So reported the Pew Research Center for the People & the Press on Nov. 11, summarizing its latest poll.

I think there's reason to believe that the public's anger is even deeper than Pew's estimate because voters believe - correctly - that "the way things are going" is not getting better.

If so, and with Republicans and Democrats fighting all the time and improving nothing, there's an opening for a third-party challenge as strong as...]]> Fri, 06 Nov 2009 00:00:00 -0600 Late in the game, Republicans are proposing alternatives to Democratic health care reform, but they're certainly not being bold.

If they were, they'd follow the lead of Rep. Paul Ryan (R-Wis.), the party's foremost Jack Kemp-style conservative, whose Patients' Choice Act aims for near-universal coverage without mandates.

Instead, to go along with incessant excoriating of "Obamacare," House and Senate Republican leaders are proposing modest "step by step" cost-saving reforms that Democrats ought to consider, but won't.

Republicans will offer a single substitute bill in the House and multiple amendments in the Senate to show they aren't, as Democrats charge, the "party...]]> Fri, 30 Oct 2009 00:00:00 -0500 There's an important task that Congressional moderates can perform on health care reform besides fighting the public insurance option and containing costs: find a middle ground on medical malpractice.

Even President Barack Obama ought to join the cause and go beyond the tepid studies that he's instituted and push for real centrist legal reforms.

And "third way" legislation is available - developed by legal reformer James Wootton and backed by several provider, physician and advocacy groups - that would make it possible to prevent and resolve medical mistakes with less resort to costly litigation.

The effort, backed by Xerox Corp., the pharmacy benefit manager Medco...]]> Fri, 23 Oct 2009 00:00:00 -0500 Suddenly, it's occurred to liberals as well as wonky budget hawks that the nation's fiscal future is "unsustainable," but the chances of action - short of a crisis - are near zero.

That's because of political polarization. For years, Republicans have complained about "runaway entitlement growth," but to sink health care reform this year, they are resorting to an old Democratic tactic - scaring seniors - to block cuts in Medicare outlays.

The same thing happened in reverse when President George W. Bush tried to reform Social Security. Democrats charged that he wanted to "privatize" the system and leave seniors victim to the vagaries of the stock market.

Bush also...]]> Thu, 15 Oct 2009 00:00:00 -0500 Having let Congress have its way in writing health care reform legislation up to now, President Barack Obama needs to weigh in heavily if he wants to sign a bill by Christmas.

Vast differences - in cost, coverage, ideology and pay-for techniques - need to be bridged among five measures approved by two Senate and three House committees.

Democratic leaders in each chamber are trying to reconcile their own bills, draft final versions, get them scored by the Congressional Budget Office and put them on the floor.

Obama should not wait for a House-Senate conference to put his stamp on the process. He needs to fashion a final product - and one that can win 60 votes in the...]]> Thu, 08 Oct 2009 00:00:00 -0500 More and more, it looks as if President Barack Obama is going to adopt a "split the difference" policy on Afghanistan that will basically continue current strategy - and likely lead to catastrophe.

Obama told Congressional leaders Tuesday that he does not intend to reduce U.S. troop levels, but he described his war aims strictly in terms of "targeting al-Qaida," not defeating its Taliban allies.

What I've been hearing for weeks is that he intends to complete his planned deployment of 68,000 troops in Afghanistan - then hold at that level - and reject his military commanders' call for up to 40,000 additional troops.

This presumably would satisfy his fellow Democrats,...]]> Fri, 02 Oct 2009 00:00:00 -0500 The good news about health care reform is that, if it passes, the ranks of the uninsured will be reduced. The bad news is that reducing the surging cost of health care in the United States will remain iffy, at best.

There's reason to fear that, even with reform, the nation's total outlays for health care - currently 17 percent of gross domestic product - will continue to soar, and so will federal health spending and insurance premiums.

The Obama White House promised reform would "bend the curve" of health spending - now growing 3 percent a year faster than the economy - but bills pending in Congress contain no guaranteed cost-containment measures such as a global budget, or...]]> Fri, 18 Sep 2009 00:00:00 -0500 From China to Russia to Afghanistan and Iran, it's a time of woe for U.S. foreign policy. But there's an exception - Pakistan - and Congress can keep the progress going.

Specifically, Congress needs finally to pass legislation, sponsored in the Senate by John Kerry (D-Mass.) and Dick Lugar (R-Ind.), authorizing $1.5 billion a year in long-term economic and security assistance.

More controversially, Congress and the Obama administration need to make it clear that the United States will do what it takes to prevent the Taliban from retaking neighboring Afghanistan.

Final passage of Kerry-Lugar - sponsored in the House by Reps. Howard Berman (D-Calif.) and Mark Kirk...]]> Sat, 12 Sep 2009 00:00:00 -0500 It would be entirely fitting for Congress to rekindle the "war on cancer" in response to the death of Sen. Edward Kennedy (D-Mass.), but another disease worthy of a war is diabetes.

