Post Politics Hour

Perry Bacon Jr.
Washington Post Staff Writer
Monday, August 17, 2009; 11:00 AM

Every Monday, The Post's Perry Bacon Jr. took your questions about the latest political news, and previews the week ahead.


Perry Bacon Jr.: Welcome to chat. Lots of health care news. Perry


Public Option: If the public option were included in the final Senate bill, how many senators would vote for it? 50? 51? I keep hearing that the dems don't have enough votes to get to 60, but how close do they actually get? Thanks.

Perry Bacon Jr.: I would assume many of the more conservative Democratic senators, Ben Nelson, Blanche Lincoln, Mark Pryor, would prefer not to have a vote on a bill that includes a public option, as they generally want a more bi-partisan bill and almost no Republican will vote for a Medicare-like public option. My guess is something like 40-45 Dems are for that ,but I haven't done a formal count.


Eustis, Fla.: I am really getting sick of hearing about the middle class. They get their houses refinanced. They get the cash for clunkers. They have health ins. What about the lower class? When is our government going to do something for them?

Perry Bacon Jr.: I don't know how we define "lower class," but that said, many people who are uninsured also have lower incomes. The stimulus was designed to help people who are unemployed. Obama has proved making Pell Grants bigger, helping lower-income people got to college. So I think this actually a lot of attention on people with low incomes in our politics.


Richmond, Va.: I am in the process of reading Dan Balz and Haynes Johnson's excellent book about the last election. In part of the book they talk about how the extreme right killed immigration reform. Now they are trying to kill health-care reform. I agree with the writer in yesterday's paper (the crazy tree article) who wrote that these people have always been around but they have never been pandered to by the media like they are now. How does anything get done in our country when these people have such a loud and unfiltered soapbox in the TV media to scare people and perpetuate out and out lies?

Perry Bacon Jr.: Without having recently read that section of Dan and Haynes book, which I agree is excellent, I would not that politicians aren't completely bound to polls, activism, etc. That's their choice. particularly when there is a Democratic president and large Democratic majorities in Congress, the biggest barrier to passing a bill may end up being Democrats who won't back it or Republicans in the Senate who block it, not activists from either party. The conservative activists don't have that much power, look who is president.


Minneapolis, Minn.: Is the public option dead-dead or playing dead?

Perry Bacon Jr.: I have to confess being a bit confused about all the shock at what Sebelius said yesterday. The White House has signaled for months the could accept a deal with no public option or a limited one. I was not surprised at all. Is it dead? No. I think the House bill will include a public option. But if it comes down to getting 10 GOP votes or public option, Dems will take the GOP votes.


Health-Care Confusion: The furious arguments over health care seem to be centered around debunking ridiculous assertions (death panels, etc.) rather than merits of a real reform plan. Part of this is lack of a genuine program that proponents can get behind. When do you think we will see a final comprehensive program?

Perry Bacon Jr.: There is a House bill and a Senate bill that have both passed through committees. So I diagree there is no "real plan." There are lots of things proponents can get behind that are almost certain to be in the final legislation, like insurance exchanges that make it easier to shop for private plans. Call me crazy, but I don't think the majority of Americans really think the big creates death panels. The voters I talk to who are undecided about this seem more wary of costs and how it will change the health care system, concerns I consider legitimate. We should not over estimate the importance of these town hall protests and side issues.


Haymarket, Va.: I would like to know if anyone has bullet points on what the health care bill actually says. I have tried reading it and can't seem to get past all the references to other bills and other paragraphs.

Perry Bacon Jr.: Try this.

Let me recommend a few sites for people to look at as they follow this debate: Kaiser Family Foundation is a non-partisan health care group, Daily Dos is the Post health care home page, and the NYT has a good page as well


Dallas and Health Care: Okay, I am a conservative but please note, I am not one who is yelling at town halls or not trying to be reasonable. I believe the conservatives are taken a bad rap for standing up for our principles.

These are the reasons why I want some brakes on Obamacare. 1. Medicaid/Medicare is hugely costly and we are already heading for default for those programs, why should I not expect the same now for health-care reform. 2. We are not focusing on the problem. We need to work on multiple problems at once if we are going to curve the cost for healtcare. I.e. immigration which counts for a large part of the uninsured. 3. Insurance, believe it or not, is a privilage, not a right as the Democrats proclaim. Last time I checked, nowhere did it say that everyone should have health care. 4. Cost, I will say this again, how are we going to pay for it, should we not all pitch in instead of having only the minority rich pay for eveyone else. I make way under 100k a year and would be willing to pay a smaller percentage now if everyone else will too. We all have to be willing to pay for it, and not just have only a few.

All I am saying is, if we are going to do this, let's do it right. Slow it down, talk, converse, and be open to all sides. Is that too much to ask?

Perry Bacon Jr.: Just posting what I think is an interesting comment. I was in Iowa last week following Sen. Grassley, so let me make one point: illegal immigrants would not be covered under this bill. And I think illegal immigrants getting health care, while perhaps a big issue in California and Texas, is not a huge driver of health care costs in Iowa.

