It took me a week longer than I anticipated, but I finally finished compiling links to Bleeding Heartland’s coverage from last year. This post and part 2, coming later today, include stories on national politics, mostly relating to Congress and Barack Obama’s administration. Diaries reviewing Iowa politics in 2009 will come soon.

One thing struck me while compiling this post: on all of the House bills I covered here during 2009, Democrats Leonard Boswell, Bruce Braley and Dave Loebsack voted the same way. That was a big change from 2007 and 2008, when Blue Dog Boswell voted with Republicans and against the majority of the Democratic caucus on many key bills.

No federal policy issue inspired more posts last year than health care reform. Rereading my earlier, guardedly hopeful pieces was depressing in light of the mess the health care reform bill has become. I was never optimistic about getting a strong public health insurance option through Congress, but I thought we had a chance to pass a very good bill. If I had anticipated the magnitude of the Democratic sellout on so many aspects of reform in addition to the public option, I wouldn’t have spent so many hours writing about this issue. I can’t say I wasn’t warned (and warned), though.

Links to stories from January through June 2009 are after the jump. Any thoughts about last year’s political events are welcome in this thread.

The White House and key Democratic senators, including Iowa’s Tom Harkin, appear to be walking into a trap for the sake of bipartisan agreement on health care in the Senate.

There is growing support for a fake “public option,” as opposed to a government health insurance plan that would compete directly with private insurance companies.

If Congress passes this kind of deal and President Barack Obama signs it, we will get a enormously expensive non-solution to an enormous problem, and Democrats will pay the political price.

After the jump I’ll explain why political hacks as well as policy wonks should refuse the latest efforts to derail the public option.  

Yesterday Marc Ambinder mentioned Senator Tom Harkin as a possible nominee for Health and Human Services secretary in Barack Obama’s cabinet. As much as I agree with Harkin’s views on health care, I would hate to lose his voice in the Senate.

Huffington Post contacted Harkin, who praised the idea of nominating former Vermont Governor and Democratic National Committee Chairman Howard Dean for the job:

“I think that would be a very good move,” Harkin told the Huffington Post. “He brings all the background and experience. He’s very strong on prevention and wellness, which I’m very strong on. I think he’d make an outstanding secretary of HHS.”

Asked if he had spoken to White House on the matter, Harkin demurred: “I’m not going to get into that,” he said after a pause.

You may recall that Harkin endorsed Dean for president shortly before the 2004 Iowa caucuses. I like Dean and his views on health care, but I fear that he is not necessarily the best person to bring Democrats in Congress along with a comprehensive health care reform package.

I had to laugh at this paragraph in the Huffington Post piece:

Whether this endorsement helps or hurts is a topic of debate. The conventional wisdom seems to be that Dean’s frosty relationship with White House chief of staff Rahm Emanuel will be the main impediment to his ending up at HHS. Others are concerned that a major netroots movement to appoint Dean will actually turn the White House off the notion. They don’t want it to seem like they are “bending to the demands of the left,” as one Democrat put it — not because they aren’t concerned with progressive priorities, but because the choice will be criticized as an effort in political pacification.

Heaven forbid Obama should appoint someone from the Democratic wing of the Democratic Party! People might think he cares about left-leaning Democrats. Never mind that thousands of former Deaniacs became dedicated volunteers for Obama’s presidential campaign. Without people like them he never would have won the nomination.

Marc Ambinder reported yesterday that Congressman Raul Grijalva has urged Obama to appoint Dean. Grijalva is a leading figure in the House Progressive Caucus and was favored by more than 130 environmental organizations for Secretary of the Interior (a job Obama gave to conservative Democrat Ken Salazar).

According to Ambinder, Governor Phil Bredesen of Tennessee is “a top candidate.” Daily Kos diarist DrSteveB discussed some of the names being floated yesterday and explains why Bredesen would be “beyond awful.” After reading that diary, I’m ready to remove the Obama-Biden magnet from my car if Obama nominates Bredesen.

By the way, DrSteveB likes Dean but doesn’t think he’s a good fit for Secretary of Health and Human Services.

Update: On February 3 Daschle withdrew his nomination for secretary of Health and Human Services. It looks like he won’t be the “health care czar” in the White House either.

When Barack Obama announced plans to nominate Tom Daschle to run the Department of Health and Human Services, I agreed with Ezra Klein that the choice signaled Obama’s commitment to get comprehensive health care reform through Congress. I knew that Daschle’s wife was a longtime lobbyist, and that Daschle was not nearly as liberal as the right-wingers made him out to be. But we all know that the Senate will be the biggest obstacle to any good health care plan. Daschle knows that body’s procedures and the majority of its members extremely well.

The choice isn’t looking so good today.

Not paying taxes on the use of someone else’s limousine looks bad, but as we saw last week with Treasury Secretary Timothy Geithner, failure to fully meet one’s tax obligations no longer seems to be a barrier to serving in the cabinet. (By the way, Daschle knew about this problem last summer but didn’t tell Obama’s vetting team.)

