How much is the MA election a national statement/referendum on anything?

[Leaper]

Obama, health care reform, the economy... Whatever you feel like bringing into this.

They say "all politics are local." Does this prove it wrong?

[Richard Parker]

MA still supports Obama by a wide margin. If this was a referendum on anything national, it was on healthcare. Probably, the race was half about Brown>Coakley, and half about opposing "Obamacare."

It's not a surprise that health care reform is unpopular. The deeper question is whether it is unpopular because people know what's in the bill, and oppose it, or because they've been deluded about what's in the bill, and what it does.

[Leaper]

And, perhaps, why any opposition is there. Each side certainly has very differing views on that.

[Squink]

Just goes to show that Obama should have gone to bat for single payor, and also stopped Reid from trying to compromise with stonewallers for the better part of a year.
The base felt betrayed, and stayed home to smoke a joint or two, rather than endorse a change that feels more like warmed over leftovers.
Obama and the Dems need to straighten up and fly left, if they know what's good for them, and the country as well.

[pinkyvee]

Obama, health care reform, the economy... Whatever you feel like bringing into this.

They say "all politics are local." Does this prove it wrong?

To quote a former president:

"It's the economy, stupid."

[2ply]

It's the economy. Obama has been able to escape blame for the recession for most of his presidency so far, but it's catching up to him. The longer we're in a recession while Obama is in the office, the more responsibility for it falls on Obama and the Democrats and the less they can use the excuse that is was inherited from Bush.

I seriously believe the election of Brown has much more to do with unemployment than health insurance reform. People are unsure of what the health bill will do to them and the effects are going to be years away, but people are feeling the unemployment situation NOW and the Democrats haven't presented a solution for it.

[Zephyurs]

The idea that everything would be hunky dory if Obama went for single payer seems to be wishful thinking, to me.

The primary issue is a 10% unemployment rate and a mediocre candidate who shrieked "establishment." That's not a winning combination.

[athelas]

Brown certainly campaigned on an anti-Obama, anti-healthcare bill stance. And Obama made tentative steps to support Coakley. So both sides made it pretty clear that they meant it to be a referendum on healthcare.

For those claiming local issues predominated, just what local issues would those be?

[Zephyurs]

And since this is an evidence based board, I'll throw something out there to support my statement. The Rasmussen exit poll showed that some 22% of Democrats voted for Brown. If they had gone for Coakley at regular rates (e.g. 2008), she would have won, despite independents turning against her.

Some Democrats might have stayed home, but no one who is mad at Obama for not pushing single payer is going to go out and vote for Brown to spite him.

On the other hand, Republican turnout tonight was the same as 2008. Democratic turnout was 60% 2008.

[gonzomax]

The progressives are very unhappy with the metered improvement in health care and the financial industry. We expected more. People are pissed when they read about the bankers and their bonuses. Then the watering down of the health care to try and satisfy everybody a little, failed miserably. People without jobs go crazy when the guys who caused the financial mess are able to reward themselves huge bonuses while we are in a down economy that they caused.

[flickster]

Combine this with the election results in Virginia & New Jersey and you have trifecta. While the individual reasons may very, the overall message is one of how this administration has lost touch with the voting public.

Either one of the election results be themselves could have been shrugged off as an anomaly, but not three in a row.

[Richard Parker]

[T]he overall message is one of how this administration has lost touch with the voting public.

But how do you explain why a majority of voters in MA and NJ (not sure about VA) still support Obama?

[dalej42]

It means that the unemployment rate is still 10%.
People don't have time to care about Bill Clinton getting a blowjob when the stock market is up and the unemployment rate is low. People have time to get worked up over 'socialism' when they're not working and spend all day watching the news.

Ronald Reagan was is worse shape in 1983. Didn't work out so bad for him.

[flickster]

But how do you explain why a majority of voters in MA and NJ (not sure about VA) still support Obama?

Not sure, but polls can be manipulated much easier than voting results

[Richard Parker]

Not sure, but polls can be manipulated much easier than voting results

So all the pollsters are manipulating them in the same direction? Seems unlikely to me. You'd think at least Rasmussen would be Fair and Balanced.

[Daedelus]

I'm not sure how much of a "referendum" the outcome may be, but I do believe that it is clear that Obama has wasted away the mandate he came into office with. He made poor moves by handing health care reform over to Pelosi & Reid instead of marshaling it through himself, and has struggled to instill the promised transparency (along with several other issues). I would like to say that his administration is not in trouble, but the momentum is definitely swinging away from his administration and if his next battle is to seriously reform financial regulation, then he's in trouble.

[Xema]

But how do you explain why a majority of voters in MA and NJ (not sure about VA) still support Obama?
Perhaps their support is growing tepid, and they don't mind sending a wake-up call.

