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Photos from Precinct 4-8 Caucus, Saint Paul

Obama swamped Hillary in Minnesota and did even better in our very liberal precinct. I am thrilled at the number of new caucus participants who showed up last night, lined up patiently and waited as overwhelmed volunteers like me adapted and adjusted. There’s nothing but good in that turnout for the Democratic agenda nationally and the progressive agenda locally. So congratulations to the Obama people for running a successful campaign in Minnesota. Of course, it ain’t over yet. Hillary remains ahead by about a hundred delegates. Obama isn’t going to roll into the nomination on the Pink Bunny Express. If he wants it he is going to have to broaden his appeal. Latino and Asian American voters in California; white female and older voters (male and female) everywhere are not convinced. Maybe they are, like me, waiting to hear something a tad more specific about what he intends to do as President and how he intends to get it done. In the meantime, Hillary Clinton will keep slugging away earning the votes of people who are looking for substance in a Presidential candidate.

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chaired the task force developing the plan, it was driven from the shadows by the President. He knew there would be forces arrayed against the strategy. As Hillary said in her debate with Barack last night, these people spent hundreds of millions of dollars to defeat the plan. If anything, she should know now what is needed to get one side playing against the other and formulate a strategy that represents progress if not revolution. One of my fears is that these people will do to Barack Obama what they did to the Clintons. My guess is the insurance and drug company lobby would like nothing better than an Obama Presidency. More baby lambs on their way to the slaughter.

One of the best minds I know on healthcare is Paul Starr, now a professor at Princeton University. Back in the 80s when I was just beginning my career in nonprofit healthcare, I read Starr’s excellent doctoral dissertation made into a book: The Social Transformation of American Medicine. It is eery the number of things Starr predicted that have come true with a vengance. I doubt even Paul Starr could have predicted just how far things would go.

Starr was involved in Clinton administration efforts to create rational healthcare policy. In this recent article he offered an analysis that is important reading for anyone who sincerely cares about the future of healthcare in the United States.

Read the blog entry AND see the myriad comments

I have never understood why Americans are so ambivalent about something so basic to life in a modern civilized society — access to affordable, comprehensive, healthcare. But I wonder whether it is “The American People” in general behind this problem or special interests and a Congress that has so long accepted their contributions to maintain the status quo.

When health insurance was invented easily within the lifetime of a Baby Boomer, it was a set of schemes created by physicians and hospitals to ensure they were paid for services rendered. Medicare came along and provided another way for providers to get paid. Then we saw a vast explosion in the healthcare industry. Hospitals grew and became more sophisticated. Quality of care improved. Physicians at last had good incomes and could take vacations. The cost of this more sophisticated healthcare increased so rapidly that people who once paid for doctors visits with chickens and a bushel of produce found themselves locked out of the system altogether.

Then an outfit called Kaiser Permanente in California showed it was possible to create a highly integrated system of doctors, hospitals and clinics, charge people to keep them healthy, and make money at it in the bargain. The Nixon Whitehouse became enamored with it and soon there was legislation that created a place for United Health, Aetna, and dozens of other companies to make money taking care of sick people. Serious, serious money. In no time at all they joined the drug companies as the most powerful lobby of all time. In the succeeding years the objective of the entire system shifted from taking care of sick people to making money for rich people.

Americans seem, again, to be calling for reform in the healthcare system. The major Democratic candidates began issuing policy statements and publishing their reform plans on their websites. They are fairly similar to each other so it is not really a question of which candidate has the better idea. The question is, which candidate has the best chance of getting his or her idea passed into law. That person, in this writer’s estimation, is Sen. Hillary Clinton.

For weeks and weeks now the people in this household — four Minnesota Democratic caucus participants — have been sitting on the fence with regard to Barack Obama and Hillary Clinton. Sen. Obama certainly is an exciting candidate. I can push a button on my computer right now and listen to then Illinois state lawmaker Obama deliver his outstanding speech to the Democratic National Convention in 2004. He is a skillful politician and orator and could make a very exciting President I think.

Sen. Clinton, on the other hand, has been working away in the cloakrooms and corridors of Congress getting real legislation made into law. She has worked hard. She has been effective and she is highly regarded by her constituents in the state of New York. When it comes down to hard tack politics, I believe Hillary Clinton can best use the bully pulpit of the Presidency to advance a progressive agenda. And after all of the shouting and speechifying is done, that’s what it’s all about, isn’t it? Getting things done?

FOR ME THE HEALTHCARE CRISIS IS EMBLEMATIC of a much larger problem in this country. There seems to be a fundamental inability of government to recognize the plight of its citizens and to take action on their behalf. Barack Obama has not had an opportunity to show me what he can do. Hillary Clinton has. This government faces a host of intractable problems, many of them created by the malevolent and incompetent Bush administration. The Iraq war isn’t going away anytime soon. The “War on Terrorism” isn’t going to be resolved no matter how good any President might be. However a determined and skilled chief executive can certainly get something done about the state of our healthcare system. There are no forces external to the United States at work. It is not money standing in the way (we pay far more per capita for healthcare than Canada or the UK). Only politics.

In Hillary Clinton we have someone who is, very much in her own right, a master politician. She compromises in ways that Progressives do not like. She manages to get laws passed that Republicans do not like. She shoots down the middle keeping in mind her duty to the poorest and most vulnerable among us. If Barack Obama manages to get to the Whitehouse he will have to move to the center as well, and compromise and accommodate. If I have learned anything about elected office I know this: campaigning for office is one thing; governing is another. The moment you take your hand off that Bible you have constituents who voted for you and constituents who didn’t. Let the compromising begin. I want someone who can get the best deal for the American people — especially those most vulnerable among them — and I believe that person is Sen. Hillary Rodham Clinton.

- Patrick Sheehy

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