Many people might honestly not realize that if they use someone else’s car, they need to report the value of that service as taxable income. But what is Daschle’s excuse for overstating his tax-deductible charitable gifts and not reporting more than $83,000 in consulting income? If Bill Richardson was asked to step aside because of an investigation that hasn’t even proven wrongdoing, then Daschle should not get a pass for not paying his taxes.

As is so often the case in politics, though, what’s legal can be even more disturbing. From Politico:

Daschle made nearly $5.3 million in the last two years, records released Friday show, including $220,000 he received for giving speeches, many of them to outfits that stand to gain or lose millions of dollars from the work he would do once confirmed as secretary of Health and Human Services.

For instance, the Health Industry Distributors Association plunked down $14,000 to land the former Senate Democratic leader in March 2008. The association, which represents medical products distributors, boasts on its website that Daschle met with it after he was nominated to discuss “the impact an Obama administration will have on the industry.”

This week, the group began openly lobbying him, sending him a letter urging him to rescind a rule requiring competitive bidding of Medicare contracts.

Another organization, America’s Health Insurance Plans, paid $20,000 for a Daschle speaking appearance in February 2007. It represents health insurance companies, which under Obama’s plan would be barred from denying coverage on the basis of health or age.

There was a $12,000 talk to GE Healthcare in August, a $20,000 lecture in January to Premier, Inc., a health care consulting firm, and a pair of $18,000 speeches this year to different hospital systems, among other paid appearances before health care groups.

The speaking fees were detailed in a financial disclosure statement released Friday, which showed that Daschle pulled down a total of more than $500,000 from the speaking circuit in the last two years, and $5.3 million in overall income.

These speaking engagements are legal, but it is an unacceptable conflict of interest for Daschle to have taken that much money from groups with a major financial stake in health care reform.

At Daily Kos nyceve examines one of those paid speeches and tells you why you should care: As UnitedHealth subsidiary Ingenix defrauded Americans, Daschle was its 2008 keynote speaker.

A lot of liberal bloggers are now calling for Obama to withdraw Daschle’s nomination and appoint Howard Dean to run HHS instead. As much as I like Dean, I do not think he’s the person to shepherd health care reform through Congress. But I agree that Obama needs to find a replacement for Daschle–the sooner, the better.

If Obama stands by Daschle, I suspect the Senate insiders’ club would confirm him, but let’s hope it doesn’t come to that.

Speaking of stalled confirmations, Senator Mike Enzi of Wyoming appears to be the Republican who is holding up Hilda Solis’s nomination for Secretary of Labor. This is purely ideological, based on Solis’ support for the Employee Free Choice Act. Solis has not been accused of any wrongdoing.

Will Obama stand behind his choice for this cabinet position? The president expressed support for organized labor on Friday while signing executive orders to boost labor unions.  

Tom Vilsack appears to be on track for unanimous confirmation by the Senate as Secretary of Agriculture in Barack Obama’s cabinet. At his confirmation hearing yesterday, Republicans didn’t ask hostile questions, and Vilsack didn’t have to explain away any embarrassing behavior like Treasury Secretary-nominee Timothy Geithner’s failure to fully meet his tax obligations over a period of years.

Despite the lack of drama, Vilsack made a number of noteworthy comments during the hearing. Here are some highlights.

Vilsack told senators on Wednesday that

The Obama administration wants to accelerate the development of new versions of biofuels made form crop residue and non-food crops such as switchgrass. The plants’ fibrous material, or cellulose, can be converted into alcohols or even new versions of gasoline or diesel.

“Moving toward next-generation biofuels, cellulosic ethanol, is going to be really important in order to respond” to concerns about the impact on food prices of using grain for fuel, he said.

Vilsack addressed a range of other issues, pledging, for example, to promote fruit and vegetable consumption and promising to ensure that any new international trade agreement is a “net plus for all of agriculture.”

It makes a lot of sense to produce ethanol from perennial plants that are less energy-intensive to grow and need fewer herbicides, pesticides and fertilizer than corn.

Vilsack’s opening statement also

promised swift implementation of the Conservation Stewardship Program (CSP) which, alone among farm bill conservation programs, has languished under the Bush Administration since passage of the 2008 Farm Bill last May.

A little later during the hearing, Vilsack described the Conservation Stewardship Program as important for the environment and cited its potential to boost farm income and create jobs.

By the way, Vilsack’s disclosure documents show that he collects payments from the US Department of Agriculture on some Iowa farmland he and his wife own:

The former Iowa governor and his wife, Christie, have been receiving payments since 2000 for an acreage in Davis County that is enrolled in the land-idling Conservation Reserve Program, according to USDA data compiled by the Environmental Working Group.

In a Jan. 8 letter to USDA ethics officials, Vilsack said he would seek a waiver to continue receiving CRP payments while he is secretary. Otherwise, experts said, he would have to break his contract and reimburse the USDA for all previous payments he has received, which would total nearly $60,000.