[Squink]

if his next battle is to seriously reform financial regulation, then he's in trouble.His next battle is going to have to be reforming the senate so as it can accomplish the nation's business with something less than a supermajority of democrats.

[Daedelus]

That seems to be what he's going to have to do isn't it, Squink? I'm just basing my statement off of statements released by his office. I just don't see anything happening with the complete lack of bipartisanship on any front, despite the public outcry for action.

[stolichnaya]

I hope this means we actually see a gorram fillibuster, after all of this panty-wetting about the concept.

I want to see some old white dudes reading from the bible and grabbing their bladders before we get in a tizzy about 60 votes.

[athelas]

But how do you explain why a majority of voters in MA and NJ (not sure about VA) still support Obama?Obama left the healthcare wrangling to Congress rather than being hands-on, so he isn't as tainted by association as he could be.

[Knorf]

Yay. Now we can count of a referendum supporting Republican obstruction against anything that might be good for democrats, regardless of what is good for the country.

We can forget any kind of meaningful legislation happening for the foreseeable future.

[Sam Stone]

I don't think this was just a referendum on Obamacare - it was voters wanting to break the stranglehold Democrats have on Washington. Americans have never liked one-party rule, whether it be Republicans or Democrats.

The Democrats have been incredibly tone-deaf to the real concerns of the people. There's a major recession, jobs are still being shed, there are still all kinds of fiscal problems, mortgage defaults are continuing, and what are the Democrats focusing all their effort on? Reforming healthcare. Something that will do squat to help the economy come out of recession, and in fact would make it worse because of the uncertainty, new taxes, and delayed benefits.

What else are the Democrats focusing on? Global warming. Cap and Trade. Regardless of what you think about the issue of global warming, the timing for the largest tax increase in history couldn't be worse.

The stimulus turned out to be a grab-bag of handouts to Democratic constituencies more than anything else, and was far less effective than it should have been because of it.

But aside from the wrong-headed things the Democrats have focused on, the real shame is the stuff they haven't done. For example, a big part of the government's job is trade promotion. Increased trade would help the economy recover, but the Obama administration isn't paying attention to trade issues at all. And when they did, it was to start pissy little trade conflicts with China, Mexico and Canada, along with angering all other trading partners with the 'buy American' clause in the stimulus package. The administration's trade policy is incoherent and trade agreements are sitting unsigned while everyone focuses on health care.

In any event, I think this election sends a message to Washington that the people's concerns are not being addressed, and the Democrats' priorities are all out of whack. Hopefully, Democrats will get the message and put aside their big taxing plans and start working on things that will help the economy instead of hurting it.

If they don't - if they ram through health care under reconciliation and continue pushing the rest of their agenda, they're going to get hammered in the fall. They could lose the house completely, and wind up with only a 2-3 seat majority in the Senate.

[Jophiel]

I hope this means we actually see a gorram fillibuster, after all of this panty-wetting about the concept.
Except the filibusters are procedural matters, not "Mr. Smith Goes To Washington" ordeals.

[Sam Stone]

Yay. Now we can count of a referendum supporting Republican obstruction against anything that might be good for democrats, regardless of what is good for the country.

We can forget any kind of meaningful legislation happening for the foreseeable future.

That's true so long as Democrats continue shutting Republicans out of the debate and telling they have to vote for everything the Democrats want or sit on the sidelines.

But there are lots of things that could get widespread bipartisan support. New trade agreements. Some modest regulatory reform. Deficit reduction measures. Modest health insurance reform. Higher education reform. Programs to help minimize real estate defaults and bankruptcies. You know, boring day-to-day good governance, instead of sweeping ideological change.

[stolichnaya]

I don't think this was just a referendum on Obamacare - it was voters wanting to break the stranglehold Democrats have on Washington. Americans have never liked one-party rule, whether it be Republicans or Democrats.

There is truth in this, your mistake is in nationalizing it. Mass voters want to break the Dems' hold on MASS, and not Washington. For Pete's sake, the Democrats have not done anything, but the Republicans are not brimming with fresh ideas.

In fact, there is backlash against the nationalization of the race, the assumption that Kennedy's seat goes to a Democrat, all of that. And the Republicans trumpeting this as a national bellweather is likely to have a humbling effect on local perceptions of Brown- these folks did not vote for a Republican, they voted for a populist, and a person.

We all need to take a breath and let the voters of Massachusetts have their decision.

[Spectre of Pithecanthropus]

Yay. Now we can count of a referendum supporting Republican obstruction against anything that might be good for democrats, regardless of what is good for the country.

