January 18th, 2012
Brian Beutler
January 18, 2012, 5:25 AM
In an encyclopedic new book that sheds fresh light on the defining fight of President Obama’s first term, one of the administration’s key health care reform allies recalls a thin-skinned, “weak-kneed” White House, strategically unwilling and temperamentally unable to face criticism from progressive reformers, whose toughest tactics were reserved for its natural allies.
Many of the revelations will be unsurprising to those who followed the year-long fight over health care reform closely. But they serve as a thorough reminder of the administration’s uneven strategy during the debate, including its horsetrading with private industry, and private dealing with supporters on the left — particularly those, like the author, who fought a bruising fight for a public health insurance option and lost.
The book is Fighting For Our Health, by Richard Kirsch, who directed the advocacy group Health Care for America Now during the push for reform. HCAN is a well financed umbrella group backed by scores of liberal groups, unions, and other reformers — making Kirsch a close witness to the entire saga. He confirms that the White House treated the public option like a bargaining chip with powerful industry players, and believes that when his group became most critical of the bill mid-way through the fight, that top White House aides sought to have him canned.
“The White House had negotiated a number of deals with the health industry, designed to win their support for reform, including agreeing to oppose a robust public option, which would have the greatest clout to control how much providers got paid,” writes Kirsch, largely confirming what has become an open secret in Washington.
Kirsch’s book is replete with similar stories. Thematically, it centers on contradictions within the Democratic party, and Obama himself, that gave rise to the infighting that marked the debate. To keep factions from spinning apart, Kirsch suggests, the administration was averse from the outset to the idea that progressives and sympathetic stakeholders should play an outside game, pressuring the President and problem Democrats in Congress to pass robust reforms.
That tension was clear to reporters, many of whom received first-hand accounts of private, angry meetings between White House officials and outside advocates. Yet despite the fact that HCAN was generally more compliant with the administration than other less-influential groups, Kirsch reports that some in the White House were incensed enough when he stepped out of line that they sought reprisals — and may have tried to have him fired.
Kirsch singles out Obama’s then-Deputy Chief of Staff Jim Messina, who now manages Obama’s re-election campaign. After HCAN criticized an early version of the health care law, drafted by Senate Finance Committee Chairman Max Baucus, Kirsch writes, “I got a call from a member of the HCAN Steering Committee. The message was brief: Someone at the White House had called [the Service Employees International Union] and asked that I be fired.” Kirsch suggests in the book that it was Messina who tried to have him fired, but was never was able to directly confirm this. Still, Kirsch describes a tense relationship with Messina, and between Messina and other reform advocates.
Messina did not respond to a request for comment Tuesday night.
“Messina took a tone that clearly discouraged dissent,” Kirsch writes. “I did find out that the White House had complained about me to SEIU [and] that Messina had also complained about me to Chuck Loveless, who was [the American Federation of State, County, and Municipal Employee’s] legislative director.”
Kirsch adds, “A friend of mine in Congress told me that I had earned the White House’s animosity because they thought I had lied about HCAN’s role when I said that we were building an army to help the President pass his plan. The White House believed that I was promising that HCAN would be like Organizing for America, doing whatever the White House wanted.”
This strategic aversion to outside pressure from the left has defined Obama’s legislative victories and failures. And as House Republicans are now discovering, there’s some advantages to that kind of arrangement — too much outside pull can leave a party extremely divided. But by keeping dissenting forces on the left marginalized, the White House had little negotiating power with Republicans in the early days and later, when the GOP fully abandoned health care reform, or with the conservative Democrats who watered it down.
“In one oft-quoted story, President Franklin Roosevelt met with the leading progressive groups of his day and after hearing their agenda said, ‘I agree with you. Now make me do it.’,” Kirsch writes. “But that was not the stance taken by the Obama White House. A White House insider told me that when he asked Messina what the ‘inside/outside strategy’ was for passing health care reform, he replied, ‘There is no outside strategy.’”
Brian Beutler
Brian Beutler is TPM’s senior congressional reporter. Since 2009, he’s led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight, and the debt limit fight. He can be reached at brian@talkingpointsmemo.com.
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Doremus Jessup 2.0
blockquote”A friend of mine in Congress told me that I had earned the White House’s animosity because they thought I had lied about HCAN’s role when I said that we were building an army to help the President pass his plan.”/blockquote
Oh boy, notice the delusions of grandeur in the language from people who believe themselves to be very very important to the process. Whose army? Kirsch’s army? How would he build this army of loyal followers and how would he direct them to do his bidding? Is that covered in the book?
