The hour-by-hour drama of the Democrats’ attempt to secure 60 votes in the Senate to advance their health care agenda is gripping the nation. Is Joseph Lieberman (I-CT) in? Or is he out? And what about Ben Nelson (D-NE)? While Lieberman is rightly accused of flip-flopping on the issue of the Medicare buy-in, the Harry Reid-led majority is even more unprincipled in its shameless willingness to discard what many consider the heart and substance of the bill to appease one senator. We don’t yet know if Lieberman pulled a Mary Landrieu (D-LA), who took a $300 million payoff being called the Louisiana Purchase to sign on. In her case it was for extra Medicaid funds for her home state. The mainstream media have largely been pushing this process as some kind of moral imperative for the country, and abandoned their role as impartial providers of information.

At this point, the battle is between Democrats who hate this bill and the process, but believe they need to pass something, anything, and those who now oppose it on principle and who feel it is so watered down, compromised, and beneficial to insurance companies that it is too distasteful to support in any way. And there are a few, like Lieberman and Ben Nelson, and maybe Jim Webb of Virginia and Blanche Lincoln of Arkansas who don’t like certain provisions, or the whole idea of national health care, or are concerned about their chances of re-election if they support it. What is holding this coalition together so that the 60 votes are in sight, though not yet assured, are 1) the attempt to save President Obama and the party from a crushing defeat; and 2) the creation of the framework of national health care, which could and would be over the coming years amended, tweaked, redefined, expanded beyond all recognition from the bill; and 3) raw, power politics, including carrots (worth up to $300 million) and sticks, which would only be administered behind closed doors.

Howard Dean, former Democratic National Committee chairman, announced this week that he had finally had enough. He says pull the plug and start again. On MSNBC, after Sen. Harry Reid (D-NV) agreed to pull the Medicare option from the bill, Dean, who doesn’t have a vote, weighed in. As a doctor and the spiritual leader of the “progressives,” his opinion might carry enough weight to sink the legislation for this term. Howard Fineman of Newsweek, honorary member of the lobbying firm of Olbermann, Matthews, Maddow and Schulz (the evening line-up of MSNBC shows), who nightly (at least up until this week) have attempted to shame, cajole, ridicule, kick and scream this legislation across the finish line, followed Dean on Countdown (normally hosted by Keith Olbermann, but this night by former Democratic staffer and MSNBC analyst Lawrence O’Donnell). In between Dean and Fineman was Sen. Ron Wyden (D-OR), who disagreed with Dean, and basically admitted that there is no compromise too far that would cause him to vote against this legislation.

Fineman reported that Obama told the senators, during an approximately one-hour meeting with them on Tuesday, that if they don’t pass this bill, it will weaken him, and he won’t be able to be effective for them next year come election time.

This is where Obama’s sinking poll numbers come in. He has dropped farther and faster than any first year president in history, according to various polls. And the public has turned against this health care process, and his handling of it. In the RealClearPolitics average of polls, the plan is opposed by nearly 14% more than those who favor it – 37.9% favor it, 51.6% oppose it. Obama’s job approval has fallen below 50% in the RCP average of polls, marking one of the steepest first year declines of any president. The Democrat-controlled Congress, meanwhile, in a new NBC-Wall Street Journal Poll shows 22% approval, and 68% disapproval. And these polls are skewed to begin with. This same poll shows that Obama’s approval is 47%, compared to 61% in April, and his disapproval is 46%. But if you look further down, it shows that of the people surveyed for this poll 40% identify themselves as Democrats, whether strongly, or leaning, or not so strongly, and only 34% identify themselves as Republicans, in the same three categories. So this six percent margin creates a built-in bias, which is found in many polls. By the way, a Rasmussen poll shows Obama’s approval rating at 44% versus a disapproval rating of 54%.

Sen. Evan Bayh (D-IN), one of the few moderates left in the Democratic Party, said they are being asked to vote for a bill that they haven’t seen. Even the number two man in the party, Sen. Majority Whip Dick Durbin (D-IL), told Sen. John McCain (R-AZ) that he doesn’t know what’s in the bill.