We can forget any kind of meaningful legislation happening for the foreseeable future.I agree. Conservatives and libertarians will never stand for the get-everybody-into-the-pool strategy that would make UHC possible. It would be wrong in their view to force the young and healthy to cough up some money for something they won't need in the next six months.

We have 10% unemployment, but that's not enough, apparently. Only if 51% of the population faces job loss and the cruel joke that is COBRA will enough voters say, "Maybe we do need a real safety net, including UHC, just like they have in Canada and Europe." But as long as the other 90% are still sitting pretty, I don't think it can happen.

[stolichnaya]

Except the filibusters are procedural matters, not "Mr. Smith Goes To Washington" ordeals.

I wouldn't know, I've never seen one. You can't just threaten something, you have to actually do it. You can't say you're going to run the ball, you have to actually run it, or there is no reason to defend it. Let's see a fillibuster, I got time.

[BrainGlutton]

The Massachusetts Lesson: Go Populist Now (http://www.thenation.com/blogs/edcut/518786/the_massachusetts_lesson_go_populist_now)

[Blalron]

I hope this means we actually see a gorram fillibuster, after all of this panty-wetting about the concept.

I want to see some old white dudes reading from the bible and grabbing their bladders before we get in a tizzy about 60 votes.

That's the problem I have with the Democratic leadership. They simply won't put up a fight on anything. If they had a lick of common sense they could beat the GOP in a PR battle.

What would really be effective if they called the GOP's bluff on a filibuster would be to organize a 45,000 person candlelight vigil outside capitol hill during the night. That's the number of people in America who die every year because they lack health care coverage.

[Lochdale]

Absolutely a referendum on the current national administration. Any suggestion to the contrary is an exercise in ignorance. A secure Democratic seat has gone Republican. Whilst it may not suggest an overall trend for November it does suggest that most of us are more comfortable withour a supermajority party.

[EddyTeddyFreddy]

From DailyKos, another view (http://www.dailykos.com/storyonly/2010/1/19/827160/-My-Mom-is-a-Democratic-machine-operative-in-Bostonheres-her-explanation) on what the hell happened, making the argument that state-level internal infighting among Democrats was part of Coakley's loss:
My mom has been a Democratic machine operative in Boston since the 70's. She knows about Massachusetts politics, and she knows about this election. Here's what she says happened:

[snip]

In this particular race, there has been a great deal of conflict between the Democratic insiders in Western Mass [where Coakley is from] and the Democratic insiders in Boston.

[snip]

According to my mom, the Western Mass Democrats got a lot more momentum in the primary because no one in Boston believed that Capuano could lose. Western Mass turned out, Boston and vicinity did not.

Mom says Capuano would probably have won easily had he not lost the primary (he never has a serious challenge when he runs for his House seat).

Coakley, on the other hand, not only dropped the ball as everyone knows, but no politicians in Boston wanted their names associated with her after she won the primary. My mom isn't high enough up the chain to know why this is (or maybe she is holding out on me

[snip]

As the race went on, she (mom) asked around as to why she hadn't been called out to phone bank, check lists of registered voters, etc, for the campaign as usual. She was told "we're not backing anyone" by "someone on the committee" (she is not telling me what committee because this blogging thing is making her uneasy).

Menino never backed her publicly ("Don't name names!" says mom. "Everyone knows he's the mayor!" I say). He never backed her secretly either, the machine was not turned out for Coakley.

"Nobody likes her" says mom. What she means is, Coakley had no friends in politics. The Democrats in Massachusetts let this happen because - "I don't know" says mom.

Maybe they weren't about to let Western Mass manipulate them. Maybe it all comes down to nothing more than who is friends with whom.

[snip]

The proverbial house divided among itself, fell.

Yeah, yeah, I know -- one anecdote from an anonymous source reporting hearsay, on a Democratic blog currently engaged in thrashing about seeking answers. A stellar cite from a stellar site. ;)

But I have to tell you, as a Massachusetts resident, that I perceived a curious silence among much of the Democratic political structure throughout much of the race after the primary. Capuano, Pagliucca, and Khazei (Coakley's three primary rivals), after pledging their support when Coakley won, didn't campaign at all for her. Boston's Mayor Menino did appear with Coakley (http://www.wbur.org/2010/01/17/mass-senate) "at a Sunday morning prayer service in Boston’s Dorchester neighborhood for victims of the Haiti earthquake." But what I'm picking up is that any machine aid for Coakley came in a floundering too-little, too-late panicky last-minute scramble.

A perfect storm of causes led to this result -- unsympathetic candidate, crappy campaign, attractive outsider, anti-incumbent anger, national issues -- but if this anecdotal analysis is correct (in part, not as the entire reason), it would not at all surprise me.

