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The Campaign Spot

Election-driven news and views . . . by Jim Geraghty.

The Obama Critique Takes Shape



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A little while back, after my here’s-what’s-likeable-about-the-GOP-frontrunners post, a reader e-mailed in and asked what, if anything, positive I would say about the Democratic frontrunners. Here’s what I wrote back about Obama: 

I’m still learning about the Illinois Senator; so far my assessment is that he seems like a good man who might not make a good president. I saw in an interview last year him talking about losing a political race early in his career; he said he learned from the experience that losing a race is not the end of the world, and so he doesn’t really fear “losing.” I think this comes across in his speeches, his interviews, etc.; he is pleasant, respectful, but not craven or desperate for votes. He seems very relaxed and at home with who he is; he won’t pull a Clinton, Gore or Kerry and try to be who his audience wants him to be. I think his “I want to unite us” rhetoric is genuine; I don’t think there’s another Democrat out there so gracious or respectful to his opponents. (See his feeling of “shame” after learning his campaign literature called pro-lifers “extremists.”) Another interesting thing is the degree to which he’s been in [a version of the pubic] spotlight and under scrutiny for so much of his adult life; first black editor of Harvard Law Review, etc. He’s been a trailblazer, and I’m sure that comes with its own pressures. 

Like I said, good man; I’m a little wary of how he will handle the pressures of the office, leadership in a national crisis, etc.

And in recent days, bit by bit, we’re seeing the case against Obama take shape. The short version: Good man – maybe even an exceptionally decent man – but not a bold man, and far from a proven leader. If his appeal is that he is a ‘fresh face,’ that is another way of saying, ‘people don’t know much about him’, which is selling point for a cipher.

 

Two righty voices recently assessed Obama’s books. First, the often-must-read Andrew Ferguson
He’s appalled at the budget deficit, for example, and he’s determined to fix it. But beyond that — well, let him explain the details.  “We know what to do,’’ he writes. “We can cut and consolidate nonessential programs. We can rein in spending on health care costs. We can eliminate tax credits that have outlived their usefulness and close loopholes that let corporations get away with paying no taxes.’’  

The book is filled with passages that follow the same pattern: belaboring the obvious on the assumption that no one has ever had dared speak such bromides before, and then concluding the discussion with a rear-guard blast at those cynical politicians who “refuse to make the tough choices.’’

 

Rather than make his own tough choices, the 45-year-old Democrat prefers to float on a high level of abstraction. This, indeed, is how he is able to appeal to all segments of his party as well as large numbers of independents and even many conservatives and Republicans.

Dean Barnett, writing about Obama’s first book, ‘Dreams From My Father,” at HughHewitt.com:

What struck me about this book is how modest an effort it was for a future politician. Throughout the book, we get the picture of Obama as a supremely talented but ultimately passive guy. Stuff just seems to happen to him. Some of this is really interesting stuff, like being born to parents who each went through multiple spouses and left Obama with half-siblings scattered across the earth. But it’s almost a little disconcerting that Obama didn’t trace his path from Hawaii to Occidental College to Harvard Law to managing editor of the Law Review.  One thing that was crystal clear from his book that Obama has a unique ability to serve as a vessel for the ambitions and dreams of others. Whether it was his grandparents or his mother or his far-flung African family, they all had a lot invested in their hopes for “Barry.” Suffused in the book was the unstated fact that Obama has an innate characteristic that makes others project their dreams onto him. …Having read Obama’s first book, I’m convinced that this trait has been the key to his political success to date. Others invest their hopes in him, and he rides their investment to victory. In many ways Obama is a pedestrian and orthodox politician; no grand plans or displays of leadership have marked his public life. His ideology is the most hackneyed form of liberalism, the kind that stopped being progressive over a generation ago. 

In some ways, Obama almost seems like an accidental presidential candidate. His Senate seat was almost bequeathed to him; his top-tier presidential status was definitely bequeathed to him. On paper, there is nothing that this man has done that would make you say, “He should be president.”

Peggy Noonan, spotting this back in December:

He has obvious appeal. I asked a Young Democrat college student why he liked him. After all, I said, he has little experience. That’s part of what I like, he said. “He’s not an insider, he’s not just a D.C. politician.”

 

He is uncompromised by a past, it is true. He is also unburdened by a record, unworn by achievement, unwearied by long labors.  What does he believe? What does he stand for? This is, after all, the central question. When it is pointed out that he has had almost–almost–two years in the U.S. Senate, and before that was an obscure state legislator in Illinois, his supporters compare him to Lincoln. But Lincoln had become a national voice on the great issue of the day, slavery. He rose with a reason. Sen. Obama’s rise is not about a stand or an issue or a question; it is about Sen. Obama. People project their hopes on him, he says.  He’s exactly right. Just so we all know it’s projection.

Finally, this criticism was bound to be noted by some of his rivals, and yesterday, Joe Biden, assessing his rival’s position on Iraq:

“I don’t recall hearing a word from Barack about a plan or a tactic.”

I much prefer a candidate whose persona is that of a nice guy to the alternatives, and whose keywords are respect and manners over, say, ”YEARRRRGH!” But at some point, a leader has to actually make decisions, and those decisions will inevitably upset somebody.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Joe Biden: The Bruiser of the Democratic Primary



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I fear that if Joe Biden gets any rougher (or more blunt, in stating that which many Democrats believe to be true but do not wish to address) in his assessments of his rivals, Rich and Kathryn may ask him to become a blogger at the Hillary Spot.

In the New York Observer:

“From the part of Hillary’s proposal, the part that really baffles me is, ‘We’re going to teach the Iraqis a lesson.’ We’re not going to equip them? O.K. Cap our troops and withdraw support from the Iraqis? That’s a real good idea.” The result of Mrs. Clinton’s position on Iraq, Mr. Biden says, would be “nothing but disaster.” … 

“Are they going to turn to Hillary Clinton?” Biden asked, lowering his voice to a hush to explain why Mrs. Clinton won’t win the election. “Everyone in the world knows her,” he said. “Her husband has used every single legitimate tool in his behalf to lock people in, shut people down. Legitimate. And she can’t break out of 30 percent for a choice for Democrats? Where do you want to be? Do you want to be in a place where 100 percent of the Democrats know you? They’ve looked at you for the last three years. And four out of 10 is the max you can get?” 

Mr. Biden is equally skeptical—albeit in a slightly more backhanded way—about Mr. Obama. “I mean, you got the first mainstream African-American who is articulate and bright and clean and a nice-looking guy,” he said. “I mean, that’s a storybook, man.” But—and the “but” was clearly inevitable—he doubts whether American voters are going to elect “a one-term, a guy who has served for four years in the Senate,” and added: “I don’t recall hearing a word from Barack about a plan or a tactic.”

Everybody’s oohing and gasping over Biden’s “clean” and “nice-looking” comments, but the “he has no plans or tactics” will actually be a bigger factor as this race advances.