Craig Cox, Midwest vice president of the Environmental Working Group, a research and advocacy organization, welcomed having an agriculture secretary who receives conservation payments.

At a time “when simultaneously protecting our soil, water, wildlife habitat and climate is an urgent priority, it is encouraging that our new secretary of agriculture is personally participating in a conservation program that does just that,” he said.

I’m with Cox; it’s good for the secretary of agriculture to have first-hand knowledge of the conservation reserve program’s value.

Earlier this week the Register published an article on the opening statement Vilsack prepared for his confirmation hearing:

Tom Vilsack is promising to use the U.S. Department of Agriculture to “aggressively address” global warming and energy independence.

In an opening statement prepared for his Senate confirmation hearing on Wednesday, President-elect Barack Obama’s nominee for agriculture secretary also said he would use the department to “create real and meaningful opportunities” for farmers and to guarantee that rural communities grow and prosper. […]

Vilsack, a former mayor of Mount Pleasant, also said rural communities continue to lose population and “find it increasingly difficult to keep pace with the ever-changing national and global economy.”

He pledged to try to resolve the long-standing civil rights claims against the department.

“If I’m confirmed, the message will be clear: discrimination in any form will not be tolerated,” Vilsack said.

After reading that Register article, La Vida Locavore’s Jill Richardson commented,

I want to see our subsidy structure change to reward farmers for sustainability instead of yield. I want the government to ease the financial risk on any farmer transitioning to organic because it appears to me that being an organic farmer isn’t so bad on your bank account, but transitioning alone might break several farmers financially. I want to outlaw CAFOs altogether. But will Vilsack do this? Let me just say this: I am so confident he won’t that I promise now to entirely shave my head if he DOES do each of these 3 things.

I think we can all agree that Jill is not going to look like Sinead O’Connor anytime soon. I totally agree with her first two suggestions. As for CAFOs, it’s not realistic to expect them to be banned, but I believe they would be greatly reduced in number and size (over time) if government policy made them pay for the harm they cause.

On a more encouraging note, I read this at the U.S. Food Policy blog:

Some highlights included Vilsack’s encouragement of locally grown fruits and vegetables and pronouncement that they should be grown not just in rural areas, but everywhere. He announced that he met with Health and Human Services nominee Tom Daschle last week in order to demonstrate the importance of working together for nutrition. “It’s going to be important for us to promote fresh fruits and vegetables as part of our children’s diets. . .that means supporting those who supply those products” and making it easier for consumers to buy locally grown products, Vilsack said.

Maybe Vilsack and Daschle will take some of Angie Tagtow’s excellent advice on how their agencies can work together to improve human health. I would also encourage them to read this recent piece by Steph Larsen: “For healthy food and soil, we need affordable health care for farmers.”

I am curious about what Vilsack means by “supporting those who supply” locally-grown fresh fruits and vegetables. One problem with our current agricultural policy is that commodity farmers lose all federal subsidies if they put more than two acres into growing fruits or vegetables. Apparently that was the price needed to get California’s Congressional delegation to vote for various farm bills over the years. Even though almost no subsidies go directly to California farmers, this penalty limits the competition California growers might otherwise face from Midwestern farmers.

So, very little of the produce consumed by Iowans is grown in Iowa, and our grocery stores are full of produce trucked in from thousands of miles away. Most of the crops Iowa farmers grow are inedible for humans without processing.

A few years back the Leopold Center for Sustainable Agriculture at Iowa State University published a report on “Food, Fuel and Freeways.” It showed how far food travels to Iowans and how much Iowans could reduce greenhouse-gas emissions if we increased the proportion of locally-grown food in our diets to even 10 percent of what we eat.

Getting back to the Vilsack hearing, members of the Senate Agriculture, Nutrition and Forestry Committee made some notable comments yesterday. who questioned Vilsack made some notable comments on Wednesday. Iowa’s own Tom Harkin, who chairs the committee, gave Vilsack a warm welcome:

“I just couldn’t be more proud to see you sitting there. I don’t think President-elect [Barack] Obama could have picked a better person for this position,” Harkin said.

Harkin also discussed federal child nutrition programs:

Agriculture Chairman Tom Harkin , D-Iowa, said reauthorization of a law (PL 108-265) governing school lunches and other child nutrition programs “is really the only thing that we have to do this year.” […]

During the hearing, Harkin said he will propose that the Department of Agriculture use Institute of Medicine guidelines to set standards for junk food sold in schools. Current USDA school food standards exempt most snack foods, because they aren’t a part of subsidized lunches.

During the last renewal of the child nutrition act, then-Gov. Vilsack wrote a letter to lawmakers and the Bush administration expressing concern about childhood obesity and the problem of vending machine snacks that compete with school meals.

