As Barack Obama battled Hillary Rodham Clinton over health care during the Democratic presidential primaries of 2008, he was adamant about one thing: Americans, he insisted, should not be required to buy health insurance.

“If things were that easy,” Mr. Obama told the talk show host Ellen DeGeneres in February of that year, “I could mandate everybody to buy a house, and that would solve the problem of homelessness. It doesn’t.”

Now President Obama may wish he had stuck to those words. On Monday, the Supreme Court agreed to take up a constitutional challenge to his landmark health care bill, and a decision could come in the midst of Mr. Obama’s 2012 re-election campaign.

At the heart of the challenge is “the mandate” — a provision requiring nearly all Americans to buy coverage or pay a penalty — that he so vigorously opposed as a candidate. If it is struck down, much of his signature legislative achievement could fall with it in a decision that would undoubtedly be construed as a rebuke to the president.

Polls show the mandate is by far the most unpopular provision of the 2010 bill, and now Mr. Obama, who ultimately embraced the idea, is in the awkward position of defending something he once rejected.

“I think his political instincts were right,” said Paul Starr, a health policy expert at Princeton University who argues that it is possible to expand coverage by other means. “I think he saw that there could be a backlash against a mandate and that there needed to be some other kind of approach. So in a way, I’m sorry he didn’t stick to his original position.”

The theory behind the mandate, according to its proponents, is this: Requiring coverage brings both sick and healthy people into the pool of those insured, which is essential because premiums paid by the healthy offset the cost of covering the sick. Otherwise, healthy people wait until they are ill to buy insurance, which leads to what policy analysts call a “death spiral” in which premiums skyrocket out of control.

As a candidate, Mr. Obama did favor requiring all children to have insurance. Once he took office, his top aides began examining other options, said Ezekiel J. Emanuel, a former health policy adviser to Mr. Obama. The aides studied the experience of Massachusetts, which has a mandate, and health laws in other states that do not. They considered voluntary incentives to get healthy people to enroll.

Their internal modeling, Dr. Emanuel said, showed that a mandate would extend coverage to 32 million uninsured people. Without such a requirement, he said, the administration estimated it could cover 16 million people at three-fourths the cost of covering the 32 million. In the face of such evidence, Mr. Obama reversed himself.

“I don’t think it was a slam-dunk,” said Dr. Emanuel, now a vice provost at the University of Pennsylvania and a regular contributor to The New York Times’s Op-Ed page. “The president did take very seriously his reputation for following what he said, so he was very reluctant to change his opinion unless he was very convinced.”

Health insurers also insisted on a mandate, as did the Democrats who controlled Congress. In July 2009, Mr. Obama told CBS News that he was “now in favor of some sort of individual mandate as long as there’s a hardship exemption” for people who truly could not afford to buy insurance.

While the White House may have been prepared for the public unhappiness over the provision, it appears to have been caught off guard by the constitutional challenge — in part because Obama advisers regarded the mandate as a conservative notion. The idea gained currency in the early 1990s, when some Republicans proposed their own version of an “individual mandate” as an alternative to the “employer mandate” in President Bill Clinton’s health plan.

Polls show that the individual mandate is unpopular. The Kaiser Family Foundation, which tracks public opinion on the health measure, reported in March that 74 percent of Americans would keep, rather than repeal, the law’s provision barring insurers from discriminating against people with pre-existing conditions. But only 27 percent would keep the mandate. (A CNN poll released Monday found that 52 percent supported the mandate, up from 44 percent in June, though unlike Kaiser, CNN did not explain that failure to comply would result in a fine.)

The Obama administration insists that if the mandate falls, so does the provision on pre-existing conditions. “The mandate,” said Jonathan Gruber, a health economist at the Massachusetts Institute of Technology who has advised the administration, “is the spinach you need to get the chocolate you want.”

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Should the middle class be eligible for Medicaid?

The health program, funded jointly by the feds and the states, was devised to cover the poor. But if a provision in last year’s health law isn’t changed that could be the case for people with pretty healthy incomes.

