How Healthcare Reform Can Still Hurt Senate Democrats

Summary: Democrats in the upper chamber will have to defend some indefensible votes this November.

As you may have heard by now, the healthcare reconciliation bill will have to go back to the House of Representatives. The fear among proponents of the bill was that Senate Republicans would offer amendments that Democrats could not pass up, which would automatically mean it would need to go back to the House for approval.

What actually happened: the Republicans won on a point of order at 3:00 AM this morning using a parliamentary rule that by necessity changes the bill in question. Democrats have thus far been resilient to resist tempting amendments.

This means that little in the bill changes, it will likely be passed about an hour from now, and be approved by the House later tonight. President Obama will then likely sign this last piece of healthcare legislation in to law by next week.

And as we mentioned Monday, healthcare reform success should help Democrats in the midterm elections this November.

At least in the House - the Senate may be a different story.

So far the Senate GOP has introduced no less than 146 amendments to the reconciliation bill that Democrats have had to vote against to guarantee swift passage. They’ve been steadfast, but it comes at a price.

Among some of the amendments:

• S.AMDT.3556 - Senator Tom Coburn (R-OK) introduced an amendment “prohibiting coverage of Viagra for child molesters and rapists” under the government’s health insurance exchange.

• S.AMDT.3639 - Senator John Thune (R-SD) introduced an amendment to “ensure that no State experiences a net job loss as a result of” healthcare reform.

• S.AMDT.3564 - Senator Chuck Grassley (R-IA) introduced an amendment that guarantees “the President, Cabinet Members, all White House Senior staff and Congressional Committee and Leadership Staff are purchasing health insurance through the health insurance exchanges” established in the overhaul.

Now who would disagree with these measures?

Most people wouldn’t. And that’s exactly the point. Republicans are making sure that Democrats have to choose between a rock and a hard place.

The rock: the healthcare bill faces a tougher time getting passed.

The hard place: Democratic Senators at risk in 2010 have to face attack ads that say “Senator So-and-So voted to give rapists Viagra at the taxpayer’s expense.”

The hard place is a lot more important.

According to Nate Silver’s most recent Senate Forecast, there’s more than a 50% chance that the Democrats will lose at least 5 Senate seats this year. There’s even some chance - albeit, a small one - that they could lose the majority.


Protecting our at-risk incumbents would be a lot easier if they didn’t have to make some of these votes.

How the New Healthcare Law Changes the Dynamics of 2010

Summary: the Democrats’ legislative success means an electoral challenge for Republicans.

President Obama finally signed healthcare reform into law this morning. Soon, millions of uninsured Americans will have access to healthcare, sick Americans will be at lesser risk of losing coverage, and insurance prices will stop skyrocketing.


Over the past year, the healthcare debate has changed the political landscape entirely. It has led to the growth of the Tea Party movement, made members of Congress like Bart Stupak and Joe Wilson household names, and seriously depleted Obama’s approval ratings.

By the end of 2009, we warned that a failure to pass healthcare would mean more trouble than security for the Democratic caucuses in Congress.

Now that it’s passed, the tables have turned. Republicans warn that a “yes” vote on healthcare will mean trouble for Democrats come November, but it is the GOP that needs to start worrying.

They’ve been pursuing a strategy of “no” for the past year. Even now, they’re only suggestion is to repeal the law.

Except most of the legislation is quite popular. Measures that most voters would generally approve will be in place before July, including the end of pre-existing conditions. Young Americans could stay on their parents’ plans until they’re 26, and insurance companies would be unable to drop someone from coverage when they get sick.

One of the demographics most afraid of the overhaul - the elderly - will see huge benefits very soon, such as free preventive care and the closing of the Medicare Part D donut hole.

Republicans won’t actually want to repeal all that, will they?

Democrats, meanwhile, saved themselves a lot of trouble by proving to their base they could accomplish something. Things were looking pretty dismal here and there throughout the debate, and Democrats around the country were becoming less and less confident in Congressional leaders.

They won’t be feeling quite so disaffected come November, knowing that near-universal healthcare was achieved as promised.

Watch the President's remarks here:

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The Aftermath of the Healthcare Summit

Summary: What the summit means for a healthcare reform bill and the 2010 midterm elections.

As promised yesterday, we need to give our wrap-up opinions on yesterday’s healthcare summit in Washington, DC.


First of all, the media have not been impressed by what was accomplished yesterday. I’m not quite sure what they were expecting, but evidently they seemed to assume that the bill would have been ready to go after the summit.

In fact, the new deadline for passing a bill is before Easter. That gives Congress over a month to continue hashing out the details - and even that’s under the unlikely scenario that they’ll meet the deadline - before there’s a final vote.

In part, it’s because the GOP still seems unwilling to cooperate.

From Politico:

Heading into the summit, Democrats were preparing to start the steps to get the bill through the Senate with reconciliation — needing only 51 votes to pass a bill — as early as next week. They didn’t expect Republican cooperation Thursday and they didn’t get any. Republicans walked out of the session saying the same thing they said going in — unless you start over, we can’t get on board.

Yet watching the summit, they seemed to be a lot more engaged in reaching a pragmatic compromise than usual. With the exception of John Boehner - who gave a speech loaded with conservative rhetoric about killing the bill - most Republicans (even the super-conservative Sen. Tom Coburn) appeared more focused on working with Democrats than we’ve seen so far.

This is in no small part thanks to President Obama, who took a very serious tone yesterday about bipartisan efforts, which I feel encouraged some Republicans to drop the talking points - especially because the one who did were called out on it.

So we come to two questions. 1) Will this lead to a bill being passed? 2) What implications will it have for the 2010 elections?

It seems to me like a bill was going to be passed regardless of the summit, but I feel that this helped the GOP get over their minority-complex. The attention President Obama showed them (and has been showing them) contrasts - in their minds - with the way the Democratic Congressional leadership has treated them.

And some bridges were built yesterday. Senators Kent Conrad (D-ND) and Tom Coburn (R-OK) made some progress together regarding prescription drug coordination, while Democrats and Republicans in general came to some broad agreements regarding the healthcare-deficit connection.

