If you’ve been following the health care debate closely, this is not news to you:
Emanuel and other White House advisers made a calculation early in the healthcare debate that they needed at least one powerful industry on board with their plans to overhaul the nation’s healthcare system. Suspecting that the insurance industry would probably not be on board, the divide-and-conquer strategy focused on the pharmaceutical industry.
A veteran of the Clinton White House, Emanuel witnessed the death of healthcare reform in 1994 after it was attacked repeatedly by powerful players in the healthcare community.
Fifteen years later, that experience appears to be guiding Emanuel’s thinking.
Despite being a huge advocate as a congressman for the reimportation of drugs from Canada and negotiated bulk-purchasing of drugs by Medicare, Emanuel negotiated away both of those items in a deal with PhRMA. In return, PhRMA agreed to cut the price of brand-name drugs for seniors by $80 billion over the next decade. More importantly, they agreed not to oppose the legislation moving through Congress, and to actually spend money supporting it. This last piece is a classic double-whammy. As we look at the political landscape today, it is easy to take for granted that we haven’t been fighting off Harry and Louise ads from pharmaceutical industry. It’s easy to assume that positive advertising from PhRMA has had no positive impact.
I think the benefits of this deal are self-evident, even if they aren’t as obvious as the down side. I don’t think Emanuel’s thinking was any more complex than what I’ve just laid out. But, it remains quite possible that Congress will not honor the deal. And, if that happens, it will be very interesting how Emanuel’s gambit is viewed by historians.
In the weeks ahead, Democratic Policy Committee Chairman Byron Dorgan (N.D.), Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Tom Harkin (D-Iowa) and others will push policies that the White House pledged to fend off.
Dorgan said he “wasn’t involved” in the deal. Dorgan added that a senior White House official denied that the president would oppose drug re-importation provisions in healthcare reform.
Dorgan said he will offer an importation amendment to the healthcare reform bill when it reaches the Senate floor, something that administration officials may find difficult to lobby against. Not only did Emanuel sponsor drug re-importation bill that passed the House in 2003, Obama himself was a former co-sponsor of Dorgan’s proposal and campaigned on the issue last year.
Unlike many Democratic proposals, Dorgan can count on the support of a few Republicans. Sen. Olympia Snowe (R-Maine), whom many Democrats consider a crucial vote in the healthcare debate, is the lead GOP co-sponsor of the measure. Sens. John McCain (R-Ariz.) and David Vitter (R-La.) have also supported it.
If Dorgan is correct that the president will not veto a bill that allows for the reimportation of drugs, that’s an invitation to renege on that part of the deal. And what would PhRMA do? Would they turn on a dime and oppose the legislation? How much impact could they have in a just a few days between the passage of such an amendment and the vote on final passage? Wouldn’t the drug industry find that it was too late to credibly and effectively challenge a bill that they had been supporting all year?
No, I think PhRMA would be stuck. Their only option would be to raise hell with the White House for breaking their word and pour money into electing a Republican president in 2012.
I’m not saying that this was Emanuel’s plan all along. I think his strategy has been fairly sophisticated, but not here. He’ll probably fight to see that the deal is honored. The mystery will be whether he does that for show, or he really means it.
If Dorgan does it and Congress agrees, the White House can fight it and it still will pass. I don’t see how that is “breaking their word”.
When the legislation is ready, it needs to be passed rapidly to prevent the industry from readjusting its advertising and creating any more delays. That means that the Senate will have just roll over Baucus, the primarily Congressional negotiator in the deal. And the House will have to roll over — who is it? — Mike Ross?
The Ross and Baucus can say “We didn’t have the votes to stop it.”
I can’t see them vetoing the bill, but it’ll be interesting to see if they can defeat Dorgan’s amendment. They have to appear to try, right?
Appear to try?
You’ve unwittingly expressed the essence of Obama’s strategy. Smoke and mirrors my man; and you’re doing your best to sell Obama’s little tricks.
Appear to try. Play 11th dimensional chess. Bah.
But you’re not being half as clever as you think.
I’m certainly not buying this shit sandwich. People despise being lied to and will ultimately rebel.
Obama’s game is designed to frustrate the truth and tie up progressives. Obama may win a temporary ‘victory’, that is if one can call enacting the insurance companies wet dream into law a victory, but I really doubt that Obama can convince actual liberals that this shit sandwich is really palatable.
