Bobo’s gone all concern troll in “Not as Dull as Expected!” in which he wrings his hands and says the health care summit may not have bridged the partisan rift, but there were moments of hope for the next set of reformers. You’ll notice that the key words are “next set.” In other words, Bobo’s praying the summit will be called “Kill Bill 2.” Mr. Cohen, in “An Eye for an Eye,” says as drone attacks on terror suspects grow more frequent, it’s time for the U.S. to set out its doctrine on targeted killings. Prof. Krugman also watched the health care summit. In “Afflicting the Afflicted” he says since Republicans didn’t bother making much of a case at Thursday’s White House meeting, Democrats may have the last laugh by finishing the job and enacting health reform. From his lips to God’s ear. Here’s that tool Bobo:
Going in, I was as cynical as everybody else about the Blair House health care forum. I was planning to watch for a half-hour and then write about something else.
But the event was more meaningful than that. Most of the credit goes to President Obama. The man really knows how to lead a discussion. He stuck to specifics and tried to rein in people who were flying off into generalities. He picked out the core point in any comment. He tried to keep things going in a coherent direction.
Moreover, he seemed to be trying to get a result. Republicans had their substantive criticism of the Democratic bills, but Obama kept pressing them for areas of agreement.
The second useful thing about the meeting was that it bypassed the Congressional power structure. As usual, the quality of the comments got worse the closer you got to the party leadership. The Democratic Senate leader, Harry Reid, gave remarks that veered between the misleading and the incoherent. Statements from Nancy Pelosi, the House speaker, were partisan spin. The Republican leaders, Mitch McConnell and John Boehner, were smart enough to stand back and let Senator Lamar Alexander lead the way, which he did genially and intelligently. While Alexander was speaking, Reid and Pelosi wouldn’t even deign to look at him.
Once you got to the other members, about two-thirds of the statements were smart and well-informed. This was not a repeat of the Baltimore summit, in which Obama dominated the room. This time, Obama was very good, but so were many others, like Mike Enzi, Jim Cooper, George Miller and Tom Coburn. If you thought Republicans were a bunch of naysayers who don’t know or care about health care, then this was not the event for you. They more than held their own.
The third useful thing about Thursday’s forum was you got to see the Obama presidency encapsulated in one event. At the very end, the president summarized some possible points of agreement between the two parties, offered some concessions and asked Republicans to see if they could make some on their own.
As always with the Obama compromise offers, this offer seemed to be both sincere and insincere. Embodying the core contradiction of the Obama presidency, the president seemed both to want to craft a new package and also to defend the strictly Democratic approach. I think he’s a bipartisan man stuck in a partisan town, but maybe he’s an iron partisan fist in a velvet postpartisan glove.
Fourth, you got to see how confident Republicans are. Obama’s compromise offer is one the Republicans can happily refuse. In their eyes, he is saying: If you don’t make some concessions now, I’m going to punch myself in the face. If you don’t embrace parts of my bill, I will waste the next three months trying to push an unpopular measure through an ugly reconciliation process that will probably lead to failure anyway.
Fifth, you got to see at least one area of bipartisan agreement. Neither side was willing to be specific about how to cut costs and raise revenue. The Republicans continued to demagogue efforts to restrain Medicare spending. The Democrats (and the Republicans) conveniently neglected to mention the fact that they had just gutted the long-term revenue source for their entire package, the excise tax on high-cost insurance plans. That tax was diluted and postponed until 2018. There is no way that members of a Congress eight years from now are going to accede to a $1 trillion tax increase to pay for a measure that the 2010 Congress wasn’t brave enough to pay for itself.
Sixth, the summit illuminated one of the core mysteries of this whole debate: Are the two parties so fundamentally divided that there will never be any agreement, or is there at least the theoretical possibility of a compromise approach?
Both parties see the same problem. The current system is a mess, with opaque prices and perverse incentives that mostly favor the insurance companies. But, as Yuval Levin has pointed out in National Review, the Democrats believe the answer is to create a highly regulated insurance system with inefficiencies eliminated through rational rules. The Republicans believe that the answer is to create a genuine market with clear price signals, empowered consumers and an evolving process.
Philosophically, it is hard to bring these two sides together. And there were times on Thursday when compromise seemed hopeless. But there were other times, when participants started talking nuts and bolts of the exchanges, when there was overlap: how to create interstate insurance markets without a race to the bottom; how to end insurance company power over those with pre-existing conditions.
Health care reform probably will not get passed this year. But there were moments, at the most wonky and specific, when the two sides echoed each other. Glimmers of hope for the next set of reformers.
Here’s Mr. Cohen, writing from Madrid:
Back in 1976, a Chilean hit squad assassinated former Foreign Minister Orlando Letelier and an American colleague in Washington. Letelier was one of the most prominent opponents of the dictatorship of Gen. Augusto Pinochet.
A rough equivalent today would be China orchestrating the elimination in the United States of a prominent Uighur opponent, or the Russians assassinating a leading Chechen on a Georgetown street.
Needless to say, the U.S. government would be outraged at such extrajudicial executions on American soil. We don’t want to live in a world where nations blow up enemies, or smother them with pillows, in other countries with which they’re not at war.
But nor, of course, can we do less than everything possible to avert another 9/11, and that’s where things get murky.
So let’s make a few things clear. Since 9/11, with greater intensity under the Obama administration, the United States has wordlessly lifted the ban in effect since the Ford administration on targeted killings by U.S. intelligence officers. Such killings are now taking place almost daily under a C.I.A.-directed covert program. Drones firing Hellfire missiles have eliminated several Al Qaeda leaders.