At the time, Vilsack backed limits on the kinds of snacks and beverages students can buy outside the lunch line. Nutrition advocates want junk food kicked out of schools, but many schools use the cash from sales to cover the rising costs of meal services.

(Side note: the state of Iowa is now considering banning the sale of junk food in public schools.)

Meanwhile, Iowa’s Republican Senator Chuck Grassley urged Vilsack to act quickly on several other fronts, including rule-making that would protect smaller volume livestock producers. Also, Grassley and Democratic Senator Byron Dorgan of North Dakota wrote an open letter to Vilsack asking him to close a loophole affecting commodity program payment limits. Ferd Hoefner, Policy Director of the National Sustainable Agriculture Coalition, explains that “This particular loophole is the single most important one allowing mega farming operations to collect payments in multiples of what otherwise appears to be the statutory dollar limit.”

According to Hoefner,

Another former chairman, Pat Leahy (D-VT), weighed in with a comment that the Department is not keeping up with the rapid growth of organic and then with a question asking whether it wasn’t time for the Department to get on with the business of actually actively promoting organic.  Vilsack said we need to “celebrate and support” organic and USDA should view it as one very legitimate option in a menu of options for improving farm incomes.  Then, in response to an extended monologue from Senator Pat Roberts (R-KS) deriding organic as marginal, Vilsack held his ground, but diffused the implied antagonism, saying the Department needs to support the full diversity of American agriculture.

The Ethicurean blog published an excerpt of Roberts’ insult to “small family farmers”:

That small family farmer is about 5’2″ … and he’s a retired airline pilot and sits on his porch on a glider reading Gentleman’s Quarterly – he used to read the Wall Street Journal but that got pretty drab – and his wife works as stock broker downtown. And he has 40 acres, and he has a pond and he has an orchard and he grows organic apples. Sometimes there is a little more protein in those apples than people bargain for, and he’s very happy to have that.

How disappointing that an imbecile like this could easily get re-elected in Kansas. Roberts’ caricature does not resemble any of the sustainable farmers I know. They work just as hard as Roberts’ idealized “production agriculture farmer” but don’t receive any federal subsidies, despite growing high-quality food and being good stewards of the land.

If you haven’t already done so, please go to the Food Democracy Now site and sign their new petition recommending 12 good candidates for undersecretary positions at the USDA. These will be important appointments, since Vilsack won’t single-handedly be setting the USDA’s policy direction.

The Center for Rural Affairs has also launched a petition worth signing, which urges Vilsack to implement a number of programs that would benefit farmers and rural economies.

I don’t recall nearly as intense a reaction to Bill Clinton’s or George Bush’s nominees for secretary of agriculture. Either food and farm issues are much more salient now than they used to be, or I am noticing it more because Barack Obama is tapping an Iowan to head the USDA.

Tom Vilsack’s friend Jennifer Donahue says Vilsack is the “best possible” choice for secretary of agriculture.

Denise O’Brien urges sustainable agriculture advocates not to give up hope, because as governor Vilsack was accessible and did some good things on food and environmental issues.

Another Iowan, Food & Society Policy Fellow Angie Tagtow of Elkhart, wants Vilsack and incoming Health and Human Services Secretary Tom Daschle to work together:

A dichotomy exists between agriculture policies and Dietary Guidelines for Americans – yet, ironically, both are overseen by the USDA. Current food and farm policies stand in the way of making healthy food the easiest choice.

Food and agriculture policies must support disease prevention efforts and can save millions in health care costs. The USDA and USDHHS must use sound science, instead of pressures from special interests like biotechnology companies and the food industry, to reform policies and programs that support a healthy and sustainable food and agriculture system.

Specifically, Tagtow advocates cooperation between Vilsack and Daschle toward the following goals:

1. Creating an intradepartmental Food Policy Council, led by a Food Czar, “to assure farm, food and nutrition policies and programs support public health goals.”  

2. Enacting policies to build fertile soil. “Farmers should receive support or credits for decreasing use of synthetic farm chemicals, protecting natural resources, building soil, reducing fossil fuel use and capturing carbon.”

3. Creating incentives to grow more fruits and vegetables in the U.S.: “Our agriculture system does not grow enough of the right foods that promote our health. We are forced to rely on other countries to put fruits and vegetables on our plates.”

4. Making fresh fruits and vegetables and whole grains more available to people on federal food and nutrition assistance program: “Improving the nutritional quality of the WIC food package and the foods served in schools will nourish healthy children, prepare them to learn, reduce childhood diseases, reduce food insecurity and produce healthy, productive adults.”

5. Leveraging food production as economic development. “Growing more food closer to where we eat it increases our access to fresh seasonal food, cultivates a closer relationship with farmers, and builds community resiliency, economic stability, food security and health.”

Tagtow’s suggestions are all excellent, and I hope Vilsack and Daschle will act on them.

