sure. But those are the questions that everything else hinges on. Those who say reforms are possible will stay in the Democrat and Republican Parties. Those who say no will work to nullify the influence of the twin parties and to build mass action movements.

If Kucinich were serious he'd quit the Democrat Party. If the AFL-CIO was serious they'd do the same and unleash the closeted Labor Party they’re holding in reserve.

I think that this next round in politics depends on whether the recession becomes a depression or remains just a very long, very deep recession. We don’t know the answer to that yet.

In either case the decisive fragmenting of US politics will go on, with partisan bickering replaced by a no holds barred struggle for power between the two parties. Polarization is the order of the day and both the left and right will grow at the expense of the center.

In the meantime the wars for oil and other resources, assaults on the standard of living of working people and unions will continue without letup. The all out assault of christers on the GLBT communities continues to strengthen. Obama’s election awakened the not very deeply buried racism of millions of rightist scum, many of whom are Democrats. Their attack on imported and immigrant workers is will intensify.

Interesting times.

just a few things more:

--i'm still not at all convinced that private ownership of care delivery systems means that patients and taxpayers must be the losers, with the "ownership class" as the only winner, and i'll tell you why.

canada, the uk, and australia (toss in germany as well, if you want) all achieve more or less similar public health outcomes at more or less similar costs to the economies of those nations, yet each has a different ownership model.

the canadian system is entirely dependent upon private ownership, the uk system, the exact opposite, and the german and australian systems are a mix of public and private ownership of care delivery.

at least as far as those four examples are concerned, there seems to be no association between ownership model and outcomes. in order to be convinced that all private ownership must be abolished before true reform can occur i'd need to see that such an association exists.

to take this analysis one step further, the top five largest countries in terms of life expectancy are japan (which is basically a "many-payer" version of single-payer), singapore (which uses, in part, health savings accounts with mandatory collection of 6% of income and competitive public and private care delivery), canada, sweden (which mixes government control over spending on public and private resources), and france (who uses private care delivery and seems to keep waiting lines low by creating high co-pays--up to 40%--for services, which is why almost all french citizens also have private insurance).

so of those top five, all five--including sweden--utilize privately-owned care delivery as part of their systems.

so what that (admittedly exceptionally rough analysis) suggests to me is that having elements of private ownership in a system is not inherently harmful to the quality of care delivery.

there is an additional issue: would turning over the medical device and pharmaceutical industries over to government control actually improve delivery, keep the level of innovation high, and control costs better than what we do today abnd better than any potential improvements in regulation might yield?

i can't answer that question, primarily because i have no publicly run model with which to compare.

however, i would suggest that regulatory reforms are likely to hit the same walls we're seeing today in care delivery reform efforts...including the wall of corporate ownership of congress.

"...The correct question is do reforms work or, in decisive terms, can political democracy exist when the economy is controlled by an overwhelmingly powerful and very tiny oligarchy who call the plays and assign the players...."

that's a good question, but it leads to another: what about the role of incremental success?

an example might be the voting rights act.

obviously racism isn't over ("can you say tea bag? i knew you could..."), but that was a pretty substantial victory. so was the americans with disabilities act and the clean air act.

none of these have "solved" the problems they were meant to attack, each is subject to manipulation by special interests...but each has created a better situation than we had before.

so what do we do at this point with health care (and part two, what are the democrats likely to do)?

do we say "forget it, because we don't have a socialized medicine proposal"?

do we walk away from it if there's no public option, even if we get preexisting conditions and "you can't drop people for having claims"?

i'm having a tough time with the answer. one reason is because, in any other year, getting preexisting conditions and "don't kick people off" would have been a satisfactory outcome. this year, not so much.

i think we'll know more in about six weeks, and we'll know a lot more when the budget process starts after the first of the year.

moving on: i've always had doubts about the ability of a third party to elect presidents.

the reason i say that is because the politically disaffected in this country are themselves a split community, which is comprised of left- and right-leaning voters. it's possible that four parties might be the outcome of this situation, rather than a third party that aligns the currently divided centrist community.

in such a scenario the fights would be between the two factions of the "original" two parties and, on the larger level, "generic" left and right.

just a few things more

Well, if you insist.

i'm still not at all convinced that private ownership of care delivery systems means that patients and taxpayers must be the losers, with the "ownership class" as the only winner,

Simple. Profit is theft and the money used to profit private owners could be used to enhance medical care. Some of those systems worked in a period of relative prosperity and are collapsing as the world economy collapses. South Africa's health care system is a mix of public and private and it’s in total collapsed under the impact of world economic collapse and the HIVAIDS pandemic. Contrast those to the excellent and robust heath care provide by the socialized system in Cuba.

