“A few timid people, who fear progress, will try to give you new and strange names for what we are doing. Sometimes they will call it “Fascism”, sometimes “Communism”, sometimes “Regimentation”, sometimes “Socialism”. But, in so doing, they are trying to make very complex and theoretical something that is really very simple and very practical.” Franklin Roosevelt, on Social Security, June 28, 1934

The White House is feeling the pushback from the Left over talk of dropping the health care public option, and Michael D. Shear and Ceci Connolly report for the Washington Post that the White House is surprised.

“I don’t understand why the left of the left has decided that this is their Waterloo,” said a senior White House adviser, who spoke on the condition of anonymity. “We’ve gotten to this point where health care on the left is determined by the breadth of the public option. I don’t understand how that has become the measure of whether what we achieve is health-care reform.”

“It’s a mystifying thing,” he added. “We’re forgetting why we are in this.”

Another top aide expressed chagrin that a single element in the president’s sprawling health-care initiative has become a litmus test for whether the administration is serious about the issue.

“It took on a life of its own,” he said.

I don’t know that I can speak for anyone else, but for me, a plan that creates a big, national risk pool; that doesn’t have to make a profit; that can streamline administrative costs; and which cannot refuse applicants for any reason, is the one part of the bill that holds out real hope of meaningful change. By itself it won’t do enough to cut costs or expand health care delivery, but it would bring immediate relief to millions of Americans.

WaPo‘s Steven Pearlstein argues that a good bill can be passed without the public option, and liberals ought to be willing to let it go. I respect Pearlstein’s opinions, but I fear “co ops” and “exchanges” will turn out to be mirages — programs that look like reform from a distance, and which sound great on paper, but which turn out to be useless for most people who need help. I’ve run into too many programs like that already, and I suspect most of you have as well.

Although I’d rather have single payer, I’d be happy with this: Everyone, younger and older, sick and healthy, in one risk pool. Easy applications. No preconditions to be met. Just say, hey, I need insurance. Where do I send the premium checks? And poof, you are insured. End of process. Simple and practical.

The more complicated it is,the more hoops citizens have to jump through to make it work for them, the bigger the cracks through which to fall. And when I hear “exchanges” and “co ops,” I hear “hoops to jump through.” Maybe I’m being stubborn. But the time has come to be stubborn.

The insurance co op idea was being floated as a possible alternative to the public option, and now the Republican leadership in Congress has rejected it. So, screw ’em. Why are we wasting any more time trying to please them? No matter what the Dems do, the Republicans are going to reject it.

Indeed, Carl Hulse and Jeff Zeleny report for the New York Times that Democrats now seem inclined to “go it alone.”

Steve Benen says,

This week, however, we seem to have reached the tipping point. A variety of GOP leaders explained that Dems could drop the public option altogether, and it wouldn’t make any difference. Sen. Chuck Grassley (R-Iowa), who’s become increasingly belligerent about the very idea of reform, said he’s prepared to vote against his own compromise bill. Senate Minority Whip Jon Kyl (R-Ariz.) announced that Republicans will reject reform no matter what’s in the bill.

Fine. Thanks for being honest. Now, get out of the way.

Amazing. At a conservative rally, local news stations were interviewing an Israeli man who was praising national health care in Israel. During his remarks, a woman yelled out, “Heil Hitler!”

The man stopped, became visibly upset, and exclaimed, “Did you hear this? She say to a Jew, ‘Heil Hitler’! Hear? I’m a Jew! You’re telling me, ‘Heil Hitler’? Shame of you!” After he angrily confronts her, the woman mocks him by making a crying sound to imply he is a whining baby.

Go watch the video.

You don’t have to be Freud to understand why some people, men in particular, feel inadequate unless they are packing. On the other hand, I suspect that people who bring loaded firearms to a presidential appearance are doing so to display aggression and hostility, not to commit a violent act. I assume that someone openly carrying a firearm is not planning to assassinate the President, but rather is using the firearm to make a symbolic statement.

A British journalist, Shaun Waterman, writes,

This is legal in New Hampshire apparently – the gun was registered and not concealed, and the man was on private property – and as the New York Times has noted, the two incidents in Portsmouth are not the only ones where firearms have turned up, legally or otherwise, in the hands of anti-health care reform protesters. All of which underscores a fact about the American right which bears repeating for a foreign observer: These people are armed.

Let’s be clear: No one is predicting the assassination of President Obama, or anyone else.