And then the second half of the quote..
blockquote “The White House believed that I was promising that HCAN would be like Organizing for America, doing whatever the White House wanted.” /blockquote
It’s a bitter experience when a general loses his army.
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Flying Squid
Doremus Jessup 2.0 Bloomberg has more of an army and he doesn’t have one either.
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Dave5
So someone with an ax to grind serves up a mixture of sour grapes, recrimination, and revenge and serves it up with a topping of Monday morning quarterbacking. The health care law was a major achievement, it got a corrupt and dysfunctional congress off it’s sorry a()() and working again, and it educated the American people about the threat to their health care posed by Wall Street. As everyone who knows about the issue will say, it’s just the beginning of a long process that involves action at the state level as well as future adjustments to the overall system.
If the WH had pushed blindly forward for a public option, there would have been no bill. As it is, we’ll eventually get a public option.
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Eustace Tilley 2.0
Wow. Seditious progressives claiming NOBAMA ISN’T progressive ENOUGH? The problem with THE seditious progressive NANNY STATE is that it chooses WINNERS and LOSERS, BINDING THE HANDS OF the free mARKET IN chains, thereby enslaving the FREE MARKET to the whims of seditious progressive PLANTATION OWNERS. I’m sorry, LIBTARDS, but the PARTY OF LINCOLN already freed the slaves against the WISHES OF THE demonRATs and if we have to do so again, so be it.
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mb1
Eustace Tilley 2.0 yawn…
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radicalrealist
@Eustace Tilley 2.0 Speaking of choosing winners and losers, I’m hoping for a Giants-Patriots rematch.
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Eustace Tilley 2.0
radicalrealist@eustace Of course, you can guess I am a BIG FAN of the Patriots.
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radicalrealist
@Eustace Tilley 2.0 You want to marry a Brazilian supermodel?
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Flying Squid
Eustace Tilley 2.0radicalrealist@eustace Not a big fan of the Browns though.
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Eustace Tilley 2.0
radicalrealist@eustace Michigan alum who new Tom Brady was going to be special.
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Dave5
Eustace Tilley 2.0 Tilley, your comment is a good illustration of why the gop is becoming obsolete.
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stephen-maturin
Okay, I’m open to faulting the Obama team on this if I can find a good argument describing the leverage they had and didn’t employ to bring Nelson, Wyden, Landrieu, Snow, Collins and Lieberman into line.
It’s a given that we all wanted a public option and a real change in the way health care is mishandled in this country, but I don’t see how it was going to happen given the climate and the intransigence of the Blue Dogs.
So, someone please give me a scenario where this was going to happen but Obama dropped the ball.
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George C
stephen-maturin This is absolutely correct, Stephen. There were never 60 votes for a public option, particularly because Lieberman and Nelson were from insurance states, and Landrieu is Landrieu. I think Obama saw this immediately and decided to jettison the public option so he could focus on what he could get.
My daughter is doing a thesis on Obama’s inability to get cap and trade legislation in 2010 while Australia was able to get it a couple of months ago with virtually identical political considerations. She’s introduced me to the concept of “resource exchanges”, which is an academic term for horse trading: the ability to give something up in exchange for a favorable vote. The Obama team can be faulted (maybe) for giving up their resources too early, leaving too much on the table, but given that Obama was able to get the ACA through while so many others had failed would seem to put to rest the ultimate challenge to his tactics.
That the left continues to demand that the gift horses open their mouths is just amazingly mystifying.
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Doremus Jessup 2.0
stephen-maturin Where was Kirsch’s army? I have my suspicions.
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mb1
stephen-maturin I think what most people are ticked off about is, he didn’t even use the bully pulpit to go to the masses and try to rally them to influence their reps vote/position. He never really led the charge until right at the end AND he gave away most of his bargaining chips from the git go. Come on Mr. President at least START with a willingness to fight for your supporters positions.
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stephen-maturin
It’s interesting how different people have different recollections of that time.I watched all the proceedings with an edge-of-the-seat intensity and what I remember most was the violent rhetoric of the Right wing echo chamber and whispers of a First Amendment solution to the Socialist/Communist path that this President was taking. Apparently this message was getting through to the base as evidenced by the Great Obama Ammunition Shortage of 2009.
IMHO, getting a bill passed that would lay a foundation for future improvement and introducing a concept that people would accept gradually was the most we could hope for in that climate.