After reading Biden’s thoughts on Edwards, I cannot wait for the first debate:

“I don’t think John Edwards knows what the heck he is talking about,” Mr. Biden said, when asked about Mr. Edwards’ advocacy of the immediate withdrawal of about 40,000 American troops from Iraq.

“John Edwards wants you and all the Democrats to think, ‘I want us out of there,’ but when you come back and you say, ‘O.K., John’”—here, the word “John” became an accusatory, mocking refrain—“‘what about the chaos that will ensue? Do we have any interest, John, left in the region?’ Well, John will have to answer yes or no. If he says yes, what are they? What are those interests, John? How do you protect those interests, John, if you are completely withdrawn? Are you withdrawn from the region, John? Are you withdrawn from Iraq, John? In what period? So all this stuff is like so much Fluffernutter out there. So for me, what I think you have to do is have a strategic notion. And they may have it—they are just smart enough not to enunciate it.”

At a New York event, as reported by the Huffington Post:

“The more people learn about them (Obama and Hillary) and how they handle the pressure, the more their support will evaporate.”

Good for Biden. He was always going to be the tall, balding, verbose guy in the debates; now he’s going to be the sarcastic guy who’s got the guts to address his opponents’ flaws openly.

(For fans of Joss Whedon, Biden is now playing the role of Cordelia, Anya, or Jayne from Firefly: The character who says aloud what every character is thinking, but is too polite to mention.)

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

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Gallup Polls Democrats on Feelings About Hillary, Obama, Edwards



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Gallup asked 504 Democrats and Democratic leaners to compare their assessments of Hillary Clinton, John Edwards, and Barack Obama.

Best Public Speaker? Clinton 41, Edwards 11, Obama 44. (Closer than I thought.)

Most likeable? Clinton 31, Edwards 24, Obama 41.

Most qualified? Clinton 61, Edwards 21, Obama 13.

(Does this mean we’ll see the “Obama’s a good and likeable man, but not qualified to be president” charge coming from the Hillary campaign?)

Best chance to beat the Republican? Hillary 44, Edwards 27, Obama 21.

(Way lower than I expected for Obama.)

Would perform the best in debates? Hillary 57, Edwards 10, Obama 29.

Best in a crisis? Hillary 54, Edwards 20, Obama 20.         

Is the strongest leader? Hillary 59, Edwards 15, Obama 22.

In most of these categories, Hillary performs much better than I expected, and Obama underperforms.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Are New York Times Columnists Souring on Hillary Clinton?



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In the past few days, Frank Rich and Maureen Dowd have whacked away at Hillary Rodham Clinton in their columns. Of course, thanks to TimesSelect, no one will ever hear about it. But there’s some interesting tea-leaves to read here. The Washington Post has taken a few whacks at Barack Obama since the beginning of the year; are these columns signalling that Hillary is not the preferred choice for the Democratic nomination within the offices of the New York Times?

I’ll keep the excerpts brief, lest I be accused of undermining the Great Wall of TimesSelect. Dowd:

The Achilles’ heel of “The Warrior,” as she is known, is the war. She expressed outrage about Iraq, but ended up sounding like a mother whose teenage son has not cleaned up his room: “The president has said this is going to be left to his successor … and I think it’s the height of irresponsibility, and I really resent it.”

She uttered the most irritating and disingenuous nine words in politics: “If we had known then what we know now. …”

 And Frank Rich:

This is how she explains her vote to authorize the war: “I would never have expected any president, if we knew then what we know now, to come to ask for a vote. There would not have been a vote, and I certainly would not have voted for it.” John Kerry could not have said it worse himself…

Compounding this problem for Mrs. Clinton is that the theatrics of her fledgling campaign are already echoing the content: they are so overscripted and focus-group bland that they underline rather than combat the perennial criticism that she is a cautious triangulator too willing to trim convictions for political gain. Last week she conducted three online Web chats that she billed as opportunities for voters to see her “in an unfiltered way.” Surely she was kidding. Everything was filtered, from the phony living-room set to the appearance of a “campaign blogger” who wasn’t blogging to the softball questions and canned responses. Even the rare query touching on a nominally controversial topic, gay civil rights, avoided any mention of the word marriage, let alone Bill Clinton’s enactment of the federal Defense of Marriage Act.

I realize snark and sniping are the bread and butter of these columnists, but one can’t help but wonder if the opinion-shapers at the Times are wondering if they really want to be writing about another Clinton presidency for the next four to eight years, or would prefer a fresh face…

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Oddly, Teens Were Less Interested in Reading ‘It Takes a Village’



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You know you’re not dealing with a normal presidential campaign when community leaders and seniors at a high school choose to read from your book at “Read-In” public events at high schools and churches.

Somehow I don’t think the public readings of The Audacity of Hope will be followed by Edwards’ Homes: The Blueprints of Our Lives or Huckabee’s Quit Digging Your Grave with a Knife and Fork.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

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Donna Brazile Speculates Gore Will Announce Presidential Bid on Oscar Night



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It’s only speculation from a former employee, but perhaps it is informed speculation:

Sens. Hillary Rodham Clinton and Barack Obama are the hot early front-runners, while 2004 Democratic nominee John Kerry has already bowed out.

But could former Vice President Al Gore be waiting to make a dramatic entrance into the 2008 presidential race, especially if he wins an Oscar next month?
 
His former campaign manager, Donna Brazile, strongly implied that possibility while speaking at Moravian College in Bethlehem Tuesday night.

’’Wait till Oscar night,’’ Brazile told an audience of about 100 people at Haupert Student Union. ‘’I tell people: ‘I’m dating. I haven’t fallen in love yet.’ On Oscar night, if Al Gore has slimmed down 25 or 30 pounds, Lord knows.’’

’’An Inconvenient Truth,’’ a film built around Gore’s presentation on the effects of global warming, is one of the Oscar nominees for best documentary feature.

I have figured that as Hillary, Obama, Edwards and Richardson are signing on staff, setting up campaigns, raising money, building relationships with donors and interest groups, etc., that because we hadn’t heard much from Gore yet, he was unlikely to jump in late. But then again, an announcement at the Oscars would suddenly create enormous buzz.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

I Feel Like I’ve Written This Headline Before, But Biden’s In



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Biden’s in. In a delightful change from the standard pattern, he’s declaring that he’s just plain running for president, not “forming an exploratory committee” kabuki.

From certain comments by the senator, one might wonder whether he would be happy to be someone else’s running mate:

A 34-year Senate veteran known for his foreign policy expertise and somewhat windy oratory, Biden acknowledged his campaign would generate little of the buzz surrounding the celebrity candidates New York Sen. Hillary Rodham Clinton and Illinois Sen. Barack Obama.

Even he was moved by his colleagues’ trailblazing candidacies, Biden said.

“There’s good reason to be excited,” he said. “You have the first woman running who is qualified, and a very attractive African-American who has demonstrated crossover appeal. I got involved in politics 40 years ago during the civil rights movement, so yes, it’s an exciting thing.”

And just think – he would lock up all three of Delaware’s electoral votes, on par with Dick Cheney securing Wyoming’s.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Dealing With the Claim of a ‘Right’ to Health Care (And Housing)



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Jim, a Hillary Spot reader in uniform, makes a more basic point about the recent commonplace rhetoric that health care is a “right.”