Going forward? I agree with stolichnaya and Blalron on the filibuster. Now that Reid hasn't the fig leaf of a 60-seat "filibuster-proof" majority, it's time to make those who'd block legislation in the Senate actually get off their pasty aging butts and do it, live, before the C-SPAN cameras.

[Shodan]

We will see in November how much of a harbinger this is, but it doesn't look good for Dems.

This should have been the safest of safe Senate seats - it was one warmed by Teddy Kennedy's sizable ass for the last umpteen years, for heaven's sake. And Obama himself came down from heaven and campaigned, with the results we see. It should have been a cakewalk - Coakley was 20 p0oints up at the beginning - and wound up defeated by five percent.

Practically, it means relatively little - 59 is not that much less than 60. Symbolically, it means Obama and the Dems have (likely) lost their last, best hope of enacting their agenda. They had control of all three branches, and a filibuster proof margin. Not any more.

Again, at this point it is more symbolic than anything else, but it does not bode well for November for the Dems.

Regards,
Shodan

[John Mace]

But how do you explain why a majority of voters in MA and NJ (not sure about VA) still support Obama?

Do they still support Obama's agenda or do they just like him? The right track/wrong track numbers are terrible right now. So, if it's not Obama, then it's Democrats in general.

[magellan01]

There is truth in this, your mistake is in nationalizing it. Mass voters want to break the Dems' hold on MASS, and not Washington.

I don't think that's right. Brown ran on being the 41st vote in Washington.

[muldoonthief]

Since the pre-election thread (http://boards.straightdope.com/sdmb/showthread.php?t=548017) is locked, I just wanted to address this here:

By law, they can't certify him for fifteen days. I suspect that the GOP will nevertheless blame Dems for the delay. Want to take bets?

I would have more respect for this particular law if state officials had scrupulously observed it in the past - but when it came to seating various Democrats after special elections they have shown that exceptions can surely be made.

I won't pretend that circumstances are the same now as they were for Niki Tsongas or Ted Kennedy - however we surely shouldn't pretend that this law is so absolute when it has been shown in the past not to be.

There was an interview with the MA Sec of State, Bill Galvin, on the radio this morning. He said he is going to send a letter to the U.S. Senate today, stating that Brown is the unofficial winner. He cannot certify the results for 10-14 days. However, the Senate may choose to act on the unofficial results. In the last 2 special elections in MA, where Niki Tsongas (2007) and Stephen Lynch (2001) were elected to the House of Representatives, he sent a similar letter, and in both cases, the House chose to act on the letter and swear them in to office before the results were certified.

So it will be up to the U.S. Senate leadership when Brown is sworn in, not state law.

[muldoonthief]

There is truth in this, your mistake is in nationalizing it. Mass voters want to break the Dems' hold on MASS, and not Washington.


I doubt that. Democrats get reelected to the state house with depressing regularity, even after things like drunk driving convictions and tax evasion. We'll see in November - if the Republicans can't get their act together and get a slate of viable candidates for the state legislature (around half of the Dem. candidates in an election run unopposed in MA) together after this victory, they may as well pack up and go home.

[Xema]

And Obama himself came down from heaven and campaigned, with the results we see.
It was ill timed and not helpful. Reports I heard said his speech was dull and seemed poorly prepared. (By contrast, the TV ad he made got decent reviews.) Meanwhile, Brown was able to say, in effect "Look how important this election has become."

But for Coakley it was a day late and a dollar short - to help, Obama should have been there sooner. It seems the White House was no more perceptive than a great many other about trends leading up to this election.

[stolichnaya]

I doubt that. Democrats get reelected to the state house with depressing regularity, even after things like drunk driving convictions and tax evasion. We'll see in November - if the Republicans can't get their act together and get a slate of viable candidates for the state legislature (around half of the Dem. candidates in an election run unopposed in MA) together after this victory, they may as well pack up and go home.

Well, this is what I mean. If there is normally no choice but to vote for a Democrat, wouldn't people seeking some measure of checks and balances in their state sieze an opportunity to vote for a reasonably acceptable Republican? Even if it is a national office, this is a strong message to send and I understand the impulse. I certainly can't speak for Mass voters en masse (ba dum bum) but I am getting this message from the several Brown voters that I know. That and, of course, Coakley was a toad on the trail.

[Shodan]

It was ill timed and not helpful. Reports I heard said his speech was dull and seemed poorly prepared. (By contrast, the TV ad he made got decent reviews.) Meanwhile, Brown was able to say, in effect "Look how important this election has become."

But for Coakley it was a day late and a dollar short - to help, Obama should have been there sooner. It seems the White House was no more perceptive than a great many other about trends leading up to this election.
QFT, I think. Spending your political capital on a losing Senate race is a Bad Thing for Obama. It means he's got no coat tails, and therefore no leverage with the Dems who are up for re-election in 2010. Just the opposite, in fact - to the degree that this is a repudiation of Obama's policies, it creates the need to distance oneself from him.