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hcurtisabbey
stephen-maturin Bingo… the concept that Obama was able to bargain away something that never had a prayer of passing should be something we’re proud of him for. Don’t forget there were more Democrats that didn’t want a public option; Baucus, Lincoln, Evan Bayh, Carper wanted the triger, and there was the Conrad plan. And there wasn’t just one Nelson against it, there was also Bill Nelson in Florida, add to that TWO Democratic Senators from Arkansas that were against it… and Mark Warner wasn’t a big fan of it. My favorite story from that whole fight was the example of Senator Bennett from Colorado. As of mid July 2009 he said he “preferred a co-op, but could support a public option.” 6 months later he was the Progressive hero with the all important letter sternly written letter to the President to save the public option. It was pathetic, and people like this guy from HCAN were leading the charge to make our outside game all about grandstanding, loud and daily action free outrage.
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Captain Crunch
Someone selling a book and crying martyr? Quelle Surprize!
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bdtex
“HCAN is a well financed umbrella group backed by scores of liberal groups, unions, and other reformers”
Kirsch did his job and didn’t get everything he wanted. Nobody did. Pres. Obama did his job too. He had been through the GOP obstruction of the Stimulus Bill. On Healthcare Reform he had to deal with it from a handful of Dem Senators,only one of which will still be in office 4 years later. If HCAN had got everything he wanted the legislation would’ve died in committee.
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Captain Crunch
bdtex Kirsch is a whiner and now writes a ‘tell-all’ book that HE didn’t get everything he wanted. Who cares!
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Steve LaBonne
Look, we need, urgently, to re-elect Obama. That does not mean that we have to be idiots who pretend that all has been for the best in the best of all possible Administrations. There are many signs that even Obama recognizes that he has made some serious errors and is in the process of making a significant course correction, which makes him (unsurprisingly) much smarter than the Obots around here,
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ImpureScience
Steve LaBonne “Obots”?
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michandaro
Steve LaBonne i like everything you said except for obots, and this is from a “firebagger”
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michandaro
Steve LaBonne meaning me!
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gwiech
My hope is that since the states are empowered to experiment we’ll get single-payer anyway. Vermont and Montana are setting up their single-payers systems already and once they work out the kinks the rest of the states will follow.
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jackrussell
gwiech This may be the way forward.
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rajensen088
A public option was dead on arrival. Democratic ‘blue dog’ Seantors joined all the Republican Senators in vowing to filibuster to death any inclusion of a public option in the Affordable Health Care Act. The Democratic Senators who objected to any public option all had close ties to the health care industry or the pharmaceutical industry (Evan BAyh, Joe Liebermann, Blance Lincoln. Ben Nelson) Evan Bayh and Joe Libermann’s wives actually served on the Board of Directors of private health care insurers.
The House bill did include a public option but the house votes on a simple majority rule while the Senate requirtes 60 votes to end a filibuster and the Senate Democrats never had a filibuster proof majority. In order to enact the legislation that House had to swallow its pride and accept the Senate legislation as written in order that the Bill would not die in conference.
This has happpened before. In 1935 when FDR introduced the Social Security Act of 1935, he had to placate the southern Jim Crow southern Democratic Senators who did not want African-Americans to participate in program. The original bill was written to exclude most African-Americans by exempting domestic servants, agricultural workers and even Pullman porters.
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Itamp;s Pat
rajensen088 Don’t forget our good pal Bart Stupak who muddied the waters with his abortion in the bill nonsense. Yeah, that helped, especially when we had to deal with the “death panel” bullspit.
We had A LOT of people who were supposedly on our side being just as bad as a stumbling block as the GOP.
But I’m sure that was Obama’s fault too.
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Eustace Tilley 2.0
It’s Patrajensen088 don’t you LOVE how blithe SEDITIOUS PROGRESSIVES can be when confronted with FACTS THAT death panels are ripping out the organs grandma is STILL USING! Parting out grandma like 1988 CAMARO IROC Z. Shameful progressive libtards!!!!
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Flybynite
rajensen088 Interesting last graf, I hadn’t heard that story before. A little historical perspective never hurts, although it does seem to annoy purists.
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jdb316
You have to cut deals to get big legislation through Congress, because the interest groups are very powerful and influential. The Clintons tried to force their 1993 healthcare bill through without any deal making, and it never even made it out of committee.
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alphaliberal1
jdb316 I don’t think anyone is saying don’t cut deals. People are saying to exert pressure for a *better* deal. Instead we got pre-emptive capitulation plus attacks on advocates working for better policies.
And that’s one of the big questions. Do we want a Dem Party where the elites promise things during the campaigns, then forget the promises afterwards and fight their own base *more than they fight Republicans* (what Repubs did they get fired)?