In the much-maligned and now withdrawn DHS intelligence assessment that warned earlier this year of the potential threat posed by resurgent right-wing extremists, there was no mention of assassination, and indeed the authors state that though “Rightwing extremists have capitalized on the election of the first African American president […] they have not yet turned to attack planning” of any kind.

And yet, when one considers the availability of firearms to protesters with an angry narrative of victimization, and the growing influence of a movement which glorifies violence against African-Americans, one can hardly avoid a sense of foreboding.

Of course, the “pro life” movement didn’t plan the assassination of George Tiller, either. They incited it, but they didn’t plan it. That makes them innocent, see.

Here are a couple of dueling headlines, both published August 13:

“Conservative Groups Dismiss Report on Rise of Militias” (Fox News)

“Extremist militias see resurgence under President Obama’s tenure” (New York Daily News)

They aren’t militias. They are concerned patriots with guns preparing to take the government into their own hands through force because they don’t respect the results of an election. Oh, and they love the Constitution.

Paul Harris, The Guardian:

Welcome to the disturbing new face of the radical right in America. Across the country, extremism is surging, inflamed by conservative talkshow hosts, encouraged by Republican leaders and propagating a series of wild conspiracy theories. Many fear it might end in tragedy.

Obama has been labelled as a threat to democracy and an anti-white racist by senior presenters on the TV channel Fox News. Republicans, seizing on the fierce debate over Obama’s plans to reform healthcare, have called him a socialist who plans “death panels” for the elderly. Rumours have circulated that Obama was not born in America and that he plans to ban firearms. Despite having no basis in fact, they have become widely believed. A recent poll in Virginia showed only 53% of voters believed Obama was born in the US. In neighbouring North Carolina, 54% of voters shared that opinion.

Such extremism is becoming a major security issue, prompting fears of an attack on Obama’s life or some other incident of domestic terrorism. “This is a very dangerous situation that can spin off ‘lone wolf’ individuals who decide now is the time to act against people they see as an enemy,” said Chip Berlet, author of a book on rightwing extremists.

I could go on and on. The syndrome is a racial-religious nationalism combined with a persecution complex, which you can find represented in various ways in many cultures. This syndrome is the cause of most, if not all, of the mass violence in the world today. You see it all over the Middle East. You see it in Sri Lanka. You see it wherever people have persuaded themselves that they are entitled to enforce their will through violence, because they have Right on their side, and the other side is Evil.

This is the most dangerous force in the world today, and the leadership of the Right is stoking it for all they’re worth.

The forces of civility already are bowing to the pressure of the mob. We might remember that people wearing anti-Bush T-shirts were not allowed to be within view of Dear Leader, whereas law enforcement can do very little about visibly angry people carrying loaded firearms in the streets.

Sadly, No:

Number of U.S. Presidents killed by firearms: 4
Number of U.S. Presidents killed by t-shirts: 0 (so far!)

But you know that if the Obama Administration tried to enforce the same rules against gun-toting righties that the Bushies enforced against T-shirt wearing lefties, it would give more fuel to those stoking the fire, and the “aggression” would get worse. So, yes, the situation is already out of control. People are either going to calm down on their own, or the aggression/hostility will escalate until somebody gets killed.

A number of news items came out over the weekend saying the public option was being excised from health care reform. This morning the White House is scrambling to reassure people this is not so.

However, the overall message is that while the Obama Administration wants the public option, the President would sign whatever Congress can pass, including a bill that does not include the public option. And there appears to be a strong movement within the Senate to kill the public option. Jacob Hacker explains why that would be more than a damn shame.

The New York Times‘s new pet conservative, Ross Douthat, seems to have noticed one of the massive inconsistencies in the fight from the Right against health care reform: By stoking the fear of senior citizens that their Medicare benefits will be cut, the GOP has placed itself in the role of defender of an entitlement.

Medicare’s price tag, if trends continue, will make a mockery of the idea of limited government. For conservatives, no fiscal cause is more important than curbing this exponential growth. And by fighting health care reform with tactics ripped from Democratic playbooks, and enlisting anxious seniors as foot soldiers, conservatives are setting themselves up to win the battle and lose the longer war.

The fact is, it’s the Right that wants to cut Grandma’s Medicare benefits, not the Left.

We’re already practically a gerontocracy: Americans over 50 cast over 40 percent of the votes in the 2008 elections, and half the votes in the ’06 midterms. As the population ages — by 2030, there will be more Americans over 65 than under 18 — the power of the elderly and nearly elderly may become almost absolute.

In this future, somebody will need to stand for the principle that Medicare can’t pay every bill and bless every procedure. Somebody will need to defend the younger generation’s promise (and its pocketbooks). Somebody will need to say “no” to retirees.