Rob Hubler, former Congressional candidate in Iowa’s fifth district, is asking everyone on his e-mail list to support petitions calling for a more sustainable agriculture policy:

Friends,

[…] Will you join me in continuing to work for the same values we campaigned on? There are two quick, but important, actions I want you to take. Both will make a difference for the future of rural communities, family farming and our entire food system.

First, I was proud to add my name to a remarkable effort to pressure President-elect Obama to appoint a “Sustainable Secretary of Agriculture” originated in our own district. Food Democracy Now (http://www.fooddemocracynow.org), launched last week by Iowan Dave Murphy, rocketed to national attention when Nicolas Kristof endorsed the effort in his New York Times column.

Nearly 50,000 people have already signed. Will you help push the petition to 100,000?

Second, the Center for Rural Affairs launched a Grassroots Letter to the next Secretary of Agriculture. No matter who Obama selects, the next head of the USDA needs to hear from you. You can sign the Center for Rural Affairs Grassroots Letter and leave your own comment about the change you would like to see to food, farm and rural policy. The Center for Rural Affairs will send your signature and comment onto the next Agriculture Secretary.

Join me in signing their letter here: http://www.cfra.org/08/grassro…

Peace & Justice,

Rob L. Hubler

I agree that it’s helpful to add more names to those petitions. Food Democracy Now has more than 58,000 signers already. The Center for Rural Affairs’ proposals are wide-ranging and sensible.

The Organic Consumers Association, which came out swinging against Vilsack last month, hasn’t given up on blocking this appointment. On Wednesday they launched a “Stop Vilsack” petition.

This strikes me as ineffective and unwise. There is no chance of Obama backing off from this nomination. He was aware of Vilsack’s position on agriculture when he made the decision. There is no chance of the Senate not confirming Vilsack. Senator Tom Harkin of Iowa chairs the relevant committee and has already said he will make sure Vilsack’s confirmation hearings go smoothly.

The Organic Consumers Association would do better to organize pressure on Vilsack to take specific actions, either reversing bad Bush administration policies or moving in a more sustainable direction, as the Center for Rural Affairs and Tagtow are proposing.

Daily Kos user CornSyrupAwareness had a different take on Vilsack’s nomination:

I’m glad to see Iowa get their due with this pick of Tom Vilsack. They were instrumental in getting our man elected, and we should all tip our caps to Iowa. Iowa is now paid in full for their efforts and I’m glad. This way they don’t get their due by ‘vetoing’ a Surgeon General’s warning on High Fructose Corn Syrup.

CornSyrupAwareness also quoted some comments Obama made months ago about corn syrup, and posted this great clip of Bill Maher asking Joe Biden, “Which is more likely to contribute to the death of your average American: a terrorist strike, or high-fructose corn syrup, and air that has too much coal in it?”

Once Vilsack is confirmed as secretary of agriculture, a lot of other positions within the USDA will need to be filled. At La Vida Locavore, Obama Foodorama drew attention to last week’s little-noticed resignation of Elizabeth Johnson, the Under Secretary for Food Safety of USDA and made the case for Bill Marler to replace her:

[T]here are opportunities for swift and dramatic change, particularly in food safety. If the USDA fulfilled even half of its already existing mandate, we’d have a far cleaner and safer food chain. Elizabeth Johnson’s now-vacant post as Under Secretary for Food Safety needs to be filled by an inspired, activist leader, someone with both a long institutional memory, and a firm grasp on how to rapidly change what’s so terribly wrong with our system. There’s one individual in the food safety world who is the most uniquely qualified candidate to take on such a huge challenge: Attorney Bill Marler, the foremost food poisoning authority in the country (pictured).

A founding partner of Seattle’s Marler Clark law firm, Marler is an extremely activist consumer advocate and champion of change in food safety policy and practice, both in the US and abroad. His focus on food safety began in 1993, when he won a landmark settlement against Jack in The Box for E. coli contamination. Since then, Marler’s firm has become a powerhouse of food borne illness litigation, garnering close to half a billion dollars in settlements for injured clients.

Marler himself is now the leading US expert in institutional and agricultural structures for food safety, and he regularly works with farmers and major corporations to change/create safety practices (most recently, he persuaded global conglomerate Conagra to dramatically alter their policies). He’s repeatedly testified before Congress on food safety, and has been a vociferous and much-published critic of government policies and practices (including the ongoing labeling fights over “organic”). His Marler Blog is the best internet source for food safety information, and as the years have gone by, Marler has devoted more and more of his professional life to non-profit consultations on food safety and security around the world. Under the umbrella of Marler Clark’s non-profit organization, Outbreak, Marler consulates with foreign food agencies, producers, and governments on how to better protect the public from poisoned food, and how to create safe food systems. This is crucial for any Under Secretary for Food Safety, because America imports a huge part of our food supply each year. Marler has not only been an activist on getting foreign producers to focus on safety, but he’s also intimately acquainted with exactly what goes on in international markets.