It’s a big question and insulting people (as others here are doing) is not helpful.
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Flying Squid
alphaliberal1jdb316 “It’s a big question and insulting people (as others here are doing) is not helpful.”
Welcome to the Internet. First time?
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NCSteve 3.0
alphaliberal1jdb316 So, would calling you a “backseat driver” be one of those insults you’re decrying?
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rajensen088
alphaliberal1jdb316
FDR ‘capitulated in’ 1935 when he placated the southern Jim Crow Democratic Senators who did not want African-American to participate in social security. The first Social Security Act of 1935 excluded domestic workers, agricultural workers even Pullman porters. The Progressive left of that era accused FDR of capitulating to the Jim Crow southern Democratic Senators an being a tratior to left wing Progressive principles and ran a third party Progressive candidate in the 1936 re-election campaign who received 800K votes. Had FDR not ‘capitulated’, any Social Security Act would have been left for dead for decades. FDR knew that the egregious exlusions would be corrected over time but fighting for them in 1935 would have meant defeat for any social security bill,
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From_an_Idiot
What a barbaric country we live in.
The only civilized nation on the planet that still has a for profit healthcare system, and now the IRS will be empowerd to fine me unless I buy high deductible junk insurance.
Wealth transfer at its finest you could say.
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Flying Squid
From_an_Idiot Plenty of ‘civilized’ nations still have for profit healthcare systems. They are just usually in competition with public ones. ACA is very similar to Australia’s system.
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From_an_Idiot
Flying Squid No. Only 2nd and 3rd world countries have for profit healthcare.
In Australia if you break your leg you can go to the hospital and tratment will cost $140 US dollars
In the United States if you walk into a hospital without insurance it will cost north of $22,000 for that broken leg and if you don’t pay it your life will be ruined by crippling debt collection
Barbaric mandated wealth transfer.
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Flying Squid
From_an_Idiot Sorry, that’s just not true. For example, the UK has both the National Health Service and private insurance, hospitals, doctors, etc. People can choose to use private health care if they like.
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radicalrealist
@FlyingFrom_an_Idiot Squid ACA is designed to make sure you have insurance before you break your leg.
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From_an_Idiot
Flying Squid No.
In the UK if you break your leg you can walk into a hospital and be treated with the equvilant of a few US dollars.
In the United States you can not do that unless you have private health insurance which cost thousands a year in premiums.
If you don’t have that then you will be on the hook for tens of thousands of dollars.
Our system is barbaric.
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Flying Squid
From_an_Idiot I’m not suggesting otherwise. That doesn’t mean the UK has no private health care. They do. They have both the NHS and private care. That’s a fact.
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rajensen088
Flying SquidFrom_an_Idiot
Private health insurance is available in the UK, for wealthy people who can get coverage for procedures not covered by the NHS such as cosmetic surgery or elective surgery. Few people in the UK can afford supplmentary private heallth care coverage.
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KeithL
Flying SquidFrom_an_Idiot Yep. In a rational society, there’s plenty of room for private health insurance. It is typically supplemental to a basic, publicly financed “floor” of guaranteed healthcare. That’s fine!
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Flying Squid
rajensen088From_an_Idiot Again, I’m not saying otherwise. The claim was that no other country had private health care. Many do, they just also have a public system.
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alphaliberal1
From_an_Idiot Profit has no place in the provision of health care. It does not improve the final product or provide any socially redeeming value. We have the most expensive health care system with worse outcomes of just about any advanced economy. It’s crazy.
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radicalrealist
alphaliberal1 From_an_Idiot Even in a single payer system there are profit making entities: pharma and device companies, those who sell supplies to hospitals, etc. And in most single payer countries doctors are independent contractors billing the government (Canada, France) or private insurance companies (Germany, the Netherlands). Also, not everything is covered. In Canada, drugs are only covered for the poor and the elderly. Everyone else has private insurance (usually for-profit) or pays out of pocket.
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rajensen088
radicalrealistalphaliberal1From_an_Idiot
1 million bankruptcies in th US are related to the cost of health care. In Canada, the UK, France, Germany, the Scandiniavian countries that have universal health care coverage the total number of medical bankruptices is ZERO.
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Captain Crunch
From_an_Idiot You are correct, you are an idiot!
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Maggyw519
F these people who don’t even understand the bill…just adding to the negative noise…maybe they should learn about how the bill will work and educate others. Sick of the whiners who seems to be as proud of their ignorance as the tea baggers…on second thought maybe they are.
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