Op-Ed Columnist - The Rage Is Not About Health Care - NYTimes.comMarch 28, 2010
Op-Ed Columnist
The Rage Is Not About Health Care
By FRANK RICH
THERE were times when last Sunday’s great G.O.P. health care implosion threatened to bring the thrill back to reality television. On ABC’s “This Week,” a frothing and filibustering Karl Rove all but lost it in a debate with the Obama strategist David Plouffe. A few hours later, the perennially copper-faced Republican leader John Boehner revved up his “Hell no, you can’t!” incantation in the House chamber — instant fodder for a new viral video remixing his rap with will.i.am’s “Yes, we can!” classic from the campaign. Boehner, having previously likened the health care bill to Armageddon, was now so apoplectic you had to wonder if he had just discovered one of its more obscure revenue-generating provisions, a tax on indoor tanning salons.
But the laughs evaporated soon enough. There’s nothing entertaining about watching goons hurl venomous slurs at congressmen like the civil rights hero John Lewis and the openly gay Barney Frank. And as the week dragged on, and reports of death threats and vandalism stretched from Arizona to Kansas to upstate New York, the F.B.I. and the local police had to get into the act to protect members of Congress and their families.
How curious that a mob fond of likening President Obama to Hitler knows so little about history that it doesn’t recognize its own small-scale mimicry of Kristallnacht. The weapon of choice for vigilante violence at Congressional offices has been a brick hurled through a window. So far.
No less curious is how disproportionate this red-hot anger is to its proximate cause. The historic Obama-Pelosi health care victory is a big deal, all right, so much so it doesn’t need Joe Biden’s adjective to hype it. But the bill does not erect a huge New Deal-Great Society-style government program. In lieu of a public option, it delivers 32 million newly insured Americans to private insurers. As no less a conservative authority than The Wall Street Journal editorial page observed last week, the bill’s prototype is the health care legislation Mitt Romney signed into law in Massachusetts. It contains what used to be considered Republican ideas.
Yet it’s this bill that inspired G.O.P. congressmen on the House floor to egg on disruptive protesters even as they were being evicted from the gallery by the Capitol Police last Sunday. It’s this bill that prompted a congressman to shout “baby killer” at Bart Stupak, a staunch anti-abortion Democrat. It’s this bill that drove a demonstrator to spit on Emanuel Cleaver, a black representative from Missouri. And it’s this “middle-of-the-road” bill, as Obama accurately calls it, that has incited an unglued firestorm of homicidal rhetoric, from “Kill the bill!” to Sarah Palin’s cry for her followers to “reload.” At least four of the House members hit with death threats or vandalism are among the 20 political targets Palin marks with rifle crosshairs on a map on her Facebook page.
When Social Security was passed by Congress in 1935 and Medicare in 1965, there was indeed heated opposition. As Dana Milbank wrote in The Washington Post, Alf Landon built his catastrophic 1936 presidential campaign on a call for repealing Social Security. (Democrats can only pray that the G.O.P. will “go for it” again in 2010, as Obama goaded them on Thursday, and keep demanding repeal of a bill that by September will shower benefits on the elderly and children alike.) When L.B.J. scored his Medicare coup, there were the inevitable cries of “socialism” along with ultimately empty rumblings of a boycott from the American Medical Association.
But there was nothing like this. To find a prototype for the overheated reaction to the health care bill, you have to look a year before Medicare, to the Civil Rights Act of 1964. Both laws passed by similar majorities in Congress; the Civil Rights Act received even more votes in the Senate (73) than Medicare (70). But it was only the civil rights bill that made some Americans run off the rails. That’s because it was the one that signaled an inexorable and immutable change in the very identity of America, not just its governance.
The apocalyptic predictions then, like those about health care now, were all framed in constitutional pieties, of course. Barry Goldwater, running for president in ’64, drew on the counsel of two young legal allies, William Rehnquist and Robert Bork, to characterize the bill as a “threat to the very essence of our basic system” and a “usurpation” of states’ rights that “would force you to admit drunks, a known murderer or an insane person into your place of business.” Richard Russell, the segregationist Democratic senator from Georgia, said the bill “would destroy the free enterprise system.” David Lawrence, a widely syndicated conservative columnist, bemoaned the establishment of “a federal dictatorship.” Meanwhile, three civil rights workers were murdered in Philadelphia, Miss.
That a tsunami of anger is gathering today is illogical, given that what the right calls “Obamacare” is less provocative than either the Civil Rights Act of 1964 or Medicare, an epic entitlement that actually did precipitate a government takeover of a sizable chunk of American health care. But the explanation is plain: the health care bill is not the main source of this anger and never has been. It’s merely a handy excuse. The real source of the over-the-top rage of 2010 is the same kind of national existential reordering that roiled America in 1964.
