The Nation

Hillary, Obama and Healthcare

With Iowa one month away, the almost obsessive horserace coverage is in full swing and, as it has for much of campaign, it shortchanges the substance of the serious and urgent issues in dispute.

Take the fight between Hillary Clinton and Barack Obama over whose healthcare plan would cover more people or cost less. The substance of that battle received about two sentences in today's Washington Post front page story out of Iowa. But here's the real problem (because we all know horserace coverage is what we're going to get at this stage in this endless campaign)....Even if the Post or the Times devoted a full story analyzing the leading candidates' healthcare proposals, how much attention would the two papers give to alternatives offered by someone like Congressman Dennis Kucinich--the only candidate supporting a truly universal, Medicare for all, healthcare plan that, according to recent polls, has majority support? I suspect very little. In our downsized politics of excluded alternatives, media polices the parameters of what's considered "realistic" when it comes to many choices, including healthcare reform.

That's why a recent analysis of the mainstream candidates' healthcare proposals is so valuable. Released byHealthcare-NOW, an organization committed to universal single payer reform, it's a useful guide for voters who want to understand the full range of choices they should be seeking in this campaign. It's not that all of the leading candidates' proposals aren't advances over what we have now, but as voters and citizens we could demand more. And it will require an independent progressive movement to push truly universal healthcare reform onto the next president's agenda.

Check out the analysis below, prepared by Len Rodberg, Research Director, New York Metro Chapter, Physicians for a National Health Program, September 25, 2007. Presented to the New York Chapter of Healthcare-NOW on November 6, 2007.

The Mainstream Democratic Candidate' Proposals for Universal Healthcare

The mainstream Democratic candidates for President -- John Edwards, Barack Obama, Hillary Clinton -- have each put forward their proposals for "affordable quality health coverage for all." The three Democrats' proposals, while purporting to provide "universal health care", will not actually achieve this goal:

None of these plans offers a realistic way of containing the rising cost of health care. All will add additional funds to an already too-costly system. None will truly provide universal access to care.

Only a single payer national health insurance program can actually achieve affordable, workable universal access to health care.

The three proposals share a set of common elements:

The private insurance system would remain in place, with no fundamental change in the way it operates. Those who currently have insurance would not experience any change in how they are insured or the coverage they have.

Large employers would be required to provide insurance for their employees or (in the case of Edwards and Obama) pay into a fund to subsidize insurance for their employees.

Everyone (for Edwards and Clinton) or children (for Obama) would be required to have insurance, either through their employer or purchased on their own (an "individual mandate"). Income-related subsidies would be provided through the tax system.

Insurers would be required to offer coverage to everyone ("guaranteed issue") without limits on pre-existing conditions, and without "large premium differences based on age, gender, or occupation" (from Clinton's plan).

All would make available a "choice" of private insurance plans, as well as a public insurance option modeled on Medicare. (They use the language of the insurance industry -- and Hillary Clinton uses it in the name of her plan itself, the "American Health Choices Plan" -- suggesting that what consumers want is a choice of plan.)

All claim to achieve cost savings through expanded use of information technology, an emphasis on prevention, and better chronic care management.

What is missing from these plans?

Since multiple payers would remain (even if one of them might be a public payer), few of the savings and simplifications that are possible with a singe payer can be achieved.

Consumers must purchase insurance, but no limits are proposed on what insurers can charge them.

No regulations are proposed that would assure the adequacy of benefits or that would affect either the restrictions that insurers now impose on the choice of doctor and hospital or the way they handle, and deny, claims.

There is no simplification of the complex and wasteful private insurance system with its copays, deductibles, exclusions, and claim denials.

There is no assurance of a "level playing field" between the public insurance plan and the private ones. Insurance company advertising and targeted marketing will still be used to promote private plans over public and to avoid the poor and the sick. At the same time, the private insurers will surely insist on the additional subsidies they already enjoy in the Medicare Advantage program.

Nothing is proposed that would control the rising cost of health care. (The measures they suggest to achieve savings may well increase costs rather than reduce them. In any case, the possibility for savings is speculative at this point.)

Are these plans politically "realistic"?

The insurance companies will resist guaranteed issue and community rating, as well as other requirements in some of the plans (e.g., Edwards would require that they spend at least 85 percent of their revenue on medical care).