Cancer kills more people each year - 560,000, according to the Centers for Disease Control and Prevention, compared with 233,600 for diabetes and its complications.

But the CDC estimates that the diabetes figures are hugely underreported and that the actual numbers may be 65 percent higher, or 386,000.

Kennedy's death from glioblastoma, an aggressive brain cancer, is one reason for a renewed attack on cancer.

But, as Gina Kolata pointed out in an illuminating article in the New...]]> Thu, 03 Sep 2009 00:00:00 -0500 Among the most common themes in the tributes paid to the late Sen. Edward Kennedy (D-Mass.) was his willingness to negotiate across party lines and achieve his liberal goals incrementally, if necessary.

It's time for his fellow Democrats and President Barack Obama to apply those principles to health care reform.

So far, except in the Senate Finance Committee, there's been almost zero Kennedyism applied to the health care debate.

The House Democratic majority has produced its health legislation with a contempt for the minority that's customary for that chamber - but inappropriate when huge changes for one-sixth of the U.S. economy are in play.

The Senate...]]> Fri, 21 Aug 2009 00:00:00 -0500 I'm taking my annual one-column breather from the nation's political storms to promote not-exactly-earthshaking ideas that have been bugging me and, maybe, you.

This year: golf on television, parking your car, simplifying voicemail and non-alcoholic beer (also wine).

Golf: Prior to last Sunday's CBS coverage of the PGA Championship, I was prepared to plead with the television networks to please tell us golf enthusiasts one vital piece of information previously almost always denied us.

To quote my son-in-law, single-digit-handicapper James Morehead of Seattle, "What every amateur golfer wants to know is how far the pros are hitting those drives."

Overall, TV...]]> Thu, 13 Aug 2009 00:00:00 -0500 There's no question that Republican criticism has helped undermine support for President Barack Obama's health plan. But it hasn't done much to help Republicans.

That's because while Republicans actually do have alternative ideas on health care reform, they have spent most of their time accentuating Obama's negatives.

In fact, the negative so dominates GOP statements that an ordinary citizen could well believe that Sen. Jim DeMint (R-S.C.) represented the whole party when he said, "If we're able to stop Obama on this, it will be his Waterloo. It will break him."

And disruption by right-wing hooligans of town-hall meetings held by Democratic Members of Congress only...]]> Fri, 07 Aug 2009 00:00:00 -0500 "Too big to fail" is the tagline that health lobbyist Fred Graefe applies to the health care reform effort, and he's got it dead right.

The failure of an overwhelmingly Democratic Congress to pass President Barack Obama's No. 1 priority would be a political disaster for the president and his party.

It would also be a disaster for the country to continue with mounting numbers of uninsured people - soon to top 50 million - and mounting, unconstrained costs that employers, premium-payers and government can't afford.

So Graefe, a Democrat who represents hospitals, pharmaceutical and related companies, and device manufacturers, bravely predicts that "President Obama will...]]> Fri, 31 Jul 2009 00:00:00 -0500 For one supposedly dedicated to bringing parties together for health care reform, President Barack Obama shows unremitting hostility toward one of them: the health insurance industry.

In practically every speech he gives or town hall he hosts, there's a slam at insurance profits and methods - and no recognition of the role its lobby, America's Health Insurance Plans, has taken to advance reform.

AHIP CEO Karen Ignagni, a former AFL-CIO official and Democratic Senate staffer, has departed utterly from the role that the insurance industry played in sinking health reform during the Clinton administration.

AHIP's predecessor organization, the Health Insurance Industry...]]> Fri, 31 Jul 2009 00:00:00 -0500 For one supposedly dedicated to bringing parties together for health care reform, President Barack Obama shows unremitting hostility toward one of them: the health insurance industry.

In practically every speech he gives or town hall he hosts, there's a slam at insurance profits and methods - and no recognition of the role its lobby, America's Health Insurance Plans, has taken to advance reform.

AHIP CEO Karen Ignagni, a former AFL-CIO official and Democratic Senate staffer, has departed utterly from the role that the insurance industry played in sinking health reform during the Clinton administration.

AHIP's predecessor organization, the Health Insurance Industry...]]> Thu, 23 Jul 2009 00:00:00 -0500 If Congress and the Obama administration aren't too far down the road to big-government health care to rethink, they ought to read "Who Killed Health Care?" by Harvard business professor Regina Herzlinger.

Her answer to the title question of her book is the same as Agatha Christie's in "Murder on the Orient Express."

She writes that "everybody" - especially hospitals, employers, insurance companies, lawyers and government - created the current wasteful health system that, she argues, also kills people.

But even more compelling than her acid evaluation of what's wrong is Herzlinger's recommendation of the right alternative.

"Consumer-driven health care," she...]]> Fri, 17 Jul 2009 00:00:00 -0500 If any story this year deserved Page One coverage - but didn't get it - it was Education Secretary Arne Duncan's challenging speech July 2 to the nation's largest teachers union.