The undersecretary appointments don’t get much attention but are quite important. Thanks to Obama Foodorama for shining a light on food safety. (UPDATE: Daily Kos user Halcyon informed me that Marler is an occasional diarist at Daily Kos. His most recent post is about the top ten food safety stories of 2008.)

Share any relevant thoughts on Vilsack’s nomination or federal policies on food and agriculture.

Strong words from President-elect Barack Obama at yesterday’s press conference introducing Tom Daschle as Secretary of Health and Human Services:

Some may ask how, at this moment of economic challenge, we can afford to invest in reforming our health care system. Well, I ask a different question — I ask how we can afford not to….If we want to overcome our economic challenges, we must also finally address our health care challenge.

Obama also promised to address health care “this year,” implying that he will spend political capital to get a plan through Congress in 2009.

Daschle linked health care reform to economic recovery:

Addressing our health care challenges will not only mean healthier and longer lives for millions it will also make American companies more competitive, address the cause of half of all of our personal bankruptcies and foreclosures and help pull our economy out of its current tailspin.

Obama also named Jeanne Lambrew as Daschle’s deputy. Ezra Klein is very pleased with that pick:

Lambrew is an incredibly talented and knowledgeable health wonk, and her involvement should cheer liberals. Unlike during the campaign, when Obama’s health care team seemed heavy on relatively cautious academics, Lambrew has long White House and executive branch experience, and comes to health care as a crusade as much as a topic of study. As Jon Cohn says, the importance of her presence “goes beyond the fact that she happens to know a heck of a lot about health care. She, too, has a strong commitment to what you might call the ‘social justice’ side of the debate.”

For more from Lambrew, check out her congressional testimony from late October, where she argued that “the short-run economic crisis has health policy causes and effects-and arguably the most serious long-run economic challenge is our broken health care system.” That was almost exactly the message Obama delivered today. And it’s the message that will be heard in the White House, and translated into a political strategy by Tom Daschle.

In this article for The American Prospect, Klein compares Obama’s team of “health care heavyweights” to Bill Clinton’s disastrous strategy for pushing health care reform in 1993 and 1994.

The major battle will be making sure there is some public insurance plan Americans can opt into, so that private insurers will need to cover health care in order to compete for customers.

I don’t expect to get everything I want from Democratic politicians in power. Probably liberals like me will have plenty of disappointments in the coming years. But if Barack Obama and the Democratic Congress only follow through on one big campaign promise, I hope it’s health care.

The many injustices of our current health care system have been thoroughly documented by nyceve, among others, but I want to add my two cents.

The 46 million Americans lacking health insurance represent one very large part of problem. Some can’t afford insurance, and others can’t find a private insurer who will sell them a policy for any price. You could spend all day listing the ways uninsured Americans get a raw deal on health care. They can’t afford preventive care and routine diagnostics, so they are more likely to be diagnosed with late-stage, incurable cancer. They are less likely to receive care for any number of chronic illnesses. They live with terrible, crippling pain. Few Americans without health insurance coverage are able to receive organ transplants, though many become organ donors after dying prematurely.

We need to get these people covered and get away from our broken employer-based health care system. Every day Americans who thought they had good benefits are joining the ranks of the uninsured–like my friend whose husband got laid off in October, right before his employer (a small manufacturer) went under. It turned out the boss had secretly stopped paying the health insurance premiums some time before. Or the retirees who worked at Maytag or at John Deere for many years and are now losing some of the health benefits they were promised.

Employer-based health care is also a huge drag on large corporations and our national economy, as clammyc pointed out in this recent diary.

In an ideal world, I’m for a Canadian-style single-payer system (also known as HR 676 or “Medicare for all”), but as a political compromise I would settle for something like what John Edwards and Hillary Clinton proposed during the primaries: mandatory health insurance, which would be portable with no exclusions for pre-existing conditions, and the option for any American to buy into a public insurance plan. Momentum is building in Congress for this kind of reform.

But getting Americans health insurance will solve only part of the problem. It’s shocking how many Americans with “good” insurance go without needed medical care. Only occasionally does a case makes national news, as when the teenager Nataline Sarkisyan was unable to get a liver transplant last year. A recent study found many Americans with chronic illnesses forgo medical care for cost reasons, even if they have insurance.

Then there are the “lucky” people who get the care they need for a medical emergency, but later face financieal ruin when their insurance company denies coverage. Medical bills are implicated in about half of all personal bankruptcies in the U.S.

When I had a medical emergency last winter, I got to the doctor relatively early, I received good care in the hospital, no lasting damage was done to my body, and my insurance company covered almost all of the costs (once we had exhausted our deductible). I remember our relief when the biggest bill arrived in the mail, for about $18,000, and our required payment was only $600. (I recognize that $600 would be a hardship for many families, but we are fortunate to be able to pay that without cutting back on any essentials.)

Yesterday I was reminded again of how things could have turned out very differently for my family. If you are a regular at Daily Kos, you may recognize the handle AdmiralNaismith. Among other things, he wrote a series of diaries about the political scene in all 50 states between April and October. The links to all of those pieces are here, and he wrote an interesting post-election wrap-up diary here.