The basic problem I have with socialized medicine is a philosophical one.  In effect, universal health care makes health care a right.  In fact, John Kerry called it a right in 2004 (and went unchallenged as usual).  A simple question for the supporters of this: At what point did health care become a right?  Our basic inalienable rights (free speech, owning guns, etc.) do not impose on others.  You can exercise these rights without imposition.  Once we concede the premise that health care (or education, a nice place to live, transportation, etc.) are rights, we are headed down a path where anything can be declared a right if enough people want it. Or are we already there?  Want a right? Put it to a vote.

You guys are arguing about implementation and money-schemes when it’s the idea that needs to be discredited.  Forced servitude and extortion are a few words that come to mind.

Here’s the bad news, Jim. Looking at those comments responding to Hillary Clinton’s question on Yahoo, it appears we’re already more than halfway there. A big chunk of the American people don’t care what it takes to get them “free” health care; they believe they’re entitled, and that somebody else ought to pay for it.

I’ve been hesitant to blog about one of my recent rant-inspiring topics — real estate — but we can see the outlines of this mentality in this area, as well. (The thirty second version of my rant: There’s a bubble, and it’s popping. Housing prices went way up in recent years, partially due to a speculative market, partially due to “flippers”, partially because real estate looked safe because of the dot-com crash, and partially because lenders made loans to people that they shouldn’t have. Many buyers bought a lot more house than they could afford, using all manner of potentially dangerous agreements – interest-only mortgages, adjustable rate mortgages, little or no down payments (the typical down payment of a first-time home buyer in 2006 was 2 percent!) etc. Now the supply of housing is increasing dramatically, as demand shrinks. (Those who face foreclosure will not be getting approved for new mortgages for new purchases anytime soon.) You know what that does to prices; but many speculative real estate investors went into the game convinced that prices could only go up.)

Anyway – so significant number of Americans are going to find themselves in financial dire straits because they bought an overvalued house as the market was going up, they can’t keep up with their monthly mortgage payments, and now cannot resell it for enough to even break even.

So what is Washington doing?

Senate Banking Committee Chairman Christopher J. Dodd, D-Conn., says he is working on legislation to prevent an “unprecedented” wave of subprime foreclosures and to give homeowners a grace period so they can get back on their feet. “This is a homeownership crisis of unprecedented proportions,” Sen. Dodd told a group of mayors. He is planning to hold hearings soon, possibly in two weeks. The committee chairman indicated that the legislation might include a rescue fund. “That is a possibility, but it would have to be paid back,” he told reporters. Sen. Dodd also told reporters that he wants to move quickly on GSE legislation to strengthen regulation of Fannie Mae and Freddie Mac and pass a bill in the next two months. He said the Senate government-sponsored enterprise bill will be a “little different” from the House bill. And he declined to take a position on raising the GSE loan limits. “I have to be careful about jumping into that,” Sen. Dodd said after speaking to the mayors. “I want to talk with my colleagues first.”

A rescue fund, “but it would have to be paid back.” Dodd is seriously considering having the federal government loan money to people whose primary problem is that they can’t pay back the loan (mortgage) they already took out. (Fluuuuush! That’s the sound of our tax dollars going into this rescue fund.)

Take care of me, Big Government! Save me from the consequences of my own decisions and actions!

Sad to say, I can see this being a big issue on the campaign trail in the coming two years. We’ll be hearing a great deal about these poor home buyers who took out loans with rediculously risky terms, and who had NO IDEA that the house they were buying could drop in value.

Conservatives have a much harder task in persuading the public of the value of our ideas; there is always someone out there willing to promise a policy that will no longer hold individuals responsible for their actions.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Quinnipiac finds Hillary ahead in Ohio; Giuliani leads among Republicans



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Quinnipiac polled Ohio voters.

Sen. Hillary Clinton holds a three-to-one lead over any Democrat and has a razor-thin lead over leading Republican presidential candidates in the key state of Ohio, according to a Quinnipiac University poll released today.

In general election matchups, the independent Quinnipiac University poll finds:

Sen. Clinton squeaks by Arizona Sen. John McCain 46 – 42 percent;

Clinton inches by former New York City Mayor Rudolph Giuliani 46 – 43 percent;

Clinton tops former Massachusetts Gov. Mitt Romney 52 – 31 percent;

McCain edges Illinois Sen. Barack Obama 41 – 38 percent;

Former Vice Presidential candidate John Edwards edges McCain 44 – 41 percent.

Giuliani leads McCain 30 – 22 percent among Ohio Republicans.  Former House Speaker Newt Gingrich gets 11 percent and Romney gets 4 percent.

Among Ohio Democrats, 38 percent pick Clinton, followed by 13 percent for Obama, 11 percent for Edwards and 6 percent for former Vice President Al Gore.

“Those who say Sen. Hillary Clinton can’t win the White House because she can’t win a key swing state like Ohio might rethink their assumption,” said Peter Brown, assistant director of the Quinnipiac University Polling Institute. “While it’s a long way – 21 months – to Election Day, these numbers indicate that at this point she is very competitive in Ohio.”

To be honest, Mr. Brown, I’m a bit skeptical of any conclusions drawn from 3 or 4 point leads this far out. The only matchup with a statistically significant gap is the Hillary-Romney matchup, and Mitt has much lower name recognition. The nominees of both parties will have something approaching 100 percent name recognition by Election Day 2008.

In other news:

Among the top contenders, Sen. Clinton has by far the largest bloc of voters who don’t like her, with a 49 – 38 percent favorability.  By comparison, Obama’s favorability is 35 – 12 percent, but 52 percent say they don’t know enough to form an opinion.   Edwards gets a 46 – 24 percent favorability.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

A Few More Details On Stately Edwards Manor



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Judging by this thread on RedState, John Edwards’ new house is going to generate a lot of talk – it’s just so ostentatious. One could easily imagine your average rapper or NBA star showing off all the rooms and features on an episode of “Cribs.” It’s the details that illustrate the opulence of this dream home. From the News and Observer:

The main living section of the house is 10,778 square feet and has a tax value of $3.1 million, according to tax records. It has five bedrooms, 6 ½ baths and a library. A second wing of the house is connected by a heated enclosed walkway, valued at $192,664, and is lined with family and political photographs.

 The second wing, called “The Barn” by the family, has 6,336 square feet and includes a lounge and offices that are 70 percent complete. It has a current tax value of $567,403. It also has a basketball court, which is 60 percent complete and valued at $300,960; a racquetball court, 70 percent complete and valued at $41,000; and a pool, according to tax records.
 (I was unaware, until today, that Edwards’ old house in Raleigh was in a neighborhood called “Country Club Hills.” I kid you not. The Edwards also currently have an oceanside vacation home in a gated community. The gate, I presume, is to keep one of the Americas out of the other one.) As one commenter on the RedState thread noted, “Man, that’s gonna cost him a ton in carbon offsets.” Speaking of candidates and real estate, Pataki’s campaign headquarters in New Hampshire is available on Craigslist. Looks like a great space for some latecomer to the race. 