Of course, there will be plenty of time for Tea Party special interest groups to disrupt this progress, but I feel that the summit probably did help bringing Republicans to the table, making it a little less likely that the inevitable filibuster efforts will succeed.

But in order for a bill to pass by Easter, it is entirely clear that President Obama and the Democratic leadership will have to continue to engage Republicans.

In the 2010 midterms, Democrats will be between a rock and a hard place, but there is a growing agreement among pundits that passing a bill will be more beneficial to them than failing on a key issue they were elected to address. This is something we’ve been saying for months.

Yet if a bill doesn’t pass, pointing to the summit will be a good way for Democrats to defend themselves. “Hey, we had a summit,” they can say, “the Republicans still refused to work with us. They care more about these elections than about the American families who are struggling with healthcare costs.” It’s not a great defense, but it helps solidify the idea that the GOP is nothing more than a “Party of No” these days.

Anyone who watched the summit - there weren’t many who did, albeit, though web traffic for it tripled that of the State of the Union Address - could see how Democrats were more willing to work with Republicans on the bill than vice versa.

Yet even a lot of Republicans were less aggressive than normal yesterday.

Ultimately, a lot of people may be disappointed with the outcomes of the healthcare summit. I, for one, think it could prove to be rather successful.

Healthcare Summit and Getting the Job Done

Sorry this post is so late, as it’s been tough to avert my eyes from the healthcare summit going on today.

Watching it reminded me yet again why President Obama was such a wise choice in 2008. Throughout the day he’s been doing such a great job trying to put politics aside and hash out policy.

Perhaps nowhere was it more obvious then during an exchange that’s making headlines right now with his former rival, Sen. John McCain (R-AZ):


Watch CBS News Videos Online

Indeed, he seems to be taking this summit much more seriously than a lot of the attendees. This demeanor reminds me a lot about what Eric and I said yesterday about getting the job done.

Anyway, be sure to come back tomorrow as we give our wrap-up on the healthcare summit, and what it means for 2010.

In the meantime, you can watch the healthcare summit at www.WhiteHouse.gov.

We’ll also start live tweeting the summit at @HSGWAYLABlog.

Editorial: Can’t We Just Get the Job Done?

Summary: Eric and Dave explain their frustrations with the politics of pessimism.

It’s not difficult to be pessimistic about the outlook of the world sometimes. In recent years, it hasn’t been difficult to be pessimistic about the future of the United States.

For liberals, many of us made the claim that we would move to Canada following the re-election of George W. Bush. In our knee-jerk reaction to the unconscionable decision of the American public, we were certain America was on its downfall. But when we had the chance to think clearly, we remembered it was our country, and we needed to fight for it.

Two years later, we started to win this fight by taking back both chambers of Congress for the Democrats.

Have we reached some sort of Utopia? Of course not. We never will.

Some liberals are now feeling that pessimism in the midst of the healthcare debate. We’re not getting the perfect bill we were hoping for. And some are afraid that if we pass an even mildly-controversial bill, seats will be lost in November.

But as Mark Sump from Activate reminded us on Monday, sometimes we just need to get the job done.

From his blog post:

My son is 16, six foot four and plays varsity basketball at his high school. I attend all of his games. A couple weeks ago his team was playing one of the top teams in the conference. It was close. The other team stole the ball, drove the floor and went in for the lay up. There was one player between him and the basket. They both went up. Our player was trying not to foul, but there was no chance he wouldn’t. He tried to block the ball, but it was out of reach. The ball went in and the foul was called. I thought to myself, if you’re going to foul…foul. Don’t let the shot go in.

Sixteen years ago we tried to pass health care reform. We failed. That year the Republicans took the House. First time in decades. They patted themselves on the back and told the country it was because they succeeded in pushing back against change, against finally bringing true reform to our health care system.

In 1992, Bill Clinton won an electoral landslide. The campaign was built on hope and change. The cornerstone issue was health care reform. He had a mandate. He really did. Then he ran into a Democratic Congress who played not to lose. The more change that was proposed, the dimmer the outlook was for Democrats in Congress. They hesitated. They blinked. They were afraid to lose. Guess what? They lost anyway…

… So, here we are sixteen years later. We’re playing defense. The Republicans are going up for the dunk. Democrats have a decision to make. Do we stop them from scoring and take the penalty, or do we try not to foul.

We can learn from the past. We can know that sixteen years ago as many people were discouraged by our lack of ability to bring real change as were afraid of what that change might bring. Democrats can stand up today, knowing they will lose in November but knowing they did the right thing. Sixteen years ago we blinked and we know the results. History shows we’re going to lose seats in Congress if we do nothing.

So, do the right thing. Pass health care reform. Pass a public option. Pass a Medicare buy-in. Do it by any means possible. Pass a real reform by reconciliation.

If you’re going to foul…foul.

This is how it seems to be with a lot of things these days - even when we put partisan politics aside. On TV, pundits and politicians are constantly telling us that we’ll be losing out to the Chinese because of our deficits, and that it’s placing an unfair burden on the next generation.

Guess what? We are that generation! We’re the next slot of Americans who will have to clean up this mess (Eric is 32, Dave is 22). So here’s our message: either grab a mop, or get out of the way.

In the end, it doesn’t matter if you’re old or young, conservative or liberal, Republican or Democrat. Times are tough, but complaining about it isn’t going to get us anywhere. We need to reform healthcare (everybody knows it), we need to curb climate-change, and - yes - we need to reach a balanced budget sooner rather than later.

So let’s do it. Let’s grab a mop and get the job done. And let’s make sure that we force out those who are standing in the way of this job - those practicing the politics of pessimism. Barack Obama (as he’s said himself) cannot the sole maker of change - we all have to be change makers.

What makes our country great is the resilience of the American people. We were resilient enough after the 2004 elections to re-group and get the job done for the Democrats.

Now we need to be resilient in the face of great challenges and get the job done for America.

The Healthcare-Deficit Connection

Summary: Explaining the real impact of healthcare reform on our deficits to the American voter.