Business will resist a mandate that they purchase insurance. (In Massachusetts, they were unwilling to pay more than $295 per employee, and even objected to that small fee.)

None of these plans improves the situation of those who currently have insurance. Thus they are unlikely to generate strong popular support.

The proposed subsidies -- amounting to about $2,400 per uninsured individual -- are about half the cost of purchasing group insurance today. Millions will continue to find insurance unaffordable. (The attempt to impose an individual mandate in Massachusetts is already showing that, as long as the program continues to rely on private insurers, very large subsidies will be needed if coverage is to be both affordable and comprehensive; without such subsidies, either coverage will be limited, or it will be unaffordable.)

Millions of Americans who are currently underinsured, and threatened with bankruptcy in the event of serious illness, will continue to be underinsured and insecure.

These plans would add significantly to our overall spending on health care, already the highest in the world, with much of the additional spending going to insurance company administrative costs and profits.

Conclusion: These Plans Will Not Work! None of these plans will truly provide universal access to care. They do not overcome the very significant deficiencies of private insurance. None assures the American people of comprehensive coverage, none offers a realistic way of containing the rising cost of health care, and all would add additional funds to an already too-costly system.

They are at best a diversion from the direction we should be going, toward the creation of a single national, publicly-funded insurance pool that can provide comprehensive, continuous, cost-effective coverage along with the budgetary tools needed to begin containing costs.

Bush Buddy Putin Trumps Democracy, Chavez Embraces It

So how's George Bush's campaign for to spread his version of "democracy" going?

The results are in from the American president's favorite former superpower, the Russian Federation, and from his least favorite hemispheric neighbor, Venezuela.

Russian has been a special project of the Bush presidency.

Since claiming his chair in the Oval Office -- with an assist from a 5-4 Republican majority on the Supreme Court -- Bush has done his best to maintain friendly relations with Russian President Vladimir Vladimirovich Putin.

Famously, Bush declared after meeting with Putin in June of 2001 that, "I looked the man in the eye. I found him to be very straightforward and trustworthy. We had a very good dialogue. I was able to get a sense of his soul; a man deeply committed to his country and the best interests of his country."

Bush has worked hard to encourage Putin to respect the popular will and the American president has guarded against isolating the man in Moscow, even going so far as to front the drive to secure Russia a place in the World Trade Organization.

Venezuela, on the other hand, has always been written off as a lost case.

President Hugo Chavez's efforts to redistribute the country's oil wealth to aid the poor never sat well with our oil-man president, who administration quietly encouraged an attempted military coup against the elected leader.

Every effort has been made to isolate Venezuela, and to diminish and demonize its president as a dictator.

So the stage was set for the weekend's voting in Russia and Venezuela.

What a remarkable juxtaposition the elections in these two country's would provide!

And so they did.

In an election so managed and manipulated that key opposition parties were tossed off the ballot and critics of Putin were jailed, the Russian president has completely consolidating power in himself. The United Russia Party ticket he headed has claimed total control of the national government in voting that opposition campaigner and former world chess champ Garry Kasparov dismisses as "the dirtiest" in Russian history.

"There can be no doubt that, measured by our standards, these were not free and fair elections, they were not democratic elections," says German government spokesman Thomas Steg. "Russia was no democracy and it is no democracy."

And what of Venezuela?

In voting that saw a massive turnout but few serious complaints about irregularities, voters in the South American country rejected Chavez's request for constitutional changes that would have increased his authority and allowed him to serve as president for so long as he continued to win elections. In effect, the voters chose to maintain term limits on a popular leader who was seen as having overreached.

Accepting the results, Chavez held up a copy of the constitution he had attempted to alter and declared, "We will continue constructing socialism but under this constitution."

Thus, in the country where Bush worked with Putin to advance some kind of democracy, there is no democracy.

And in the country where Bush did everything he could to undermine the elected and popular leader, democracy appears to have prevailed.

Incident in Rochester, Challenge for Clinton

The problem for Hillary Clinton that arises from the incident in which a disturbed man invaded her Rochester, New Hampshire, campaign headquarters is not any kind of physical threat. Clinton is the most carefully-managed and thoroughly-secured presidential candidate since Ronald Reagan, who when he began to show the first signs of the dementia was placed in a sort of protective custody during the 1984 campaign. Clinton is is no greater danger now than she has been in since the start of her campaign; and neither, thankfully, were her New Hampshire supporters, who exited the headquarters without injury.