And I have no doubt the Right will do just that, as soon as they defeat health care reform.

It also needs to be said that while Medicare costs are rising, they are not rising nearly as fast as costs in the private health care sector. Inefficiency and excessive costs are only bad when they are found in government. If the private sector is bleeding you dry, you’re supposed to be thankful for capitalism.

Update: Nate Silver counts the Senate votes.

There’s a presentation of What’s Wrong With America in the Los Angeles Times today. There are feature stories on this week’s Remote Area Medical (RAM) health clinic in Inglewood, near Los Angeles, that shine a line on pain and medical neglect. Several of the physicians and dentists who volunteered to work at the one-week RAM fair also volunteer to work in Third World countries. And they said that what they were seeing in Inglewood was just as bad.

Steve Lopez, “At Free Clinic, Scenes From the Third World“:

Stan Brock, who founded RAM in 1985 to bring medical care to Third World countries, told me that in 1992 he began getting requests to do the same work in the United States.

“I don’t have the answers,” said [Dr. Mehrdad] Makhani, the dentist who insisted I look closely at his patient’s ailing mouth. “I’m not a politician. But I have people here with infected teeth, gums, abscesses. I saw a lady bus driver who lost her job and she’s walking around here crying. Her tooth is infected, she’s in pain and she can die from this. This is disastrous. This is a Third World country and people need to come and see this.”

“The people we’re seeing here have teeth as bad as the people in the Upper Amazon,” said Brock, who used to tangle with wild beasts on “Mutual of Omaha’s Wild Kingdom.”

One woman had lived with infected teeth for a year; she had no insurance because she had lost her job. She needed two extractions and a root canal. The dentist who took care of her, Joseph Chamberlain, also had done volunteer work in Brazil.

“They have a nice system of public hospitals and clinics,” he said.

But don’t patients have to wait for treatment?

“Yes,” Chamberlain said. “But not like this. Not for a year.”

I already mentioned the Tzu Chi Foundation, an international Buddhist charity headquartered in Taiwan. Tzu Chi does a lot of medical relief work in impoverished countries around the globe. And now it’s here. I can remember a time when it would have been unthinkable for an Asian charity to come to America to help the poor.

Eugene Taw, an ear, nose and throat specialist with the Buddhist Tzu Chi Free Clinic in Alhambra, was one of many Forum volunteers who has worked in other parts of the world. Yes, he said, there are far too many parallels between the uninsured in the United States and the residents of impoverished Third World nations.

At the Forum, his patients included a diabetic amputee who had not been able to buy his medicine for months, a retiree who couldn’t afford an X-ray for a lung problem, and a 30ish female diabetic with a kidney ailment so serious that Taw called for an ambulance to take her to a hospital.

Kimi Yoshimo, “How L.A.’s massive free clinic event came together“:

It’s pretty profound, the scale of it, the human stories,” Manelli said. “Those things don’t show up on a spreadsheet.”

In all, an estimated $500,000 in care has been provided daily to patients granted appointments on a first-come, first-served basis. Despite the pace, hundreds of uninsured and underinsured people have been turned away. Organizers lament that they could treat more if additional dentists and eye doctors showed up to volunteer in the clinic’s remaining few days.

One woman said she had received an abnormal pap smear result a year ago but was unable to get further medical attention. And then there is “The trumpeter who couldn’t play because he’s missing two teeth. The mother who camped overnight so her daughter could get glasses.” As one of the volunteer doctors said, these things don’t show up in a spreadsheet.

But it gets better. In this same newspaper, in the editorial section, there’s an op ed by Newt Gingrich warning America that if the Democratic plans for health care reform go through, we could have rationing.

Wow. Imagine.

The fear of government rationing is based on the premise that once government has such power, especially the ability to control what is covered by your private insurance policy, it also has the power to deny and restrict.

Those defending the House legislation claim rationing is not in any of its versions, and though that is technically true — no one wants rationing — the unprecedented power this legislation would grant to virtually unaccountable government agencies is all but certain to lead to rationing.

See, in a Free Country, the power to deny and restrict belongs to insurance companies, not the government.

I’ve got more to say, but I have to leave for a bit. I’ll get back to this later.

Brits are becoming increasingly alarmed and astonished at the lies being told about their National Health System. A sampling —

“Americans should put their own health care in order” (Mike Ponton, Wales Online).

“Britons rally to defend their healthcare system” (Henry Chu, Los Angeles Times).