People will realize Obama is yet another salesman for our corporate Empire.
We will see. Maybe I”m wrong and there is an endless stream of Obama fanboy rejects from Daily Kos that want to be spun by Obama’s great chess games.
This comment is unresponsive.
If Dorgan introduces the reimportation amendment, it probably has the votes to pass at either the 60 or the 51-vote threshold. He says he’s getting the go-ahead. So, what part of ‘appear to try’ is out of bounds here?
‘Appear to try’ is not only Dorgan’s modus operandi but Obama’s as well–indeed, it ‘appears’ to be the critical component of Obama’s chess games. He pretends to stand for something to all people. You have to flat out be a complete sucker to think that Obama wanted/wants strong health care reform.
Who you going to believe? Your lying eyes or a pretty speech and fanboy spin?
This is what’s going to happen. Dorgan will ‘appear to try’ and then fail. Obama’s secret deal will stand (and love how you give Obama a pass for violating with extreme prejudice his promise to have this debate in the open). This has been the Dems health care ‘reform’ plan from the beginning. Dorgan and Obama only want to appear to try because they want cover for their epic SELLOUT. They are frauds. They probably think their only mistake was overselling the reform to the suckers in the Dem party.
Meanwhile, Obama winks to us that he really was on our side but the forces of evil are just too great and he is taking the pragmatic course–whatever. It’s bullshit you are too willing to peddle in and therefore will be very effective as the ‘left’, really the Dem establishment, will be divided by this obfuscation and spinning. You and Obama will succeed in the short term in obscuring your true intent. Obama fanboys will say any criticism is simply coming from the ‘far left’ (single payer people are not serious people dontcha know) and that Obama and Dorgan brilliantly understood that they need to cave-in in the beginning but had to try a sneak attack at the last minute, which was really part of the plan (!), blah, blah, spin, spin.
Too clever by half. No way he pulls off this chicanery over the long haul.
So, let me get this straight.
Are you saying that Dorgan’s amendment won’t pass and that Dorgan doesn’t even want it to pass?
I don’t know what Dorgan wants. Frankly, I don’t take any of what these Senators say at face value. And I have no interest in reading the tea leaves and playing these games–they are designed to mislead.
My God, Obama promised that we would see negotiations on CSPAN and instead he made a secret deal with industry that comes awfully damn close to criminal fraud. He secured money for his political comrades in exchange for policy changes. Which you tout as a brilliant and clever move. And now Obama spinners hint that maybe Obama wants to join Dorgan in secretly undermining the secret pharma deal? Whatever. It’s bullshit designed to obfuscate the truth.
The deal is done. Industry gets its blowjob from the Dems. The Dems get paid for said blowjob and meanwhile middle America gets the teabagger treatment. We get the hairy balls and Obama and the Dems get the filthy lucre. They’re frauds and sellouts and whores and one has to be a fool to trust them.
Maybe Dorgan is one of the good guys and really wants to fight . . . whatever.
It’s beside the point. These senators stick together and take turns playing good cop or bad cop. They’re playing us for fools and I’ll believe Dorgan is serious when he gets his fucking pound of flesh from pharma–but I wouldn’t be holding my breath.
The whole process is fucked up. The damage has already been done. The Dems have already sold out.
All that’s left is the spinning and the coverup and to sell this shit sandwich. And I’m not going to be suckered into this good cop bad cop game.
I really don’t get why you’re in such a frenzy over what might happen. You’re right — it’s a possibility. But you sound like it’s what you want to happen, you’re so committed to it. Do you think that calling Obama a traitor (just like the teabaggers) somehow puts useful pressure on the Dems? I think it does exactly the opposite. Is this about preexisting hatred of Obama or what?
Ah, yes, the only logical explanation is Obama Derangement Syndrome slur.
It’s the Obama fanboys that are overly focused on the cult of Obama. I could care less about Obama the person (other than the fact he’s the first black president–which is the best thing to come from his presidency). He’s simply another Dem politician for me. I admire his political skills. Other than that I simply consider him a typical conservative triangulating Clintonian Democrat.
I just want the truth. And I call it like I see it.
If you’re not pissed off at the state of our government, being completely in the pocket of Wall Street, and especially the military-industrial complex, then you’re not paying attention or are more interested in the cult of personality around Obama.
