Democrats on Health Care

Nice.

 

Well played, House Republican Conference.

The Republican Health Care Failure

Much ink and many pixels are being expended on writing health care's political postmortems, but the focus should rightly be on the policy front -- in the think tanks and in the legislative priorities of recent Republican administrations and Congresses. In short, the battle was lost before the first shot was even fired because Republicans did not present a compelling alternative story of what was wrong with the health care system, or how they would fix it. 

When it comes to health care policy, conservatives have been seriously outgunned. And I say this in all fairness to the friends I have who work night and day on free market solutions to health care. On economics, you always know what the conservative answer is: tax cuts and generally hands-off regulatory policies to spur economic growth. No matter how good the Democrats' promises sound, we return to these simple, pro-growth touchtones that resonate with a majority of Americans who intuitively get that you can't micromanage your way to a better future. 

On health care, I have no idea what our basic guiding principle is. Seriously, I don't. 

We have tried ineffectively to stretch free market rhetoric to health care without appreciating that health care is already too far removed from a free market for the analogy to make sense. Real markets are sensitive to price. Health care isn't. The insurance companies hide the cost of actual care from the consumer. 

What we have lacked in this debate is a simple clarion call to address an aching need -- bringing free market principles to bear to improve tangible health outcomes.

Instead, we have allowed the left to define the problem as exclusively one of access -- of the nearly 50 million without insurance dying in the streets (of course, we don't talk about that number anymore because nearly a third of that number are illegal immigrants, an issue Obamacare studiously avoids). 

And it's no surprise. The left has had a far greater number of health care analysts devising grand plans for the eventual takeover. And they have invested more political capital in this issue than any other. It should surprise no one that the conservative effort in this space has been paltry in comparison. We just haven't had as many people thinking about health care, and we didn't actively move legislation on it when we were in power. 

Perhaps you might say that's beside the point of the awfulness of this plan, and that our full efforts must go towards repeal. Be that as it may, Republican inattention to health care and the failure to develop a compelling free market narrative on the issue led to the place we are now. By pounding home the notion that the uninsured were the central problem with the health care system, and pointing to the fact that their numbers were growing each and every year, liberals built a sense of urgency that conservatives didn't have and were able to demand action -- even if that action was political suicide. 

At the outset of his Administration, George W. Bush set out to neutralize a key Democratic issue, education, with his No Child Left Behind Act. NCLB was a grab bag and not beloved by conservatives for its massive expansion in Federal spending in education, but it did insist on the vaguely conservative principle of accountability. 

The merits of that legislation can continue to be debated, but one political outcome is clear. We don't talk much about education at the federal level these days. There is a sense that the problem was "solved" by NCLB, which is now nearly a decade old. Likewise, no one will try to move welfare reform legislation because the successful 1996 reform law substantively and politically took the wind out of the sails of that issue. 

Imagine if instead of the Medicare Part D entitlement, the Bush administration had moved a smart, substantive health care bill that addressed cost as the key to unlocking access, making health plans dramatically more affordable, addressing medical liability, and moving away from employer-based plans by giving any group -- whether an employer or not -- the ability to organize their own health insurance pools? 

I was there, and I can attest that the Bush Administration did make good faith efforts to move medical liability and association health plans, but it was never the central, overarching focus. It was clear they would never expend political capital like they did on the prescription drug issue that they let themselves get baited on by Al Gore in the 2000 campaign, or the war, or tax cuts. 

A well-developed Republican health reform effort could have addressed the high cost of health care -- actually the most glaring issue in our system -- in a way that would have served as a kind of tax cut for the already insured. And in lowering costs, we could have covered the people who wanted health care but couldn't afford it -- the nub of the uninsured problem. 

Debate the details of this all you want, but the political upshot of this would have been to render the health care issue, a major Democratic hobbyhorse, politically dead for a generation. A bill less ambitious in scope, designed to address real pain points not a quixotic campaign for 100% insurance, could have forestalled this bill even in the event of a complete Democratic takeover. 

This may be oversimplified. There are certainly many very good conservative health care scholars whose work I should have been reading more closely these last few years. But politics is a battle of perceptions, and the perception -- that became reality -- was that Republicans brought a knife to a gun fight when it came a debate about the scope and reach of health care reform. We may have won the political battle over health care, in that a majority of Americans opposed Obamacare, but sometimes it is the policy battles that set the tone for the future political battleground, moving the entire spectrum on which they are fought further left. 

Kinzinger Tops Polls in 11th District (Good Illinois Pickup)

From the Adam Kinzinger for Congress campaign (11th District)…

Adam Kinzinger is currently holding townhalls across the district and after Wednesday night, he will have held 11, Debbie Halvorson, who voted yes for healthcare, has held zero. This is the first poll conducted on the Congressional Level after the Healthcare vote.