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

A Long, But Interesting, Discussion of Health Care Policy With Readers



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Wow. Here I was, thinking health-care policy was this dry, wonky topic about premiums, and I’m greeted with an avalanche of e-mail. (And very few of it was people complaining and looking for health advice.) A great deal of reader response has been eye-opening personal experience with our Byzantine system from the supplier side, and the various ways that government attempts to “fix” the problem have made it worse.

 

John points out that the current system is light-years away from anything resembling the free market: 

I had to quickly scan your Hillaryspot column on Health care, and you seem to be suffering under a delusion that American physicians are free to set their fees, and will be paid accordingly.  I can assure you that we physicians are not free to do anything of the sort.  We can not pass on costs, we can not compete by lowering prices, we can not even charge what supplies may cost us, if they happen to be over the set fees.  Medicare has set the fees, and just about every insurance company and managed care contract has keyed off of Medicare.  Feel sorry for that poor old person, so decide to see him for half price?  Congratulations, you are guilty of Medicare fraud.

 

Physicians may not give the same service for less than the Medicare mandated fee if those physicians have agreed to be a Medicare provider. It is even illegal to waive a copay.  As for trying to charge higher fees for costs, just because your malpractice went up 100% last year?  You may try to increase your fee schedule, but it will just be written off by the payors, and it is, of course, illegal to attempt to recover anything over the schedule.

 

We have had this degree of socialization for years.  I am disappointed that even on NRO that this is not better known.  There is no free market, nor will there be, for physician services.

 

In PA, where I practice, malpractice has driven many physicians away from the state, and will likely continue to do so.  When I began practice in 1983, I paid about $3500  for my premium.  This year it is north of $20,000, even with the state helping out to some degree.  In the 1980’s, about 50% of physicians who went to medical school in PA stayed here to practice.  This past year, retention is at 4%.  In addition to malpractice premiums skyrocketing, reimbursements are regional.  If you set up practice 30 miles from where I am, and get into Ohio or NY, your fee base could be 30-40% better than it would be in PA, for exactly the same service. 

Just a foretaste of central planning run amok.  I liken it to having congress decide that NOAA had become so good at forecasting weather, that they could save heating and A/C costs by running every thermostat in the country from Washington according to their long-range forecasts.  In order to make sure that they had good control, laws would be passed making it mandatory to nail shut your windows and outlawing fans.  Such is the state of health care in this country, and it doesn’t look much better in the future unless we can somehow wrest back the thermostats.

Michael offers his firsthand experiences:

I am an Emergency Room Physician and hence am qualified to make a few observations.  The first point is in regards to financing so-called universal health care.  It is plainly immoral to force one individual to pay for another’s health care.  That is however, the basis for all universal health care schemes.  As soon as 51% of the populace figures out how to force the other 49% to pay for their health care “universal health care” suddenly becomes politically viable.  And you will note that progressive taxation schemes are invariably used to pay for it.

 

Next, it should be noted that “preventive” health care is practically a joke.  There are very few diseases that can actually be prevented.  Most that can be are already covered by free or nearly free programs such as immunization, most of the rest are lifestyle related.  It is entirely a myth that preventive measures would, for example, help avoid ER visits, the top eleven reasons for going to the ER have no relation to any sort of preventive measures whatsoever.

 

Lastly, the idea that providing people with free care through the government or a national health insurance program would help control costs is ridiculous.  The people who get the free care now are the ones who constantly abuse the system.  In the course of my day my patient population consists of about 70% Medicaid “beneficiaries” and illegal immigrants.  These patients pay nothing to access the health care system, yet approximately 90% of them are in the ER with a trivial or non emergent complaint.  But Hey! It’s free! 

 

Giving another 46 million people, only 55% of whom are U.S. citizens, free health care is a just a great idea all right.Move health care financing to a free market basis, do something about malpractice, reward charity care and make people responsible for their own health care decisions, only then will you solve the “health care crisis” in a moral fashion.

(When a member of the military writes in, I usually make a note to say, ‘thank you for your service. Maybe I ought to do so for the medical personnel write in. Then again, I’ll have to thank everybody who writes in – cops, firemen, accountants…) 

Warren, who also has a medical background, thinks Bush’s latest proposal may be a key step:

The cure is gradually falling into place now; over time employees are having their Cadillac style medical policies replaced by an affordable Ford version.
In the State of the Union speech GWB actually provided the solution that will be phased in.


Health insurance under some dollar amount will be exempt from income tax to everyone. Anything more provided by an employer will be taxed as income. In addition, there must be a Federal mandate that stripped down basic health insurance policies with the exact same policy wording can be offered across state lines.

 

That is today’s problem. Insurance companies have arranged for every state to have different health insurance mandates. Once there is a Federal requirement that the same basic stripped down health insurance policy must be available everywhere, Insurance companies can quantify their costs and will make them available on a nationwide basis at an affordable cost.

Richard has some optimism:

As I understand it, new drug pipelines are slowing down.  That being the case, might it be that within the next few years the vast majority of drugs that Americans take regularly are, or can be generic. (If not the exact drug, then one that is close enough)   If that is the case, is prescription drug coverage only necessary for catastrophic cases.  If we can get 90% of the drugs we need inexpensively, there is no need for insurance to cover them.  It is only necessary for rare cases that demand new or rarely used (and hence expensive) drugs.  If we can we get good enough drugs for blood pressure, cholesterol, birth control, stomach acid and a few others in generic form nowadays, and if they can be made for for a few cents a pill it’s worth asking if we need insurance for anything other than rare diseases or diseases for which good medicines have yet to be found.  Perhaps antibiotics are the joker here.  As drug resistant strains of germs and disease rise, the new antibiotics we are forced to use become expensive.

At the moment, we all want the newest drug, even if it’s only marginally better (and possibly not that).  System-wide, that’s not reasonable.

I loved the parallel that inspired this idea from Drennan:

How about this: A National Health Care Plan that simply says that insurance companies may offer policies across state lines, that they must offer a choice among 1) catastrophic care 2) basic care 3) enhanced basic 4) super-enhanced basic and 5) pay per view.  If this sounds familiar, it should,  It is based on the offerings from Comcast and my telephone company.  The government will stay out of what these categories consist of–it’s up to the Insurance companies and the market.  If they want to offer special pricing for bundling these categories, fine.  Competition should do wonders for the market.  People need only 1) and 2).  If they want to go to Chiropractors, Massage Therapists and Naturopaths and have their birth control pills paid for, they’ll have to go for one of the enhanced plans. 

I suppose, however, that getting government to stay out of it is beyond the ability of our political system.

Or combine them. “I’ll take HBO, muscle relaxants, recreational Cipro, the NFL Dish package, and emergency care.”