The facts call for extreme pessimism. I haven’t always been pessimistic and am not such by nature. But I hew as close to reality and the facts as practicable. And I don’t take well to being lied to and gamed.
Which is Obama’s game. So I am justifiably pissed off. And I will continue to seek out the truth.
Why does it cause you such consternation for me to be pissed off? Isn’t that the rational response when someone lies to you and plays games with you? You’re not pissed off at all that Obama promised open negotiation and made a secret deal with industry? Have you no shame that you sit quietly by because this president is on your team?
Fraud is the appropriate word here.
I think your anger is premature and counterproductive. Neither you nor Booman has definite knowledge about what the final bill will be. We are still at a point where productive action pressuring Congress and the White House is possible. If you are too angry to do so then your fears become a self-fulfilling prophecy.
I find it very productive to tell the truth–especially when those truths are uncomfortable. Truth is the best weapon against obfuscation.
I wanted Obama to succeed. That’s why I reluctantly voted for him–I wanted to give him a liberal mandate and ‘make him do it.’
But, I am often ahead of the curve on these things, or, premature as you say. My prediction from months ago was that Obama and the sellout Dems would turn their fire on the progressives if the progressives try to stop this corporate blowjob. I didn’t think the progressives would put up as much of a fight as they have so they have definitely made it tougher for Obama to ram his insurance ‘reform’ bill through. I was indeed slightly premature in that pessimistic prediction–though the main conclusion still stands.
I bet Obama does successfully pressure the progressives into backing off. This is the one area where Obama has actually spent some capital and it shows that Obama is indeed capable of getting things done when he tries. Too bad he has only shown a willingness to fight for more war and more corporate giveaways and the only group he proves willing to take on are liberals.
I also knew we would eventually move into this stage of the game where it’s Democrats fighting amongst themselves. It doesn’t take a political genius to observe the Democrats would get here–if one has been paying attention to the Democrats the last 17 years one would have seen this coming.
Realistic pessimism is far preferable to naive optimism.
The progressives are surprising me, as well. Pelosi and Schakowski (?sp) went on record again today saying there will be a public option available. Grijalva (?sp) and Woolsey have whipped the progressive caucus together more effectively than I thought possible. In the Senate, Rockefeller advocated for the public option much more strongly than I would have expected, and I was surprised by Schumer’s proposals as well. Wyden almost seems like a loose cannon at this point.
So I don’t know how it’s going to end. I’m disappointed by the White House’s involvement, but I’m optimistic that the battle is not yet over, no matter which side the WH is taking.
The problem with your anger like yours is that it’s self-defeating. People who think victory is possible will donate to DFA, make phone calls, contact Congress, contact the media, let their views be known.
They are suckering you. They are making you feel like you have a say in the process, winking at you and making you feel like you’re special and that they are really on your side, when they actually have no interest in standing up for you.
I should clarify–a few are truly fighting the good fight. And you identify those people. The “they” are the majority of Democrats, including Obama, that care more about their own pocketbooks, their own party, and their tribe than fighting for liberal policy.
The game is already over. The public option is extremely weak as is and we are fighting over scraps.
You need to step back and realize the big boys already decided the bulk of what’s going to happen and its only because there are so many troublemakers out there and they can’t just roll the troublemakers like they originally planned–so they had to come up with this game where Obama throws a scrap out there makes goo goo eyes at you tells you “make me do it”, wink, wink, and we’re all suppossed to swoon at this brilliant strategy and how thrilled we are to be pawns on the master’s chessboard.
We are pawns and these games are designed to distract us from the screwing we are taking. He’s just not that into you.
Thanks, I think. I’m not stupid, and I’m aware that I’m just another peon. I know what Obama said on the campaign trail, and I’ve followed what’s gone down.
I also know that there is a fight out there. Maybe you’re right, and it’s one the left is destined to lose. But you don’t know that, and the louder the fight, the more the public is aware of just how bad the Baucus bill is. They can’t afford for the general public to know that the whole health care bill is a fraud, so I think the fight is very real and still ongoing.