So today, the House approved a bill that would make the change. The bill is backed by President Obama, among others, and it passed relatively easily in a vote of 262-157.

But, as usual with things related to health and tax policy, nothing is quite as simple as it seems.

The “glitch,” if it is one, refers to the fact that under the health law, most Social Security benefits are not taxed. And the untaxable portions of those benefits aren’t counted to determine eligibility for Medicaid. Same goes for the State Children’s Health Insurance Program, and for other income-tested provisions of the law, including subsidies for private health insurance premiums.

By failing to count most Social Security benefits, it’s true, as last summer’s stories pointed out, that a couple retiring at age 62 (too young for Medicare but just barely eligible for early Social Security) earning as much as $60,000 per year could gain access to Medicaid for those three years.

“This is unacceptable,” said Rep. Diane Black (R-Tenn.) sponsor of the House bill, on the floor Wednesday during the preliminary debate on the measure. “The health care law’s deviation from the typical method of counting income results in taxpayer dollars being directed to individuals who do not… meet the standard definition of low income.”

But the change will affect more than just the near-elderly retiring early. According to the Congressional Budget Office’s latest estimates on the effects of the change, the measure would reduce Medicaid enrollment by between 500,000 and 1 million people per year, including those receiving Social Security retirement payments, survivor benefits, disability benefits and some other types of payments.

Some of those people would get other coverage, but some, said CBO, would be uninsured. “It was not a glitch,” insisted Rep. Joe Crowley (D-N.Y.) on the House floor during debate on the measure. “This language was deliberately put into the health care law to expand affordable health insurance. And it will particularly help early retirees between the ages of 62 and 64, as well as Americans on disability.

But if the prospect of cutting back on people getting insurance alone wasn’t enough to bother many House Democrats (only a couple of dozen voted for the measure), the money saved by the bill (an estimated $21.7 billion over the next 10 years) is now being used to offset the cost of another bipartisan bill. That one would repeal a requirement that governments at all levels withhold 3 percent of funds paid to contractors in order to ensure tax compliance. The repeal of the withholding requirement — originally passed under President George W. Bush — is considered a job-stimulating measure. It passed overwhelmingly: 405-16.

“Republicans want to pay for the 3-percent bill by making it harder for retirees, the disabled and poor to get access to health insurance,” said Alcee Hastings, (D-Fla.). “My friends in the majority have decided to throw retirees and disabled individuals under the bus in order to offset a completely unrelated bill.”

But using the money saved by making the Social Security tax change to pay for the jobs bill means that those health-related savings will no longer be available to pay for other health legislation.

And what legislation might that be? Well, noted House Ways and Means Committee ranking member Sander Levin (D-Mich.), there is that small matter of a 30 percent scheduled cut for doctors on Medicare that will take effect unless Congress acts by the end of the year.

“Essentially what would be done now is to use up a provision that impacts health and lose the possibility of using it in terms of physician reimbursement,” he said.

Still, the majority of House Democrats were outvoted. Both the health and jobs bills are now on their way to the Senate, where their tied fates remain uncertain.

The Obama administration announced Friday that it was scrapping a long-term care insurance program created by the new health care law because it was too costly and would not work.

Kathleen Sebelius, the secretary of health and human services, said she had concluded that premiums would be so high that few healthy people would sign up. The program, which was intended for people with chronic illnesses or severe disabilities, was known as Community Living Assistance Services and Supports, or Class.

“We have not identified a way to make Class work at this time,” Ms. Sebelius said. She said the program, which had been championed by Senator Edward M. Kennedy, Democrat of Massachusetts, was financially unsustainable.

Kathy J. Greenlee, the assistant secretary of health and human services in charge of the program, said: “We do not have a viable path forward. We will not be working further to implement the Class Act.”

The administration’s decision was another setback for the new law, which is under attack in court, in Congress and in many state legislatures. Ms. Sebelius said her decision “does not affect the rest of the health care law,” which is supposed to provide coverage to more than 30 million people who are uninsured.