NRCC Memo Adam Kinzinger currently leads on the ballot test 44%-38% over Congresswoman Halvorson, with 16% of voters undecided. Among high interest voters (8-10s), Kinzinger’s lead improves to 49%-35%, with 13% undecided.

On the generic Congressional ballot test, the generic Republican candidate enjoys a ten point advantage in the district (43%-33%, with 21% undecided).

Voters in the district are unhappy with the job President Obama is doing, as 45% approve of the job he is doing, and 52% disapprove. Nearly four in ten voters (38%) strongly disapprove of the job the President is doing.

Congresswoman Halvorson’s image stands at 33% favorable/31% unfavorable. Her challenger, Adam Kinzinger is still relatively unknown, with a name ID of 50% and an image of 19% favorable/5% unfavorable.

Congresswoman Halvorson’s re-elect stands at 31% total re-elect to 44% total new person, with 24% of voters saying they do not know if Halvorson deserves to be re-elected. Such a low reelect score shows that Halvorson is in a precarious position for a first term Member of Congress.

www.electadam.com Results from Public Opinion Strategies:

Key Findings 1. Voters in Illinois’ Eleventh Congressional District are ready to elect a Republican candidate and disapprove of the job President Barack Obama is doing.

On the generic Congressional ballot test, the generic Republican candidate enjoys a ten point advantage in the district (43%-33%, with 21% undecided).

Voters in the district are unhappy with the job President Obama is doing, as 45% approve of the job he is doing, and 52% disapprove. Nearly four in ten voters (38%) strongly disapprove of the job the President is doing.

2. Congresswoman Debbie Halvorson’s image is polarized and her re-elect score is poor.

Congresswoman Halvorson’s image stands at 33% favorable/31% unfavorable. Her challenger, Adam Kinzinger is still relatively unknown, with a name ID of 50% and an image of 19% fav/5% unfav.

Congresswoman Halvorson’s re-elect stands at 31% total re-elect to 44% total new person, with 24% of voters saying they do not know if Halvorson deserves to be re-elected. Such a low re- elect score shows that Halvorson is in a precarious position for a first term Member of Congress.

Her position further weakens with high interest voters – the 70% of the electorate who describe their vote interest as an eight, nine, or ten on a scale from one to ten. Among these voters, Halvorson’s re-elect score stands at 30% re-elect to 48% new person.

3. Adam Kinzinger leads Congresswoman Halvorson on the Congressional ballot test.

Adam Kinzinger currently leads on the ballot test 44%-38% over Congresswoman Halvorson, with 16% of voters undecided. Among high interest voters (8-10s), Kinzinger’s lead improves to 49%-35%, with 13% undecided.

The Bottom Line Adam Kinzinger is in solid position to win, and Congresswoman Debbie Halvorson is on very shaky ground to be re-elected on Election Day. The political environment is against Halvorson, as voters in the 11th Congressional District prefer a Republican candidate on the generic ballot test and disapprove of the job President Obama is doing.

Halvorson has a polarized image, has an upside down re-elect score, and trails Adam Kinzinger on the Congressional ballot test. Halvorson trails by a larger margin on the re-elect and Congressional ballot among the voters most interested in the election. Adam Kinzinger, with an issue-oriented campaign, can defeat Congresswoman Halvorson on Election Day.

Methodology Public Opinion Strategies conducted a telephone survey among likely voters in Illinois’ 11th Congressional District on March 21-22, 2010. The survey was completed among 400 likely voters and has a margin of error of +4.9% in 95 out of 100 cases.

 

Fire Nancy Pelosi

Well done, RNC.  

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2012 and the 2010 Presidential "Permission Threshold"

A Tale of Two Brackets

It is an axiom in presidential politics that national polls are meaningless (ask Rudy Giuliani) -- the states select party nominees, and the states elect the president.  However, since large slices of the political establishment buy into national polls, a candidate's standing there affects his or her ability to raise money and gain attention that can be translated into votes in the critical early primaries.

The national polls fall into something larger and deeper, though.  The rank a candidate holds in national polls is far less important than which of two brackets the candidate falls into: Bracket 1) the top three who net double digits, and Bracket 2) everybody else.

Who says that the tea parties aren't winning elections?

Over the weekend, Politico ran a story by Alex Isenstadt about the "failures" of Tea Party candidates. This article reads more like DC-based myopia. Movements don't transform at the federal level or statewide level first. Simply creating the network with the skills to execute huge campaigns is hard and takes time.