The problem for Clinton is a political one.

The incident in Rochester reminds prospective Democratic primary voters and caucus-goers that the front-runner for the party's presidential nomination is a celebrity candidate who attracts controversy, who is legitimately seen as divisive and who-- barring a major shift in tone and style -- will always campaign at a distance from the American people.

This is not entirely fair to Clinton. She has indeed been the victim of the "vast right-wing conspiracy" that she named after millionaire conservatives and their paid minions defining her as a cruel and conniving egomaniac who would stop at nothing to obtain power and position.

But there is nothing fair about American politics. And, while Clinton has made some progress when it comes to softening her image, she has not begun to transform herself so successfully as did the "ruthless" Bobby Kennedy in 1967 and 1968 -- or even the "boring" Al Gore in the period since he ceded the presidency to George Bush.

Hillary Clinton remains a charged figure who excites great passions. She is a highest-profile politician whose fame is both blessing and curse. The blessing is that, without offering much more than platitudes, she has been able to wink and nod her way to the top of most Democratic polls. The curse is that, if an desperate man in Rochester, New Hampshire, is looking for a campaign headquarters to invade, it's going to be Clinton's.

If a few other desperate men target the Clinton campaign in coming weeks -- or even a desperate woman as hyped up as the one who called the Democratic senator a "bitch" at a recent John McCain event -- the contender who so recently seemed inevitable will be in trouble.

It's won't be Clinton's fault, at least not wholly. But incidents of this kind will make Democrats, who think they have a good chance of winning the presidency in 2008, start asking: Why invite the volatility that goes with Hillary Clinton? Why not nominate someone -- a John Edwards, a Barack Obama, even a Bill Richardson -- who provokes a little less passion?

To deny that such thinking will go on in the heads not just of pundits but of grassroots Democrats would be absurd as the calculus that said John Kerry was the most electable Democrat of 2004.

The challenge for Clinton, then, is not to avoid the issue. She must confront it. She must turn her volatility to her advantage. She should take a risk that puts her outside the comfort zone of her own campaign -- and of contemporary politics. She should speak bluntly about the bitter partisanships, the crude tactics, the open hatreds that now characterize campaigning and that so undermine the ability of elected leaders to govern in a functional, let alone inspiring, manner.

The incident in Rochester was not a big deal. It was overplayed by the media. Clinton and her aides are safe, as safe as any serious presidential contenders and their hangers on. But the Friday's headquarters invasion got the attention it did for a reason. Everyone recognizes the emotions -- both positive and negative -- that Hillary Clinton inspires. And everyone suspects that they could boil over again, either physically or politically.

Clinton needs to address her perception and her reality as a remarkable political figure who has already made a great deal of history and could make a great deal more. She cannot do it with spin. The reliance on spin, on managed messages and manipulated moments, is a big part of what Americans -- even some of her supporters -- distrust about her.

Hillary Clinton needs to open up. She needs to speak frankly. She needs to acknowledge that, for better or worse, she inspires intense reactions. She needs to start talking about that intensity. And she needs to explain to the American people -- if she can -- how that intensity, as opposed to silly spin about "bringing us all together, is what this country needs after George Bush's sleepwalk across the minefield.

If Clinton does this, it will not matter what passions play out during the course of the coming campaign. She will be on her way to the Oval Office. If she fails to do so, Clinton will remain vulnerable to the incidents that are all but certain to unfold, and that vulnerability will beg questions that could well cost her the presidency.

Mental Health and the Hillary Hostage Situation

I don't know anything more about Leeland Eisenberg--the 40-something year old man who held Hillary Clinton's campaign office in Rochester, New Hampshire, hostage for several hours this afternoon--than what's being reported on network news. But the ordeal--which thankfully ended without any casualties--ought to focus attention on the dire state of mental health care in this country. More than a third of this country's homeless population have severe mental health issues, including schizophrenia and manic depression. At least one in every six inmates in America have been diagnosed with serious mental health conditions.

The gutting of public mental health services began with Reagan, first in California where he closed state-funded mental health facilities. As president he cut aid for federally-funded community-run mental health programs. The result: thousands of more homeless people in California and nationwide and a spike in the prison population. The New York Times recently reported that despite a rapid rise in the suicide rate in New Orleans in the aftermath of Hurricane Katrina, the city has half of its psychiatrists, social workers and mental health care workers.