 

Jim points out “another costly result of the explosion of malpractice suits that you mentioned: Out of fear of being sued for malpractice for overlooking (1) an alternate (albeit unlikely) diagnosis and/or (2) a test that might reveal another (previously undiscovered but unlikely) condition, doctors now feel constrained to order up pretty much any and every test in the book that might be tangentially related to the problem at hand. In other words, CYA. Ka-ching, ka-ching.” 

Jill points out how some states’ regulations – particularly, the Certificate of Need – can really gum up the works:

Certificate of Need (CON) has had a broad impact on health care providers and markets for over three decades.  CON is based on the premise that governments can do a better job of matching supply and demand than the health care marketplace.   

In a CON state, with few exceptions, you can’t acquire or replace any facility or equipment, and offer new or add to existing health service with CON approval.  If the need for a service, facility, piece of equipment is not in the annual state plan, you can’t apply for it until there is a need found according to the state’s need methodology.  Hospitals, EDs, beds, ORs, CTs, linear accelerators, MRI, cardiac cath, hospice, Medicare certified home health agency, nursing home, you name it are regulated by CON.  CONs work by county – if you want to move CON asset within county, CON application.  If you want to move a CON asset from one county to another, no can do.  If you have a chronically underperforming CON asset, your underperformance will be included in the mathematical need methodology, and could be outcome determinative – no new need in the annual plan.  The market – what’s that?

Phillip notes something that’s been nagging at me – more and more Americans’ views on health care is “give me the very best care available, and give it to me for free,” at the exact moment when so many of us are… well, carrying around a spare tire. And/or a minivan.

In answer to the above question:  EAT RIGHT AND GET ENOUGH EXERCISE.  Also get married before you get pregnant.  Finish high school.  Get a job.

 Sounds rather simple.  But I wonder how much of our health care costs are related to “life-style” choices which bring about ill health rather than the “accidental” illness, either through true accident, accident of genetics (ALL the males in my family had some sort of heart disease before they turned 50.  I got the message through some measure of careful diet, exercise, and luck, and managed to make past that milestone without incident), or accident of age (average life expectancy is increasing and our bodies just fall apart at some time).  Car insurance is based on your history – the more accidents you have, the more you pay.  Life insurance is likewise – the older you get the more you pay.  Unfortunately, health insurance typically isn’t.  Yes, it may be on the individual level.  But at group levels, it’s averaged out over the history of the group.  And if it goes universal, it will be truly averaged out.  Somehow, I don’t want to waste my tax dollars of subsidizing someone else’s bad habits.  The thought of paying for quadruple bypass surgery on a 40 year old 50 lbs overweight smoker makes me sick.  Think I’ll go to the doctor.

Chris reveals another complication of having somebody else – i.e., the government – pay for checkups.

The concept that if you pay for people to get their teeth cleaned now so they don’t have to get a root canal later really doesn’t work.  I had an Uncle who was a Dentist in East St Louis, most of his work was welfare (Medicare/Medicaid) and he had about a 60-70% no show rate on appointments.  It turned out to be a vicious cycle; to cover costs he would have to triple book every appointment and at some point during the day all three people would show up, thus long waiting times, etc.   

If you pay for it yourself you know you will get billed if you don’t show, so those little conflicts (like the cat being sick) have a lower priority than if you aren’t paying yourself and there is no consequence of not showing.

Finally, many readers note that my reader’s comment about Cuba having a lower infant mortality rate is dodgy at best and a lie at worst. 

JC:

Cuba has lower infant mortality because pre-term babies are considered “stillborn” and not infants. Also Castro gets to edit the numbers. (I mean seriously, Cuba?) See here.

 

Vaccination is low because people chose not to have their kids vaccinated. This is not an cost issue, its way more complicated and the cost doesn’t go down if we share the bill. I live in Japan. Semi-socialized vaccines. Except mumps, for that they hang a sign on your door. Better?

(Yeah, but then the government will start regulating the mumps-door-sign market, and a single sign will cost $800 and there will be a three-week waiting list…)

 

Kirk:

Since when do we take self-reported numbers from totalitarian societies seriously?  If Cuba truly had a better health care system, you would think we would have Americans flocking to the sunny Cuban shores for their healthcare instead of Cubans trying to get here. 

Fascinating stuff, and I thank my well-informed readers. At this point, I’m going to put the topic aside for a bit – this is the Hillary Spot, not just the Health Care Policy Spot – but I’m sure we’ll be coming back to this, when some other candidate unveils their health care proposals.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

More on Health Care Policy, and Trying To Not Be Boring



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Hillary Spot reader Keith asked a respectful question:

I’ll be honest- I do not consider myself a conservative but I find it important to read political points of view from all sides.  And forgive me for souding ill-informed but I don’t ever here any “conservative” plan for providing universal basic healthcare.  I understand that it would be too costly (and unnecessary)to provide laser eye surgery for everyone.  It’s probably not possible to offer everyone the most advanced and expensive cancer treatments, either.  But given that the US, by comparison with other wealthy nations, provides relatively poor basic care (prenatal, vaccinations, etc…-according to US census data, we have a higher infant mortality rate than Cuba), what could be the conservative argument against providing a basic level of universal healthcare? If the issue is cost it seems to me that providing basic universal healthcare might actually be even cheaper in the long run. 

Keith has a point that health care is not an issue that generally gets conservatives revved and fired-up. I came up with three points/ideas/concepts.

Part of our problem may be the sense that when health care is “paid for” by someone else – your employer, the government, etc., there’s little incentive to eliminate unnecessary tests, procedures, etc. (Somebody once explained it that when you’re buying something for yourself with your own money, your top priority is value. When you’re buying something for yourself with someone else’s money, price matters much less, your top priority is quality. When you’re buying something for someone else with your money, you’re usually very concerned with price and are willing to compromise on quality; and when you’re buying something for someone else with someone else’s money, you’re not too worried about value, quality, or price. P.J. O’Rourke noted that 99 percent of all government spending is in that last category.) Much of health care spending is using somebody else’s money to take care of yourself. 

One of my readers, Jim, put it this way:

My wife works in health-care. Biggest reason for expense: right now there is every incentive for her team to provide every conceivable service, even if the client is nearly dead. Since the clients or their families don’t pay directly, they want as much as they can get; since the therapist gets paid, they want to provide as much as possible, and no one ever says “Uhhh, is this helping?” The government has rules, but they know how to fulfill the requirements easily.

Programs like Medical Savings Accounts, etc., are, admittedly, comparably small-time solutions compared to grand, sweeping, single-payer overhauls. But if the procedures are being paid for by Joe Patient, instead of the insurance company, or his or employer, or Medicaid or Medicare or some single-payer government system, there’s greater incentive to say, “is this test/procedure/treatment necessary, or are there alternatives (preferably cheaper ones)?” As it is now, neither the doctor nor the patient has much incentive to look for treatment options that are cost-effective as well as effective - we don’t want anyone not healing or not healthy, obviously. But we also can’t act as if money is no object.

Second point – an issue completely missing from Obama’s address – malpractice insurance.  (Jay Nordlinger follows this endlessly depressing topic, and here is one of his best articles on “Tort Hell” in West Virginia.) Two generations ago, suing your doctor was pretty rare, I’ll bet.

