"Kill Bill," starring Howard Dean (with added notes on the persistence of CDS)

The worms are indeed turning. We are, in fact, seeing so many turning worms that America is beginning to look like yet another remake of Dune.

According to Rasmussen's polling, only 38% of the American citizenry now supports the Democratic health reform package; 56% oppose. Granted, Rasmussen skews right. Still, I think those numbers aren't too far from reality.

Trouble is, the pollsters aren't asking the right questions. What I want to know is: How many of those polled understand the bill? I think that a lot of people in the 38% category are still under the mis-impression that this legislation constitutes some form of single-payer. I know that many in the opposition camp remain under the delusion that we're talking about a "government takeover" of health care. In essence, both sides are reacting to a proposal that does not exist.

Howard Dean has grown so disgusted with the actual bill that he now says let's kill it. Ian Welsh's response is worth quoting:

He’s also made the point that if Democratic Senators won’t vote with their party on procedural votes, it’s the death of fundraising for the DSCC—for years they’ve talked about getting to 60, now they have, and they still can’t pass anything that isn’t crap. What next, 65?

2010 is shaping up very nicely for the Republicans. Their base is motivated, the Democratic base is less and less motivated, and by 2010 will be demoralized. The economy will not have recovered by the time of the election, Republicans have effectively demonized stimuluses and deficits, so no new meaningful stimulus is likely to pass, so there’s nothing Democrats can do to fix the job situation. Of course, 700 billion of stimulus, done right, would have created a lot more jobs than the lousy stimulus bill Obama put through.

As Welsh says, Dean did indeed do a lot of water carrying for this bill. So did Bill Clinton.

Hillary works for the administration, which may explain why, as recently as November 10, Bill was still toting Obama's H20, arguing that any bill would be better than none and that any problems could be fixed with subsequent legislation. That's true technically, but not politically; the right's power will only increase over the next two years.

It is interesting to note that Bill Clinton refused five days ago to attend a health care event which Keith Olbermann (the host) had "politicized." I'm not sure that it is possible to have a non-political health care event in today's environment. The problem seems to have been that Olbermann used the occasion to blast Lieberman and company, while Clinton thought that the four hold-outs still could be wooed. Or maybe the rift had another motive...?

You should read the comments from HuffPo readers on that story. They still consider Bill Clinton to be enemy #1 -- despite all the effort that he has mistakenly (but loyally) expended on behalf of Obama's crappy reform effort. Examples:

And most of us no longer give a rat's a$$ about anything you say or do Wild Billy, go back to chasing women in R-kansas.

I so wish I had that 92 vote back.

Shabby, Bill, really really shabby. Thank god for Keith!!

The bots just cannot change their programming. You can be sure that they won't pile nearly so much hatred on Howard Dean, even though Dean wants an end to the bill, while Clinton still (apparently) hopes to salvage it. And how will they respond to Arianna's recent sharp criticisms of Obama...?

I think that CDS (Clinton Derangement Syndrome) has become the only fixed point in the progressive universe. Since their beloved Lightbringer has proven to be Bush III, and since everything they worked for and hoped for throughout 2008 has proven to be a massive lie, inchoate Clinton-hate is all that the poor little proggies have left in their dismal little lives.

Dean thinks, correctly, that Lieberman, Mary Landrieu, Blanche Lincoln and Ben Nelson are all un-turn-roundable. He's right. I would argue that we're better off without them, because I want to see a genuine filibuster. Ah, the spectacle of it! C'mon, admit it -- aren't you looking forward to making popcorn and hot dogs, then firing up CSPAN to watch Joe Lieberman do his renown one-man performance of The Mahabarata?

As I've pointed out before, the Senate's rules allow for a 2/3 majority all of those present to vote (under filibuster conditions) to change the Senate rules. Which means that either all the Republicans will stay in the building while Joe drones on and on -- oh, such exquisite torture that will be! -- or they will go home, at which point the Dems can vote for a rule change, and we can be done with the threat of filibuster once and for all. The Senate will then return to the principle of simple majority rule, just as the founders intended.

The only problem with that scenario is that the current health reform package might pass. One reason to worry about that prospect -- aside from the mandates and penalties that you already know about -- is the Medicare Advisory Board. (Thanks, lambert.)

Under the Senate bill, that board would be required to offer cost-saving proposals when Medicare spending rises too fast; Congress could not reject its proposals without substituting equivalent savings. Since the board would be prohibited from offering changes that raise taxes or "ration care," and since the legislation initially exempts hospitals from its recommendations, it could choose to promote the sort of payment reforms the bill establishes.

But the payment reforms are intended to promote cost-cutting, and that could get dangerous. Moreover, the bill gives us

a Center for Medicare and Medicaid Innovation in the Health and Human Services Department. Though this center has received much less attention than the Medicare Commission, it could have a comparable effect. It would receive $1 billion annually to test payment reforms; in a little known provision, the bill authorizes the HHS Secretary to implement nationwide, without any congressional action, any reform that department actuaries certify will reduce long-term spending. While the House bill omitted the Medicare Commission (a top priority for Obama) it included the innovation center.

How can you reduce spending without reducing care?