What the GOP should do is what they did in 1994 - a Contract with America, where they lay out a clear, limited agenda. Don't know if there is a Gingrich equivalent who can put it together - maybe Newt himself can advise the Republs on how it is done. It would be a good idea to include some kind of limited health care reform package. Focus on catastrophic coverage and tort reform. Both are popular, and doable - and tort reform in particular won't bust the budget and will actually do something about the root causes of health care inflation.

Regards,
Shodan

[yorick73]

What the GOP should do is what they did in 1994 - a Contract with America, where they lay out a clear, limited agenda. Don't know if there is a Gingrich equivalent who can put it together - maybe Newt himself can advise the Republs on how it is done. It would be a good idea to include some kind of limited health care reform package. Focus on catastrophic coverage and tort reform. Both are popular, and doable - and tort reform in particular won't bust the budget and will actually do something about the root causes of health care inflation.

Yeah...if there was ANY leadership in the party right now. The Republicans will be twisting in the wind for some time. If they can't get their act together by November we might start to see a third party forming.

[pinkyvee]

That's true so long as Democrats continue shutting Republicans out of the debate and telling they have to vote for everything the Democrats want or sit on the sidelines.

But there are lots of things that could get widespread bipartisan support. New trade agreements. Some modest regulatory reform. Deficit reduction measures. Modest health insurance reform. Higher education reform. Programs to help minimize real estate defaults and bankruptcies. You know, boring day-to-day good governance, instead of sweeping ideological change.

Forget deficit reduction. Congress is whoring for more $$$.


Pending in Congress is a measure to increase the Debt Limit by $290 billion, which amounts to six more weeks of routine borrowing for the federal government. (The House just passed the increase, though the Senate has yet to act. It is expected to approve the measure.)



http://www.cbsnews.com/blogs/2009/12/16/politics/politicalhotsheet/entry5987341.shtml

THIS sort of irresponsible debt & borrowing is what, I think, is driving the wave of massive discontent amongst the middle-of-the-road voters.

My husband and I live within our means. Congress wants to live beyond anyone's means.

It is NOT a Dem vs Rep sentiment.
That is just too convenient.

It NOT "screw health care reform".
That is just too convenient.

This nation is hurting, and cannot afford more debt.
It makes no sense to expand/invent any more huge & expensive entitlement programs while at the same time borrowing money to pay for the already huge expensive entitlement programs.

If an American family is borrowing money in order to make their mortgage, should they install a pool?

Modest health insurance reform.
Yes. And, yes.
First step of reform is to decrease costs.
First step is not to broaden coverage by borrowing more $$$.

"You know, boring day-to-day good governance, instead of sweeping ideological change."

Sam Stone, you got that right.

[stolichnaya]

If they scrub, which I doubt, I kind of like Dean's "Medicare for 55+" idea. To his points, it is easy to explain, it extends a popular program, and it can be passed via reconciliation.

/wipes hands

[Daedelus]

Yeah...if there was ANY leadership in the party right now. The Republicans will be twisting in the wind for some time. If they can't get their act together by November we might start to see a third party forming.

Possibly, though unless some galvanizing leader emerges, there's little hope for that. Dems and Pubs have no one leading the way for either of them, as the recent losses for the former and the inchoate Tea Party for the latter, attest to. Obama has decided to step back instead of step up, and that's the best thing the Pubs have going for them right now. If he changes his tune, and actually starts acting like the leader that those who voted for him thought he was, there will be less momentum for a moderate third party. The months leading up to November will be very interesting, indeed.

[pinkyvee]

If they scrub, which I doubt, I kind of like Dean's "Medicare for 55+" idea. To his points, it is easy to explain, it extends a popular program, and it can be passed via reconciliation.

/wipes hands

http://online.wsj.com/article/SB10001424052748703436504574640711655886136.html

Quote from the article:

"Mayo says it lost $840 million last year treating Medicare patients, the result of the program's low reimbursement rates. Its hospital and four clinics in Arizona—including the Glendale facility—lost $120 million. Providers like Mayo swallow some of these Medicare losses, while also shifting the cost by charging more to private patients and insurers.

Of course, only governments can lose that much money and pretend they don't have to change. "Mayo Clinic loses a substantial amount of money every year due to the reimbursement schedule under Medicare," the institution said. "Decades of underfunding and paying for volume rather than value in Medicare have led us to this decision."

[stolichnaya]

What you say does not discourage me from pursuing an extension of medicare. Runaway medical costs will respond to downward incentives only when more people are willing to pay less. Medicare is a way for the gvt to help force this.