I don't advocate 'government control' particularly when the government is run by dunces and hustlers, aka Republicans and Democrats. I advocate nationalization without compensation and democratic socialization via control by workers, consumers and health car advocates.

Incremental successes have a way of being wiped out over time.
• Cleaner air in the US was largely a byproduct of the export of heavy industry to bust unions. Global warming remains unchecked and it's largely the result of the burring of fossil fuels in the USA.
• I live in an over-55 apartment complex and know lots of folks who are poor as a result of being disabled. The fact that they get a handicapped parking spot doesn’t mean squat when they can’t afford to eat or by vital meds. That act is a sham and a disgrace.
• Voting means little if your choices are limited to idiots (Republicans) and backstabbing hustlers (Democrats).

Elections don't produce change. Mass action produces change. The last time we had real change was in 1865. The intense fracturing of US politics isn't as likely to polarize conservative, neocons, liberals and progressives as it is to make them extinct. The reason is that they all support private profit.

The ship is sinking and they won’t abandon it.

i was surprised to hear you say that there's been no "real change" since 1965.

i would thought you would have looked appreciatively on the era when the worker's rights movement first asserted itself here, especially the period from maybe 1915 (just before the formation of the iww) until after the flint sit-down strikes.

i'm also surprised you don't see progress in the fact that you don't see so many "colored only" water fountains these days or governors deploying national guard troops to keep the black kids out of the white high school.

neither of those represent anything close to "solved" problems--and of course, progress made back then in the labor movement has for the most part been lost in later years--but it's also fair to say that neither example represent worlds in which time and the ugliness of people have conspired to keep everything in an entirely static state.

I was speaking of fundamental changes made by the rulers of the US. The last time that happened was 1865 and the passage of the 13th Amendment to the Constitution which abolished slavery. It was fundamental becasue it was the product of the civil war between the slavers, who wanted to extend slavery to the North and West and farmers, city workers, antislavery groups and others.

After a huge military and political fight organized by a radical new party that shattered the old political order and a radical new, mass army and navy, the 13th Amendment completed the work of 1783. It was the Second American Revolution.

Since then mass movements have forced many needed concessions from our rulers.

Public works and public health projects were won by progressives and populists. Recent years have seen major backward trends. Foodstuffs are very unsafe and the infrastructure is, as the song says, in tatters.

Suffragist won women's suffrage but the fact that voting is largely meaningless makes that a hollow victory.

Unions made tremendous strides, on their own against the tide of rightwing and reformist politics represented by political hustlers like TR. Wilson, Coolidge, Hoover, FDR Truman, but most of that has been reversed under the impact of union busting by Nixon, Reagan, the Bushes, Clinton and Obama. None of it was fundamental.

African Americans won civil and voting rights in the 1960's and early 1970's. All were welcome but the problems racism are still with us in terms of gaps in income, education, police violence, unequal application of the law, housing, education, medical services and etc.

We need fundamental changes. We'll have to use tools like the electoral process to educate and organize people and mass, militant continuous actions campaigns to mobilize to compel fundamental change.

A constant theme of US history is that reforms won from the rulers in one era are taken away by the rulers in another. Reconstruction and Jim Crow. Regulation and deregulation of markets, public health and etc. Union rights wiped out by union busting. The Bill of Rights is constantly under attack: McCarthyism and the witchhunts, Kent State and merde like the Clinton-Bush-Obama policies of civilian spying, kidnapping, torture, murder and running concentration camps like Gitmo, Bagram and those in Iraq.

Reforms are always the product of social struggle, they’re rare and they’re impermanent. Reformism is a failed strategy. Reforms are never won by elections or lobbying but by mass action in all it's forms.