_______________________ Graphic: Health-Care Reform: How the Bills Stack Up (Post, Aug. 5)


Floris, Va.: Perry: The shouters who invade town hall meetings carrying Obama as Hitler signs say that it's okay since the left did the same thing. But didn't the response against Bush occur after he waged war against Irag which was several years into his term and not a few months as with President Obama?

Perry Bacon Jr.: I'm not sure who held Hitler signs when and consider this a very fringe phenomemon. That said, the conservatives view Obama's first few months the way liberals did the Iraq War, i.e. fatally flawed and dangerous.

_______________________ Prescriptions (The New York Times, Aug. 17)


Hamilton, Va.: I see some liberal reresentatives are saying that a public option is a make or break on reform. They're correct. Without a public option reform is worthless. The current ideas about making it possible for more people to get insurnace will simply funnel more money including my tax dollars to the for profits. It is amazing to me that conservatives whine about their tax dollars being wasted but pay no attention to money going to inefficient, socially damaging entities in the form of subsidies.

Perry Bacon Jr.: Gov. Dean said this yesterday. From a policy standpoint, I"m not sure this is true. If you can get 20 or 30 million of the 45 to 50 milion with insurance coverage, I would think that would be a positive change. Will the insurance companies make more money if they have more people to cover? Maybe. The bill would deny them the ability to make some of the moves they use to reduce costs, such as denying people who have pre-existing conditions from getting insurance plans.


Hamilton, Va.: People are worried what reform will cost but don't they look at their pay stubs and see what has happened by doing nothing? The premiums keep going up and employers are cutting their shares or dropping plans. It's going to cost no matter what. If people don't care if the unisured don't get coverage let them come out and admit it.

Perry Bacon Jr.: This is the Obama argument, minus the last sentence.


Prescott, Ariz.: Let's say that the Senate drops the public option from their healthcare bill and they still only get 3 or so Republican votes. Can Dems then say that they gave Republicans concessions and play for bipartisanship but they still got sandbagged? Then under this cover, submit a conference bill with a public option and dare the Ben Nelson's and Blanche Lincoln's to filibuster a Dem bill?

Perry Bacon Jr.: I guess they could. One thing to remember, Sen. Kennedy has missed most of the votes of the year, leaving Democrats with 59 votes if Sen. Byrd is there. That leaves them one short even if all members of the party band together. Snowe, Collins, etc. have all said they don't want to a be part of a tiny coalition of Republicans like on the stimulus. To me, bipartisanship isn't a game on this bill or some kind of strategy for the White House to seem nice, it may be the only way to get something passed. It may be necessary to get a bill that would get 70 votes to pass something.


Hamden, Conn.: Dear Mr. Bacon, I wish I could share your faith in the public, but the town halls and blogs suggest that there are more than a few people who do believe the misinformation (e.g Death Panels). How can we have a constructive debate when it appears that one side does not want anything that could be construed as a success for the Dems? Thanks for taking by question.

Perry Bacon Jr.: I think we've had a health care debate for two years now, from the time Obama and Clinton discussed the issue daily. I don't deny some people believe in the death panels, but I don't that's dominating the entire debate by any means. I think think is a complicated issue with a lot of reasons to be for or against the bill.


New York, N.Y.: It looks like Obama's health care reform is headed the way of Clinton's.

At what point does our health-care system "break" badly enough that someone actually has to do something about it? If we don't do anything, what does the situation look like 10 years down the line?

Perry Bacon Jr.: I say stayed tuned. I don't think it's nearly early enough to conclude this effort won't happen. The president is making the case that you are that the status quo is broken, but I'm not sure he's yet convinced Americans or Congress what he's proposed is that much better.


San Diego, Calif.: If you'd have told me even as recently as last summer that respectable mainstream media outlets would be citing Facebook entries by Sarah Palin with all the gravity of, say, a policy paper, I'd have thought you were nuts.

Perhaps this question is so "last week," but what standards should the media have when it comes to politicians who don't bother to issue many press releases and totally avoid substantive interviews in which their assertions about "death panels" could be challeged directly?

Perry Bacon Jr.: It's Sarah Palin, the rules are different for her. I just think there is so much interest in her that it's worth writing about what's she's saying, even if we have to fact check it and note when it's wrong. Just so you know, I read the facebook messages of McCain, McCaskill, Grassley,. Sometimes they won't agree to do interviews with us or there is no time and personally, I want to hear as much as I can from politicians I can. These guys still do dozens in interviews in the Senate every day and appear on CNN all the time. Palin is different in that sense, but I don't think you can run for president with Twitter messages alone, so if she really wants to make a big impact, she'll have to take real questions.