Conversely, I assume you would support a repeal of all Medicare?

[pinkyvee]

What you say does not discourage me from pursuing an extension of medicare. Runaway medical costs will respond to downward incentives only when more people are willing to pay less. Medicare is a way for the gvt to help force this.

Conversely, I assume you would support a repeal of all Medicare?

You assume incorrectly.

I recently retired from a 3 decade career in the medical field as a primary care nurse practitioner. I took care of countless tens of thousands of Medicare folk. And, it was wonderful.

"Runaway medical costs will respond to downward incentives only when more people are willing to pay less."


What people are you talking about?
People are always "willing to pay less" for the same goods or services.

[kingbighair]

*Talking point time*

Since Massachusetts apparently already has a (popular?) health care system similar to the proposed national bill and Brown ran on stopping it, can this be taken as support for that style of health care? As in, "We don't want the government messing up our health care."

Politics!

[stolichnaya]

Well, that's good to hear. I'm not trying to be a dick, just trying to understand your point in posting that WSJ article without commentary.

So given that you think that Medicare can be fixed, then, what is wrong with Medicare, and how would you fix it, and how would that fix not also apply to an extension of medicare coverage? Maybe medicare needs to raise reimbursement rates, or maybe there needs to be another class of care for Medicare folks. I'm not anti that concept, the Mayo Clinic is a seriously elite organization and I would expect them to be expensive. I don't want caddilac for all, just coverage for all.

Re: willing to pay less. I mean basically that insurance companies have not been successful in lowering costs, likely because the buyer never sees the whole bill, and for whatever reason insurance co's don't apply the same price pressure as Medicare. If Medicare is willing to apply downward price pressure, then expanding the Medicare pool should increase that pressure.

If I could start from scratch, then I think there would be a "Chevy" clinic and emergency reception outlet wherever there is a certain number of people. This first line would reduce a lot of expense, but still not eliminate the issue of $50,000 per dose drug treatments or $15,000 in tests every time someone faints. At some point someone has to stop paying for all this.

[pinkyvee]

the Mayo Clinic is a seriously elite organization and I would expect them to be expensive.

Did you read the article in the link about the Mayo?


"President Obama last year praised the Mayo Clinic as a "classic example" of how a health-care provider can offer "better outcomes" at lower cost."

And, you're not being a dick.

[stolichnaya]

I did read the article, it is all over the place opinion wise, which is why I was seeking yours. SOme points from the article as I discern them:

1) Obama thinks that the ACO model is a good idea
2) despite the ACO model, Medicare is becoming persona non grata at the Mayo clinic
3) Even though this outcome-based model kinda works, it is futile to think it can work everywhere

I don't know much about ACOs - do you think that Medicare should incentivize this kind of treatment by issuing "episodic" payments instead of procedure-based reimbursements? And perhaps that this sort of reform should be prioritized ahead of extending the Medicare rolls?

I'm just asking what you think here. And trying to figure out what I think.

[pinkyvee]

2) despite the ACO model, Medicare is becoming persona non grata at the Mayo clinic

Only because the Mayo could no longer afford to participate.
It was not intended to be any sort of shot across the bow of medicare, per se.


I'm just asking what you think here. And trying to figure out what I think.

I understand.
I personally do not know how to "fix" healthcare. It's above my (former) pay scale.
What I do know is this.

The national debt is a huge threat to our country.
A far bigger threat than any healthcare "crisis".

[pinkyvee]

The national debt is a huge threat to our country.
A far bigger threat than any healthcare "crisis".

And, in my opinion, this is what the voters in MA were saying when they cast their ballots.
First things first. Fix the economy.
Don't spend more than you can afford.
Don't vote on anything as important as healthcare without being transparent to the public.

[Airk]

Mass voter here. Frankly, I think the major decider in this election was the candidates. Coakley is BOOORING, lacks personality, and practically refused to campaign. Here. Watch the first chunk of The Daily Show from Monday. (http://www.thedailyshow.com/full-episodes/mon-january-18-2010-david-walker) It tells you just how much of a personal flop Coakley is.

The very fact that this election was close when the Democratic candidate was so weak speaks pretty strongly against this being a "referendum" and more of a "Martha Coakley is tedious".

[pinkyvee]

Mass voter here.

Who got your vote?

[ElvisL1ves]

What the GOP should do is what they did in 1994 - a Contract with America, where they lay out a clear, limited agenda.You mean, think of something to be for? I dunno, sounds radical.