The Congressional Budget Office has surprised observers, who expected it to have scored the current bill by earlier this week. But in the meantime, the Department of Health and Human Services, the primary agency if this legislation becomes law, has already spoken. And it should be the final nail in the coffin. From an editorial in Investor’s Business Daily: “The administration’s own health department, in a devastating analysis, warns of rising costs, shrinking benefits and a long-term health care ‘death spiral.’ ‘Reform’ has been pronounced dead. It is referring to a report from the chief actuary of the Department of Health and Human Services’ Centers for Medicare and Medicaid Services that says health ‘reform’ will mean the opposite of its advertised promises.

“Reform was supposed to be about reducing ever-increasing costs. But HHS says that under the bill now being steamrolled through Congress, total health costs over the next decade (now estimated at $2.5 trillion) ‘would increase by about 0.7%’ over what would take place if we made no changes at all.

“And the plan to ‘save’ nearly $500 billion in Medicare costs that Democratic leaders ask us all not to worry about? The result would be cuts in services as providers and physicians who take Medicare patients ‘could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program (possibly jeopardizing access to care for beneficiaries).’”

Howard Dean said this on Countdown on MSNBC on December 15: “This is not real reform. It’s not health care reform. There are no choices. What the decision has been made without really thinking about it, it’s been made because people are exhausted and they want to pass a bill so desperately they’re not thinking about what they’re doing, it’s been made to commit the United States to health care reform through the private sector.” He said there are some good things in the bill, but that ultimately you have to buy from private insurance companies who will make big profits, or you will be fined, but that ultimately it is not health care reform.

He said the right thing for senators to do is vote no. “Absolutely not. You can’t vote for a bill like this in good conscience. It costs too much money, it isn’t health care reform, it’s not even insurance reform. Take for example, this, there’s a lot of talk about people who have pre-existing conditions can get health insurance. Well not exactly. The fine print in the Senate says the health care insurance industry gets to charge you three times as much if you’re older than if you’re younger. And they get to write the rules. This bill is no longer reform…If it were me, I don’t think this will happen, I’d kill the bill entirely and have the House start in reconciliation which is what they should have done in the first place.”

He then suggested that another option is that “they could pass the good stuff, pass the exchanges, pass the money for the prevention and wellness, pass the community health care center money in a small bill, don’t run our children into debt, and come back and do this two years later…We’re in crisis here. This bill I think is more likely to make the crisis worse than it is better because it’s so expensive.”

Later in the week, in a column for The Washington Post, Dean rightly pointed out that the process has resulted in “legislation that has been crafted to get votes, not to reform health care.”

And ABC’s George Stephanopolous, new to his position on Good Morning America, clearly indicated his support for Obama and the health care legislation by chiding Dean, warning him that his opposition to the bill could harm President Obama.

Howard Fineman noted the significance of Dean’s “defection.” He said it could have a “big effect,” and added that “the interview [that O'Donnell] just conducted with former governor Dean was remarkable, for a couple of reasons. First of all he’s a doctor. He’s got credibility on this. Second he’s been a reformer on this for years and knows it as well if not better than anybody as an issue. And third, he was chairman of the Democratic National Committee. Hello! That interview that you did could be cut in its entirety, and placed in a Republican ad attacking the process right now. I don’t know how much weight Howard Dean has nationally any more, but in terms of a weapon the Republicans can use I think he’s very useful. It was utterly fascinating to watch what just happened on the show.”

Fineman added that it was problematic for President Obama. He said the subtext of the meeting that day at the White House was that if they couldn’t pass this legislation, they’re going to be damaging Obama. “You know the economy is bad,” he said, paraphrasing Obama, “historical trends are against us in the midterm elections in 2010, but if we don’t pass this bill, I’m the one that’s going to look bad and that’s going to make me useless to you as a vehicle to try to help you guys next year and the period after that.”

Fineman added that his understanding is that Harry Reid is saying, behind closed doors, “We need to pass a bill. We can’t afford to damage our President further than he’s already been damaged. That’s kind of a back-handed way to argue the thing, but that’s what’s going on behind closed doors right now.”