The drone strikes are concentrated on Pakistan, with which America is not at war. The Obama administration has declined to say anything about this doctrine of targeted killing. It’s not clear how you get on a list to be eliminated; who makes that call; whether the decision is based on past acts (revenge, say, for the killing of C.I.A. agents in Khost, Afghanistan) or only on corroborated intelligence demonstrating that the target is planning a terrorist attack; what, if any, the battlefield limits are; and what, if any, is the basis in law.
The closest I can find to an official accounting of the drone program was from Senator John Kerry last October: “I am convinced that it is highly circumscribed now, very carefully controlled within a hierarchy of decision-making, significantly limited in its collateral damage, and profoundly successful in the impact it has had in putting Al Qaeda on the run. It is why we can now say that perhaps 14 of the top 20 Al Qaeda leaders have been eliminated.”
That success is significant, even if “on the run” is hyperbole. But the “collateral damage” is also substantial and has a cascade terrorist-recruitment effect. On balance, President Obama, who campaigned against the “dark side” of the war on terror and has insisted that America must lead by example as a nation of laws, owes Americans an accounting of his targeted killing program.
Revenge killings don’t pass the test for me. They’re unacceptable under international law. I want to know that any target is selected because there is verifiable intelligence that he’s actively planning a terrorist attack on the United States or its allies; that the danger is pressing; that arrest is impossible; and that civilian lives are not wantonly risked.
The bar of pre-emptive self-defense is then passed. A pinpoint strike is better than the Afghan or Iraqi scenarios. But that bar must be high. America departs at its peril from its principles.
I know, terrorists have no rule book, no borders and no compunction. The global war on terror (GWOT) is untidy. Still, the current accountability void for U.S. targeted killing is unacceptable.
America is treading a familiar path. Israel pioneered the use of unmanned drones to kill Hamas operatives. Gerald Steinberg wrote recently in The Wall Street Journal that “U.S. forces have copied Israel’s technique with their own drone killings of jihadi terrorists.” But, of course, the United States is not Israel. It’s not a small nation, surrounded by more numerous enemies, at war since its foundation against foes bent on its destruction. It’s not consumed by the specter of nonexistence.
Vicky Divoll, a former C.I.A. lawyer, told The Los Angeles Times: “At one time, the United States did not kill in the shadows — until we became as afraid for our lives as the Israelis have been for decades.” That’s right — and unacceptable. Fear cannot be a global license for the United States of America to kill.
My doubt level that the Israeli intelligence service, Mossad, was behind the murder in Dubai last month of the senior Hamas operative, Mahmoud al-Mabhouh, is about that of the Dubai police chief who said he was “99 percent, if not 100 percent” certain that Israel was responsible. An eye for an eye: al-Mabhouh was the murderer of two Israeli soldiers, as well as a shipper of arms to Hamas. I won’t shed a tear.
But what a messy trail: all that video, European passports belonging to Israelis whose lives are now at risk, diplomatic fallout. So what, argues Steinberg, who teaches political science at Bar Ilan University, al-Mabhouh was “probably making arrangements for the next round of attacks.”
Note the “probably:” That’s insufficient grounds for extrajudicial execution. Israel, too, must at a minimum have specific intelligence that a target is planning an imminent terrorist attack. Revenge is a blind alley.
And America must lead by its own — not a far more vulnerable ally’s — example or it will end up eyeless in GWOT.
And now here’s Prof. Krugman:
If we’re lucky, Thursday’s summit will turn out to have been the last act in the great health reform debate, the prologue to passage of an imperfect but nonetheless history-making bill. If so, the debate will have ended as it began: with Democrats offering moderate plans that draw heavily on past Republican ideas, and Republicans responding with slander and misdirection.
Nobody really expected anything different. But what was nonetheless revealing about the meeting was the fact that Republicans — who had weeks to prepare for this particular event, and have been campaigning against reform for a year — didn’t bother making a case that could withstand even minimal fact-checking.
It was obvious how things would go as soon as the first Republican speaker, Senator Lamar Alexander, delivered his remarks. He was presumably chosen because he’s folksy and likable and could make his party’s position sound reasonable. But right off the bat he delivered a whopper, asserting that under the Democratic plan, “for millions of Americans, premiums will go up.”
Wow. I guess you could say that he wasn’t technically lying, since the Congressional Budget Office analysis of the Senate Democrats’ plan does say that average payments for insurance would go up. But it also makes it clear that this would happen only because people would buy more and better coverage. The “price of a given amount of insurance coverage” would fall, not rise — and the actual cost to many Americans would fall sharply thanks to federal aid.
His fib on premiums was quickly followed by a fib on process. Democrats, having already passed a health bill with 60 votes in the Senate, now plan to use a simple majority vote to modify some of the numbers, a process known as reconciliation. Mr. Alexander declared that reconciliation has “never been used for something like this.” Well, I don’t know what “like this” means, but reconciliation has, in fact, been used for previous health reforms — and was used to push through both of the Bush tax cuts at a budget cost of $1.8 trillion, twice the bill for health reform.
What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.
One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.
In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.
Don’t take my word for it. Look at the Congressional Budget Office analysis of the House G.O.P. plan. That analysis is discreetly worded, with the budget office declaring somewhat obscurely that while the number of uninsured Americans wouldn’t change much, “the pool of people without health insurance would end up being less healthy, on average, than under current law.” But here’s the translation: While some people would gain insurance, the people losing insurance would be those who need it most. Under the Republican plan, the American health care system would become even more brutal than it is now.
So what did we learn from the summit? What I took away was the arrogance that the success of things like the death-panel smear has obviously engendered in Republican politicians. At this point they obviously believe that they can blandly make utterly misleading assertions, saying things that can be easily refuted, and pay no price. And they may well be right.
But Democrats can have the last laugh. All they have to do — and they have the power to do it — is finish the job, and enact health reform.
