Death panels and rope-a-dope

T.A. Barnhart

The Death Panels are back. You know what that means, right? Yet more vindication for the Obama’s Incrementalism:

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit. Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves. While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.

This is, as the NY Times quotes Rep. Earl Blumenauer’s office, “a quiet victory” — albeit a tenuous victory: Mr. Blumenauer said, “Lies can go viral if people use them for political purposes.”

As the Times notes, a significant number of older Americans believe the lie that government can make end-of-life decisions for them. The misnomer “death panel” still persists in too many people’s minds; thus, Blumenauer’s attempt to keep the new rules from being touted by supporters. So, despite Sarah Palin’s use of “death panels” to pander to the worst anti-government inclinations of many voters, end-of-life planning will be part of national health care policy as of January 1st.

Progressives (whatever that means) and the so-called Democratic Party “base” have been described as angry and disappointed with Obama, his concessions to the Republicans (especially the tax cut compromise) and his careful, and frequently ineffective, attempts to find “bipartisan” solutions to major issues. Because of the recalcitrance and obstructionism of the GOP, especially in the Senate, many on the left have wanted Obama to take bold, direct, partisan action. To respond to the Republican partisanship with an attack reminiscent of Cassius Clay — forgetting that one of Muhammad Ali’s greatest victories involved laying back and playing rope-a-dope with an over-confident and ill-prepared opponent.

Will you feel better if we refer to this as Obama’s Rumble in the Jungle?

In 2009, Obama compromised the hell out of health care reform. He jettisoned single payer and the public option almost with no discussion, especially of the former. He allowed the elimination of end-of-planning because of the political furor the TPers were able to stir up; to be fair, no one expected “death panels” to take center stage and as is too often the case, once a catchy meme like this grabs hold in the mainstream media, as it did here, the issue is settled. There was nothing Blumenauer, Obama or anyone else could have done except what they did: drop the provision and look for an alternative route to the same policy outcome.

In the end, of course, Obama got done what Clinton, Carter and Truman failed to do: enact national health care legislation. An imperfect bill, too heavy on care for the insurance industry, but a bill that protects children, provides that all Americans will have coverage and, most importantly, sets the precedent that this kind of legislation is doable. And now, with the implementation part of the legislation under way, we see why passing even an inadequate bill is so important: The defeat of “death panels” is on the way to become the victory of “voluntary advance care planning”.

Oh yea. This President’s got game. Not to mention smarts and the power of Executive Office’s ability to write the rules that implement laws.

Following the tax cut compromise, Obama and Harry Reid ran off an extraordinary number of legislative victories: DADT repeal, the New Start Treaty, the 9/11 First Responders Health Care bill, long-term jobless benefits and even almost got the DREAM Act through. Every single one of these bills was important to Obama, to the Dems and to their supporters. Every single one of them was also dead in the water. The GOP Senate had made a pledge: to block every other piece of legislation until the tax cuts for the rich were extended — permanently. They were willing to let the long-term jobless lose all benefits, force a tax hike on the middle-class, even let Russian nukes be stolen and sold to al Qaida. The only thing that McConnell and his gang of thugs were interested in was serving the demands of the corporations who bankroll them and driving Barack Obama from office in 2012.

And yet they agreed to a temporary tax cut extension — allowing Obama to have a potent campaign tool in time for his re-election run — and then, in a display of political submissiveness not seen since LBJ was around to stare down wayward Senators, they proceeded to roll over and let Reid and Obama get almost every item on their Christmas wish list. And while none of the final products are perfect — the 9/11 bill has far less money than it should, Social Security funding faces new challenges, and the rich still get a tax cut that does the nation more harm than good — the good accomplished by Obama is huge.

And given the direction of the country since 1968, simply changing course in the way the Obama Administration has done is little short of a miracle.

I’m not going to argue that Obama gets everything right. He should have pushed harder for a bigger, more cash-laden stimulus. He needs to get rid of economic advisors tied to Wall Street and the banks. Aiming at leaving Afghanistan in 2014 is foolish; he should aim for January. But I’m also not the person sitting in the Oval Office with the responsibilities and pressures he deals with daily. While I’m discouraged by a lot of what is visible, especially the political messaging, things like the end-of-life planning rules have been happening since day one of his administration, and these rules enable him to have an impact where politics and GOP obstructionism try to block him.

A lot of progressives want Obama to make noise and stomp hell out of the Republicans and Tea Partiers; it just isn’t going to happen. He’s going to use tools that fit his style: inspirational speeches and thoughtful use of compromise and rule-making. After all, while it is true that a confrontational style will fire-up supporters, it also impassions opponents. And if we’ve learned anything in 2010, it’s that getting opponents to Obama fired-up and ready-to-go is too easily accomplished. And while that opposition did undermine Obama’s ability to act over the coming two years, it perhaps also opened the door to the lame duck miracle. No amount of hysteria from either right or left will stop the President from writing the rules he wants government agencies to follow. With Harry Reid having regained his strength by eating the Republicans’ lunch, the GOP House may be able to hold hearings and make loud whining noises, but they’ll not be able to overturn Administration rules.

Still, expect to see Obama continue to work the compromises. He understood when he signed off on the tax cut compromise that he would catch hell from his side of the aisle; he also knew it was the only way to move forward. He will have to accommodate the GOP over the next two years if any legislation is going to be passed, and zero legislation is not an option. The federal budget has yet to be passed, and a partisan battle will only harm those who need their government’s help the most. Because too many former Obama supporters stayed at home on Election Day and sulked, the GOP now has the power to do great harm to our country. Obama does not have the ability to force them to do his bidding; no president has that power. He will do what all presidents have done: find whatever path is available to move forward. This is what LBJ did in 1964: compromise, including a final bill that was weaker than the original, that brought the means to true justice to American law. FDR’s social security legislation was far from the most progressive of his options; it was the one that, however, that could pass. Obama could have chosen to hold the line on tax cuts for the rich, but his determination was that a compromise was the only means to move forward.