Hale “Bonddad” Stewart had a good post at FiveThirtyEight.com over the weekend exploring the details of the federal budget. It clearly spelled out one factor of government spending that many of us have known about for a long time: the connection between our country’s rapidly inflating healthcare costs and the growing national debt.

As he maps out, mandatory spending (on programs like Social Security, Medicare, Medicaid, and Veterans Affairs services) has been steadily increasing over the past forty years while discretionary spending (for things such as national defense, agriculture subsidies, and a wide variety of other government programs) has been steadily decreasing in that time.

I should note that I would generally consider interest on the national debt as mandatory spending, but Stewart does not.


Now, among the mandatory spending programs - which are not covered by PAYGO rules in the House or Senate the same way that discretionary spending is - Social Security expenditures have actually gone down a bit since 1970, while Medicare and Medicaid expenditures are (for the most part) rising fast.


Now Republicans like to trash healthcare reform as something that will increase our debt. In fact, it is quite clear that without healthcare reform, our debt will continue to rise. In fact, it would not be wrong to assume that a balanced budget is impossible without controlling healthcare costs.

Democrats can do themselves a world of good by driving this point home. It needs to be a message that is consistent and constant in order for voters to believe it. If they do, we can kill two birds with one stone: justifying our support for healthcare reform, and letting voters know we are the party of fiscal responsibility.

That’s not to say it will be easy, especially in the age of sound-bite attention spans. The typical voter will struggle to understand the connection between these two issues - after all, there will be new government spending associated with healthcare reform, and the GOP has done a pretty good job characterizing government as incapable of saving money.

Perhaps we can start where Activate left us off last week with the Three Degrees of Separation.

Explaining the connection between healthcare reform and deficit reduction to volunteers shouldn’t be too difficult. Political activists are well engaged and equipped with the ability to see the relationship.

If they explain to fellow voters in their sphere of influence the benefits of healthcare reform on the federal budget, a basic level of understanding will trickle down. From there, they can talk to voters in their spheres of influence about this connection. This second degree of separation probably won’t understand the argument, but at least they’ll know of it.

Assuming your campaign has a volunteer base of at least 1,000 supporters (it will obviously depend on the size of your district) the message could theoretically reach as many as one million voters.

Tell me that wouldn’t help in 2010!

(By the way, the guys at Activate have a great new post up today about healthcare reform on their blog, The New Paradigm in Politics)

Will Progressives Backlash Over Healthcare Reform?

Summary: With Lieberman holding up the Senate healthcare bill, Democrats need to explore their options looking forward to 2010.

Every liberal in the country following the ongoing healthcare debate is furious. Much of this anger is directed at one man in particular: Senator Joe Lieberman (I-CT).

After Senate Democrats met to reach a compromise bill that could pass the 60-vote threshold for cloture, they cut the public option and replaced it with a plan to allow 55-64-year-olds to opt-in to Medicare, and give the government power to negotiate non-profit plans with private insurance companies.

For Lieberman, that was not good enough. He continued to threaten a “no” vote on cloture, preventing a final up-or-down vote on the bill. The White House pushed Majority Leader Harry Reid (D-NV) to accommodate Lieberman’s concerns and cut the Medicare expansion provision.

Progressives, who have argued that reform without a public option is hardly reform at all, seemed to wake up to the threat Lieberman poses for passage of a bill. Headlines from the Huffington Post this week read along the lines of the Connecticut Senator holding healthcare hostage.

To be sure, the fight over healthcare reform on the part of political activists is still heavy on the conservative end, but as this recent Politico video demonstrates, neither side of the debate is happy with Lieberman.



What other developments have come out of Lieberman’s stubbornness?

• Liberals are becoming as likely to oppose the Senate bill as conservatives. Former DNC Chairman - and a big advocate of healthcare reform - Howard Dean, M.D. told MSNBC last night that “you can’t vote for this bill in good conscience.” The video below includes Dean’s interview, as well as a lot of insight towards how progressives are feeling right now.

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Now, not all liberals are going to necessarily agree. In a late-night post this morning, Nate Silver suggested that progressives were “[expletive] crazy to oppose the Senate bill.”

“I understand that most of the liberal skepticism over the Senate bill is well intentioned. But it has become way, way off the mark. Where do you think the $800 billion goes? It goes to low-income families just like these. Where do you think it comes from? We won't know for sure until the Senate and House produce their conference bill, but it comes substantially from corporations and high-income earners, plus some efficiency gains.”

Silver argues that come 2016 (even after inflation) a family of four earning $54,000 per year will still pay significantly less for coverage.


His only mistake might be that the public option would, in fact, help hold down costs. The data he uses is from a CBO report that took the public option into account. Without the public option, premiums may rise a lot faster than 7.5% per year.

• Politico reports that Lieberman’s Connecticut colleagues are “fed up” with him. U.S. Rep. Rosa DeLauro (D-CT) even told the news service “No individual should hold health care hostage, including Joe Lieberman, and I’ll say it flat out, I think he ought to be recalled.”

• When asked if he would run as a Republican when his term ends in 2012, Lieberman told CNN it was “a possibility” and that “all options are open.”

• The House Democrats are becoming increasingly frustrated with the slow pace of the Senate. Some went so far as to say “Sometimes I get the feeling that some of those guys [in the Senate] just like to see their names in the paper and see their faces on TV,” and “If you just take a look at the number of bills we’ve sent to the Senate and what they’ve done, I don’t know what they’re doing with their time honestly.”

• Upset that one or two Senators could uphold an entire bill years-in-the-making - like Lieberman and Senator Ben Nelson (D-NE) have done with healthcare - Senator Tom Harkin (D-IA) recently announced that he was considering introducing a bill that would eliminate the Senate filibuster.

From the Omaha World-Herald:

"It really is an abuse," Harkin said. "It's an abuse of a person's position as a senator to demand, because we need one more vote, just to demand everything. It's really unfair to the rest of the Senate, rest of the caucus."

He said lots of senators, himself included, have to come to terms with disappointments in the health care bill.

"To sort of lay down an ultimatum, 'Well, it's got to be this or nothing and I'm walking away from it,' well that's not the way you do legislation," Harkin said. "If you want to be a legislator, maybe it's not the right place for a person to be that takes a position like that."