Just this year, John Broderick, the Chief Justice of the New Hampshire Supreme Court, drew attention to this crisis when his son was released from prison. Suffering from depression and severe anxiety, Broderick's son injured him in a violent attack in 2002 and served three years in prison. As Broderick noted in a press conference earlier this year, only 1.5 percent of New Hampshire's prison budget went to mental health services.

Without appearing to capitalize on the situation, Clinton, and all elected officials, can and should take this incident as an opportunity to emphasize the importance of mental health services in any health care package, criminal justice reform, and indeed, in any vision of what a more caring, safer America looks like.

Bringing Democracy Home

We're headed into an election year with Americans in overwhelming numbers looking for a dramatic change in direction. Progressives have already pushed some major issues onto the table – ending the war in Iraq, affordable healthcare, alternative energy, global warming and trade. But the limits of the current debate are also increasingly apparent: where's the agenda to deal seriously with Gilded Age inequality? With the tsunami of foreclosures precipitated by the subprime mortgage crisis? Where's the public investment agenda to address the staggering investment deficit in infrastructure? Where's the attention to poverty and stunning racial inequalities – from childhood poverty to criminal justice? And, as The Nation pointed out in a recent special issue on "The US & The World: 2008 & Beyond," leading candidates of both parties remain committed to increasing a military budget that is already as large as the rest of the world's military spending combined.

The emerging pro-democracy movement is working to address these symptoms of our downsized politics of excluded alternatives, as well as much of what ails our broken voting system: not only reliable voting machines, but Election Day registration, fighting 21st century Jim Crow tactics , and getting the obscene piles of money out of our politics. (See Ari Berman's post on how it's now estimated that spending for the congressional and presidential campaigns will top $5 billion!)

Another important step towards advancing our democracy is implementing instant runoff voting (IRV), and it's making headway these days at the state and local levels, and showing promise for federal elections too. With IRV, voters can vote their conscience and not worry that a vote is being "wasted" on someone who "can't win." IRV promotes greater debate and more alternatives, and also results in the winning candidate having the support of the majority of voters. Here's how it works: if four candidates were on a ballot, you would rank them one to four. When the votes are tabulated, if one of the candidates is the first choice for 50 percent of the voters, then he or she wins. If not, then the last-place candidate is eliminated, and if you voted for that candidate, your vote in the next round of tabulations is added to the vote totals of the candidate you ranked as your second choice. The process continues until one candidate receives over 50 percent of the vote.

In Australia, IRV was introduced in 1918, and has historically benefited parties on both the left and the right. Last Saturday, it helped the Australian Labor Party – but not before the Australian Greens were able to run a strong campaign and collect 8 percent of the parliamentary vote, and perhaps push debate further on issues like climate change and the Iraq War than Labor wanted to go. In the initial tabulation Labor won only 44 percent of the vote, but with IRV most of the Green votes ended up being awarded to Labor. The party had worked hard to be the second choice of Green voters, and designated former Midnight Oil lead Singer Peter Garrett – "a-rock-star-environmentalist-turned-politico" – as their likely environment minister. In the end, Labor ended up with 54 percent of the two-party tally.

"What a difference a fair voting method like instant runoff voting can make," Rob Richie, Executive Director of FairVote told me. "With IRV, Greens not only didn't split the vote and help elect candidates opposing their positions, but they got to make their case for change in a way that almost certainly transformed majority opinion on the environment and Iraq and made the Labor Party more responsive to that opinion. And with proportional voting in the senate, the Greens have ongoing power, all the better positioned to help hold Labor accountable to its campaign promises."

In the US, IRV has been chosen by voters in more than a dozen city ballot initiatives. Most recently, voters in Sarasota, FL and Aspen, CO elected to move to IRV by a three-to-one margin. In Pierce County, WA 67 percent of voters chose to keep IRV on track for next year's county executive race. The city council of Santa Fe, NM gave unanimous preliminary approval to place IRV on the March 2008 ballot. Finally, in Vermont, IRV looks promising for congressional elections next year – it's passed the state senate and there are encouraging signs it will pass in the house too.