In fact, the current surge of anger — and the accompanying rise in right-wing extremism — predates the entire health care debate. The first signs were the shrieks of “traitor” and “off with his head” at Palin rallies as Obama’s election became more likely in October 2008. Those passions have spiraled ever since — from Gov. Rick Perry’s kowtowing to secessionists at a Tea Party rally in Texas to the gratuitous brandishing of assault weapons at Obama health care rallies last summer to “You lie!” piercing the president’s address to Congress last fall like an ominous shot.
If Obama’s first legislative priority had been immigration or financial reform or climate change, we would have seen the same trajectory. The conjunction of a black president and a female speaker of the House — topped off by a wise Latina on the Supreme Court and a powerful gay Congressional committee chairman — would sow fears of disenfranchisement among a dwindling and threatened minority in the country no matter what policies were in play. It’s not happenstance that Frank, Lewis and Cleaver — none of them major Democratic players in the health care push — received a major share of last weekend’s abuse. When you hear demonstrators chant the slogan “Take our country back!,” these are the people they want to take the country back from.
They can’t. Demographics are avatars of a change bigger than any bill contemplated by Obama or Congress. The week before the health care vote, The Times reported that births to Asian, black and Hispanic women accounted for 48 percent of all births in America in the 12 months ending in July 2008. By 2012, the next presidential election year, non-Hispanic white births will be in the minority. The Tea Party movement is virtually all white. The Republicans haven’t had a single African-American in the Senate or the House since 2003 and have had only three in total since 1935. Their anxieties about a rapidly changing America are well-grounded.
If Congressional Republicans want to maintain a politburo-like homogeneity in opposition to the Democrats, that’s their right. If they want to replay the petulant Gingrich government shutdown of 1995 by boycotting hearings and, as John McCain has vowed, refusing to cooperate on any legislation, that’s their right too (and a political gift to the Democrats). But they can’t emulate the 1995 G.O.P. by remaining silent as mass hysteria, some of it encompassing armed militias, runs amok in their own precincts. We know the end of that story. And they can’t pretend that we’re talking about “isolated incidents” or a “fringe” utterly divorced from the G.O.P. A Quinnipiac poll last week found that 74 percent of Tea Party members identify themselves as Republicans or Republican-leaning independents, while only 16 percent are aligned with Democrats.
After the Civil Rights Act of 1964 was passed, some responsible leaders in both parties spoke out to try to put a lid on the resistance and violence. The arch-segregationist Russell of Georgia, concerned about what might happen in his own backyard, declared flatly that the law is “now on the books.” Yet no Republican or conservative leader of stature has taken on Palin, Perry, Boehner or any of the others who have been stoking these fires for a good 17 months now. Last week McCain even endorsed Palin’s “reload” rhetoric.
Are these politicians so frightened of offending anyone in the Tea Party-Glenn Beck base that they would rather fall silent than call out its extremist elements and their enablers? Seemingly so, and if G.O.P. leaders of all stripes, from Romney to Mitch McConnell to Olympia Snowe to Lindsey Graham, are afraid of these forces, that’s the strongest possible indicator that the rest of us have reason to fear them too.
Op-Ed Columnist - Fear Strikes Out - NYTimes.comMarch 22, 2010
Op-Ed Columnist
Fear Strikes Out
By PAUL KRUGMAN
The day before Sunday’s health care vote, President Obama gave an unscripted talk to House Democrats. Near the end, he spoke about why his party should pass reform: “Every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made ... And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine.”
And on the other side, here’s what Newt Gingrich, the Republican former speaker of the House — a man celebrated by many in his party as an intellectual leader — had to say: If Democrats pass health reform, “They will have destroyed their party much as Lyndon Johnson shattered the Democratic Party for 40 years” by passing civil rights legislation.
I’d argue that Mr. Gingrich is wrong about that: proposals to guarantee health insurance are often controversial before they go into effect — Ronald Reagan famously argued that Medicare would mean the end of American freedom — but always popular once enacted.
But that’s not the point I want to make today. Instead, I want you to consider the contrast: on one side, the closing argument was an appeal to our better angels, urging politicians to do what is right, even if it hurts their careers; on the other side, callous cynicism. Think about what it means to condemn health reform by comparing it to the Civil Rights Act. Who in modern America would say that L.B.J. did the wrong thing by pushing for racial equality? (Actually, we know who: the people at the Tea Party protest who hurled racial epithets at Democratic members of Congress on the eve of the vote.)
And that cynicism has been the hallmark of the whole campaign against reform.
Yes, a few conservative policy intellectuals, after making a show of thinking hard about the issues, claimed to be disturbed by reform’s fiscal implications (but were strangely unmoved by the clean bill of fiscal health from the Congressional Budget Office) or to want stronger action on costs (even though this reform does more to tackle health care costs than any previous legislation). For the most part, however, opponents of reform didn’t even pretend to engage with the reality either of the existing health care system or of the moderate, centrist plan — very close in outline to the reform Mitt Romney introduced in Massachusetts — that Democrats were proposing.
