Friction On The Left Over Health Care Getting More Personal

The battle over health care reform on the left is getting more personal. Ronald Brownstein attacked Howard Dean for his criticism of the bill:

Maybe one reason former Vermont Gov. Howard Dean and so much of the digital Left can so casually dismiss the Senate health care reform bill is that they operate in an environment where so few people need to worry about access to insurance.

The 2004 presidential campaign that propelled Dean to national prominence was fueled predominantly by “wine track” Democratic activists-generally college-educated white liberals. (In the virtually all-white 2004 Iowa caucus, for instance, exit polls showed that two-thirds of Dean’s votes came from voters with a college degree.) Those are the same folks, all evidence suggests, who provide the core support for online activist groups like or Dean’s Democracy for America and congregate most enthusiastically on liberal websites. (According to studies by the Pew Internet & American Life Project, college graduates are more than twice as likely as those with only a high-school degree to communicate about politics online.) Along with Dean, those digital Democratic activists are generating the loudest demands to derail the Senate bill.

Some individuals in these overlapping political networks undoubtedly face challenges with access to health care, but as a group college-educated whites are much less likely than any other segment of the population to lack health insurance

This may or may not be what is influencing Dean, but he does have some valid points which deserve an answer, along with some points which have been countered. Considering how similar the current plan is to his 2004 plan which also lacked a public option, it is also possible that the bad blood between Dean and the White House is influencing him on this.  This was most evident when Dean was not offered a spot in the Obama administration. (This would not be the first time that Howard Dean has created political waves by attacking someone with a similar viewpoint. During the 2003 fights for the 2004 nomination, Dean repeatedly distorted and attacked John Kerry’s position on Iraq despite the fact that the views of the two were virtually identical.)Regardless of Dean’s motivations, there are some real issues here and I would prefer to see actual discussion of the issues rather than dwelling on speculation over his motivation.

If we must attack Democrats (including Lieberman who still caucuses with the Democrats), it should be the Democrats who are really standing in the way of meaningful health care reform. Ezra Klein points out that Joe Lieberman is responsible for much of the mess we are now in:

Joe Lieberman’s reckless decision to blow up last week’s compromise has had exactly the impact many of us predicted. Much of the left has flipped into vicious, angry opposition to the bill. Is that because the Medicare buy-in, a good but limited policy, has disappeared from the bill? Ostensibly. But not really. If you don’t believe the bill has cost controls, Medicare buy-in was not an answer to your concerns. If you believe the mandate is bad policy, letting the small slice of exchange-users between 55 and 64 choose public insurance did not answer your fears.

But progressives had compromised plenty already. Single payer became a strong public option, a strong public option became a weak public option, a weak public option became Medicare buy-in, and Medicare buy-in became Joe Lieberman’s revenge. Progressive ends are submitting to conservative means, and industry is laughing all the way to the bank. All this amid the first year of a president they elected, a Democratic majority they built…

Lieberman has tossed the process into chaos. But the short-term satisfactions won’t overwhelm the long-term judgments. Lieberman is “point person” because he has appointed himself the 60th senator. Every other member of the Democratic caucus could have done the same, but most all have judged the underlying bill more important than their disagreements with it. Lieberman did the opposite, and there’s little evidence that he actually had disagreements with the bill so much as dislike for some of its supporters.

And Lieberman, let’s remember, is not a lefty blogger. He isn’t a pundit or an op-ed columnist. He is the “point man,” and by choice. He bears a special responsibility. Atop the shoulders of another man, it would make for a heavy load. But not his. His recklessness has endangered the bill, and through it, many, many lives. He may not be ashamed. But he should be.

I agree with Klein’s assessment of Lieberman but disagree with his push to maintain the mandate. Dropping the mandate would appease many on the left (as well as center and right) who now oppose the plan. Previously it appeared that the mandate at least made health care reform simpler. Now, instead of simplifying the legislation, among the many other problems with the idea, mandates to purchase private insurance are causing the greatest degree of friction on the left.

There are many other ways that the legislation could be written to provide assistance to those who desire to purchase private insurance while simultaneously providing disincentives to trying to game the system by holding off on purchasing insurance until one becomes ill. Currently the Medicare D program for prescription drugs is voluntary and, while few turn it down, even Medicare B which covers physician services is voluntary.  The bill could provide greater advantages for those who sign up by 2014 which are phased out if people do not enter the system and/or exclusions on pre-existing conditions could be reserved for those who fail to obtain coverage. Obama also should have stuck to his first instincts and maintained the position he held during the primary campaign.

As bad as Lieberman has been during this debate, we must not forget Ben Nelson. Jed Lewison sums up his objections to the plan:

In sum: unless Ben Nelson is bluffing, the only way he will vote for cloture is if abortion is restricted, the subsidies are whacked, the revenue provisions are nuked, and its Medicaid expansion is gutted. Oh, and he doesn’t think there’s any chance of it happening by Christmas.

Compared to this, Dean’s attack on the Senate bill  doesn’t look anywhere near as bad. Even David Axelrod has backed away from calling Dean’s criticism “insane.”

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  1. 1
    healthy says:

    » Friction On The Left Over Health Care Getting More Personal …: Some individuals in these overlapping political…

  2. 2
    Billy McKee says:

    » Friction On The Left Over Health Care Getting More Personal …

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    Billy McKee says:

    » Friction On The Left Over Health Care Getting More Personal …

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    libhomo says:

    I will never vote for Schumer or Gillibrand again in my entire life if they vote for cloture on this HMO/insurance company wealthcare bill.

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