Kingston,NY: Perry, Yesterday, I watched John King push hard on K. Sebelius with his question about the public option. I felt that he phrased the question in such a way that she had to come off as being absolutely unwilling to compromise or as wobbly on the public option. I'm not sure if either option is particularly fair, but the media snatched on the "public option out" view. Now the White House has issued a clarification and judging from the reaction on C-SPAN this morning it seems that this interpretation has riled up the left. Is it possible that this non-story will actually energize those in favor of the public option or is it already too late? Thanks

Perry Bacon Jr.: I think Obama's comment on Saturday really drove this, as he seemed to be saying the obsession with the option is overstated. And it's August, small things get more coverage. But I think this might be the time for public option people to really push for it if they want it.


Public Option: I understand there are a handful of Blue Dogs who won't vote for a health-care bill with a public option. But aren't there more dems who won't vote for a health-care bill if it DOESN"T include a public option? And if there's not, why aren't these Dems forming a colalition similar to the Blue Dogs to push for the public option? The Blue Dogs are winning because they're organized. Why can't the more liberal Dems organize to fight them? Then the Blue Dogs would be outnumbered.

Perry Bacon Jr.: Pelosi made a remark about this that got some liberals angry before the recess. Here's the deal: no one really thinks progressives in Congress are going to vote down a health care reform bill that ensures 95% of Americans have coverage and Obama backs because of the lack of a public option. Blue Dogs on the other hand live in conservative districts and face electoral pressures not to back the bill. But you're also correct the liberals in the House aren't as unified as the Blue Dogs, who tend to take a strong stand on a issue and never back down.


Wokingham, U.K.: When the health-care business is settled one way or another, presumably before winter sets in, will immigration become the next political volcano?

Perry Bacon Jr.: No, I don't think. Doesn't seem a priority for Obama or Dems in Congress. I suspect energy and economy will remain at the front of the agenda.


Bluffton, S.C.: I'm surprised you didn't tell Haymarket that he/she can go online and find the House bill, the only bill reported out of committee. It's 1047 pages long so lots to read (I'm halfway through it!). Just Google HR3200 and the reader will find many places where the entire bill can be read.

Perry Bacon Jr.: I know I will be criticized for saying this, but I the House bill is really hard to read and I think the for many people the summaries are really helpful.


Port Aransas, Tex.: There is so much merit in the comments which everyone is submitting here. The clarifying information is critical to all of us. Please be sure to write to your senators and representative with your thoughts. THEY will be the ones to vote on the bills.

Perry Bacon Jr.: Good point.


Concord, N.H.: Sorry if this is an insensitive question, but if Sens. Kennedy or Byrd are so infirm that they are unable to be present for floor votes on the health-care bills, shouldn't they resign their seats and let the Democratic governors of their states replace them with people who can be present for those votes?

Perry Bacon Jr.: Just posting this.


Fairfax, Va.: Can you not see Sen. Kennedy being rolled in on a gurney to make his vote for the health care bill, which has been his baby? I think he would literally rather die than not have a health care bill passed because of his vote. The 60 votes will be there, if needed.

Perry Bacon Jr.: My sense is that 15-20 Democrats in the Senate dont' vote for a bill that passed 60-40. So I don't think this is realistic scenario.


Why don't the Democrats: use the reconciliation process to push through a bill that includes a public option? And why are there only 6 members of the Senate Finance Committee negotiating? Where is the Democratic majority?

Perry Bacon Jr.: I don't think the negotiations are exclusive, but rather Baucus created a group of people who are willing to make a deal and compromise and talk. Reconcilation is still on the table, but it could limit the scope of the bill.

Here's a good piece on this;


Cheltenham: Are we entering health-care burnout? Seems most of the arguments both for and against are getting pretty lame.

Perry Bacon Jr.: just posting a few comments.


Iowa: Regarding the costs of reform: we already pay twice what Great Britain spends (8 percent of GDP vs. about 16 percent) and everyone is covered in their system. The U.S. spends a fortune for health care that is rated 37th (WHO). We may have the best health care MONEY CAN BUY, but if you don't have money, you often can't buy.

Perry Bacon Jr.: and another.


Re: Dallas and Health Care: Unfortunately, the one issue that conservatives (and liberals as well, for that matter) are not discussing as a present and future unsustainable cost in health care is fee-for-service. Rewarding health care providers (and I am one) for services without regard to whether they are necessary or proven effective may be in step with free-market entrepreneurship, but doesn't necessarily deliver the best sevices to the patient.

Perry Bacon Jr.: I think the White House people say this constantly.


Lake Forest, Ill.: Hi Perry -- Thanks for taking questions today. I want the president to succeed and hope some sort of health-care reform happens, but if it doesn't, what does that mean for Obama? Will he give it another try, or cut his losses and move on? More importantly, what kind of impact will it have on the rest of his term?

Perry Bacon Jr.: Who knows is the real answer. But it would suggest his leadership style can't take on the big challenges he said he could when he ran. And it would make Republicans and conservative Democrats even less interested in helping his agenda. That's why I think he wont' end this process until he signs something he can declare as "reform," however limited in scope.


Perry Bacon Jr.: great questions. Thanks for the chat folks.



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