The place to go to see the successes are things like county parties, congressional district conventions, state legislative, and municipal seats. Those are races where a little bit of money and a little bit of energy go a huge way. They are also races with relatively low name ID. And they are the entry-level races for future leaders.

One of races that showed me that something was going on was the November election of Dan Halloran to the New York City Council. He is also the chairman of the New York chapter of the Republican Liberty Caucus. (recall that RLC is the branch of the Ron Paul movement that believes in integration with the GOP party infrastructure)

Similarly, anyone who has been following local party politics knows that tea party supporters and Ron Paul and RLC organizations have had a huge impact on local party organizations. I wrote about this in response to Ken Cuchinelli's crushing convention victory to become the Republican nominee for Virginia's Attorney General.

It is easy to miss what is going on in American politics and to the American right if you focus on Washington.  It isn't happening in Washington. What is happening will lead to the Washington-based leadership being overturned by a generation of new leaders.

 

2010: Beat the Arrogant Establishment

After the March 2nd Texas primary, CNN proclaimed "Tea party changes tone, but not outcome of Texas primary." Politico's Jonathan Martin asks, "Is the tea party movement a paper tiger?" Locally, a San Angelo, Texas paper framed the result as "GOP incumbents held seats against Tea Party."

This is a classic straw man, and a dramatic misreading of the tea party's political objectives. 

Somehow, national media types got it into their heads that the tea party movement was the magic elixer for the kinds of unknown, underfunded and largely unskilled candidates who run in every race to claim the mantle of "tea party candidate" and knock off incumbents. A perusal of the Texas results at the Congressional level shows that the over/under for random, unknown unchallengers (a/k/a "tea party candidates") to incumbents was about 14%. This is basically the "none of the above" vote that materializes in every primary. When a prohibitive frontrunner has a semi-credible challenger, the frontrunner usually wins 70-30. Even when the challenger is unknown or unacceptable, 15 or 20 percent is doable. Convicted felon Lyndon LaRouche got that in some Democratic primaries against Bill Clinton in '96. 

Beyond that, the subtext is also that the tea party empowers uniquely conservative candidates, with Rubio/Crist as the model for every primary in the country. 

Again, no. 

It's clear that there is a lot more primary activity than there was in '06 and '08, largely because the prospects of getting elected as a Republican this year are so good. And in those primaries, proclaiming oneself a "tea party candidate" is about as fashionable as proclaiming oneself a "social media expert."

Going state by state and district by district, the case for conservative ascendancy in primaries is muddled at best. For every Rubio/Crist, there is a Mark Kirk walk-in-the-park. The '08 primaries showed that Republican primary voters are if nothing else pragmatic. 

A few basic misconceptions underlie the expectation that the more conservative the primary candidate, the better their chances are at winning. And the main one is that conservatives are uniquely advantaged this year because the tea parties show the party is moving right. 

This notion would require one to believe that the grassroots base of the GOP -- not its leaders, but its base -- was somehow un-conservative prior to '09 and '10. There's no evidence for that. Fueled by Rush Limbaugh and talk radio, 1994 was a conservative year. In fact, 1994 probably marked the end of the shift in the ascendancy of conservatives over moderates in Republican grassroots politics, a shift that started with Goldwater. Ever since '94, the ideological change within the Republican Party has been marginal at best.

What has changed in the last two years, is that Republicans are now unshackled from having to defend the Bush Administration and the mood of the country, and inside the Republican Party in particular, has grown more solidly anti-establishment. Those changes alone can explain the emergence of the tea party movement. 

While the case for conservative ascendancy in primaries is muddled, what isn't muddled is this: run as the milquetoast candidate of the arrogant establishment, and you lose. 

Practically every electorally relevant example points in this direction. 

NY-23? Check. 

Florida Senate? Check.

Massachusetts? Check. 

Texas Governor? Check. 

In Texas, the tea party candidate was not Debra Medina. It was Rick Perry, whose political fortunes were revived around the Tax Day tea parties last year. That points to a movement that is much more broadly relevant than the marginal nutjob candidacies that media is holding up as an example of the movement's failures. I know that one can point to Medina strength among the organizers -- and I've certainly played up the role Ron Paul's brigades have played in that effort -- but there is a convincing case that the rank-and-file attendees and their compatriots who followed from the radio dial or Fox News were solidly with Perry. And that's who matters when delivering votes in a primary, as opposed to a straw poll. 

But more importantly, the movement was aligned against Kay Bailey Hutchison, who barely disguised her sense of entitlement at holding not one, but two statewide offices. Strike one was trying to elbow aside Perry with a blatant "It's my turn" appeal not to run again, and then going ahead with a challenge. Strikes two and three were the Texas Two-Step around resigning her office, which, quelle surprise, will likely end up with Hutchison holding on to public office against her word. 