But the Senate Republican leader, Mitch McConnell of Kentucky, said the long-term care program was “only one of the unwise, unsustainable components of an unwise, unsustainable law.” He and other Republicans in Congress want to repeal the entire law.

Advocates for older Americans and people with disabilities expressed disappointment at the decision, and Ms. Sebelius said Americans still had an “enormous need” for long-term care insurance. “At $75,000 a year for a nursing home and $18,000 a year for home health care, most families cannot afford to pay out of pocket,” she said.

The program was intended for people with severe disabilities who wanted to live in the community, though benefits could also have been used to help pay for nursing home care or assisted living. It would have been financed with premiums paid by workers, through voluntary payroll deductions, with no federal subsidy. Premiums were supposed to have ensured the solvency of the program over 75 years.

But Ms. Sebelius said she agreed with actuaries who feared that “not enough young, healthy people” would enroll. “This could have led to a vicious cycle where premiums would have to be set higher and higher to cover the likely costs of benefits, leading fewer and fewer healthier people to sign up for the program,” Ms. Sebelius said.

Two early critics of the Class program — Senator John Thune of South Dakota and Representative Charles Boustany Jr. of Louisiana, both Republicans — said they had been vindicated.

“The Obama administration ignored repeated warnings about the financial solvency of this massive new entitlement and suppressed information on the viability of the program,” Mr. Thune said.

In an interview, Mr. Boustany said that “in their haste to get the bill passed,” President Obama and Congressional Democrats ignored warnings about the program’s financial risks.

When Congress was developing the program in late 2009, Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee, described it as “a Ponzi scheme of the first order” because it required an ever-increasing stream of premiums to cover the cost of benefits. Connie Garner, who helped devise the long-term care program as an aide to Mr. Kennedy, said she was “very, very disappointed” by the decision. “The program could have been made to work” if the administration had tried harder, Ms. Garner said.

Healthcare has already been proclaimed the central issue of the 2012 Presidential election, just like it was hailed the central issue of Obama’s presidency. It was also a central issue during the 2010 election, and the 2008 campaign. So why don’t we ever hear the end of it?

Our leaders still have not solved the problem with our nation’s healthcare crisis. Even with the passage of Obama’s Affordable Care Act, there will still be millions of Americans under-insured and without insurance.

America’s healthcare debate showed there are only two ways we’re willing to go: expand the for-profit health insurance industry by mandating everyone buy insurance, with its over-priced premiums, co-pays, and deductibles; or expand Medicare for all, providing universal healthcare through a single-payer system that lowers costs.

In a for-profit model you’re essentially paying for healthcare, as well as CEOs’ rising salaries, massive administrative costs for denial-of-claims departments, and those DTC advertisements we all love so much.

In the non-profit single-payer healthcare model individuals and businesses pay less in taxes than they’re currently paying in co-pays, premiums and deductibles. The administrative costs are also less, because medical records and “billing” would be on a National Healthcare Card. With a single-payer healthcare system everyone has a better healthcare plan — and access to it — than most anyone could afford now.

Lessons in America’s healthcare debate

Poll after poll shows the majority of doctors, nurses and consumers support expanding Medicare for all. During the “Healthcare Debate” a 2009 CBS/NYTimes poll reported that 59% of Americans agreed that the government should provide national health insurance.

Single-payer healthcare was also the deciding factor in Democrats winning the 2008 election and losing it in 2010. In ’08, many thought Obama would make demands for a system that covered everyone. Indeed, during the campaign a video emerged from 2003 where then-State Senator Obama proclaimed to the Illinois AFL/CIO: “I happen to be a proponent of a single-payer universal health care program.” To leave out any confusion, Obama followed that with the movement’s own mantra “everybody in, nobody out.” Many hoped that was a signal of change to come.

