On health care, I have no idea what our basic guiding principle is. Seriously, I don’t.

We have tried ineffectively to stretch free market rhetoric to health care without appreciating that health care is already too far removed from a free market for the analogy to make sense. Real markets are sensitive to price. Health care isn’t. The insurance companies hide the cost of actual care from the consumer.

. . . A well-developed Republican health reform effort could have addressed the high cost of health care — actually the most glaring issue in our system — in a way that would have served as a kind of tax cut for the already insured. And in lowering costs, we could have covered the people who wanted health care but couldn’t afford it — the nub of the uninsured problem.

Ruffini concedes that Republicans “brought a knife to a gun fight,” but the metaphor actually misses the point Ruffini works so hard to make. Democrats laid the ground work for a policy debate, heaving sheaf upon sheaf of data, assessment, and conclusion upon the table. In their favor, in this case, was the general awareness among Americans that our current system isn’t all that hot.

Republicans meanwhile tried–and arguably succeeded, at least on this point–to recast the battle as one of politics, rather than policy, and they simply said “No.” But before the real political battle could be redefined, Republicans needed to neutralize the policy debate, and they never did. That’s at the heart of Ruffini’s observations, and as such, he could have pointed out that Republicans brought an orange to a gun fight. In other words, by refusing to engage even an iota on the policy at hand, Republicans ginned up for a fight but left all their weapons at home.

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It’s no secret that Republicans are unhappy with the Patient Protection and Affordable Care Act. But cutting the U.S. Senate’s hours of operation in retaliation is inexcusable. Not only was Mark Udall unable yesterday to address pine beetle problems in the West, but Claire McCaskill was unable to conduct hearings on police contractors in Afghanistan.

I suppose for all this we can thank John McCain: “There will be no cooperation for the rest of the year.” It doesn’t matter to the GOP that pine beetles and Afghan police contractors are each pretty serious issues in their respective regions, nor that they have absolutely nothing to do with health care. Classy.

But here’s the thing: if the Supreme Court decided to overturn decades of precedent and strike down the mandate even though Kevin Drum says they shouldn’t (hard to imagine, I know), the insurance industry will go ballistic. If they’re required to cover all comers, even those with expensive pre-existing conditions, then they have to have a mandate in order to get all the healthy people into the insurance pool too. So they would argue very persuasively that unless Congress figures out a fix, they’ll drive private insurers out of business in short order. And that, in turn, will almost certainly be enough incentive for both Democrats and Republicans to find a way to enforce a mandate by other means.

Drum’s post raises the point that, even if the attorneys general swayed the Supreme Court to interpret the individual mandate as unconstitutional, repeal would only go as far as the individual mandate, not the entire act. And as Kevin points out, the insurance lobby is unlikely to sit idly by.

The eventual consequences of fighting the Patient Protection and Affordable Care Act are far reaching and difficult to foresee. Serious conservatives seem to be aware that, now that the act is law, it’s not going to go away. David Frum certainly thinks so. And the US Chamber of Commerce has already distanced itself from political efforts to repeal the act. Stay tuned.

Every single one of you at some point before you arrived in Congress and after you arrived in Congress have met constituents with heart-breaking stories. And you’ve looked them in the eye and you’ve said, we’re going to do something about it — that’s why I want to go to Congress.

. . . Every single one of you have made that promise not just to your constituents but to yourself. And this is the time to make true on that promise.

The president, I think, spoke to the kernel of idealism that once took root in every hardened incumbent before he or she ever served in public office. It’s one thing to wax poetic about the historic proportions of the bill that’s scheduled for an up or down vote tomorrow on the House floor,  and Obama did plenty of that, to be sure. But the president balanced ambitious political cheerleading with an appeal to the most intimate type of promise a campaigning politician makes to a constituent, and then Obama balanced that again with an appeal to each representative’s conscience.

I know this is a tough vote. I’ve talked to many of you individually. And I have to say that if you honestly believe in your heart of hearts, in your conscience, that this is not an improvement over the status quo; if despite all the information that’s out there that says that without serious reform efforts like this one people’s premiums are going to double over the next five or 10 years, that folks are going to keep on getting letters from their insurance companies saying that their premium just went up 40 or 50 percent; if you think that somehow it’s okay that we have millions of hardworking Americans who can’t get health care and that it’s all right, it’s acceptable, in the wealthiest nation on Earth that there are children with chronic illnesses that can’t get the care that they need — if you think that the system is working for ordinary Americans rather than the insurance companies, then you should vote no on this bill. If you can honestly say that, then you shouldn’t support it. You’re here to represent your constituencies and if you think your constituencies honestly wouldn’t be helped, you shouldn’t vote for this.