In a recent op-ed , former Illinois Congressman and presidential candidate, John Anderson, advocated for IRV and noted that "one-third of all voters who are not registered as Republican or Democrat feel pressured to vote against their worst nightmare rather than their best hope…. General elections should be a marketplace of innovative ideas, and independent and third-party candidates can prevent them from becoming a showcase for an overly narrow ideological duopoly."

Until we get a system which is more democratic – including IRV and other democracy reforms – we won't have as effective an independent politics and as vibrant a debate as we deserve.

Exclusive: Washington Lobbying Secrets Sort of Exposed

Did you know that people increasingly use the Internet, even more so than radio? Or that e-mail is an effective communication tool but recipients don't like flooded in-boxes?

Yes! It's true and I learned it all at a $225-a-ticket briefing called "Innovative Advocacy: New Strategies for Effective Advocacy" sponsored by the United States Chamber of Commerce and the Adfero Group, a D.C. public affairs firm. I was hoping to get an inside look at the secret handshakes of the Washington rainmakers and influencers but it was not to be. Mostly the hill staffers and lobbyists who spoke debated things like whether or not e-mail is the "only way to communicate." It turns out no, it is not.

There were a few interesting nuggets: One powerpoint slide showed results from a poll in which Congressional staffers ranked the information sources they use for research. The Congressional Research Service, which is only starting to become open to the general public, finished first followed by Capitol Hill rags (like The Hill and Roll Call). "Political blogs," meanwhile, finished 15 out of 15 behind "Unsolicited policy materials from advocacy organizations" and "Other types of blogs."

"Everybody says we ought to start using the blogosphere" said Eric Hultman, chief of staff for Nebraska GOP Representative Lee Terry. "Eh, I'm not so sure."

Staffers and lobbyists also shared their concerns, or lack thereof, about new lobbying and ethics reform. A concerned member of the powerful D.C. law firm, Hogan & Hartson, asked about inviting staffers to a reception, with new rules preventing staffers from accepting meals from lobbyists.

"I had a staff member confused by the new ethics rules," recalled Hultman. "He said there was Makers Mark, Grey Goose, shrimp and filet mignon. I asked, 'Did you use a fork?' He said no and so I said, 'Enjoy!'"

The most valuable part of the briefing, however, for this marginalized politcal blogger was an inspiring look at Capitol Hill movers-and-shakers. A slide entitled a "World of Info and Media" gave sage tips like when eating dinner with friends to "check Blackberry twice" and "Multitask on morning commute: listen to podcast of Washington Week while flipping through Washington Post, watch 5-minute video podcast of ABC News Top Headlines, check Blackberry 6 times."

So maybe the secret to Washington advocacy is to never have time to consider life outside of Washington.

World AIDS Day

To most casual observers of AIDS, which is to say, most people who haven't known anyone afflicted with HIV, the situation seems to be improving rapidly. While this view is not without foundation when looked at from one (narrow) perspective, the reality is far more complicated and determined by class than most media accounts suggest.

The fact is that the spread of HIV and AIDS continues to be a major challenge across the globe, the epidemic is growing and there is concerning evidence that some countries are seeing a resurgence in new infection rates that were previously stable or declining.

According to the UNAIDS/WHO 2006 AIDS Epidemic Update, an estimated 39.5 million people are currently living with HIV. There were 4.3 million new infections in 2006 with 2.8 million (65 percent) of these occurring in sub-Saharan Africa and significant increases seen in Eastern Europe and Central Asia, where there are indications that infection rates have risen by more than 50 percent since 2004. The latest National AIDS Control Organization report showed 72,000 new HIV infections in 2005, compared to 28,000 in 2004 – a 157 percent jump. Most of the new infections are in the 22 to 45 age group. In 2006, 2.9 million people died of AIDS-related illnesses.

This Saturday's World AIDS Day -- the nineteenth -- is trying to keep these facts present in the minds of those whose energy and money have been crucial in combating the disease in the past. Started on December 1, 1988, World AIDS Day is not just about raising money, but also about increasing awareness, fighting prejudice, improving education and reminding people that HIV has not gone away, and that there are many things still to be done.

The day is also an important opportunity for activists to galvanize public and legislative sentiment behind campaigns like Planned Parenthood's call for Congress to halt funding for harmful abstinence-only programs that deny teenagers life-saving information about preventing infections like HIV/AIDS and the National AIDS Housing Coalition's push for policy-makers worldwide to acknowledge the link between stable housing and positive health outcomes when addressing HIV/AIDS prevention, care and treatment.