“In the US, my credit card saved my life” (Mitch Glickstein, The Guardian).

[Update: “‘We were duped’: Two British women tricked into becoming stars of campaign to sabotage Obama’s healthcare reforms” (Daily Mail)]

We here are used to it, of course. Nothing positive happens in the U.S. without quickly being smothered by a fog of crazy. But I think the Brits are genuinely shocked. They hadn’t fully appreciated how crazy The Crazy gets here.

I was going to write a longer piece about the fog of crazy, but fortunately Rick Perlstein has a piece in tomorrow’s Washington Post called “In America, Crazy Is a Preexisting Condition” that pretty much says everything I was going to say.

Update: “Healthcare paranoia is part of America’s culture war” (Edward Luce, Financial Times)

One hears over and over that most Americans are happy with their health insurance and the health care they receive. I assume that is true. Righties hold this up as proof that most Americans don’t want to change the system. Polls say that is not true, or at least it wasn’t true before the “death panel” rumors got started. But I want to look at the fallacy behind the assumption that if most Americans are happy the system doesn’t need changing.

Our health care system is something like an old and slowly sinking cruise ship. Passengers on board the ship are having a reasonably enjoyable time. The food and entertainment are pretty good, and everyone still gets clean towels every day. However, in order to keep the ship afloat, from time to time the crew cancels the tickets of a few passengers and tosses them overboard.

At first most of the passengers were not aware this was happening. Or, if it was happening, passengers rationalized that the people tossed overboard must have done something to deserve it. But now enough people have been tossed overboard that most passengers were at least acquainted with one of the tossed, and knew he or she was not a bad person. Further, it is dawning on many that the selection process is random and could fall on anyone at any time, not just those in the cheapest cabins.

Meanwhile, slowly and imperceptibly, the ship continues to sink. The passenger-tossing strategy is just postponing the eventual drowning of everyone on board. So even though the cruise is pretty sweet for those remaining on the ship, there is a growing sentiment that there ought to be another way to keep the ship afloat.

Then the ship’s management announces that maybe there’s another way to keep the ship afloat, but it would require a lot of money to make repairs. Management promises it will only collect money from wealthy first-class passengers and will make up the rest of the difference by budget tightening.

The ship’s passengers divide into two factions. One faction wants to leave well enough alone. They refuse to accept that they might find themselves heaved overboard. They believe the cruise ship company will want more money from all the passengers, not just the wealthy ones, and they don’t see why they should pay more money to fund someone else’s cruise. They also deny that the ship is really sinking, even though all kinds of data have been collected showing that it is.

Passengers in the other faction are not just afraid of being thrown overboard. They also reason that expensive repairs are going to have to be made anyway, because the cruise is not sustainable. If nothing at all is done, eventually the ship will entirely flood with water and disappear into the sea.

The ship also has old and inefficient engines and other systems that make it more expensive to operate than most other cruise ships. If the repairs are done right, the ship could become more cost efficient to operate, and at some point in the future the repairs might actually pay for themselves. However, the longer the repairs are postponed, the more expensive the eventual repairs will be.

The anti-repair faction fights back by spreading rumors that the budget tightening will require passengers to be tossed overboard. The fact that this is happening anyway doesn’t register with these people. Soon they have the whole ship in an uproar, and leaders of the pro-repair faction begin to get death threats and find hate messages spray-painted on their cabin doors.

And there we leave the story, because we don’t yet know how it will turn out.

This is not a perfect analogy. To make it closer to reality we’d have to have vendors who are making a lot of money running the ship as it is begin the rumors to stop the repairs. We’d also have some anti-repair people coming up with nonsensical plans for saving the ship without repairing it. The plans amount to tossing people overboard, but they hide that part of the plan with lots of clever rhetoric.

And, of course, when the ship really sinks those wealthy enough to call for private rescue will transfer to one of the “socialist” ships.

If I had to guess how the story will turn out, it would be that a compromise is reached that amounts to patching the ship with chewing gum and duct tape, and passenger tossing will continue but at a somewhat slower rate for the immediate future. In a few months everyone will realize that nothing was really settled. Both factions will blame the other for the failure to find a solution, and the fight will resume.

Go ahead and discuss, if you are watching. I’ve got the television on, but Miss Lucy wants me to change the litter box first.

Update: I could have done without all the flapping about what a great guy Max Baucus is, but so far the presentation isn’t bad. On to the Q and A.

Why do we need a “uniquely American” health care system? That’s what we have now.

So far he’s not talking about the public option.

Well, it went OK, I thought. Nothing startling.