AdmiralNaismith doesn’t write many personal diaries, but he recently discussed his own family’s “medical horror story”: Drowning in medical bills, despite insurance (another link is here).

He describes the sequence of events, including his wife’s life-threatening embolism, which left his family owing thousands of dollars for medical care–more unpaid bills than AdmiralNaismith earns in three months. He asked fellow bloggers to help pay down the three largest bills, which will otherwise be sent to collection agencies within 30 days. (He’s not asking anyone to send him money directly but provides contact details for the insurer, with name and account number.) A few hundred people paying $10 or $20 each would help enormously.

I will be calling to make a payment on Monday, and I encourage anyone who’s ever benefited from reading AdmiralNaismith’s informative diaries to do the same.

But equally important, I ask the community of Democratic activists, who did so much to elect Obama, to hold his feet to the fire next year on delivering the comprehensive health care reform he promised.

I haven’t been thrilled with Obama’s cabinet appointments so far. My number one hope for the new government is that Ezra Klein is right about what Tom Daschle as secretary of Health and Human Services means:

This is huge news, and the clearest evidence yet that Obama means to pursue comprehensive health reform. You don’t tap the former Senate Majority Leader to run your health care bureaucracy. That’s not his skill set. You tap him to get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate. And he accepts because he has been assured that you mean to attempt health care reform.

Please share your thoughts or health care horror stories in the comments.

Jed L brought something remarkable to my attention over the weekend.

Michael Cannon of the conservative CATO Institute wrote a piece called Blocking Obama’s Health Plan Is Key to the GOP’s Survival. The idea is that if Obama gets universal health care passed, he will bring “reluctant voters” into the Democratic coalition. The Republicans must at all costs provent that from happening.

David Sirota and TomP both pointed out that conservative pundit William Kristol made the same case to Congressional Republicans during Bill Clinton’s first term. At first, some were afraid to be seen as obstructing the president’s health care reform efforts. But in December 1993,

Leading conservative operative William Kristol privately circulates a strategy document to Republicans in Congress. Kristol writes that congressional Republicans should work to “kill” — not amend — the Clinton plan because it presents a real danger to the Republican future: Its passage will give the Democrats a lock on the crucial middle-class vote and revive the reputation of the party. Nearly a full year before Republicans will unite behind the “Contract With America,” Kristol has provided the rationale and the steel for them to achieve their aims of winning control of Congress and becoming America’s majority party. Killing health care will serve both ends. The timing of the memo dovetails with a growing private consensus among Republicans that all-out opposition to the Clinton plan is in their best political interest. Until the memo surfaces, most opponents prefer behind-the-scenes warfare largely shielded from public view. The boldness of Kristol’s strategy signals a new turn in the battle. Not only is it politically acceptable to criticize the Clinton plan on policy grounds, it is also politically advantageous. By the end of 1993, blocking reform poses little risk as the public becomes increasingly fearful of what it has heard about the Clinton plan.

Getting back to Cannon’s recent piece for CATO, I am struck by how conservatives don’t even believe their own propaganda about the horrors of “socialized medicine.” Yes, I know that Obama isn’t proposing socialized medicine (which would work like the Veterans Administration, where the government employs the doctors and runs the hospitals), or even single-payer health care (as in Medicare, where patients choose the doctor but the government pays the bill). But for the moment, let’s accept CATO’s frame on this issue, which is that Obama’s health plan would turn into socialized medicine.

Obama’s plan would presumably allow Americans to buy into a state-run health insurance plan as an alternative to private health insurance, and would prohibit insurers from excluding people with pre-existing conditions. These measures would force the insurance companies to compete for customers by offering better coverage, as opposed to the current system, in which they try to maximize profits by denying care whenever possible, and sometimes refusing to insure people for any price.

I have a friend with a thyroid condition. At one point her husband was between jobs and they looked into buying their own health insurance. They could not find any company that would take their family. It wasn’t a matter of excluding coverage for anything related to my friend’s thyroid condition. They simply declined to sell insurance to this family at any cost. Fortunately, my friend’s husband got a job with good benefits. Otherwise, they would be uninsured to this day.

The benefit of giving families like my friend’s the option of buying into state-run insurance program is obvious. But let’s assume that conservatives are right, and that any state-run insurance scheme is bound to be expensive and inefficient. If that’s the case, wouldn’t it fail in the marketplace?

Obama’s health care plan could evolve in the direction of single-payer health care only if the government insurance plan provided superior coverage to consumers at a lower cost. CATO shouldn’t be worried about this, right?

Let’s go a step further. Conservative pundits are trying to tell us that Democratic health care proposals would be disastrous for the country and wreck the economy. If that’s true, then why is a CATO analyst worried that enacting Obama’s health care plan would cause a political realignment in the Democrats’ favor?