Instead, the emotional core of opposition to reform was blatant fear-mongering, unconstrained either by the facts or by any sense of decency.
It wasn’t just the death panel smear. It was racial hate-mongering, like a piece in Investor’s Business Daily declaring that health reform is “affirmative action on steroids, deciding everything from who becomes a doctor to who gets treatment on the basis of skin color.” It was wild claims about abortion funding. It was the insistence that there is something tyrannical about giving young working Americans the assurance that health care will be available when they need it, an assurance that older Americans have enjoyed ever since Lyndon Johnson — whom Mr. Gingrich considers a failed president — pushed Medicare through over the howls of conservatives.
And let’s be clear: the campaign of fear hasn’t been carried out by a radical fringe, unconnected to the Republican establishment. On the contrary, that establishment has been involved and approving all the way. Politicians like Sarah Palin — who was, let us remember, the G.O.P.’s vice-presidential candidate — eagerly spread the death panel lie, and supposedly reasonable, moderate politicians like Senator Chuck Grassley refused to say that it was untrue. On the eve of the big vote, Republican members of Congress warned that “freedom dies a little bit today” and accused Democrats of “totalitarian tactics,” which I believe means the process known as “voting.”
Without question, the campaign of fear was effective: health reform went from being highly popular to wide disapproval, although the numbers have been improving lately. But the question was, would it actually be enough to block reform?
And the answer is no. The Democrats have done it. The House has passed the Senate version of health reform, and an improved version will be achieved through reconciliation.
This is, of course, a political victory for President Obama, and a triumph for Nancy Pelosi, the House speaker. But it is also a victory for America’s soul. In the end, a vicious, unprincipled fear offensive failed to block reform. This time, fear struck out.
Op-Ed Columnist - Health Reform Myths - NYTimes.comMarch 12, 2010
Op-Ed Columnist
Health Reform Myths
By PAUL KRUGMAN
Health reform is back from the dead. Many Democrats have realized that their electoral prospects will be better if they can point to a real accomplishment. Polling on reform — which was never as negative as portrayed — shows signs of improving. And I’ve been really impressed by the passion and energy of this guy Barack Obama. Where was he last year?
But reform still has to run a gantlet of misinformation and outright lies. So let me address three big myths about the proposed reform, myths that are believed by many people who consider themselves well-informed, but who have actually fallen for deceptive spin.
The first of these myths, which has been all over the airwaves lately, is the claim that President Obama is proposing a government takeover of one-sixth of the economy, the share of G.D.P. currently spent on health.
Well, if having the government regulate and subsidize health insurance is a “takeover,” that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.
The only part of health care in which there isn’t already a lot of federal intervention is the market in which individuals who can’t get employment-based coverage buy their own insurance. And that market, in case you hadn’t noticed, is a disaster — no coverage for people with pre-existing medical conditions, coverage dropped when you get sick, and huge premium increases in the middle of an economic crisis. It’s this sector, plus the plight of Americans with no insurance at all, that reform aims to fix. What’s wrong with that?
The second myth is that the proposed reform does nothing to control costs. To support this claim, critics point to reports by the Medicare actuary, who predicts that total national health spending would be slightly higher in 2019 with reform than without it.
Even if this prediction were correct, it points to a pretty good bargain. The actuary’s assessment of the Senate bill, for example, finds that it would raise total health care spending by less than 1 percent, while extending coverage to 34 million Americans who would otherwise be uninsured. That’s a large expansion in coverage at an essentially trivial cost.
And it gets better as we go further into the future: the Congressional Budget Office has just concluded, in a new report, that the arithmetic of reform will look better in its second decade than it did in its first.
Furthermore, there’s good reason to believe that all such estimates are too pessimistic. There are many cost-saving efforts in the proposed reform, but nobody knows how well any one of these efforts will work. And as a result, official estimates don’t give the plan much credit for any of them. What the actuary and the budget office do is a bit like looking at an oil company’s prospecting efforts, concluding that any individual test hole it drills will probably come up dry, and predicting as a consequence that the company won’t find any oil at all — when the odds are, in fact, that some of the test holes will pan out, and produce big payoffs. Realistically, health reform is likely to do much better at controlling costs than any of the official projections suggest.
Which brings me to the third myth: that health reform is fiscally irresponsible. How can people say this given Congressional Budget Office predictions — which, as I’ve already argued, are probably too pessimistic — that reform would actually reduce the deficit? Critics argue that we should ignore what’s actually in the legislation; when cost control actually starts to bite on Medicare, they insist, Congress will back down.