Harkin said he's not sure about the level of support among other senators for eliminating the filibuster. He noted that he proposed legislation to do so years ago.

But perhaps Joe Scarborough made the best point this morning on his MSNBC program, “Morning Joe”, where he said that passing a healthcare bill progressives were unhappy with would be worse for the party’s 2010 prospects than they realize. It would keep the base at home come election time in November.

We made a similar assertion a few weeks ago when we listed the Top 5 things Democrats needed to do in 2010:

“Make sure the base believes in you. Many moderate Democrats in Congress seem to think that the only way they can win a re-election is by opposing the current healthcare reform bills. But the surest way to be defeated is to fail on healthcare reform. The base believed in you in 2006 and 2008 because you said you would bring change - if you fail them with big margins in Congress and control of the White house they will not help your re-election campaign and they may stay home on Election Day. That would be the surest way for a Democrat to lose. If the base doesn’t show up, you’re finished. If you’re running for re-election, you must fulfill at least some of your basic promises to your supporters.”

Democrats do have some leverage over Lieberman that they still seem reluctant to use: his chairmanship of the Senate Homeland Security Committee. Threatening to strip him of that role if he filibusters a favorable healthcare bill is the only way Senate Democrats can expect to pass a bill and keep the base happy.

In fact, most Americans agree with this course of action. A recent Research 2000 poll found that a plurality of Americans (by a 47%-32% margin) support this punishment. More importantly, 81% of the Democratic base agrees.

The healthcare debate is sure to shape the outcomes of the 2010 midterm elections. The Tea Parties have been strong and they may drive some key GOP victories. But Democrats need to be equally concerned about alienating their own supporters. 2010 will be a backlash year for Democrats, but fail on healthcare reform and the hardest backlash will come from the progressive base.

Editorial: Have We All Flip-Flopped on the Healthcare Debate?

Last week, I wrote the following op-ed piece for my newspaper:

In one of last year's presidential debates, then-Senator Barack Obama was asked if health care was a privilege, a right, or a responsibility. He promptly answered "a right." As a liberal, I was glad to see him take that position. My conservative father sitting next to me was disgusted.

One year later, the nation is in the midst of a contentious health-care debate. It hasn't just been an intellectual discussion on how to manage the country's health-care resources, but rather the typical back-and-forth of political rhetoric. I should know, I frequently work on the sort of message development that we've seen in the current health-care debate. Yet, once we scratch the surface of this debate, it appears that both liberals and conservatives have flip-flopped in their principles.

There's no better place to start than with the classic Republican message: "A Washington bureaucrat should not get between you and your doctor." That message implies two things.

First, it suggests that patients would not have a choice of their doctors if a public option were introduced. That's nonsense. I have never heard of a health-care system in which public bureaucrats decide which doctors you can see - including the single-payer system in Canada and the National Health Service - true socialized medicine - in the United Kingdom.

The other implication of the message - which I intend to focus on - is that a bureaucrat can deny a certain health-care procedure or medicine that you and your doctor have decided is right for you. This is especially important because "deny" and "denial" are huge buzzwords in the GOP's rhetoric. The reason is simple enough: Those words scare people.

The idea that you can be denied certain procedures now has the right screaming "rationing!" The left has quickly argued back, saying, "health insurance companies already ration care" so why would a public option be any different?

In fact, rationing only makes economic sense. All resources are limited - including those in health care - and whether you have private or public insurance, it simply cannot cover everything. This may be a hyperbolic example, but even if you're terminally ill, you cannot expect America to spend its entire GDP in order to save your life.

But wait - then aren't we liberals justifying the actions of the dreaded health insurance industry? Are we actually saying we will model a public option the same way? Aren't we putting a price on human life? The answer appears to be "yes." Meanwhile, conservatives - who evidently oppose rationing in general - appear to be arguing that, regardless of costs, health care is a right! Both sides have swapped principles.

All this being said, I believe it is possible for progressive principles to be reconciled with pragmatism. Principles are impossible to implement without pragmatism, but they are still critical when it comes to improving public policy.

In order to achieve health-care reform, we Democrats need to get our principles back on track by reaffirming our basic beliefs and then by adding conditional reasoning.

The principle can be, "You have a right to coverage for basic health services" including doctor visits, pharmaceuticals and certain procedures. The cost-benefit analysis used in all economic decision-making will still be done by patients, doctors and bureaucrats - now both private and public.

How can Republicans reconcile with pragmatism and get their principles back on track? That I don't know - you'll have to ask my father.

Top Stories: 10/12/09

The Wall Street Journal reports that House Speaker Nancy Pelosi (D-CA) will be the "key" to the GOP's 2010 strategy.

Politico, meanwhile, reports that the Tea Party activists may not be so helpful for the Republican Party.

A blogger for the Washington Post comments on Rush Limbaugh's bid for the St. Louis Rams.

Nate Silver explains the reasons behind the health insurance industry's efforts to block healthcare reform.

The Huffington Post is currently holding a vote on the biggest political "game-changers" that have come from the online revolution.

And here are this weekends late night political jokes:

Who’s Smarter - Democrats or Republicans?

Summary: Results that break along partisan lines beg the question: Who's smarter - Democrats or Republicans? You must read to find out!

Okay, that’s a loaded question. Back in March we asked “Who Leads Healthier Lives - Democrats or Republicans?” but with that we could actually back up our claims with statistics.

Ultimately, we said:

“the most realistic conclusion to make is that political ideology has little-to-no bearing on the well-being of an individual. A more obvious trend is healthiness by region - those living in the Western states tend to be particularly healthy while those living in the Rust Belt and Appalachia are among the unhealthiest of Americans.”

When it comes to brain health - however - we see some very obvious partisan lines.

A new study on brain health by state finds that “blue states” were healthier than the “red states.” Although the study did not focus on politics at all, it was not difficult to put two-and-two together.

According to this “Index of Brain Health” the top ten “brainiest” states in the country (including the District of Columbia) are as follows:

1) Washington, D.C.
2) Maryland
3) Washington state
4) Vermont
5) Connecticut
6) Colorado
7) Massachusetts
8) New Jersey
9) Maine
10) New Hampshire

With the exception of Colorado - a swing state - all of the top ten are solid Democratic-supporting states.