Hard to argue with the results of this lame duck Congress.

In 1974, the heat of the jungle and a world championship fight, Muhammad Ali let George Foreman pound on him round after round while he lay back against the ropes and let his arms absorb the blows. And then, when he saw that Foreman had punched himself into near-exhaustion, Ali knocked out the champ and took back his crown. Barack Obama did not win a championship in the past two weeks, but he turned humiliation and impending defeat into one of the more incredible political turnarounds we’ve witnessed in some time. I hope to see a more bold Obama in the coming year; the ugly nature of the modern Republican Party and the racist, anti-democratic Tea Party will force him to defend himself strongly in the coming year. I also expect to see him work with whoever is willing to move good legislation forward. Not every Republican in Congress is willing to kneel before Mitch McConnell or John Boehner; many know that their own political futures may depend on showing they can be “bipartisan”. These Republicans, like Murkowski, Brown and Collins, may need Obama as much as he needs them.

John Boehner is Speaker for the next two years. Defeating Barack Obama in November 2012 is Job #1 for he GOP. The President will need to use every tool and strategy he has, not merely to win re-election but guide the nation forward. There will be no quick knock-out, angry Clay style; the rope-a-dope may prove as effective for Obama in DC in 2011 as it did for Ali in Zaire in 1974.

T.A. Barnhart writes regularly at and less frequently at Left Coast Foodie. And he’s on Facebook a lot!

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    Another great move on an issue that matters deeply (and personally) to me. (As posted at The Solipsistic Me) I don't want or expect an angry Obama; I'm occasionally frustrated by the non-communicative, capitulating Obama; I'm glad to see the quietly effective Obama.

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      i think you reflect more accurately the anger of many Obama supporters than merely on grounds of policy. results are great, but we need a Leader as well. i think when he fully gets that, we'll get the full package we've been looking for.

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    Let us know when you figure out what "Progressives ('whatever that means')" are. I'll settle for NATO-partner style social democrats.


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      i have my own thoughts on what progressive is. it's not simply a replacement for the word "liberal" as it seems to be for too many people. here's my take: Progressive is a verb.

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        I'm going to progressive this bill. Hey, let's progressive this weekend.

        Not sure that works. I get your point, but it's still an adjective.

        -- Grammar Nerd.

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    I think the public consciousness of what is or is not a "death panel" changed significantly as a result of what's happening in AZ. Taking advantage of that is politically savvy but I don't see how it vindicates Obama's broader strategy.

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      So we do indeed have an example of atual Death Panels and, if memory serves, 40 some people who have been effectively sentenced to death by governor Brewer as the money had already been allocated elsehwere. Holding my brath for this to become a story anywhere outside of lefty blog country.

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    The liberal brand has been so effectively desecrated that it is beyond repair. A belief in human progress with policies that are based on positive effective governance for the common good is a good definition of "progressive" around which the progressive coalition can unite and it is a definition rooted in U.S. history.

    It must be remembered that the Progressive movement historically has roots across the Dem./ Republican divide and Teddy Roosevelt was among its most well known advocate (along with Republican governor Robert LaFollette of Wisconsin.) It should also be remembered that the name "liberal" means advocacy of unbridled, unregulated capitalism, and right wing conservatism on the European continent. FDR applied the name "liberal" to his policies in order to keep from being called socialist or communist.

    So I like the "progressive" brand as being a movement rooted in American soil with a name that is associated with positive government and a belief in the capacity for society's self improvement for the common good. Our president falls within that American tradition. Unfortunately the progressives wing in the GOP was driven out by Robert Taft in the election of 1912 and Roosevelt's Bull Moose Party failed.

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    I think that "the base", while not monolithic in expectations, gets mischaracterized by the press and by touchy Obama defenders. I presume to say that most of us aren't screaming for our own favorite little legal or data point but rather want to see the prez explain as he goes. When Bill Clinton neatly summarized the first two years in a twenty minute press conference las week, it made the communication incompetence of the Obama Kids very apparent. Especially when making multiple policy changes, mutiple and repeated explanations are a necessary component of the job.

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    Good article. It is nice to see some thoughtful analysis rather than just whining and complaining.

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    I think this is T.A.'s third article in three weeks defending Obama's "incrementalism" (i.e., caving). Besides seeing T.A. change the record, I'd love to see someone post an article with the obvious counterpoint that Obama is failing to lead on the most substantive issues of our day and is instead settling for minor accomplishments that likely do too little to solve our giant, systemic problems.

    Regarding this particular post, the recent rulemaking is hardly vindication that Obama's cowardice was actually cunning and clever maneuvering on his part. The problem with rulemaking is that these rules can be easily unmade by a different administration, which may be arriving as soon as two years and before these new rules will probably even take effect. If Obama had actually stood his ground and insisted the final language of the law include discussions of end of life care, that practice could not be removed unless Congress passed a bill that was signed by the president - a much tougher task.

    So T.A., you are of course free to accept less, but I will continue to expect more. While we agree that politics is about the possible, I believe we don't know what is possible until we actually try.

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    Of course everyone realizes that these victories were bought and paid for with extension of rich peoples' tax vacation. That bit of compromise tom foolery cost this nation at least $35 billion each of the two years. I hope the advances are worth it.

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