I completely agree with Rachel Q here. That the Establishment would try to foist yet another bill intended to enrich the few shouldn’t be a great surprise (after one recognizes that as the Democratic Party’s Presidential Candidate Barak Obama was, by definition, an advocate of the status quo regardless of what people thought they heard). But the talk we have seen in the past two or three weeks should be very heartening to all who believe in the democratic traditions of this country. We’ve seen them move from easily dismissing any need for a public option to one where a significant minority are now trying to make including a public option a requirement if the bill is to pass. From a time when a single-payer health care system wasn’t even considered to today when more and more are asking why it isn’t on the list. The only reason why Senators’ and Congresspersons’ positions on this matter are changing is because of voter pressure. Progress is being made. If the truth about single payer, or what a real public option is, or why we need better regulation of health care providers and big Pharma could be better explained we might see even more progress.
To me this isn’t Liberal versus Conservative or Democrat versus Republican – it’s a simple matter of putting dollars and cents in our pockets and doing the right thing for all Americans. Unfortunately I’m rather pessimistic that this movement can pick up enough steam and strength to flatten the present awesome power of a corrupt and corporately bankrolled system. But I’d love to be surprised.
Yes, a ray of hope indeed.
But I really doubt the sincerity and the willingness to follow through on the part of many progressives. Many of these progressives probably think they’ve found a new funding source and are exploiting it. Like Dodd’s flirtation with the left last year–I doubt his bona fides, but whatever, it’s good that some pols see a benefit in going after liberal votes.
In this round I would give Anthony Weiner the Gold star on health care advocacy.
And I know that it really shouldn’t matter what these politicians really think–we just need mechanisms to hold them to their word and to demand clearer communication and a more transparent process.
So yes, we have seen some movement the last few years. Not all is bad. And blogs have also been a ray of hope in a gloomy universe.
But these are faint rays of hope.
I really believe that an old-fashioned third party movement is the only viable option to save our Republic. Otherwise we are headed down the path of murderous warmongering and economic catastrophe. Our government is so cracked we are fucked. And Obama is the perfect obfuscator, giving just enough false hope to stymie any real change. He is the perfect status quo president for our time. Almost like he’s right out of central casting.
Changing the Dems from the inside will never work.
Obama is not why a multiparty system is near-impossible. The system itself is the problem. The Constitution left us with an idiotic electoral process that has become a monstrosity. It’s beyond silly to expect any politician elected by the system to work to destroy it. But of course for you, like the teabaggers and birthers, Obama is the devil responsible for every single evil in the world.
It isn’t Obama or even the Dems or even the Republicans that stymies change at that level. Only a working, passionate Left could start to make it so, and we have nothing of the sort in this country. If you really want the kind of change you preach about start devoting yourself to promoting a Constitutional Convention. That’s the only viable option to save this republic. As long as we have the creaky antique electoral system around our necks we will, as the commies predicted, find ourselves in the dustbin of history.
Well, I am a pessimist by nature. That’s why I know what kind of country we live in. There has never been a president, or head of state anywhere, who hasn’t lied his/her head off. Playing games is what they’re there for — it’s why we have representative democracy instead of American Idol. What counts is the result, and neither you nor I nor anyone else knows what that will be.
“just want the truth. And I call it like I see it.” is, frankly, bullshit. You’re talking about what will happen, which has no truth involved. And you, like the rest of us, ain’t seen nothing yet.
We might all be discussing the unknowable future, but to say “…like the rest of us, ain’t seen nothing yet” isn’t exactly true is it? We have watched the Obama administration for several months now. A simple extrapolation of its practices and methods employed should at least give a better projection of his future actions than mere hopeful speculation. On that basis I think SFHawkguy’s negativity about the future has considerable logic behind it. Definitely it is more fact-based than continuing to carry a torch for what increasingly appears to be a mirage created by good public relations.
True dat. Don’t disagree with much of what you wrote.
I don’t claim that my predictions are the truth though. They are my predictions based on the facts.
And you’re right to be pessimistic in nature–I should clarify that’s how I am too–at least with politics–I guess I just meant to say I’m not pessimistic in my personal life and wanted to counter the stereotype a lot of Obama partisans are throwing around about the ‘Naderite’ left whose disposition is somehow always negative, etc.
I guess we on the left better get used to these barbs going back and forth between Obama fanboys and the ‘far left’. Sadly. And Rahm, Rove, and Obama all stand to gain from this silliness and obfuscation.
Or to put it another way, between the Obama hateboys and the realist far left.