Conversely, these are the bottom ten “brainiest” states:

42) Indiana
43) North Dakota
44) South Carolina
45) Arkansas
46) Kentucky
47) Tennessee
48) Mississippi
49) Alabama
50) Oklahoma
51) Louisiana

With the exception of Indiana, all of these states went for Sen. John McCain in last year’s presidential election, and all ten are considered fairly reliable for Republicans.

For those Republicans who are undoubtedly upset with this so far, let me reassure you that this isn’t all about “intelligence.” U.S. News & World Report explains the study:

Diet represented 36 percent of each state's score. Of several factors used to calculate the brain-healthfulness of the foods each state eats, sales of fish and DHA-fortified foods were weighed most heavily; they made up 10 percent and 12 percent, respectively, of the diet score. Measures of the population's physical health accounted for 25 percent of each state's overall score; mental health accounted for 24 percent; and social well-being 15 percent. In all, 21 measures went into calculating each score. The creators of the index examined existing data on these metrics for all the states and the District of Columbia. The data came from agencies such as the Centers for Disease Control and Prevention, the National Institutes of Health, and the Bureau of Labor Statistics.

You don't have to be a genius to understand why the index, dubbed the "life's DHA Index of Brain Health," was based partly on DHA consumption. Its developer and sponsor, Martek Biosciences Corp., produces dietary supplements and products rich in DHA omega-3 fatty acids, including the life's DHA brand. Studies suggest omega-3s can be important to healthy brain development.

"Our goal was to draw attention to the fact that your brain health isn't solely genetic—that you get to modify it," says Michael Roizen, a doctor of internal medicine and anesthesiology, author and adviser for the index.

The District of Columbia was at the top of the pack, thanks to the high amounts of fish and DHA omega-3-fortified foods and supplements consumed there, the quantity of fruits and vegetables its residents eat and the fact that many of the capital's residents are bookworms. (Interestingly, Alaska tied with D.C. in the rate at which residents read for personal interest.)

Also receiving high marks were Connecticut (ranked fifth brainiest overall), thanks in part to the quality of its education system; Massachusetts (ranked seventh), for its high rates of health insurance coverage; and New Jersey (ranked eighth), for having one of the lowest rates of psychological distress in the nation…

…"The results show that the majority of the top-10-ranked states border or are near the Atlantic or Pacific oceans," says Michael Roizen, author and adviser to the Martek index. "One hypothesis is the accessibility of fish with its healthy fats and protein."

Louisiana, the "least brainy" state, tied with Mississippi and Utah for the highest rate of involvement in religious and spiritual activities—something Martek considers a positive indicator for brain health. That measure determined 5 percent of each state's total brain health score. In addition to its low sales of fish and DHA-fortified foods, and moderately low fruit and vegetable consumption rates, the Bayou State, along with Kentucky, has the lowest breast-feeding rate in the nation. Breast-feeding naturally provides DHA omega-3, which Martek's report on the index cites as "important for brain development of infants."

At the time we simulated a possible correlation between a state’s politics and the health of its residents, we found that it wasn’t too likely that one had much to do with the other. Somehow, I doubt that this study was much more than an outlier to that conclusion. As we said at the time, though, “finding correlations between party-affiliation and things like healthiness are very interesting, and we hope to see more studies and discussions like this in the future.”

Despite the fact that these correlations still seem a bit dubious, it was indeed very interesting and we’re glad we found it.

What was Behind the Scenes of the Town Hall Protests?

Summary: Who is behind the disruptive Town Hall Protests and what should Health Care Reform proponents watch out for?

I happened to pick up a copy of the latest edition of Rolling Stone this morning, and read a very in-depth political article by Tim Dickinson.

The article, entitled “The Lie Machine” expands on the inside story of August’s town hall protests that we started following over a month and a half ago.


Now, bear in mind that Rolling Stone is notoriously liberal, and the language they use may be more forceful than most media outlets would make it. However, I thought it would be good to relay you some parts of the article today.

From the section “Writing the Script”:

The campaign to mobilize the town-hall mobs began with a script written by the right’s foremost fear-monger, Frank Luntz. Luntz rose to fame in 1994 as pollster for Newt Gingrich’s Contract with America, and crafted the Republican playbook on global warming. In a May memo, Luntz outlined a battle plan for conservatives to block what he branded the “Washington takeover” of health care - the most terrifying buzz words conjured up in his polls and focus groups.

The logic of the language is simple, Luntz writes: “Takeovers are like coups - they both lead to dictators and a loss of freedom.” For a third of Americans, he adds, the top worry about health care reform is “being denied a procedure or medication because a Washington bureaucrat says no.” Luntz concludes by telling Republicans how best to play the fear card. “It is essential that ‘deny’ and ‘denial’ enter the conservative lexicon immediately,” he writes, “because it is at the core of what scares Americans most about a government takeover of health care.”

Distributed widely to Republicans on Capitol Hill, the memo framed the right-wing attack on health care reform. What Luntz describes as “the best anti-Democrat message” is now familiar to everyone in America: “No Washington bureaucrat should stand between your family and your doctor…The Democrats want to put Washington politicians in charge of YOUR health care.”

Here is part of the next section, “Assembling the Team”:

Americans for Prosperity, which has taken the lead in the current fight against reform, is a front group for oil billionaires David and Charles Koch, co-owners of the world’s largest private oil and gas conglomerate. The Kochs, who provide much of AFP’s budget, have a strange affinity for mock uprisings: Matt Schlapp, one of the original “Brooks Brothers rioters” - the GOP activists who disrupted the Bush-Gore recount in Miami-Dade County - now serves as director of federal affairs for Koch Industries, orchestrating the firm’s political efforts in Washington.