The president also stated flat out “Now, I can’t guarantee that this is good politics.” And he singled out Betsy Markey and John Boccieri as representatives who have looked at this measure from every angle and evaluated the politics as well as the policy and decided to vote with the majority caucus in favor of reform. Betsy Markey may well be a one-term representative. I hope it’s not so, but Colorado’s 4th District may in fact be more comfortable with Markey’s predecessor, archconservative culture warrior Marilyn Musgrave, than with Markey. But Markey also gets what this bill is about, and she gets it that she can’t vote no on this bill and then come home to her district with her head held high.

In the end, the president had to reach the people for whom a yes vote tomorrow really won’t be good politics and convince them (or effectively remind them) that voting yes is the right thing to do, even if every political survival bone in their bodies is screaming and shaking to vote no. This has been his agenda for the past week, culminating in his trip to the Hill today. We’ll know tomorrow whether he’s succeeded or not.

Welcome, Ari, to the Colorado Progressive community!

This bill will be the single largest deficit reduction bill in 27 years.   It will most likely be the single largest deficit reduction measure I vote for as a Member of Congress.

That’s why I’m voting for this bill.  There are things that this bill does immediately that I could not, in good conscience, oppose: it ends denial of coverage for people with pre-existing conditions and prevents health insurance companies from dropping people from coverage when they get sick.

Some of the other hightlights of what this bill will do are:

• It allows people who are 26 and younger to stay on their parents health care plans.  As a mother of three children under the age of 26, that is an important issue for me.
• It closes the donut hole in Medicare Part D, which will lead to lower drug costs for seniors and guarantees that Medicare benefits will not be cut, all by saving money from withing the Medicare program by weeding out waste, fraud and abuse.
• It eliminates annual and lifetime limits on all insurance coverage and guarantees that insurers cover preventitive care for afflictions like cander and diabetes.
• Additionally, more than 30 million new people will benefit from health insurance coverage withing the next ten years.  Out of pocket costs for premiums and medical expenses will finally be made affordable for individuals and families.  There are strong private health insurance options covered by this bill, with state exchanges and more benefit plan options.

Quite simply, this is a better bill than the legislation I opposed last fall and it does more to contain costs while providing increased health insurance coverage.

Emphasis mine. Good on you, Betsy Markey, for legislating with your conscience. The people of Colorado’s 4th District are well served.

Even beyond the aggravation of the campaign phone calls, though, I start to wonder why I bother to participate in Democratic politics.

After all, if I’d wanted a health-care plan that consisted of “trying to hold on until you’re 65 and eligible for Medicare,” I’d have voted for Republicans.

If I’d wanted the United States to be involved in two shooting wars in the Middle East, I’d have voted Republican.

If I wanted to give billions of dollars to prop up Wall Street and then see huge bonuses given to the same people who got us into this financial mess, I’d vote for Republicans.

If I wanted U.S. intelligence activities (performed in our name and with our money) to continue to operate without meaningful congressional oversight, I’d vote Republican.

If I wanted accused terrorists to be tried as warriors before military tribunals as if they were soldiers, instead of in civilian courts like the criminals they are, I’d vote Republican.

If I wanted the USA Patriot Act extended rather than repealed, I’d vote for Republicans.

If I wanted theocrats in Texas to require that the American history textbooks used in public schools focus on John Calvin (who wasn’t even an American) and ignore Thomas Jefferson, I’d vote Republican.

It does force one to recognize, ultimately, how close to center the Democrat establishment has hewn since Barack Obama’s watershed election. Quillen’s commentary also–albeit incidentally–highlights the slowness of substantive institutional change in our nation’s politics.

Ed Quillen’s piece today makes no room for incrementalism, and I think that’s an oversight too common among progressives right now. Of course, Democrats lined the National Mall and stood before TV sets on January 20, 2009, and many of us wept. After eight years of global shame, Democratic Americans held their heads high with their president; yet little could we have imagined the storm of obstruction and vitriol preparing to seize the nation’s capitol.

