December 21, 2009

The progressive "journo/blogospere" is sharply split over the Senate health bill. Some, like Jane Hamsher and Matt Taibbi, are saying "kill it." Others, like Paul Krugman, Ezra Klein, and Jonathan Cohn, are saying "pass it" - as is. Steve Benen says " it's worth appreciating the vibrancy, energy, and seriousness with which progressives are engaging in the debate."

I say maybe - but there's been a lot of condescension and hostility, too. And what bothers me even more is the tendency of some bloggers - good people, people who are seen not only as advocates but as as information gatherers on health policy- to ignore data that undercuts their position while pushing a false political choice. I'm not saying their decisions are deliberate, and I assume they're not. But it's disappointing, and it's worth discussing.

It's difficult for me to name names, since I respect their work a lot, but I'm talking about people like Jonathan Cohn, David Leonhardt of the New York Times, and Ezra Klein (who has been very friendly and helpful to me since the beginning.) Since I know they're people of good will, I can't help wondering if the polarized nature of this debate has something to do with what's been going on.

I've been working on a campaign to resist the excise tax, which I have long thought was based on flawed logic and would turn out to be counterproductive both as politics and policy. (Let the first part of that statement - "I've been working on a campaign" - serve as a disclaimer and full disclosure regarding what follows.) Both Klein and Leonhardt have written admiringly about the tax's ability to "bend the cost curve," but a broad range of studies have been released that challenge that assumption, whole polls have shown that its likely to be highly unpopular politically.

These are not unscientific, flaky studies. Two papers were published in the highly respected journal Health Affairs. These are studies from respected firms that seem to overturn the conventional economic wisdom behind the excise tax. Citizens for Tax Justice has reviewed data from the Joint Committee on Taxation (pdf) and drawn negative conclusions about the tax. Other studies by top benefits consulting firms like Martin E. Segal, Watson Wyatt, Mercer, Towers-Perrin, and Hewitt (whose livelihood depends on a corporate clientele) challenge the arguments made in support of the tax, while polling from a well-regarded firm suggested the tax would have a devastating political impact in front-line states. So how much have Klein, Leonhardt, or Cohn written about all of this new and revelatory information?

As far as I can tell, not a word.

The silence bothers me more than disagreement ever could. These guys are viewed as experts in health policy and as gateways and interpreters of the latest research. Sure, they've come out foursquare for accepting the Senate bill, but does that really excuse the silence? Maybe they're too busy to write about these reports. Maybe they haven't seen them (although I sent a few links to one of them.) Maybe - and I hope this isn't true - they're so concerned about ensuring that a bill passes that they'd rather not muddy the waters with new data that undercuts that position.

Or maybe I'm out of line. Maybe people don't see them as reliable sources for all the new health policy info. Perhaps they're perceived as strong advocates for a certain position, with no newsgathering brief. If so, I apologize - sincerely. But, if I'm right, they really need to address these studies. They can argue that they're methodologically flawed , or that they're inconclusive, or that it's too late to change anything now. But ignore them? That's disturbing.

"Gah," writes Paul Krugman, who also presses for passing the Senate bill. "I see that some people are still using the Rasmussen polling on MA’s health care reform. You shouldn’t do that ..." I'm one of those who has used those polls - but I've written about and linked to his critique, which includes another poll he likes better. That's what we should all be doing if we want to have a serious debate. (Now, as it turns out, I don't interpret the poll data the same way he does - but I'm acknowledging its existence, responding, and letting people decide for themselves.)

I identify with Prof. Krugman's frustration, though. Gah, why are people still saying the excise tax "bends the curve"?

There's a basic structural flaw in the Klein/Cohn/Krugman position, too: that it's either this health bill or nothing. I believe that's a false choice. Opponents of the Senate draft don't all believe that no reform is better than this bill. But they should act as if they do. Once you say the Senate bill is good enough, the negotiations with the left are over.

The Senate health bill has been improved in some areas, including strengthening the Medicare cost containment commission and - most critically - once again lifting lifetime caps on coverage. Like McJoan, I believe that's a direct result of the outcry on the left. Fear of a progressive backlash has already improved this bill, and it may continue to do so - if we don't back down too soon. In a very practical sense the Deans, Hamshers, and Taibbis are accomplishing more than any other progressives to get a better bill.

There are many people who disagree vehemently with that statement. By all means, let's keep talking about it. But let's do so openly, with all the information at our disposal, and without either hostility or manipulation. I'm not out to antagonize anyone here. I'd really like to see debate that's based on data and grounded in strategy - and not in false choices.

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