Here are some ways you can support World AIDS Day, courtesy of the Avert website:

  • Help save a child's life in an AIDS-affected community by becoming a HopeChild sponsor through WorldVision. (All it takes is one dollar a day.)
  • Raise awareness of HIV and AIDS in your area by wearing a red ribbon and ask others to do the same.
  • Sign up as a supporter of the Stop AIDS in Children campaign.
  • Protect yourself and your partners--this is the first and best way to stop the spread of HIV.
  • Put up some posters--get people talking.
  • Organize a creative writing/poster campaign.
  • Set up a debate or a quiz - there are lots of ideas for topics on the Avert site.
  • Get your friends, family, colleagues or pupils to express their feelings about AIDS.
  • Learn more about HIV and AIDS: avert.org has a great deal of information about AIDS and the global epidemic.

There are also related concerts, panels, parties and all sorts of other events taking place across the globe on Saturday. Check out this site for details.

Obama vs. Clinton, Edwards and Paul Krugman

Give New York Times columnist Paul Krugman a little credit for pointing out the uncomfortable fact that Illinois Senator Barack Obama is campaigning against universal health care.

Krugman explained in Friday's editions of The New York Times:

The central question is whether there should be a health insurance "mandate" -- a requirement that everyone sign up for health insurance, even if they don't think they need it. The Edwards and Clinton plans have mandates; the Obama plan has one for children, but not for adults.

Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they're currently healthy, and in return everyone has insurance coverage if and when they need it.

And it's not just a matter of principle. As a practical matter, letting people opt out if they don't feel like buying insurance would make insurance substantially more expensive for everyone else.

Here's why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance -- then sign up for it if they developed health problems later. Insurance companies couldn't turn them away, because Mr. Obama's plan, like those of his rivals, requires that insurers offer the same policy to everyone.

As a result, people who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn't sign up for insurance until or unless they needed medical care.

In other words, when Mr. Obama declares that "the reason people don't have health insurance isn't because they don't want it, it's because they can't afford it," he's saying something that is mostly true now -- but wouldn't be true under his plan.

The fundamental weakness of the Obama plan was apparent from the beginning. Still, as I said, advocates of health care reform were willing to cut Mr. Obama some slack.

Krugman argues that it is time to stop cutting Obama that slack because the senator has begun defending his flawed plan by echoing right-wing talking points.

"Mr. Obama, who just two weeks ago was telling audiences that his plan was essentially identical to the Edwards and Clinton plans, is attacking his rivals and claiming that his plan is superior. It isn't -- and his attacks amount to cheap shots<"argues Krugman.

"First, Mr. Obama claims that his plan does much more to control costs than his rivals' plans. In fact, all three plans include impressive cost control measures. Second, Mr. Obama claims that mandates won't work, pointing out that many people don't have car insurance despite state requirements that all drivers be insured. Um, is he saying that states shouldn't require that drivers have insurance? If not, what's his point?"

Obama's point is, of course, a political one. He is trying, desperately, to position himself as the one serious challenger to Clinton. To do that, he must distinguish himself both from the national front-runner and from Edwards, who has attracted significant union and grassroots support with his economic populism.

Obama remains, in many senses, the most appealing Democratic contender. And there is good reason to believe that he could emerge in coming weeks as the most serious challenger to Clinton. He could, yet, be the Democratic nominee and the president.

But to do that, Obama must get serious about the major issues. It is not enough to just talk about "a different kind of politics." Obama must practice it, and to do so he must develop coherent plans on issues such as health care.

Obama would not have had a hard time coming up with a better plan than that of Clinton or Edwards, both of which refuse to take the logical step of developing a universal, cost-effective and genuinely health-care oriented single-payer system, as Ohio Congressman Dennis Kucinich proposes.

But Obama has not tried to distinguish himself by being better than Clinton or Edwards.

Instead, as Krugman notes, "What seems to have happened is that Mr. Obama's caution, his reluctance to stake out a clearly partisan position, led him to propose a relatively weak, incomplete health care plan."

Rather than acknowledge the flaws in his own plan, Obama has attacked Clinton and Edwards in language that does indeed "sound like Rudy Giuliani inveighing against 'socialized medicine.'" And Krugman is right to call the senator out on his wrongheaded approach.