Fineman insisted that between their tough choices, getting a bill, any bill, and selling what they consider to be the good parts of it, was by far the preferred choice for the Democrats. “The problem they’ve got,” he added, “in order to make the thing deficit neutral, they’ve had to kind of backload it so that the fees go in first, and some of these great benefits don’t kick in till later on. Some at the beginning, others later on.”

This is a debate that was taken up by Sen. Al Franken (D-MN) and Sen. John Thune (R-SD), over how much of the benefits are at the beginning and how much come later. David Freddoso of the Examiner reported on this confrontation, and concluded, based on the reporting of Phil Klein of The Spectator, that in fact “just $9 billion of the $848 billion total spending aimed at expanding coverage from 2010 to 2019 would occur in the first four years, while the remaining $839 billion wouldn’t come until the last six. In percentage terms, a whopping 1 percent of spending would occur from 2010 to 2014. This was one of the accounting gimmicks that Democrats used to make the legislation appear cheaper over their 10-year budget window.”

Lawrence O’Donnell pointed out that the bill is now “filled with taxes that were never mentioned in the Obama campaign, an individual mandate that Obama campaigned against.” Fineman said that all this is now “ancient history.”

Arianna Huffington of The Huffington Post was on the Ed Schultz show and basically agreed with Dean, that it was best at this point to defeat the current legislation. She said that Obama had “unequivocally caved in…and that’s not the kind of change we believe in…Let’s not pretend that we can just have any kind of bill passed and then declare it reform, the way we did with education…The White House is convinced that the minute it passes health care reform everything is going to change. The numbers are going to change. This is absolutely untrue.”

Schultz then said, referring to the White House, “Don’t insult our intelligence on this. That’s the whole deal that the White House has got to figure out on this. This is changes but it isn’t reform.”

Rep. Anthony Weiner (D-NY) said that he “had already compromised his compromise, and now I’m here being asked to compromise again.” He said that President Obama must be willing to get his hands dirty and that “we need the President to stand up for the values our party shares. We must stop letting the tail wag the dog of this debate.” We’re reaching that tipping point for a lot of us that we’re wondering if Howard Dean is right. That it might be better to go start fresh.”

Sally Pipes of the Pacific Research Institute had an excellent column in the New York Post, explaining the folly of calling this reform: “To address the public’s affordability concerns, the Senate would lavish billions in subsidies on people with incomes up to four times the poverty level, or $88,000 for a family of four. Senate leaders hope these subsidies will keep people from noticing that the reform package has increased the cost of their insurance.

“Only in Washington could a measure that raises the price of insurance, requires everyone to buy it and then papers over the whole mess by throwing more public money into the system be considered ‘reform.’”

As I pointed out in an article back in August, Obama doesn’t really care what is in this bill. Just that it passes both houses of Congress. The test of whether he made the right or wrong move by leaving the process to Congress, while he refused to commit to the public option, is still open. And if anyone was spreading fear and misinformation, it was Obama and his spokesmen. And that continues to this day.

More from Investor’s Business Daily: “Much of what the president said in his Tuesday statement was patently false. With its heavy regulations, the Senate bill, even stripped of its destructive ‘public option,’ won’t mean that ‘families will save on their premiums.’ Independent studies make it clear that premiums will go up by thousands of dollars.

“It also isn’t true that ‘this will be the largest deficit-reduction plan in over a decade’ – and to hear such a promise from the biggest-spending president in his first year in office in history is hard to take.

“The president claims ‘the CBO has said that this is a deficit reduction.’ But as Sen. Robert Bennett, R-Utah, who sits on both the appropriations and banking committees, recently told Fox News’ Neil Cavuto, the definition of ‘deficit-neutral’ that Democrats have been using ‘means it’s going to cost you over $1 trillion, and we are going to find $1 trillion either in Medicare cuts or increased taxes, so that we end up with the same number at the bottom line.’

“Speaking of the Congressional Budget Office, after candidate Obama last year promised a $2,500 annual reduction in health premiums annually for average families, the CBO has warned of premium increases of about $5,000 a year.”

On Wednesday, Obama told ABC News that if we don’t pass this legislation, the country will go bankrupt. This was too much even for Lawrence O’Donnell. He went from being the host the night before on Countdown with Keith Olbermann to being a guest on the night that Obama made that claim. O’Donnell accused the President of fear mongering. “The federal government is never going to go bankrupt,” he said. “We’re not going to let that happen. But this is the kind of scare tactic that the President seems to be resorting to at this point, trying to convince people that there’s something of extreme urgency. It must be done by Christmas eve.”