Cannon’s argument is also shocking on a moral level. He appears to believe that Obama’s health care plan would improve so many Americans’ lives that the GOP’s survival would be threatened. So, he urges Republicans to put their own political interests ahead of the interests of Americans currently lacking adequate health care.

Jed L thinks

Cannon has everything backwards: the GOP’s survival depends on Republicans being part of the solution instead of being part of the problem.

I have to admit that here I agree more with Cannon. Republicans would not get much credit for helping to pass Obama’s universal health care plan. Everyone would know it was a Democratic president with a Democratic Congress who delivered on that promise.

Obstruction with the goal of making Obama look like an ineffective leader in tough economic times is probably the Republicans’ best hope of making political gains.

I am cautiously optimistic that Congress will be more open to adopting Obama’s agenda than the Democratic-controlled Congress was for Bill Clinton in 1993 and 1994. We’ve got at least two things going for us: Obama’s Health and Human Services secretary will be Tom Daschle, who knows the inner workings of Congress, and Henry Waxman (not John Dingell) will be running the House Energy and Commerce Committee.

Looks like the Guardian jumped the gun; Hillary Clinton has not accepted the Secretary of State position and is reportedly still weighing Barack Obama’s offer.

Apparently Senator Ted Kennedy wants Hillary to lead the efforts to get health care reform through Congress. That’s where I’d like to see her as well, though the cynic in me wonders whether Kennedy is primarily trying to clear the path for his friend Senator John Kerry to become secretary of state.

I would be happy with either Kerry or Bill Richardson for that job, but my dream is still Richardson as transportation secretary.

Roll Call reports that former Senate Majority leader Tom Daschle, an early Obama backer, has accepted Obama’s offer to run the Health and Human Services department. Daschle will also be the White House “health care czar,” and I’m with Matt Stoller:

isn’t it weird that cabinet appointments are basically subordinate to White House staff positions?  It’s like, when did ‘czar’ become a laudable title?

Obama is said to have decided on Eric Holder for attorney general. Holder was deputy attorney general under President Bill Clinton but supported Obama during the Democratic primaries. He also helped lead Obama’s vice-presidential search team. He is still being vetted, but if selected and confirmed, Holder would become the first black U.S. attorney general.

The Ethicurean gets real about who might become secretary of agriculture.

It’s notable that no hero of Obama’s progressive supporters seems to be in the running for any job. I admit that part of me is amused to watch heads explode among those who really believed Obama would bring transformational change. It’s been clear for many months that there was little daylight between Hillary and Obama on policy. Some people bought into the Clinton demonization project a bit too much in the winter and spring.

On the other hand, Pat Buchanan’s stopped clock is right about this: Obama should make at least one appointment that will please the “Daily Kos crowd,” which did so much for Obama during the primaries. It would be ironic if “the change we need” turned out to be a bunch of former Clinton officials and centrist Congressional leaders, with a few Republicans mixed in.

This is an open thread for any thoughts or predictions about Obama’s cabinet appointments.

UPDATE: Ezra Klein is excited by the news about Daschle:

This is huge news, and the clearest evidence yet that Obama means to pursue comprehensive health reform. You don’t tap the former Senate Majority Leader to run your health care bureaucracy. That’s not his skill set. You tap him to get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate. And he accepts because he has been assured that you mean to attempt health care reform.

UPDATE 2: CNN reports that Arizona Governor Janet Napolitano, an early Obama backer, will be named Homeland Security secretary. I want her to run against John McCain for Senate in 2010.

Step It Up 2 in DSM! – National Day of Climate Action

Saturday, November 3rd
10:30AM
West Capitol Terrace (West Steps of Capitol Building)
Des Moines

Across Iowa, environmentalists, farmers, union members, businesses, religious leaders, and concerned citizens are working to promote renewable energy and stop global warming. On November 3rd, we will unite with communities across the country to demand real leadership on global warming. The second “Step it Up” is an occasion to see who has a real plan to tackle the defining challenge of our time. One year before the election, we have to make sure the world witnesses our national call to action: “Step it up! It's time for climate leaders!”

Local, state, and federal representatives have been invited to speak. Several presidential campaigns will be sending surrogates on the candidates' behalf.

Join us at the Capitol, film a video message to our representatives, participate in our kid's art project, help us build “wind turbines” around the Capitol grounds, or just enjoy a day with community members who want to see action on global warming now!

Speakers:

~ Des Moines Mayor Frank Cownie

~ Former Senate Majority Leader Tom Daschle, on behalf of the Obama campaign

~ John Campbell, United Steel Workers Iowa Political Director, on behalf of the Edwards campaign

~ David Slutzky, Senior Environmental Policy Adviser to the Clinton Administration, on behalf of the Clinton campaign         

~ Anissa Bacon, Plymouth Congregational Church

More speakers to be announced…          

For more information or to sign-up contact Kelly at 818-282-0168 or kellyemitchell@gmail.com