Today every doctor knows that every procedure, every diagnosis, and every decision could be the trigger for a long and expensive lawsuit. There’s a reason that lawyers are derisively nicknamed “ambulance-chasers.”  We want patients who have legitimate cases against doctors to find justice, but the medical system is bending under the weight of an exploding rate of lawsuits and efforts to force an out-of-court settlement. When somebody wins a million-dollar settlement, the doctor doesn’t pay, his insurance company does. His insurance company then passes on the cost to all of the doctors they cover, who pass it on to their patients.

My third point is that when the public discusses what their health insurance ought to cover, they ought to remember that insurance is supposed to be about management of risk. Insurance policies are all about spreading risk across a broad group of people. If I run a car insurance company, I’m “gambling” that not all of my policyholders will total their car in a given year; I’m betting that only a few will, and what I collect in premiums will cover both their new cars and my operating costs and hopefully a profit. But your average insurance is designed to cover the unexpected – accidents, mostly – not the regular costs of owning and operating a car.

Over the years, our expectations of health insurance have changed dramatically. It’s no longer to cover the (hopefully) one-time-only costs if I’m in that car accident and I break my legs; now people expect their health insurance to cover contraception, regular checkups, Viagra, etc. — things that are not once-in-a-great while-expenses, but regular month-to-month expenses. (Er, in the case of Viagra, perhaps even more frequently.) This would be like having your car insurance cover filling up your tank.  On paper, it would/could/should be possible for either the government or the private sector to offer low-income citizens a low-premium health insurance plan that would only cover catastrophic cases – i.e., cancer, car accidents, etc. But your average regular month-to-month costs would be out of pocket…  

Hillary Spot reader Andrew made the case that not only is paperwork one-quarter the cost of health care, but that various lawmaking efforts to improve health care keep adding another layer of paperwork:

It is in fact possible that a quarter of all medical costs is paperwork. The problem is that almost nobody in America directly pays for his own health care (incidentally, that’s the main cause of high medical costs). And when somebody else (who is not even there) pays he surely wants a lot of paperwork. Be it Medicare, Medicaid or insurance companies and HMOs. On top of that there’s a lot of CYA paperwork in case John Edwards or one of his numerous colleagues files a malpractice lawsuit. And on top of that top there’s more paperwork to comply with HIPAA, COBRA and other acts of collective wisdom from our beloved Congress. A typical health care organization has a special “compliance department” or something like that with the sole mission of ensuring that all the government mandates are complied with (and that copious notes are taken). Oh, did I mention all the paperwork for the IRS?

On a related note, Hillary asked Yahoo users, “Based on your own family’s experience, what do you think we should do to improve health care in America?” The answers seem likely to make you weep. The dominant tone is, “I don’t know how to fix it, but give me free health care, I deserve it.”

A typical answer: “Make good health care affordable to everyone. Maybe charge for it on a sliding scale, but everyone can participate regardless of income. Health care should not be a privilege in this country it should be a right.” No word on how, just a demand that the potential future President “make” this the case.

Another answer: “I believe Canada has a better way. They say that people wait longer, and maybe some privileges are lost, but isn’t that a small price to pay for everyone having care?”

Canada has a great system, until you need a procedure that the system doesn’t cover because it’s too obscure. Also, it’s doing a… lousy (not my first word choice) job of keeping up with demand; in “America Alone,” Mark Steyn has a hilariously grim story of an expectant mother flown all over Canada because no hospital in the nearest two provinces had an open bed. Government-run health care: It will be like the DMV with surgery! 

The Canadian system is extraordinarily popular… among Americans who don’t have to use it. Similarly, one can shorten the title, “Canadian health care critic” to simply “Canadian.” 

Answer after answer demands, “lower the cost,” no word on how. Another laments, “I have been without a job, or at a job with no benefits and it is terrible to think that I either have to pay for my root canal or my rent, it is not fair to anyone to have to make such a decision.” Indeed, it is not fair. Apparently it is fairer for the state to force you and I to pay for this person’s root canal.

 

There is only one sure-fire way to lower the cost, and this goes back to that irrepressible law of supply and demand. If there were a lot more doctors and health care providers, there would be competition for patients, and doctors would have an incentive to lower their prices to attract more patients. (Obviously, this doesn’t work for emergency care, where you need the nearest ER doctor or surgeon ASAP.) Most proposals on the right side of the aisle have aimed at bringing market forces into the health care system. Inevitably, detractors accuse the right of kneeling at the altar of the free market, not caring about patients, sinister profit motives, blah blah blah, but the whole point of bringing the free market – competition – into health care is to expand choices for patients, and to bring costs down.

 

Hillary Spot reader Forbes, by the way, dismantled the sound-bite from Ron Wyden:

“For the money Americans spent on health care last year, we could have hired a group of skilled physicians, paid each one of them $200,000 to care for just seven families, and guaranteed every single American quality, affordable health care.”

So everyone else [involved in health care who isn’t a physician] works for free — nurses, x-ray techs, pharmacists, etc. (and hospital stays will be free). Isn’t that a reversal of your formula, 1950s medicine at 21st century prices? This just proves politicians are unsuited to solving complex problems–as if they really were philosopher kings–for he’s proposed that each family spend $28,500 per year on health care. What’s the median household income in America?

How is that affordable health care? A plan? That’s a non-starter, for it doesn’t even begin to understand how health care is provided–or how markets work when the incentives are all on the demand side. If your family had to spend $28,500 each year on health care, how much more health care would you be “consuming”?

In defense of Wyden, I think his sound-bite was simply designed to illustrate how much is spent on health care in this country every year. But yes, at the slightest scrutiny, the instinctive “Every doctor covers seven families? Boy, that sounds great!” reaction is revealed as hilariously shortsighted.

UPDATE: Hillary Spot reader Jaime writes in, “I agree with most of your arguments but you failed to address Keith’s central question: would providing a basic level of healthcare (vaccines and the like) drive down the costs of healthcare in the long run? A fluoride prophylaxis every 6 months is cheaper than a root canal later on. And so forth.”

Really short answer: I don’t know. Probably depends on how one defines “basic.” Vaccines are not terribly controversial; I could easily see Americans agreeing to publicly fund the cost of vaccines.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Hillary’s Weekend In Iowa: She’s Dealt With ‘Evil and Bad Men,’ But Which One(s)?



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Hillary made her first swing through the early caucus state of Iowa this weekend.

 

Fox News’ “Campaign Carl” Cameron called it a “very smooth first trip onto the campaign trail.” But she had one of those surreal moments that can only occur on a Clinton campaign in Davenport.

 

At a town hall – er, “conversation stop”, she was asked the question, “with all the bad and evil men around the world, what equips her to deal with them?”