And Olbermann, in one of his rants that he calls special commentaries, turned on Obama and the legislation, seemingly influenced by Howard Dean’s arguments. While his logic was tortured as usual, and his venom flowing, Olbermann’s defection had to be an unwelcome development for the White House. This is, after all, where the left come every night to feel morally superior.

There has been some other very good reporting on the various aspects of this legislation, and all its implications. Two articles that came out several months ago should be viewed today, as the bill hangs in the balance. One is by Mark Steyn, who writes brilliantly for National Review. In a lengthy article from last July, called “Dependence Day,” Steyn looks beyond the economics of the bill, and gives his take on the history, political philosophy, statistics and politics of health care. Peter Robinson of the Hoover Institute, in his weekly column for Forbes, described Steyn’s article as “the most important journalism of the summer.” He says that Steyn’s conclusion is that “Obama doesn’t care about health. He cares about power.” Both of these are worth reading.

Another little discussed subject could ultimately be a death-blow to the legislation if enough of the public becomes aware of it. Byron York did an investigative piece for the Washington Examiner on the role of the Internal Revenue Service in the implementation in case this becomes law:

“Under the Democrats’ health care proposals, the already powerful – and already feared – IRS would wield even more power and extend its reach even farther into the lives of ordinary Americans, and the presidentially-appointed head of the new health care bureaucracy would have access to confidential IRS information about millions of individual taxpayers.

“In short, health care reform, as currently envisioned by Democratic leaders, would be built on the foundation of an expanded and more intrusive IRS.

“Under the various proposals now on the table, the IRS would become the main agency for determining who has an ‘acceptable’ health insurance plan; for finding and punishing those who don’t have such a plan; for subsidizing individual health insurance costs through the issuance of a tax credits; and for enforcing the rules on those who attempt to opt out, abuse, or game the system. A substantial portion of H.R. 3200, the House health care bill, is devoted to amending the Internal Revenue Code of 1986 in order to give the IRS the authority to perform these new duties.”

One final subject. Howard Dean, Rachel Maddow, Keith Olbermann and others keep bringing up reconciliation as the way to go. Wouldn’t it be better, they ask, if they only needed 51 votes to pass it instead of 60? With 60 votes required, the leadership is having to make all kinds of deals with wavering Democrats. But Ron Wyden pointed out why that won’t happen. “First of all,” he told Rachel Maddow, “with reconciliation, you can’t get any of the insurance reforms. Reconciliation deals with budget matters. So you can’t get the protection for folks from preexisting conditions. You can’t protect them from cancellations. You can’t even get the exchanges up and running.”

Others have pointed out that anything passed through reconciliation has to be revisited in five years, and that the powerful committee chairmen don’t like it because it bypasses their committees. The best and most detailed explanation I have found is by Keith Hennessey, a former White House economic advisor under George W. Bush, and a former congressional staffer:

“A reconciliation bill is a special type of bill. The full name is a ‘budget reconciliation’ bill. It’s purpose is to combine into one bill the work of multiple committees that are changing federal spending and tax laws…Senators, and the Senate as a whole, value highly preservation of the unlimited debate and amendment rights of individual Senators, and so they allow these rules to be bypassed only for a specific purpose.

“To oversimplify, you can use a reconciliation bill only to change spending, taxes, or the debt limit. The process was used initially to facilitate deficit reduction – various Senate committees are each given a deficit reduction target, and are ‘instructed’ by the budget resolution to produce bills that reduce the deficit by those amounts.”

We should know the fate of this bill very soon. If the Reid bill passes the Senate by Christmas, as they are determined to do, it could go straight to the House for approval, or more likely it will go to conference. And depending on what comes out of conference, it could still die in either the House or the Senate. Obama wants Democrats to understand that whatever shortcomings they may think the bill has, it will be “fixed” later in one of the many new bureaucracies that will be created to run it, or in follow-up legislation or amendments. The media, on all sides of this issue, are beating the drums as the parade marches on.

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