To head Americans for Prosperity, the brothers tapped Tim Phillips, one of the Republican Party’s most notorious dirty tricksters. Phillips served as a strategic consultant to George W. Bush in 2000 and reputedly took part in the smear campaign in South Carolina that portrayed John McCain’s adopted daughter as his mulatto love child. That same year, Phillips was linked to a nearly identical smear campaign in Virginia that portrayed the primary opponent of Rep. Eric Cantor - a Jew - as the “only Christian in the contest.” Under Phillips, AFP became a driving force behind the Tea Party protests against Obama’s economic stimulus plan, and the group organized the Austin mob that attacked Rep. [Lloyd] Doggett. Boosted by the mobilizing effort, AFP now boasts 700,000 members and chapters in 24 states.

Dickinson continues the article - loaded with evidence from memos he has been able to collect - explaining how the team then executed the plan to mobilize the protests, and how they collaborated with Republican leaders in Congress.

It is certainly worth a read.

Top Stories: 9/22/09

Actually, it's more like "top videos" today...

President Obama appeared on Late Night with David Letterman last night:


Watch CBS Videos Online

Funny or Die has a new video about the woes of the health insurance industry:

Protect Insurance Companies PSA from Will Ferrell

Former House Majority Leader Tom Delay - following his involvement in the Jack Abramoff scandal - made his debut on Dancing with the Stars last night:



And a friend of mine sent me this video recently. What's interesting about it is how well Obama and McCain seem to stay on message. It's funny because they're actually doing everything right.

Top Stories: 9/11/09

Eight years have passed since the terrorist attacks of 9/11/01. Below is a live feed of the ceremonies marking this day:

Visit msnbc.com for Breaking News, World News, and News about the Economy

The DCCC says that Rob Miller - Rep. Joe "the Heckler" Wilson's (R-SC) challenger - has now raised over $750,000 since the incumbent's outburst Wednesday night, according to Politico.

Politico has also launched a new page: "CLICK" - filled with all sorts of DC gossip and fun political stories.

Treasury Secretary Tim Geithner says that unemployment will "absolutely" be down one year from today.

Gov. Tim Pawlenty (R-MN) says that the 10th Amendment could be used in a constitutional argument against healthcare reform.

Nate Silver at FiveThirtyEight.com explores what effect President Obama's speech will actually have on public opinion regarding healthcare.

And Letterman gives Rep. Wilson's top ten excuses for disrupting the speech:

Top Stories: 9/10/09

Nobody can stop talking about President Obama's speech last night. Here it is in case you missed it:

Visit msnbc.com for Breaking News, World News, and News about the Economy

Politico has a humorous take on "what he meant" at certain points in the speech.

The Huffington Post looks at all the outbursts during the speech - it wasn't just Rep. Joe Wilson (R-SC) that made a scene.

And FiveThirtyEight.com's Nate Silver and Tom Schaller live-blogged the address. You can read their final thoughts here.

To read the full transcript of the speech, click here.

Healthcare, Congress, and the Midterm Elections

Early last month, we asked “Will Healthcare Reform Survive the Tea-Baggers in August?” Well, now it appears that it all depends on your definition of “reform”.


For many progressives, reform is dependent on the creation of a public option as an absolute minimum. Ideally, many of them would prefer a single-payer system or even a national healthcare service. For others, reform is possible without a public option - even if they do agree with a public option, they still see the value in other reform measures, such as an end to pre-existing conditions.

In fact, Marc Ambinder recently wrote a very interesting piece in the Atlantic that Democrats have actually held together and healthcare reform will survive - even if it’s without the public option.

"After August, under the worst case scenario, there is majority support for the following major changes to health care: real (albeit limited) competition in the insurance industry (even absent a public plan). A cap on what a person pays for catastrophic illnesses. An end to insurance company recision policies. Guaranteed issue. A basic benefit package. Significant subsidies to help people who earn as much as $64,000 a year pay for health insurance. Better cost and coverage incentives. And lots more. Say what you will about these reforms -- maybe they're incremental -- but they're a foundation for center-left policy in the future."

But now some are wondering if the rowdy August recess and the Town Hall protesters have had some other meaningful impact: namely, putting members of Congress at risk in next year’s midterm elections.

From Gallup:



But will the healthcare debate sink Congress?

First, let’s take a look at Gallup’s most recent Congressional approval polls. While still low at 31%, it’s a bit of a boost since last year, when Congressional approval was at just 19%.


And most of that boost has come from Democrats (and a plurality of Americans identify as Democrats).


So while approval is still low, it does appear to be considerably better than it used to be for members of Congress.

Next we turn to our friends at FiveThirtyEight.com where Joshua Grossman points to recent special elections in California and Iowa as evidence that Democrats - who control both chambers in Congress - are still “alive and kicking”.

"It’s certainly possible that Obama will antagonize the Democratic base by not advocating strongly enough for a public option in his health care proposals. It’s also possible that the drum beat of Republican attacks on everything associated with Obama and the Democrats will continue to drive down Democratic support among Independents. The pendulum tends to swing over time. But for now – looking at actual elections, not polls which can be spun any which way – there’s no hard empirical evidence of significant changes in the electorate’s behavior since November of 2008."

538’s chief blogger, Nate Silver, would likely agree. As we posted earlier, he recently used a model to find that a majority of Congressional districts probably approve of healthcare reform - and healthcare reform with a public option!


He even lists each member of Congress and how much their district probably supports or opposes the public option.

Yet Tom Schaller would probably disagree. He relays an analysis from the Cook Political Report which compares the 2010 midterms to the 1994 Republican Revolution. While most of the Cook report has to do with ethnic makeup of the electorate (white voters make up a considerably higher percentage of the turnout in midterms) there is some evidence that particular issues will play a significant role.

From the report:

"In 1994, it wasn't easy to be a Bush-district Democrat who voted for both the Clinton budget and the Brady handgun bill. In fact, out of the 12 Democrats who fit this description and ran for reelection, two thirds lost. So far this year, 20 of the 49 McCain-district Democrats have already voted for the "cap and trade" bill. If the House Democratic leadership insists on putting a health care bill with a public option to a vote, how many of these 20 can be relied upon to take on more political risk?