Sure, there was change, but not the kind most were expecting. Soon after taking office, he then said this: “If I were designing a system from scratch, then I’d probably set up a single-payer system … Medicare would be an example of a single-payer system, if everybody was in Medicare. But the problem is we’re not starting from scratch. We’ve got a system in which most people have become accustomed to getting their health insurance through their employer.”

Obama’s explanation simply doesn’t stick. Not only is Medicare a part of the system, expanding Medicare for all would have more people paying into it as Baby Boomer after Baby Boomer turns 65. Moreover, employer-based health insurance is one of the worst aspects of private insurance. In-doctor networks cause people to become trapped in their jobs. Doctor / patient relationships are also immediately destroyed when insurance plans change.

Why are Democrats and Republicans not making the right choice between healthcare and health insurance? It’s because they’re getting paid way too much to support the problem and not the solution.

According to the Center for Responsive Politics “about $31.6 million in contributions to candidates and committees during the 2010 election cycle” (and nearly $30 million during the 2008 cycle) came from the pharmaceutical and health industry. As Senate Finance Committee Chair Max Baucus said in 2009: “single-payer is off the table.” Apparently, the insurance and pharmaceutical giants paid for the table.

The Democrats’ base lost all hope, and by 2010 the Democrats lost their majority in Congress, essentially because they didn’t stand up for real reform. Americans don’t tolerate half measures and compromise when it comes to healthcare.

Real change starts with a single-payer

A single-payer, universal healthcare system can be set up so that it’s publicly funded yet privately delivered, particularly through the example of Medicare. No matter how many Tea Party candidates rant about “Obamacare,” or universal healthcare being “socialism,” doctors and nurses will not be government employees in a single-payer system.

For those who say, “I don’t want the government rationing care!” Right now, the insurance industry is profiting from denying them care they’re paying for. A single-payer system will give you more freedom of choice: your choice of doctor, the ability to afford the medicine you need, and access to more care. This means no co-pays, no premiums, no deductibles, no out-of-pocket costs and no medical bankruptcies.

For those who are concerned about the “publicly funded” part, I have one question: do we really want to mandate or even continue to implement a health insurance system where we pay such high premiums, co-pays, and deductibles that it leaves millions of people under-insured, or without healthcare altogether?

States lead the conversation

Candidates can win elections on a single-payer, universal healthcare platform.

California passed single-payer healthcare at the state level twice, but it was vetoed by then-Governor Schwarzenegger in ’06 and ’08. Vermont passed a single-payer healthcare bill this year, signed by Governor Peter Shumlin, who recognized local organizing efforts by the Vermont Worker’s Center. Vermont’s success, still in progress, appears to set the standard.

In a hotly contested debate this year, Rep. Kathy Hochul (D, NY) stood up in support for Medicare and won in a special election against the Republican challenger Jane Corwin, who supported Medicare cuts. This election, as mentioned by the New York Times, was in “one of New York’s most conservative districts.”

One fact remains: the insurance and pharmaceutical industry can pay off national candidates, but they can’t pay off millions of Americans suffering through medical bankruptcy or living with the burden of having no healthcare at all.

Passing single-payer universal healthcare bills at the state level would far exceed the ACA’s best qualities, but it will take standing up for single-payer and good ’ole grassroots organizing to get it done. This localized approach to organizing only makes the national movement stronger.

There are now groups in 23 states working on organizing around single-payer bills at the state level. If we can learn anything from the previous election cycles, and can understand the impact of state bills on national policies, it’s this: healthcare remains a central issue, and a single-payer plan is a winner.

Josh Starcher is a Volunteer Coordinator for Healthcare-Now! NYC.

The Obama administration asked the Supreme Court on Wednesday to hear a case concerning the 2010 health care overhaul law. The development came unexpectedly fast and makes it all but certain that the court will soon agree to hear one or more cases involving challenges to the law, with arguments by the spring and a decision by June, in time to land in the middle of the 2012 presidential campaign.