Don't know if there is a Gingrich equivalent who can put it together - maybe Newt himself can advise the Republs on how it is done.What really worked for Newt, and has been the core of GOP strategy since, was the adoption of this memo (www.informationclearinghouse.info/article4443.htm) about effective choice of words in describing the Democrats.Often we search hard for words to define our opponents. Sometimes we are hesitant to use contrast. Remember that creating a difference helps you. These are powerful words that can create a clear and easily understood contrast. Apply these to the opponent, their record, proposals and their party.

abuse of power, anti- (issue): flag, family, child, jobs, betray, bizarre, bosses, bureaucracy, cheat, coercion, "compassion" is not enough, collapse(ing), consequences, corrupt, corruption, criminal rights, crisis, cynicism, decay, deeper, destroy, destructive, devour, disgrace, endanger, excuses, failure (fail), greed, hypocrisy, ideological, impose, incompetent, insecure, insensitive, intolerant, liberal, lie, limit(s), machine, mandate(s), obsolete, pathetic, patronage, permissive attitude, pessimistic, punish (poor ...), radical, red tape, self-serving, selfish, sensationalists, shallow, shame, sick, spend(ing), stagnation, status quo, steal, taxes, they/them, threaten, traitors, unionized, urgent (cy), waste, welfare Recognize any of that?

And that's the guy you want to be leading your party now, too, instead of Limbaugh.

It would be a good idea to include some kind of limited health care reform package. Focus on catastrophic coverage and tort reform. Both are popular, and doableSure. But then why did they choose not to discuss those items, or make any substantive proposals that could be considered in either House's bill, and instead to spread the "death panels" idiocy instead?

[ElvisL1ves]

Coakley is BOOORING, lacks personality, and practically refused to campaign.
Sure didn't seem that way in the primary. But yes, she made the mistake of thinking it was over then, just as it would have been for Kennedy. Mike Capuano has got to be having trouble controlling himself today.

[YoureBeingABinkyBoo]

I think it's really too small a sampling to draw any big conclusions from. Only 12% of Mass voters are registered republicans, so this election seemed to really be a fight between independents and democrats.

The real referendum will come in November, and there'll be no arguing those results. Alot can happen between now and then, economically and with national security. Obama is behind the eight ball now and needs to do something to counteract the feeling of buyer's remorse among the independents who supported him.

[pinkyvee]

3) Even though this outcome-based model kinda works, it is futile to think it can work everywhere



Well, some disclosure here, you should know that my former "big boss" is George Halvorson.
George is deeply involved in the process.

http://xnet.kp.org/newscenter/clinicalexcellence/2009/051109halvorsonreform.html

My former employer stresses evidence based medicine as a tool to reduce costs.

[John Mace]

It's all about the independents, which is the group that ushered the Dems in back in '06 and '08. The specter of Bush is fading, and after a year, I think the perception is that Obama and the Dems (in power for longer than Obama) now own the problems. Unless the economy shows signs of recovery, then we'll probably see a lot of those seats won marginally by the Dems recently go back to the Pubs.

[Airk]

Who got your vote?

Coakley, because unlike most people, I vote strictly on issues, and don't care a bit about who called whom a Yankees fan. =/

She wasn't my choice in the primary, but I think Capuano annoyed too many people being argumentative in the debate while Coakley just kept her mouth shut. That works real well when keeping your mouth shut means "let your competition tear each other down" but less well when it means "Let your competition walk all over you."

[pinkyvee]

Coakley, because unlike most people, I vote strictly on issues

Thanks for answering.

I think most people in MA voted on issues.

[ElvisL1ves]

Or tell ourselves we do. Like anyone else.

[stolichnaya]

It's all about the independents, which is the group that ushered the Dems in back in '06 and '08. The specter of Bush is fading, and after a year, I think the perception is that Obama and the Dems (in power for longer than Obama) now own the problems. Unless the economy shows signs of recovery, then we'll probably see a lot of those seats won marginally by the Dems recently go back to the Pubs.


I agree. And as someone who's mostly voted Democrat since about 2000, I don't think that's a bad thing, the "Blue Dog" democrat is not particularly useful and can actually be a PR issue- witness all of the "You have a supermajority and you can't get anything done" talk. The more that the breakdown reflects ideological reality, the better off we are.

And secondly, it (ever so slightly) increases the chances that we will either enact some reform in the cloture rules (like a reduction in the number of votes needed for cloture as time passes) or actually force a real-life fillibuster as a healthy percentage of the times it is threatened. For my money, the more often we actually use the filibuster for debate and attention, rather than punting to avoid making a decision, the better off we all are.

[Blalron]

Nope. This was a state wide election in Massachussets. One out of 50 states in the union. Brown was elected by many different voters in that particular state for a wide variety of reasons. I have yet to see any compelling evidence that health care was the primary motivating factor behind Brown's victory.

Anyone attempting to extrapolate this as national referendum on the issue of health care is simply deluding themselves. Unfortunately, the list of deluded here may include some Democrats in Congress.