On the other hand, the lessons of 1994 might serve as a reality check for GOP challengers to Democrats who plan to vote against their party's leadership on both of this year's dominant agenda items, such as Reps. Bobby Bright (AL-02), Parker Griffith (AL-05), and Chet Edwards (TX-17). In districts with challenging numbers, the strategy of voting (and running) against party leadership has persisted for generations, if sometimes for only one reason. It works."

Schaller even points out that this may be why the Blue Dogs have been so reluctant to support a public option - despite Silver’s claims that it might actually help many of them.

Ultimately, though, it seems far fetched to say that healthcare reform will be the single biggest issue in next year’s elections. Most Congressional elections come down to the on-the-ground circumstances of competitive (typically open-seat) races and rather than a particular national issue. Voters might say that healthcare reform will be a major issue in their decision now - after all, now is the time that healthcare is a big issue - but voters tend to forget a lot in 14 months.

Furthermore, Congressional approval is usually pretty low, but incumbent members of Congress never seem to lose their seats. Americans hate Congress, but love their Congressmen.

Still, this isn’t the first time we’ve seen the 2010 midterms have been compared to 1994. In the end, there’s probably no good way to say - at this point - what impact the healthcare debate will have on the voters in November next year.

Top Stories: 9/9/09

Most of the top stories on the web this morning surround the speech President Obama will deliever before Congress tonight on healthcare.

David Herszenhorn tells us what to watch for in the speech for a New York Times blog.

Politico discusses the Republican rebuttal that's already in the works.

Nate Silver at FiveThirtyEight.com explains why many Blue Dogs probably represent pro-public-option districts, even if they don't realize it.

And the Huffington Post is taking a reader-poll asking who your favorite SNL president has been so far. It's also complete with videos like this classic:

Top Stories: 8/25/09

Conservatives now want to protect government-run healthcare, according to a new GOP manifesto aimed to "protect Medicare and not cut it in the name of health-care reform."

Despite that flip-flop, Lincoln Mitchell tells the Huffington Post in an interesting editorial that "if the Democrats do not pass a meaningful health care bill, with a public option it will be hard to answer the question of what the purpose of the Democratic Party is."

Nate Silver from FiveThirtyEight.com tells pollsters how they should be surveying public opinion on healthcare reform.

Meanwhile, progressive groups are striking back on the GOP in defense of cap-and-trade. They are targeting five Republican members of Congress with TV ads arguing that their votes prevented green job growth.

Editorial: Why Aren’t We Winning On Healthcare Reform?

Dave at WAYLA ponders why Democrats have been losing the healthcare debate. Please note that these views do not necessarily represent the opinions of others at WAYLA. Possible rebuttals to this post to come.

As it was mentioned last week, healthcare has long been a winning issue for Democrats. Americans are rightfully dissatisfied with their healthcare system and they’ve long (and still) trusted Democrats to come up with solutions.

A recent Gallup poll indicates that as the economy is improving - or at least falling among the issues Americans are concerned about - the healthcare issue is rapidly rising among the public’s concerns.


I think it’s prudent to say most Americans aren’t falling for the claims coming from conservative pundits that the United States has the best healthcare system in the world.

Except over the past month support for reform seems to have declined. Confusion over whether or not to support a reform bill has risen 17% since July - most of that coming from people that once supported reform - and now the firm pro-reformers and anti-reformers are neck-and-neck in the polls.

How is that possible?

Political consultant Peter Daou wrote for the Huffington Post yesterday, and has some interesting insight as to why the conservative view is building momentum:

“Setting aside strategic errors by the Democrats (and there have been several in this fight), just look at how reform opponents have outgunned the White House using town halls, cable news, newspaper editorials, Freepers, Drudge, talk radio and chain emails. If I close my eyes, I'm transported back to my days on the Kerry campaign and the summer of Swift Boats, Purple Heart Band-Aids and rightwing attack machine antics. It's as though a half decade of technological advances disappeared in the blink of an eye. Forget Facebook and Twitter, it's all about Fox and MSNBC and CNN replaying images of angry protesters at town hall meetings railing against 'government takeovers.' It's about Glenn Beck and Rush Limbaugh spreading fear and fury. It's about anonymous emails zipping across the country, distorting the facts and sowing confusion…

Paradoxically, the attempts by Democrats to counter all this by sending emails to Obama's list and creating campaign-style fact-checking websites seem almost quaint by comparison. When a woman at a town hall spoke about ‘awakening a sleeping giant,’ she may as well have been alluding to the old media tools and techniques that have been dismissed by pundits and tech evangelists as anachronistic in the Internet age. Simply put, despite volumes of cyber-ink about the left's online prowess, and despite Democrats controlling the White House and Congress, the right can apparently dominate the national conversation using the same outlets they relied on five and ten years ago.”

But we beat all that in 2008! Barack Obama managed to overcome email rumors, conservative pundit fear-mongering, and all the other right-wing old-media tactics! What’s so different now?

The difference is there isn’t an electoral campaign, and because of that, all the progressive activism that put Obama over the top has come to a stand-still.

Sure, Obama may be using all sorts of New Media techniques just like he did during the campaign, but it wasn’t New Media that won him that election - it was the energized volunteers who knocked on doors and made phone calls. These are the most effective ways to communicate with voters, and - as WAYLA has said time and time again - Obama’s campaign was able to contact a whopping 37% more voters than the McCain campaign.

So why aren’t Democrats going door-to-door to talk to their neighbors about the benefits of healthcare reform? After all, wouldn’t that be the best way to solidify public approval of such legislative action?

This is where I can’t help but wish that Howard Dean was still Chairman of the Democratic National Committee. Not only did he give the party’s activists energy, but he developed some of the most clever strategy imaginable.

While the GOP stayed vested in their 50%-plus-one (no exceptions) mindset, Dean pushed a 50-state strategy for his own party. In the short term it probably wasted resources on races where Democrats couldn’t win, but there was a long term goal behind it. By setting up races in every state, the Democratic Party could lay down the foundation for future success with campaign infrastructure and a network of donors and volunteers for future races. It was often criticized, but there’s evidence that it worked.

Yet the Dean brainchild that comes to mind most right now - however - is something that was called the Neighborhood Leadership Program. Neighborhood Leaders would go out into their community and identify Democrats who might want to get involved with the party. One of the benefits was it would give the Democrats a heads up in getting to know their neighbors and becoming friendly with them. It wasn’t just a campaign-year thing - it was a long-term program.