What to Make of the "Good News" from Iraq

Whoa, let's hold those surging horses in check a moment. Violence has lessened in Iraq. That seems to be a fact of the last two months -- and, for the Iraqis, a positive one, obviously. What to make of the "good news" from Iraq is another matter entirely, one made harder to assess by the chorus of self-congratulation from war supporters and Bush administration officials and allies, as well as by the heavy spin being put on events -- and reported in the media, relatively uncritically.

An exception was Damien Cave of the New York Times, who had a revealing piece on a big story of recent weeks: The return of refugee Baghdadis -- from among the two million or more Iraqis who had fled to Syria and elsewhere -- to the capital. This has been touted as evidence of surge "success" in restoring security in Baghdad, of a genuine turn-around in the war situation. In fact, according to Cave, the trickle of returnees -- lessening recently -- has been heavily "massaged by politics. Returnees have essentially become a currency of progress."

Those modest returnee numbers turn out to include anyone who crossed the Syrian border heading east, including suspected insurgents and Iraqi employees of the New York Times on their way back from visits to relatives in exile in Syria. According to a UN survey of 110 families returning, "46 percent were leaving [Syria] because they could not afford to stay; 25 percent said they fell victim to a stricter Syrian visa policy; and only 14 percent said they were returning because they had heard about improved security." And that's but one warning sign on the nature of the story under the story.

A recent Pew Research Center poll of American reporters who have been working in Iraq finds that "[n]early 90 percent of U.S. journalists in Iraq say much of Baghdad is still too dangerous to visit" and many believe that "coverage has painted too rosy a picture of the conflict." In an on-line chat, the reliable Thomas Ricks of the Washington Post (and author of the bestselling book Fiasco), just back from Baghdad himself, offered his own set of caveats about the situation. He suggested that, in addition to the surge of U.S. troops into the capital's neighborhoods, some combination of other factors may help explain the lessening violence, including the fact that "some Sunni neighborhoods are walled off, and other Sunni areas have been ethnically cleansed. In addition, the Shiite death squads, in addition to killing a lot of innocents, also killed some of the car bomb guys, I am told." Of the dozens of American officers he interviewed, none were declaring success. "[T]o a man, they were enormously frustrated by what they see as the foot-dragging of the Baghdad government." And he points out that violence in Baghdad "is only back down to the 2005 level -- which to my mind is kind of like moving from the eighth circle of hell to the fifth." In 2005, or early 2006, of course, such levels were considered catastrophic.

Robert Parry of Consortium News points out that, while "good news" dominated front pages here, "the darker side" of "success" has "generally been shoved into brief stories deep inside the newspapers." He adds that "the harsh repression surrounding the ‘surge' has drawn far less U.S. press attention."

Jim Lobe of Interpress Service interviewed surge "skeptics" who "argue that the strategy's ‘ground-up' approach to pacification -- buying off local insurgent and tribal groups with money and other support -- may have set the stage for a much bigger and more violent civil war or partition, particularly as U.S. forces begin drawing down from their current high of about 175,000 beginning as early as next month."

In an otherwise unremarkable video-conference press briefing for reporters in Washington, conducted with Col. Jeffrey Bannister, an American front-line officer garrisoning Baghdad neighborhoods, sociologist Michael Schwartz recently caught a fascinating bit of overlooked news. Discussing the arming (and paying) of volunteer citizens to patrol their neighborhoods, the colonel kept referring to an unexplained "five-year plan" for the American presence there that, he indicated, was guiding his actions.

Why, asks Schwartz, based on this, is it reasonable to say that things are still not going well in Iraq? He begins his response this way: "You can tell things can't be going well if your best-case plan is for an armed occupation force to remain in a major Baghdad community for the next five years. It means that the underlying causes of disorder are not being addressed. You can tell things are not going well if five more years are needed to train and activate a local police force, when police training takes about six months."

His conclusion is interesting indeed: "As long as [the Bush adminsitration] is determined to install a friendly, anti-Iranian regime in Baghdad, one that is hostile to 'foreigners,' including all jihadists, but welcomes an ongoing American military presence as well as multinational development of Iraqi oil, the American armed forces aren't going anywhere, not for a long, long time; and no relative lull in the fighting -- temporary or not -- will change that reality. This is the Catch-22 of Bush administration policy in Iraq. The worse things go, the more our military is needed; the better they go, the more our military is needed."