But if you’re compelled to put Obama in the same box with Rove there’s not going to be much back and forth.
I’m sorry you don’t see how this political kubuki benefits both parties–what you call the ‘realist left’ (i.e. ConservaDems, or the Democratic party) as well as actual conservatives. Both the ConservaDems and the conservatives want to funnel money to their corporate donors at the expense of average Americans. In this case PHARMA and the insurance industries. You can call it the realist position; I call it the corporate whore position. I find it very odd indeed that you demand we treat these corporate whores with respect. FUCK THEM.
Pretending that Rahm and Obama have not sold out is foolish self-delusion and I will wait patiently for someone that is nicer than me to reason with you. I have seen you to be eminently reasonable and I don’t doubt reason will win out. In the meantime, I will not be suckered into your self-delusion and if you want to use my anger as yet another excuse in a whole host of excuses you’ve made for the president, then I can’t stop you. That’s your particular emotional hangup. It’s not my job to make nice arguments that don’t offend you.
In fact, I submit this has been the cause for considerable pain on the left–this sick propensity to make excuses for Obama as if he’s some God-like figure. My God man, are people really going to the fainting couches because people are daring to criticize the president and if we all just clap louder magic ponies will appear and ride us to paradise?
As to your particular point that there is a big diff between Rahm and Rove . . . .
I guess I should have clarified that there is difference in that Rahm is attempting to give a sloppier blow job to Pharma and the health insurers than Rove did, for which he will be rewarded with the filthy lucre instead of Rove. So yeah, I guess I should have noted their interests diverge slightly–because they are both vying to be the conservative corporate party whore. But they are both playing the game and auditioning for party whore.
But make no mistake about it: both Rahm and Rove want to muzzle the real left (those you now mock), and in this particular case, the majority of the American people, in an effort to protect their corporate benefactors. They are perfectly aligned on who the enemy is: progressive liberals and the millions of Americans that agree with them on these fundamental issues.
I’m sorry the truth hurts so much. I really am. I wish it weren’t so.
You can pretend Rahm isn’t doing what Rove was doing or you can admit reality. Your call. Don’t blame me for your choices.
Can’t quite figure out a way to defend your Obama=Rove claim I guess? I don’t give a shit about Rahm one way or another. If your equation is accurate you expect Obama to veto any decent healthcare reform that emerges. Is that your prediction? Cuz that’s what would happen if Bush/Rove were still president.
The prediction is that there will not be a decent health care bill at all, just another industry giveaway that makes the workingman’s life harder and criminalizes poverty.
No, I’m not SFHawkGuy’s sockpuppet, but I could almost believe that myself after reading his words. The difference is that he is still angry and I’m just sad and resigned. I’m an old guy. I’ve been fucked by politicians more times than a Manilla whore has been fucked by sailors. I’ll bet he’s still young. Take it away, SFHawkGuy, the torch has been passed. May it burn brightly.
I’ve been reading Booman since the primaries and I’m always grateful that you write such informed and reasoned pieces. I’m grateful that I have found you. You are the kind of writer that our newspapers should hire. Someone who is informed and cares about his subject.If it werent for you I’d be swimming in a non-stop sea of ignorance and misinformation. If only a respectable newspaper(are there any left?) would hire you. When I get money I’ll send some. You are definately worth paying for.
I second your thought precisely. It has definitely been a sea of ignorance out here.
So is that 12 dimensional chess now? Armando’s(?) phrase has now been superceded.
If it turns out that this was indeed the strategy, it makes sense that they’d choose pharma over insurance. At least pharma, in contrast to health insurance, produces something, at times something of great value. I’d of course prefer that government enable much more competition in the pharma markets, which would include patent reform, bulk negotiation, and repayment by drugcos for government-paid research they are making huge profits on. But that’s another issue that can and should be taken up later.
If the deal indeed paves the way for real healthcare reform with a strong public option, affordable rates for all, and an end to the worst insurance company scams like rescission, it’s a good trade for now. If it ends up that Congress stands up and “reaches out” with a compromise gutting at least one of the two forks of the deal, so much the better. But I don’t really see how Obama can do less than fight tooth and nail to honor the deal this time around — his credibility is at stake for all future negotiations if he’s percieved as doing anything less.
and I agree, at this point Pharma is stuck.