But this isn’t an argument against Obamacare, it’s a declaration that we can’t control Medicare costs no matter what. And it also flies in the face of history: contrary to legend, past efforts to limit Medicare spending have in fact “stuck,” rather than being withdrawn in the face of political pressure.
So what’s the reality of the proposed reform? Compared with the Platonic ideal of reform, Obamacare comes up short. If the votes were there, I would much prefer to see Medicare for all.
For a real piece of passable legislation, however, it looks very good. It wouldn’t transform our health care system; in fact, Americans whose jobs come with health coverage would see little effect. But it would make a huge difference to the less fortunate among us, even as it would do more to control costs than anything we’ve done before.
This is a reasonable, responsible plan. Don’t let anyone tell you otherwise.
Op-Ed Columnist - Senator Bunning’s Universe - NYTimes.comMarch 5, 2010
Op-Ed Columnist
Senator Bunning’s Universe
By PAUL KRUGMAN
So the Bunning blockade is over. For days, Senator Jim Bunning of Kentucky exploited Senate rules to block a one-month extension of unemployment benefits. In the end, he gave in, although not soon enough to prevent an interruption of payments to around 100,000 workers.
But while the blockade is over, its lessons remain. Some of those lessons involve the spectacular dysfunctionality of the Senate. What I want to focus on right now, however, is the incredible gap that has opened up between the parties. Today, Democrats and Republicans live in different universes, both intellectually and morally.
Take the question of helping the unemployed in the middle of a deep slump. What Democrats believe is what textbook economics says: that when the economy is deeply depressed, extending unemployment benefits not only helps those in need, it also reduces unemployment. That’s because the economy’s problem right now is lack of sufficient demand, and cash-strapped unemployed workers are likely to spend their benefits. In fact, the Congressional Budget Office says that aid to the unemployed is one of the most effective forms of economic stimulus, as measured by jobs created per dollar of outlay.
But that’s not how Republicans see it. Here’s what Senator Jon Kyl of Arizona, the second-ranking Republican in the Senate, had to say when defending Mr. Bunning’s position (although not joining his blockade): unemployment relief “doesn’t create new jobs. In fact, if anything, continuing to pay people unemployment compensation is a disincentive for them to seek new work.”
In Mr. Kyl’s view, then, what we really need to worry about right now — with more than five unemployed workers for every job opening, and long-term unemployment at its highest level since the Great Depression — is whether we’re reducing the incentive of the unemployed to find jobs. To me, that’s a bizarre point of view — but then, I don’t live in Mr. Kyl’s universe.
And the difference between the two universes isn’t just intellectual, it’s also moral.
Bill Clinton famously told a suffering constituent, “I feel your pain.” But the thing is, he did and does — while many other politicians clearly don’t. Or perhaps it would be fairer to say that the parties feel the pain of different people.
During the debate over unemployment benefits, Senator Jeff Merkley, a Democrat of Oregon, made a plea for action on behalf of those in need. In response, Mr. Bunning blurted out an expletive. That was undignified — but not that different, in substance, from the position of leading Republicans.
Consider, in particular, the position that Mr. Kyl has taken on a proposed bill that would extend unemployment benefits and health insurance subsidies for the jobless for the rest of the year. Republicans will block that bill, said Mr. Kyl, unless they get a “path forward fairly soon” on the estate tax.
Now, the House has already passed a bill that, by exempting the assets of couples up to $7 million, would leave 99.75 percent of estates tax-free. But that doesn’t seem to be enough for Mr. Kyl; he’s willing to hold up desperately needed aid to the unemployed on behalf of the remaining 0.25 percent. That’s a very clear statement of priorities.
So, as I said, the parties now live in different universes, both intellectually and morally. We can ask how that happened; there, too, the parties live in different worlds. Republicans would say that it’s because Democrats have moved sharply left: a Republican National Committee fund-raising plan acquired by Politico suggests motivating donors by promising to “save the country from trending toward socialism.” I’d say that it’s because Republicans have moved hard to the right, furiously rejecting ideas they used to support. Indeed, the Obama health care plan strongly resembles past G.O.P. plans. But again, I don’t live in their universe.
More important, however, what are the implications of this total divergence in views?
The answer, of course, is that bipartisanship is now a foolish dream. How can the parties agree on policy when they have utterly different visions of how the economy works, when one party feels for the unemployed, while the other weeps over affluent victims of the “death tax”?
Which brings us to the central political issue right now: health care reform. If Congress enacts reform in the next few weeks — and the odds are growing that it will — it will do so without any Republican votes. Some people will decry this, insisting that President Obama should have tried harder to gain bipartisan support. But that isn’t going to happen, on health care or anything else, for years to come.
Someday, somehow, we as a nation will once again find ourselves living on the same planet. But for now, we aren’t. And that’s just the way it is.