Quillen is right, of course, and he makes each of us scratch our heads and mutter “Damn.” Damn, because one politician is, arguably, never so very different from another politician. Damn, because yesterday’s tired policies become today’s tired policies. Damn, because Washington process, by necessity, given our parliamentary checks and balances, waters down meaningful policy before it ever gets the chance to become meaningful legislation.

And yet incremental changes do take place in Washington and do spread district by district across the nation. To agree too wholeheartedly with Quillen is to forget that, in his first year or so in office, Obama oversaw expansion of children’s health insurance; sent stimulus funding directly to support social safety net institutions such as Medicaid and COBRA; allocated nearly $140 billion in funding for education; signed legislation insisting that, by 2016, all vehicles sold in the U.S. get 35+ miles to the gallon; designated 2 million acres of new federally protected wild lands; signed the Lilly Ledbetter Fair Pay Act; began direct efforts to strengthen and update the national infrastructure (highways, rail, Internet, and more); initiated DADT repeal; and a whole lot more.*

Yes, Quillen makes a great point. Guantanamo ought to have been shuttered by now. Health insurance reform ought to have passed by now. Troops ought to have come home–not only from Iraq but also from Afghanistan–by now. No Child Left Behind ought to have been completely scrapped by now.

It’s sad that these things haven’t happened, and it’s incredibly frustrating. But make no mistake: incremental change is change. And given the extraordinary leverages afforded minority parties under current congressional rules, incremental change is about all the change we can hope for. Don’t lose sight, Democrats, of the good things that are still happening in politics today.

*List copped almost exclusively from Nathan Newman’s rundown last fall at TPM Cafe.

Democrats, similarly, will likely retain Bennet on the ballot this November, and nothing that happens to today will probably affect that outcome too much. But that should not yet be taken for granted. Clearly, Bennet is the leading fundraiser against a stagnating Andrew Romanoff and enjoys the advantages that accompany incumbency. At the same time, Romanoff is positioning himself as the outsider looking in–a strange twist for the former House Speaker and erstwhile golden boy of Colorado Democratic politics–during a year that poses significant challenges for incumbents, namely the messy health care reform issue that has paralyzed Washington and polarized the nation.

Here’s Giroux on the Romanoff-Bennet caucus stakes:

Political analysts said Romanoff, who badly trails Bennet in fundraising, needs to perform very well at the caucuses to gain traction for the difficult undertaking of unseating a senator in a primary.

“My current assumption is that Romanoff needs to win [the caucuses] … to credibly make the argument that ‘I’m the grass-roots guy,’ ” said independent Colorado pollster Floyd Ciruli.

Eric Sondermann, an independent political analyst in Denver, described the caucuses as “a home game for Andrew Romanoff” because he’s concentrated heavily on securing the support of the sliver of Democrats who will participate in them. He expects Romanoff to do well.

“If he does not fare well [Tuesday] in the caucuses, it’s hard to understand what the ongoing rationale for his candidacy is,” Sondermann said.

Katy Atkinson, a Denver-based political consultant, said that the caucuses are far less important for Bennet than for Romanoff because “Bennet has the money to be able to run a primary campaign, and Romanoff needs the momentum that a convention win would give him to help him raise more money.”

Bennet’s campaign is targeting the caucuses to build the full-fledged statewide political organization he lacked after coming to the Senate as an unelected member with no experience in elective office.

So Romanoff is in must-do mode, and Bennet is simply looking to build the momentum and recognition he never needed to win his seat in the first place.  That makes tonight’s outing particularly tough on Romanoff, who, to be honest, has done little to kick up awareness of his candidacy outside a few inside politics circles.

For the sake of argument and variety, and without tendering an endorsement, I urge Democratic caucus goers to step up tonight for Andrew Romanoff, if only to force Michael Bennet to define himself yet more clearly. Bennet is responding well under threat of a primary challenge, with strong support of a public option for health insurance reform and with a slate of new rules introduced to reduce filibuster abuse, and that’s only good news for Colorado.

Additionally, Andrew Romanoff is an effective legislator and a likable politician. If he makes it through these early rounds of primary wrangling, I’m confident that he will bring to the discourse a number of key points and policy ideas that matter to the quality of state and national politics. It’s especially important now for Democrats to energize their politics once more on the validity of clear and constructive policy discussion. Let’s learn as much as we can and then vote on the best candidate.