At the time I first learned about it, I must admit, it seemed fairly unnecessary. Why put volunteers through a year-round task of talking to neighbors about political issues? Now, I’m beginning to see the purpose.

When I looked at the DNC’s website today I couldn’t find anything about the Neighborhood Leadership Program. Then I visited my state party’s website, and could only find this page explaining that activists could call their members of Congress and go to town hall meetings. Just a year ago, I would have been able to sign up on either site as a Neighborhood Leader in a matter of seconds.

Evidently, that’s all changed. And now it appears that astroturf organizations are ready to not just kill healthcare reform, but climate change legislation as well. So far they’ve been getting away with it because there’s been an absence of progressive organizing.

So what happened?

Could it somehow be influenced by that old rivalry (driven by differences of opinion on strategy) between Dean and now-White House Chief of Staff Rahm Emanuel? Could it be that the current Chairman - Governor Tim Kaine (D-VA) - is too busy governing his state to successfully fill the shoes of his predecessor?

Could it be a lack of initiative on the part of Organizing for America? Many Democratic activists say that OFA - the remnants of the Obama campaign - isn’t actually organizing.

I keep hearing that Democrats are just too “burned-out” to make the sort of effort that conservatives are making right now. To some extent it makes sense: now that we’re in control, we’re not fighting the power like we used to - the Republicans are. But the more I think about it, the more I can’t help but believe that’s just a bad excuse.

We pointed out earlier this month that the GOP is proportionally more motivated than the Democratic Party. But guess what? There are more Democrats out there! In fact, there are about just as many energized Democrats in this country as there are energized Republicans at the moment.


In the end I just think it comes down to leadership. Ever since Dean left, there seems to be a real vacuum in the Democratic Party.

Barack Obama told us in his victory speech that the election itself was not the change everybody was seeking, just the opportunity for change. Yes, he won, but he told supporters to continue the work they were doing as volunteers for the campaign - to continue to organize for change.

I believe that progressives are ready to do so. They’ve wanted healthcare reform for so long, and they don’t want astroturfers to kill it. But it’s going to take a little organization on top before we can organize on the bottom. Otherwise the prospects for healthcare reform look pretty dismal.


UPDATE: OFA is having an online "strategy meeting" with President Obama Thursday, according to an email sent out today by former campaign manager David Plouffe. You can RSVP, submit a question, and maybe just find out what the strategy is for winning the healthcare debate.

Top Stories: 8/17/09

Politico examines the history of and reasons for the GOP recruiting football stars and coaches to run for office.

With all the new confusion about whether or not health care reform will include a public option, Nate Silver examines - in-depth - the chances of such a bill passing through the Senate.

Paul Krugman contrasts how healthcare reform in this country will look compared to the healthcare systems in other industrialized nations.

And the Huffington Post is starting to gather photos of the funniest town hall protest signs. So far they’re mostly coming from liberals who showed up to make fun of the anti-reform folks.

New Gallup Polls on the Healthcare Debate

Despite the fact that Americans don’t seem to be happy about much of anything these days, recent trends in the Gallup polls find that Americans are becoming increasingly confident in the outlook of the U.S. economy, and increasingly satisfied with the State of the Nation. In fact, these polls are reaching all-time highs for 2009.

43% of Americans now believe the economic outlook is good (with 50% believing it’s bad) - that’s a 25% improvement since the beginning of the year.


Meanwhile, 32% of Americans say they are satisfied with the state of the nation (with 65% saying they are not) - a roughly 17% improvement since the start of 2009.


Yet the issue of healthcare has become remarkably tricky to follow in terms of public opinion. This has become even more significant since the rabid town hall protests started at the end of last month.

Gallup finds that most Americans (69%) are following the disruptions at town hall meetings closely, with Republicans being the most engaged in news of protests (at 79%).

And while a plurality of Americans (36%) say that the protests haven’t made any difference towards their opinion of the healthcare issue, an incredible 34% say that the protests have made them “more sympathetic” to the conservative view.


Those views also came down along predictably partisan lines.


So far these findings appear to suggest that the anti-reform protests are working. But there is some evidence that they might be backfiring - they are only emboldening Democrats to push for reform.

The study finds that Democrats - who ended up feeling less sympathetic of the conservative view as a result of the protests - are the only group who say that the protests have been a greater factor on their opinions than their pre-existing views on healthcare.


What effect are these developments having on the healthcare debate?

No two polls are the same, so it’s difficult to compare the recent Gallup findings with others, but - at least at first glance - it appears that Americans are becoming more thoughtful about whether they support a specific bill.

A USA Today poll last month found that only 12% of Americans had couldn’t say whether or not they would support a healthcare reform bill passing by the end of 2009.

In another recent Gallup poll, 29% of Americans said they weren’t sure if they would advise their members of Congress to support a bill when they return from August recess.

Again, these results fell upon predictably partisan lines - Democrats saying “yes” and Republicans saying “no” to supporting reform.

And while a plurality of Americans (49%) disapproves of President Obama’s handling of the healthcare issue - with 43% approving - there has been no net change in approval-disapproval since before the town hall protests started.


What’s far more remarkable is that that while Americans are becoming more and more optimistic about the economy (as seen in the graph above) they are, paradoxically, supporting the president’s handling of the economy less and less.


It’s doubtful that in the coming months and years of the current administration, Obama’s approval rating on healthcare will be static and his approval on the economy will continue to dissipate while the economy simultaneously improves (as the majority of economists believe it will).

But this does demonstrate just how tricky it is to track public opinion and - for a prospective candidate or up-for-re-election politician - develop a campaign message while the nation seems so utterly confused with what it thinks.


UPDATE: An interesting comment we received for this post asks "How does shouting down to stop the conversation of the healthcare debate at town hall meetings endear them to anyone?"

We should point out that according to one of the Gallup polls Americans have differing opinions about different tactics coming from these conservative activists - except they generally think that "shouting down" those who disagree with them is an "abuse of democracy."