The Justice Department said the justices should hear its appeal of a decision by a three-judge panel of the United States Court of Appeals for the 11th Circuit, in Atlanta, that struck down the centerpiece of the law by a 2-to-1 vote.

“The department has consistently and successfully defended this law in several courts of appeals, and only the 11th Circuit Court of Appeals has ruled it unconstitutional,” the Justice Department said in a statement. “We believe the question is appropriate for review by the Supreme Court.

“Throughout history, there have been similar challenges to other landmark legislation, such as the Social Security Act, the Civil Rights Act and the Voting Rights Act, and all of those challenges failed,” the statement continued. “We believe the challenges to the Affordable Care Act — like the one in the 11th Circuit — will also ultimately fail and that the Supreme Court will uphold the law.”

On Monday, the administration decided that it would not seek review from the full 11th Circuit. Its Supreme Court petition was not due until November.

Also on Wednesday, two sets of plaintiffs who had won on the core issue in the 11th Circuit filed their own request for Supreme Court review.

“Time is of the essence,” wrote Paul D. Clement, a former United States solicitor general who represents 26 states in the case, urging the justices to move quickly to hear a case on the law, the Affordable Care Act. “The grave constitutional questions surrounding the A.C.A. and its novel exercise of federal power will not subside until this court resolves them.”

The 11th Circuit, in a decision issued in August, ruled that a part of law requiring the purchase of insurance — the so-called individual mandate — was an unconstitutional exercise of Congressional power.

The majority decision, written by Chief Judge Joel F. Dubina and Judge Frank M. Hull, said, “We have not found any generally applicable, judicially enforceable limiting principle that would permit us to uphold the mandate without obliterating the boundaries inherent in the system of enumerated Congressional powers.”

But the court ruled against the plaintiffs on two other points. It said its ruling on the individual mandate did not require “wholesale invalidation” of the law, and it upheld the law’s expansion of the Medicaid program.

The petition from the 26 states and a second one, from the National Federation of Independent Business and two individuals, sought review on the issues they had lost in the 11th Circuit.

Almost all of the usual signs indicate that the court will agree to hear at least one challenge to the law: a federal appeals court has struck down a major piece of federal legislation, the lower courts are divided about its constitutionality, and all sides, including the federal government itself, agree that review is warranted.

It is less clear which case the justices will agree to hear and which issues they will focus on. Simply agreeing to hear a case does not guarantee that the Supreme Court will decide the constitutionality of the individual mandate, the question at the heart of the challenges. The court could agree with some lower courts that some or all of the plaintiffs lack standing to sue or that the central issue is not yet ripe for decision.

The United States Court of Appeals for the Fourth Circuit, in Richmond, Va., for instance, ruled this month that it was premature to decide the central question, citing a federal law allowing suits only after certain taxes and penalties are due.

A fourth challenge to the law was heard last week by the United States Court of Appeals for the District of Columbia Circuit.

President Obama has erected what is likely to be the left flank in the debates of the Congressional Joint Select Committee on Deficit Reduction—the so-called “super-committee” that will define so much of this fall’s fiscal and economic discourse.

That flank is sturdier than some of the president’s critics on the left might feared it might be. But the flank is weak, very weak, in at least one key area: the defense of Medicare and Medicaid.

So what’s the balance that progressives should strike with regard to the speech? Let’s consider:

President Obama wants wealthy Americans to pay a little bit more.

That’s good.

President Obama rejects House Budget Committee chair Paul Ryan’s schemes to turn Medicare and Medicaid into voucher programs that shift money away from carrying for the needy and toward the accounts of private insurers.

That’s good.

President Obama rejects, at least for the time being, the prospect of increasing the Medicare eligibility age that he put on the table several months ago.

That’s good.

But President Obama was still compromising with the Tea Party right when he delivered his remarks on Monday. Indeed, he proposed $580 billion in cuts to health and welfare programs, with $248 billion coming from Medicare and $72 billion from Medicaid.

That’s bad.

Very bad.