The KBH fall is of a piece with the staggering fall of "All About Charlie" Crist, who ran on a sense of entitlement before he finished the job voters elected him to do. Only a few words need to be said about Charlie Crist: pride before the fall. 

And NY-23 was a similar case of an arrogant establishment attempting to oppose its will against that of primary voters, and getting pwned in the process. 

Do you see a pattern here? 

Yes, each of these cases was one of a "conservative" beating a "moderate" -- but each also had the essential ingredient of a particularly noxious stench of self-entitlement on the part of the losers. 

As ever, public servants need to place the emphasis on the latter part of that title: servant. Those advantaged by a long career of winning elections need to be particularly humble and even servile to the will of the electorate, especially in this environment. Votes cannot be assumed. They must be earned. 

There is no easy template for tea party victory in a Republican primary. Saying you are Marco Rubio does not make you Marco Rubio. Rubio's success is due as much to Crist's arrogance and the movement-like aura Rubio has been able to build around himself as it is to a simple ideological contrast. Those whose job it is to run and win elections quickly learn that attributes -- those pesky personal qualities like honesty, integrity, intelligence, and authenticity -- matter a whole lot more than issues, even in primaries. This is not diminish the importance of principle but to acknowledge the reality that it alone is not enough, and having a good, plausible candidate, campaign, and message still matters a whole lot. 

Dude, Where's My Health Care Bill?

The Los Angeles Times reports today:

The fate of healthcare legislation turns on the endgame skills of two Democrats who bring vastly different assets to the task: President Obama and House Speaker Nancy Pelosi....Under the Democrats' strategy, the House would pass the Senate's version of the bill. Then both chambers would approve changes under the budget reconciliation process, which could pass the Senate with a simple 51-vote majority. Democrats hope to finish by the end of the month.

 This is a complete delusion. In the immortal words of Jesse Montgomery III, "No and then."

There will never be any reconciliation process. The White House is desperate for any bill to pass so that they can then immediately pivot to anything else (probably jobs). No intelligent person believes, that after the House passes the Senate bill, that there will be any serious push to pass a reconciliation bill. It would be the exact same as completely starting over on health care. And the White House has been very adamant that that is the last thing they plan to do.

The White House is trying to frame this "last" push for health care reform as an up-or-down vote on health care. But we already have an up-or-down vote set up in the House. The Senate is irrelevant. Conservatives shouldn't even entertain the possibility of the Senate passing a reconciliation bill until that bill exists. And right now, it doesn't. Not in the House. Not in the Senate. Nowhere.

So when the President campaign for "his plan" across the country this week, be sure to ask him, "Dude, where's my health care bill?"

John Boehner's attempt to override the will of Alabama's 5th Congressional District

As I've noted on two separate appearances on the Rachel Maddow Show, the Alabama Tea Party movement clearly hasn't been usurped by the Republican Party.  Right now, Tea Party activists in north Alabama are leading a bipartisan fight over House Minority Leader John Boehner's scheduled appearance in Huntsville to support recent party swapper Parker Griffith.

A modest proposal to the federal government

This is a bold idea from Utah Republicans.

We propose a modest experiment. As Utah state leaders, we are greatly concerned about the unprecedented expansion of the federal government over many years, and the enormous debt levels being left to our children and grandchildren. We believe the federal government is attempting to do far more than it has the capacity to execute well. [...]

We'd like to relieve some of their burden. We don't believe that 535 members of Congress and the president can educate our children, provide health care, pave our roads and protect our environment as well as the nation's 8,000 state legislators and tens of thousands of local officials.

So please, let us help. Let's select a few programs -- say, education, transportation and Medicaid -- that are managed mostly by Utah's government, but with significant federal dollars and a plethora of onerous federal interventions and regulations.

Let Utah take over these programs entirely. But let us keep in our state the portion of federal taxes Utah residents pay for these programs. The amount would not be difficult to determine. Rather than send this money through the federal bureaucracy, we would retain it and would take full responsibility for education, transportation and Medicaid -- minus all federal oversight and regulation. [...] [T]oday the federal government operates like an old-fashioned mainframe computer, pushing one-size-fits-all mandates out to the states. We believe there is value in intelligent decentralization.

This would be a great agenda for the Tea Party activists.  It combines limited federal government with increased State, local and personal responsibility.  For that matter, it should be a great experiment for the empiricists and policy wonks - both left and right - who want better data on which systems work and which do not.

Let's hope some Republicans will have the courage of their convictions to put political capital behind this idea.  This would be a good agenda item for Tea Party activists to demand of Republicans.

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