 

You can watch the video at the link above, but basically, she repeats the question, paraphrasing, “people like Osama bin Laden comes to mind… And what in my background… equips me to deal… with evil and bad men.” And she just lets loose this wicked grin, and without even a punchline, the audience supplies its own, and erupts with laughter. (There’s debate on the blogs about whether she’s referring to Republicans or her husband. I don’t know if she would put Ken Starr or Newt Gingrich in the same category as Osama bin Laden; if she did, she ought to get together with Dinesh D’Sousa. On the other hand, there’s something about the grin, the phrasing – perhaps it’s the shift from ‘evil’ men to ‘bad’ men – that I think suggested Bill, or at least I think that’s where the audiences minds went. But maybe I’m wrong.)

 

Afterwards, she apparently said she was trying to be serious. “I was thinking about how our leadership for the past six years hasn’t really produced results.”

 

When asked directly if she was referring to ‘the dark side’ of President Clinton, she said no, but that she had been trying to lighten up. (Kind of an odd question to “lighten up” on.)

 

Elsewhere, Chuck Todd notes that Hillary is talking about her aspirations to be the first woman president a lot. At the same time, she’s talking about being an incrementalist. Message: “I’m safe in terms of different policies, but bold in terms of being a different gender!”

 

Also this weekend, Hillary sang, um… less than perfectly. She actually didn’t start that badly, she just kind of wandered off-key, and never quite came back. But by the standards of, say, Rosanne Barr, it was downright… adequate. 

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Hillary Reportedly On Verge of Winning The Rahm Emanuel Primary



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Novak has the scoop: “Sources close to Sen. Barack Obama are sure that Rep. Rahm Emanuel will not support his fellow Illinois Democrat for the presidential nomination but will back Sen. Hillary Rodham Clinton.”

This isn’t shocking, but if Obama had won over Emanuel, it would have triggered serious worries in the Hillary camp.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

There Are Two Americas; John Edwards’ New House Takes Up Almost All of One Of Them



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I’m sure many of us hear about John Edwards’ massive new house, and say, “hey, good for him.”

Presidential candidate John Edwards and his family recently moved into what county tax officials say is the most valuable home in Orange County. The house, which includes a recreational building attached to the main living quarters, also is probably the largest in the county.

“The Edwardses’ residential property will likely have the highest tax value in the county,” Orange County Tax Assessor John Smith told Carolina Journal. He estimated that the tax value will exceed $6 million when the facility is completed.

The rambling structure sits in the middle of a 102-acre estate on Old Greensboro Road west of Chapel Hill. The heavily wooded site and winding driveway ensure that the home is not visible from the road. “No Trespassing” signs discourage passersby from venturing past the gate.

But between this and the S Corporation tax shelter, which saved him paying hundreds of thousands of dollars in Medicare taxes, he might want to give it a rest the next time he talks about the richest one percent not paying their fair share.

UPDATE: A bit more detail here – there will be two additional residences on the property – one for Edwards’ daughter; one for guests. This quote from an unnamed Democrat suggests that Edwards’ primary rivals may find this a convenient line of attack:

“It’s one thing to be a millionaire, but it’s totally tone-deaf to be using Katrina victims while you’re putting the finishing touches on your multimillion-dollar mansion,” said one Democratic operative.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

A Model of an Anti-Insurgent Campaign In a Democratic Primary



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Over in today’s New York Sun, I have an article looking at a recent hire by the Hillary Clinton campaign, a smart guy by the name of Burns Strider. He’s best known for leading efforts at evangelical outreach among Democrats, but he also is believed to have had a hand in a tough primary campaign in Mississippi last cycle. The gist:

Strider also has recent experience helping a liberal female lawmaker quash the political aspirations of a young, up-and-coming African American in a Democratic primary. As Senator Clinton contemplates the rapidly rising star Senator Obama of Illinois and his recent interest in a presidential bid, the former first lady may wish to review Mr. Strider’s most recent experience with political hardball.

The battleground was Mississippi’s second congressional district, encompassing Jackson and rural parts of the Mississippi Delta, in the most recent election cycle. The state’s longest-serving and most influential African-American lawmaker, Rep. Bennie Thompson, had won re-election, but by a bit less than expected, in two straight cycles. A state legislator, Chuck Espy — the nephew of former congressman and Clinton administration Secretary of Agriculture Mike Espy — made comments indicating interest in a primary challenge in 2006.

The tactics Thompson used against Espy are far from certain to be elements of the Clinton campaign’s playbook – Mr. Strider wasn’t interested in talking to me, which is frustrating – but it is an interesting example of how hardball tactics can keep a young, talented challenger from getting traction in a primary.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Nevada: The New New Hampshire? Or Lost in the Shuffle?



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In Nevada, the grassroots are stirring, two years out. With the state now in between Iowa and New Hampshire Democratic primaries, campaigns are wondering how to divide their resources.

 

With California, New Jersey, and Illinois all debating moving up their primaries, we’re going to see some campaigns in a bit of confusion or panic – the familiar order, Iowa, New Hampshire, South Carolina – is disrupted; and no one knows whether any particular state will be vital or whether it will get lost in the shuffle. It seems likely with so many candidates in the race, someone is going to focus their resources on one early state, and hope that it turns out to be an important one.

 

Somehow it seems appropriate that Nevada, home of Las Vegas and gambling, would make the primary schedule such a gamble for candidates with limited resources.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Obama’s Underwhelming Words on Health Care



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Okay, for the first time, I’m somewhat annoyed with Obama. (I know, I know, he’s probably quaking in his boots over that sentence.)

It has to do with his tying his “we must come together and have the audacity of hope” message to the thorny issue of how can Americans get the best health care for their money. 

(Jim’s theories on health care in one paragraph: Remember when doctors made house calls? Even if you’re not old enough to remember it, I’m sure we’ve all see in it old movies and T.V. shows.The doctors of two generations ago brought just about everything they needed in one black bag. The line, “Take two aspirin and call me in the morning” became the punch-line of a joke, because laymen believed that was a doctor’s advice for just about every ailment. Today a doctor has a lot more than a tongue depressor and stethoscope; they have MRIs, CT scans, pacemakers, heart stents, lasik eye surgery, etc., as well as exponentially more options when it comes to prescription drugs. Unfortunately, these advances cost money, as does the cost of a doctor becoming more specialized in his knowledge, and expanding that area of understanding of ailments and healing. American consumers want 2007 (or beyond) technology at 1956 costs. More specifically, they want somebody else, either the government or their employers, to pay for it. But there is no such thing as a free lunch; sooner or later, someone has to pay the bill; it will always come back to consumers (through businesses), individuals, or taxpayers (when the government picks up the check). Any serious discussion of health care ought to acknowledge that; instead, almost every lawmaker goes to the public and says, “I will promise you the best health care you’ve ever had, and I will get somebody else to pay for it.”)

Anyway – in his most recent address on health care, Obama says the reason you’re not getting spa-quality treatment at rock-bottom prices is that favorite arch-nemesis of his… Partisanship.  

Bleah.

In the 2008 campaign, affordable, universal health care for every single American must not be a question of whether, it must be a question of how. We have the ideas, we have the resources, and we must find the will to pass a plan by the end of the next president’s first term.