The president would have us believe that the cuts can be made by addressing “waste, fraud and abuse.” The reality is that cutting a quarter-trillion dollars from Medicare will undermine the quality of care for seniors and the disabled. The Alliance for Quality Nursing Home Care estimates that Obama’s approach would lead to $42 billion in cuts for post-acute care providers “placing patients, our workforce and local facilities at risk.”

The proposed cuts to Medicare and Medicaid will put new stress on the economy by making it harder to maintain hiring levels at the skilled nursing facilities that have been some of the real job creators in a period of layoffs and rising unemployment rates.

The proposed Medicare and Medicaid cuts place new stresses on working families, many of which are already struggling to care for elderly and disabled relatives.

And the proposed Medicare and Medicaid cuts will cause aging workers to think twice about retiring, thus reducing the number of openings for young workers.

Medicare and Medicaid are efficient programs. They are not perfect, but they have been pressured on “waste, fraud and abuse” issues for years; meaning that there is no chance that the cuts Obama proposes will be painless.

They will, in fact, be painful, for retired people and the disabled, for families, for workers and their unions, for communities and for the broader economy.

It is for this reason that FamiliesUSA, the progressive health policy group, is warning that proposed changes to Medicaid “shifts the burden to states and ultimately onto the shoulders of seniors, people with disabilities and low-income families who depend on the program as their lifeline.”

Congressional Progressive Caucus co-chairs Raul M. Grijalva, D-Arizona, and Keith Ellison, D-Minnesota, are similarly concerned. “While we support cutting waste, fraud and abuse, we reject any proposal that cuts benefits in Medicare or Medicaid,” they say. “We reject false Republican assertions that the solution to our deficit is deep cuts to programs that millions of Americans rely on, and we would hope President Obama would as well.”

Instead of talking about cuts in Medicare and Medicaid, Obama and the Democrats should be talking up the expansion of Medicaid so that it can serve as at the basis for a true national healthcare program.

America does not need less Medicare and less Medicaid.

America needs “Medicare for All,” along the lines proposed by the Healthcare-Now! movement.

“The creation of the Super Committee makes three of our country’s most vital safety net programs—Medicare, Medicaid, and Social Security—targets for cuts,” explains Healthcare-Now!” But these programs are not the problem, they are the solution. Our social insurance programs keep people healthy and out of poverty, which is particularly important during times like these when so many people are experiencing economic hardship. Medicare, Medicaid and Social Security should be strengthened, not cut. Medicare should be improved and extended to all.”

That’s right. By talking of cuts to Medicare and Medicaid, the president takes the debate in the wrong direction and, unfortunately, the “super committee” is likely to follow him there.

That does not mean that Healthcare-Now! and its allies in organized labor should back off and go silent. Quite the opposite. The great debates about austerity are yet to come. Ultimately, two sides will emerge as the murky middle (which the president tries, too frequently, to occupy) collapses. There will be those who are willing to cut Medicare, Medicaid and Social Security to balance budgets. And there will be those who recognize that cuts hurt rather than heal a broken economy.

Obama has moved toward the side of those who would ask the wealthy to pay their fair share in order to balance budgets. That is progress. But he needs to move further if he wants to catch up with economic reality and the aspirations of the American people.

On July 30th, Medicare turns 46. That’s almost half a century of reducing poverty, increasing health outcomes, and keeping administrative costs below 3%.

Combined with Social Security and Medicaid, more people are able to enjoy hard-earned and well-deserved economic and health security.

If you haven’t yet, help us burn up the phone lines in honor of the anniversary of our most beloved social program: Medicare. Protect it. Improve it. Expand it to all.

We can’t let beltway politics rob us of these important programs. Call NOW at 866-220-0044 to connect to your Representative or Senators. Tell them NOT to accept any cuts to Social Security, Medicare or Medicaid. Instead, improve and expand Medicare for all.

If you don’t know who your elected officials are, click here and we’ll connect you.

