Last January, as I understand it, the White House promised Big Pharma, big insurance, and the American Medical Association the moral equivalent of what Joel Halderman allegedly demanded of David Letterman: hush money. The groups agreed to stay silent or even be supportive of healthcare reform, as long as they were paid off.Remember, just yesterday White House chief of staff Rahm Emmanuel said that it's not yet time for the president to weigh in. It's possible that the White House doesn't want to be truly responsible, in advance, for staking out what comes out of the Congress in the name of "health care reform." Why? Because if you're most important goal is to be able to say you "reformed health care," for political purposes in the next election, and you only marginally care if health care is actually reformed for the better, then you don't endorse or demand any detailed provisions, or any specific bill, in advance. That way, no matter what Congress passes, if they call it health care reform, even if it really isn't, or at the very least even if it's only a b-rate effort at what could have been legislative brilliance, you can still claim victory.
But now that it's time to collect, the bill is larger than the White House expected, and it's going to fall like an avalanche on middle class Americans in coming years. That could mean an ugly 2012 election (read Sarah Palin).
So the President has to do what Letterman did: Refuse to pay. But if Obama doesn't weigh in forcefully and say "no" to the hush money for Big Pharma, big insurance, and the AMA, America's middle class will get walloped. And if the walloping starts before 2012, Sarah Palin or some other right wing-nut populist will wallop Obama. And after she or he wallops Obama, America will get walloped even worse....
But if Obama doesn't weigh in forcefully and say "no" to the hush money for Big Pharma, big insurance, and the AMA, America's middle class will get walloped. And if the walloping starts before 2012, Sarah Palin or some other right wing-nut populist will wallop Obama. And after she or he wallops Obama, America will get walloped even worse.
If you demanded in advance that the final bill include a public option, negotiated prescription drug prices, capped insurance premia, you would have to actually fight for those provisions - and the White House has shown a reluctance towards fighting in support of its proposals. And just as bad, should those "must have" provisions not be included in the final bill, it would be harder for the White House to claim a "health care reform" victory, which it desperately wants. If claiming a victory is more important than the substance of the legislation, then you don't stake out hard and firm positions on what the bill needs to contain. Because you don't really care.
It's difficult to see any other reason to explain why the White House has been, and continues to be, afraid to have the president take a firm position on anything in this legislation.