 

I know there’s a cynicism out there about whether this can happen, and there’s reason for it. Every four years, health care plans are offered up in campaigns with great fanfare and promise. But once those campaigns end, the plans collapse under the weight of Washington politics, leaving the rest of America to struggle with skyrocketing costs.

 

For too long, this debate has been stunted by what I call the smallness of our politics – the idea that there isn’t much we can agree on or do about the major challenges facing our country. And when some try to propose something bold, the interests groups and the partisans treat it like a sporting event, with each side keeping score of who’s up and who’s down, using fear and divisiveness and other cheap tricks to win their argument, even if we lose our solution in the process.

 

Well we can’t afford another disappointing charade in 2008. It’s not only tiresome, it’s wrong. Wrong when businesses have to layoff one employee because they can’t afford the health care of another. Wrong when a parent cannot take a sick child to the doctor because they cannot afford the bill that comes with it. Wrong when 46 million Americans have no health care at all. In a country that spends more on health care than any other nation on Earth, it’s just wrong.

Now, Obama’s ideas about reducing paperwork and putting all medical records online, they’re great. But as he acknowledges, everyone from Ted Kennedy to Newt Gingrich has been calling for this for years.

 

(Obama estimates that one out of every four dollars spent on health care is spent on paperwork. That seems high to me, but I’ll take him at his word.)

 

But beyond that, a more serious debate about health care would recognize there are no silver bullets, no easy answers, no easy way to get more and better health care for less money. Yes, there are incidents of waste, fraud, abuse, and mismanagement, but by and large you get what you pay for with health care. It costs a lot to train a doctor. Doctors want to make a good living (as their job requires enormous amounts of education and training). The equipment is expensive, as it gets more advanced. As the Baby Boomers age, they’re going to want more treatment; demand will outpace supply, and we know what that does to costs. Our society also has reached a point where we medicate a lot of problems that we didn’t used to – anxiety, depression, ADD, etc. It used to be, “that guy’s got bad nerves, that gal’s always been morose, and the kid’s hyper.” (This not to say we shouldn’t medicate these problems, but that we should realize this costs money.)

 

Instead, Obama offers one paragraph of the usual somebody’s-making-too-much-money argument:

Another, more controversial area we need to look at is how much of our health care spending is going toward the record-breaking profits earned by the drug and health care industry. It’s perfectly understandable for a corporation to try and make a profit, but when those profits are soaring higher and higher each year while millions lose their coverage and premiums skyrocket, we have a responsibility to ask why.

Hey, kids! Who wants to go into the exciting field of medical research, when the government has decided the maximum level of profit you’re allowed to make on what you produce? Remember, while you may look at other professions and fields and envy their ability to have more take home pay, you’ll be getting bonuses in the imporant category of feeling good about yourself! It more than makes up for the fact that you will only be able to make a certain level of money off what you do! And investors – don’t miss this opportunity to get in on the ground floor of an industry where your maximum possible dividend will be predetermined by federal regulators!

I liked this section:

My colleague, Senator Ron Wyden, who’s recently developed a bold new health care plan of his own, tells it this way: For the money Americans spent on health care last year, we could have hired a group of skilled physicians, paid each one of them $200,000 to care for just seven families, and guaranteed every single American quality, affordable health care.

I stand corrected, there is a silver-bullet solution. All we have to do is deploy the National Guard, round up all the doctors, and force them into the National Each-Doctor-Cares-For-Seven-Families System.

Also notice, “We have the ideas, we have the resources, and we must find the will to pass a plan by the end of the next president’s first term” – in other words, “don’t expect anything from me before 2012.”

With this start, it’s easy to wonder if Partisanship is going to be the Great Bogeyman of the Obama campaign, responsible for everything from high cost of health insurance, declining housing prices, traffic, bad weather, the common cold, male pattern baldness, and the awful state of prime-time television lately.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Hollywood Publicists, Not Quite Up To Speed On Campaign Finance Laws



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I saw this headline, and started to wonder if McCain-Feingold had been repealed, or whether Hollywood just decided the laws didn’t apply to them:

Liz Taylor gives Hillary Clinton campaign $100,000

Then I saw the revised version of the story.

(Corrects figure in first and fifth paragraphs to $2,100 for the sum donated. Taylor’s spokesman initially said the donation was for $100,000, but later said this figure was incorrect.)

Dear FEC, please keep an eye on this.

Obama will be hitting up Hollywood in the near future, with some high expectations.

And three of the most powerful men in Hollywood _ Steven Spielberg, Jefrey Katzenberg and David Geffen _ have just invited Democrats to a truly high-profile fundraiser: a Feb. 20 reception for Obama at the Beverly Hilton Hotel, with a dinner later at Geffen’s home for top donors.

By the way, this picture – featuring Obama, his lovely wife, and that Lovecraftian horror of a celebrity couple known as “TomKat” – seems to depict the formation of some sort of vortex of celebrity media hype. Had Paris, Britney, Lindsey and Angelina arrived nearby, the entire universe might have been sucked into a massive black hole of celebrity ogling.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

Will the Endorsement of This Man Drive Christopher Dodd All the Way To the White House?



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I know you’ve been laying awake nights, wondering who Rep. Patrick Kennedy is going to endorse in the 2008 Democratic presidential primary. (Okay, perhaps you’ve been laying awake nights, worrying that he’s going to drive his car into your living room, and then claim that he’s late for a vote.)

Well, Hillary, Obama, Edwards and Richardson can give up and go home. The winner of the Kennedy of Rhode Island primary is… Senator Chris Dodd.

U.S. Rep. Patrick J. Kennedy said last night he will endorse, raise money and work for the underdog campaign for the Democratic presidential nomination of Connecticut Sen. Christopher Dodd, a veteran senator who is also close to Kennedy’s father, Massachusetts Sen. Edward M. Kennedy.

“Chris Dodd has a breadth of experience in both the House and the Senate,” said Kennedy in an interview. Kennedy cited Dodd’s leadership on children’s education and health-care issues, his foreign policy expertise and service in the Peace Corps.

The Rhode Island Democrat also noted that Dodd, who speaks fluent Spanish, is bilingual. “He answered President Kennedy’s call to serve in the Peace Corps, in the Dominican Republic,” said Kennedy, whose uncle was President John F. Kennedy. “I think that being fluent in Spanish in this day and age is such a powerful asset that it cannot be overvalued.”

Indeed, it is beneficial to know Spanish today. (“Dos Coronas, por favor.”)

Somewhat seriously, Kennedy may be a useful fundraiser if he’s still got all those DCCC contacts. Between this, his Connecticut base, and his chairmanship, Dodd is likely to have significant funds to stay in the game a while.

Kennedy also mentions that his father, Sen. Edward M. Kennedy, is not likely to endorse anyone for a while, now that Kerry is not running.

Tags: Barack Obama , Bill Richardson , Chris Dodd , Fred Thompson , Hillary Clinton , Horserace , Joe Biden , John Edwards , John McCain , Mike Huckabee , Mitt Romney , Newt Gingrich , Rudy Giuliani , Sarah Palin , Something Lighter , Tommy Thompson

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