In addition to calling our elected officials, you can join up with demonstrations at Congressional offices across the country on Tuesday, July 26th at noon. More information from MoveON here.

And of course Medicare’s Anniversary actions are planned across the country through the end of July.

Calls and in-person actions are most effective right now because of the extreme urgency. However, you can send an email here if calling is not possible.

This is at once an extraordinary and completely unsurprising headline:

For months, the standard narrative among progressive commentators was that Republicans were outrageously exploiting the debt ceiling deadline to impose drastic entitlement cuts on a resisting and victimized Democratic President (he’s weak in negotiations!), but The Post article makes clear that the driving force behind these cuts is the President himself, who is pushing for even larger spending cuts than the GOP was ready to accept:

President Obama is pressing congressional leaders to consider a far-reaching debt-reduction plan that would force Democrats to accept major changes to Social Security and Medicare in exchange for Republican support for fresh tax revenue. . . . As part of his pitch, Obama is proposing significant reductions in Medicare spending and for the first time is offering to tackle the rising cost of Social Security, according to people in both parties with knowledge of the proposal. The move marks a major shift for the White House and could present a direct challenge to Democratic lawmakers who have vowed to protect health and retirement benefits from the assault on government spending.

This morning’s New York Times article similarly makes clear that it is the President who is demanding an even larger “deficit reduction” package than has previously been discussed. Headlined “Obama to Push for Wider Deal With G.O.P. on Deficit Cuts,” the article reports that “President Obama has raised his sights and wants to strike a far-reaching agreement on cutting the federal deficit” and that he “wants to move well beyond the $2 trillion in savings sought in earlier negotiations and seek perhaps twice as much over the next decade.” This is all in pursuit of “an agreement that ma[kes] substantial spending cuts, including in such social programs as Medicare and Medicaid and Social Security — programs that had been off the table.” The President, as part of the package, is reportedly seeking some elimination of modest tax “loopholes” that benefit wealthy Americans to claim, absurdly, that there is “balanced” sacrifice.

It’s true that these articles rely upon anonymous sources, though multiple such sources close to the negotiations — from both parties — are cited in consensus about what is taking place, and there are numerous other reports entirely consistent with these. It’s been bleedingly obvious for some time that the bipartisan D.C. political class and the economic factions that own it have been intent on massive cuts to Social Security and Medicare — see George Carlin’s 2007 video explanation below — but the combination of deficit hysteria (repeatedly bolstered by Obama) and the manufactured debt ceiling deadline has, by design, created the perfect pretext to enable this now. As one “Democratic official” told the Post: “These moments come along at most once a decade. And it would be a real mistake if we let it pass us by.” Naomi Klein’s Shock Doctrine is not a GOP-exclusive dynamic.

How many people who voted for Obama in 2008 would have expected a headline like this a short two-and-a-half years later? Many more than should have. As Matt Taibbi explains in trumpeting Frank Rich’s superb new New York article detailing Obama’s subservience to Wall Street:

Throughout 2008, it was hard to shake the feeling that this was a politician whose legacy could still go either way. There were an awful lot of troubling signs on the horizon in Obama’s campaign, not the least of which being the enthusiastic support he was receiving from Wall Street.

Obama in part ran a very slightly economically populist campaign, but the tens of millions pouring into his campaign coffers from the very rich (and specifically from hedge funds) told all of us that we probably shouldn’t expect those promises to come off. For a piece I wrote that summer, I asked people in Washington why Wall Street would be throwing money at a guy who was out there on the stump pledging to reach into their pockets:

“Sadly, the answer to that question increasingly appears to be that Obama is, well, full of shit. . . . These populist pledges sound good, but many business moguls appear to be betting that the tax policies, like Obama himself, are only that: something that sounds good. ‘I think we don’t want to make too much of his promises on taxes,’ says Robert Pollin, professor of economics at the University of Massachusetts. ‘Not all of these things will happen.’ Noting the overwhelming amount of Wall Street money pouring into Obama’s campaign, even elitist fuckwad David Brooks was recently moved to write, “Once the Republicans are vanquished, I wouldn’t hold your breath waiting for that capital-gains tax hike.”