[Kevbo]

To quote a former president:

"It's the economy, stupid."

Ann Richards was president? I missed that.

[pinkyvee]

Ann Richards was president? I missed that.

Ha !
I suspected all along that Bill & Carville must have stolen this phrase from some smart woman.:p

My favorite Ann Richards quote:

"Ginger Rogers did everything that Fred Astaire did. She just did it backwards and in high heels."

[elucidator]

I stand second to no one in my admiration for Annie. But the line, I'm pretty sure, is not original with her. Love to be wrong, probably not.

[Blalron]

Mass voter here. Frankly, I think the major decider in this election was the candidates. Coakley is BOOORING, lacks personality, and practically refused to campaign. Here. Watch the first chunk of The Daily Show from Monday. (http://www.thedailyshow.com/full-episodes/mon-january-18-2010-david-walker) It tells you just how much of a personal flop Coakley is.

An excellent point that Stewart makes: Mass. residents already have health care reform that is more progressive than anything being proposed in Congress. They won't suffer in the least from this bill dying.

This makes any argument about it being a referendum on health reform even more ridiculous.

[DianaG]

Nope. This was a state wide election in Massachussets. One out of 50 states in the union. Brown was elected by many different voters in that particular state for a wide variety of reasons. I have yet to see any compelling evidence that health care was the primary motivating factor behind Brown's victory.

Anyone attempting to extrapolate this as national referendum on the issue of health care is simply deluding themselves. Unfortunately, the list of deluded here may include some Democrats in Congress.
You know, I live in Massachusetts. Personally, I blame Tom Brady for this. If the Patriots were still in it, all those mancrushes wouldn't have needed redirection.

I'm only half kidding, by the way. As far as I can tell (in a purely anecdotal, viewing the behavior of my personal acquaintances kind of way), a not insignificant percentage of Scott Brown "fans" didn't even vote in 2008, and have no interest in politics as a rule. Having polled a bunch, I can tell you that they have no idea how he ever voted on anything while he was a state senator. In four years, they'll have no idea how he voted on anything as a US Senator. Frankly, if there'd been a decent game on last night, they'd have stayed home.

[Anduril]

But how do you explain why a majority of voters in MA and NJ (not sure about VA) still support Obama?

Bradley effect. People don't want to be branded as racist for being against Obama so they'll rather say that they don't like his policies even as they are still very supportive.

[stolichnaya]

That doesn't make sense. They don't want to seem racist so they say they don't like his policies but they still support him? Why not just say they are against him because of his policies?

News flash, there are a lot of people who are comfortable with disagreeing vocally with this president, or any president, and don't seem to be askairt of being called a racist. Maybe people are being honest about their feelings about the Prez and weren't really thinking about rebuking him or his national agenda when they voted Brown into office, but rather giving the finger to the state Democratic machine and their listless candidate.

[Gangster Octopus]

The biggest National message is that Democrats still suck at politics.

[astorian]

Obama, health care reform, the economy... Whatever you feel like bringing into this.

They say "all politics are local." Does this prove it wrong?

Well, the odd thing is that, in THIS case, it was the DEMOCRATS who were trying to turn this into a referendum on all sorts of things outside Massachusetts.

Coakley's ads weren't saying, "Brown doesn't care enough about the needs of working people in Boston," she was saying, "A vote for Brown is a vote for Sarah Palin."

That didn't work. For future reference, Democrats might want to remember that. Until such time as Sarah Palin is actually running for some office, you might want to forget about her, and stop trying to make her an issue.

[Anduril]

That doesn't make sense. They don't want to seem racist so they say they don't like his policies but they still support him? Why not just say they are against him because of his policies?

News flash, there are a lot of people who are comfortable with disagreeing vocally with this president, or any president, and don't seem to be askairt of being called a racist. Maybe people are being honest about their feelings about the Prez and weren't really thinking about rebuking him or his national agenda when they voted Brown into office, but rather giving the finger to the state Democratic machine and their listless candidate.

Maybe. But seeing as how effectively charges of racism has been used to dismiss entire segments of the population, I can imagine why people will hold on to expressing that they personally like Obama while expressing strong opposition to what he does. Sort of like the straw-splitting distinction Catholics used on sinners and their sins.

[stolichnaya]

I guess it depends. In most of these polls that I am familiar with the question is not "do you like him personally". The question is "do you approve of the way that he is doing his job". It neatly sidesteps any connotations of racism by focusing on job performance.

I am skeptical of a Bradley effect as regards Obama, since there didn't seem to be much of one in the 2008 election. And let's be honest- vocal disapproval of this president and his policies is not thin on the ground - there ought to be comfort in at least modest numbers for people who have a genuine policy disagreement with the president.