Disgustingly, Brooks turned out to be right, and the narrative of the Obama presidency did end up turning sour, on that front anyway.

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From the New York Times –

Obama administration officials are offering to cut tens of billions of dollars from Medicare and Medicaid in negotiations to reduce the federal budget deficit, but the depth of the cuts depends on whether Republicans are willing to accept any increases in tax revenues.

Administration officials and Republican negotiators say the money can be taken from health care providers like hospitals and nursing homes without directly imposing new costs on needy beneficiaries or radically restructuring either program.

Before the talks led by Vice President Joseph R. Biden Jr. broke off 12 days ago, negotiators said, they had reached substantial agreement on many cuts in the growth of Medicare, which provides care to people 65 and older, and Medicaid, which covers lower-income people. Those proposals are still on the table when Congress reconvenes this week, aides said, and are serious options that Democrats could accept in exchange for Republican concessions that raise revenues.

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If McDonald’s receives health care waivers from HHS, Vermont should too

Petition: http://action.firedoglake.com/VThealthcare

Physicians for National Health Program (PNHP) and Firedoglake.com are joining forces to urge the Obama administration to grant Vermont the waivers it needs to implement its new health care system.

“Vermont Governor Peter Shumlin signs a historic piece of legislation today that could put Vermont on the path to being the first state with a truly progressive universal health care system” said Dr. Garrett Adams, President of Physicians for a National Health Program. “The people of Vermont, including the state’s doctors, nurses and other health professionals, have inspired the entire nation by their unflagging dedication to winning a publicly financed, comprehensive and equitable health care system based on the principle that health care is a human right.”

If fully implemented, the Vermont legislation would integrate the many pieces of a fractured health insurance system into a more effective unified system for the people of Vermont. The plan would incorporate some of the proven cost control features of a single payer system, such as simplified administration and negotiation for fair prices for pharmaceuticals.

Yet Vermont won’t be able to fully achieve this goal without multiple waivers from federal health care programs such as Medicaid, Medicare, Medicare Part D and the new Affordable Care Act (ACA).

“Vermont’s new law will reform health care at the state level and take a massive step towards a fairer more, efficient system,” said Jon Walker, Senior Policy Analyst at Firedoglake. “If the Obama administration does not grant all the waivers Vermont needs, the system could fall short of its true potential. Large segments of the state’s population wouldn’t be properly brought into the new unified plan.”

During a speech given at the National Governor’s Association earlier this year, President Obama endorsed the idea of giving states the freedom to pursue other health care alternatives. Now that Vermont is ready to move forward with a better plan, the Administration can make good on its commitment. The Obama Administration should instruct federal agencies to provide Vermont with maximum flexibility in the coming years.

“There is a strong desire by single payer supporters in many states to pass legislation that would create a truly universal and publicly funded health system in their state,” said Dr. Margaret Flowers, Congressional Fellow for Physicians for a National Health Program. “They have been watching the efforts in Vermont closely. Considering that 80% of Democrats support the single payer approach, I expect that this will be an important campaign issue and that voters will be asking the President to come through on his stated support for flexibility waivers.”

“We’re thrilled to be working with Physicians for National Health Program on this project” says Firedoglake founder Jane Hamsher. “HHS has granted waivers from the health bill to 30 corporations, including McDonald’s, so that they could provide inferior benefits to their employees than the ACA requires. All we’re asking is that if they can do that, then they ought to allow states like Vermont to cover more people and provide better benefits than they would have under the ACA.”

Firedoglake is one of the leading political blogs on the Internet, with an average 100,000 readers per day. FDL has waged successful campaigns for student loan reform, an audit of the Federal Reserve system, and improvement of PFC Bradley Manning’s pre-trial detention conditions.

PNHP is a nonprofit research and education organization of 18,000 physicians, medical students and health professionals who support single payer national health insurance.