Perhaps the most important initiative on the administration's whole, vast agenda is Duncan and President Barack Obama's effort to bring America's miserably performing public schools up to international standards.

As Duncan said, in seeking to enlist the National Education Association to join the effort, not fight it, "it's an economic imperative and a moral imperative.
"It's the civil rights issue of our generation ... a fight for social justice."

What he's up against, though, was...]]> Thu, 09 Jul 2009 00:00:00 -0500 It used to be easy to predict who the next Republican presidential nominee would be. It was decided by primogeniture: The next oldest guy in line got to be the king.

It's not so easy looking to 2012, with former Vice President Dick Cheney out of the running and a woman, soon-to-be former Alaska Gov. Sarah Palin, in.

And I do believe she's in - damaged in her chances, maybe, but fully intending to make a run and very popular with the shrinking hard core of the GOP.

In the Democratic Party, primogeniture sometimes applies, as with Adlai Stevenson in 1956 and incumbent or former Vice Presidents Hubert Humphrey in 1968, Walter Mondale in 1984 and Al Gore in...]]> Thu, 02 Jul 2009 00:00:00 -0500 Liberal health reform advocates have talked about ramming a reform plan - including a Medicare-like public insurance option - through the Senate with only 51 Democratic votes. But a leading Senate player says it won't work.

If an attempt is made to pass health reform under "reconciliation" rules - requiring just a simple majority vote - Senate Budget Chairman Kent Conrad (D-N.D.) told me, the bill would be so pared down, "you'd be left with Swiss cheese."

Conrad also serves on the Finance Committee, which will mark up its version of health care reform in July.

Reconciliation rules, he said, require that a bill be scored as deficit-reducing over six years and that any...]]> Fri, 26 Jun 2009 00:00:00 -0500 The political verdict on President Barack Obama's first five months in office has to be "so far, so good," but it also must include trepidation about clouds on the horizon.

For sure, he's popular. He's laid out a breathtakingly bold agenda that he has good prospects of fulfilling. And his opposition is in dire political straits.

But too much shouldn't be made of high approval ratings after five months. Obama's Gallup rating on June 20, at 59 percent, is exactly the average of the last eight newly elected presidents.

And that average is dragged down by Bill Clinton's dismal showing, 39 percent, in 1993 - the result of a self-created kerfuffle over gays in the military...]]> Fri, 26 Jun 2009 00:00:00 -0500 Thu, 18 Jun 2009 00:00:00 -0500 President Barack Obama went easy on Iran in his big June 4 speech in Cairo so as not to become an issue in last weekend's elections.

Some good it did. The ruling powers in Iran - rigidly hostile to the United States and determined to develop nuclear weapons - rigged the vote to restore radical Islamist President Mahmoud Ahmadinejad to power.

And, Obama's mild statements of "concern" at violence directed against opposition protesters is not likely to win him any points, either, if and when the Iranian regime decides to accept his offer of "unconditional negotiations."

Still, Obama's tactics are understandable. He's betting that the regime headed by Supreme Leader...]]> Thu, 11 Jun 2009 00:00:00 -0500 As they work on comprehensive health reform, Congress and President Barack Obama ought to look to the most successful model yet: the 2003 Medicare prescription drug law.

Passed amid rancor and predictions of catastrophe, the law has proved to be an enormous success - much cheaper than expected and overwhelmingly popular with seniors.

The problem for liberal Democrats is ideology. The Medicare Part D program is based on competition among private insurance plans, whereas they are determined to model health reform on government-run, price-controlled Medicare Parts A and B or on Massachusetts' individual-mandate plan.

But, as the latest Medicare trustees report warned,...]]> Fri, 05 Jun 2009 00:00:00 -0500 The Obama administration is confronting what's left of the "axis of evil" this week, with the president in the Mideast talking about Iran and top aides in the Far East dealing with North Korea.

The strategy in both cases is the same: Enlist "friends" like Saudi Arabia, Japan, South Korea and China to pressure the two rogue states to stop developing nuclear arsenals.

President George W. Bush, author of the "axis of evil" concept, toppled Saddam Hussein's regime in Iraq, but got nowhere containing Iran and North Korea, either with policies of rigid isolation or, later, multilateral diplomacy.

Now, with Iran's uranium enrichment centrifuges spinning and North Korea...]]> Thu, 28 May 2009 00:00:00 -0500 My mother died this month at age 95. This column is a tribute to her example of living - and also a public policy tribute to the manner of her death, in hospice care.

Genevieve Kondracke was a tough, giving, self-reliant survivor of the Great Depression: frugal, dedicated to duty and personal responsibility, and a realist.

When she was diagnosed in April with probable ovarian cancer, she decided against a biopsy, risky major surgery and a long hospital stay.

"Well, I signed my death warrant today," she told me at the time. But she died peacefully, at home, visited often beforehand by her family, in no pain.

This is my second experience with hospice, and it...]]> Thu, 21 May 2009 00:00:00 -0500 President Barack Obama plans to tackle, one by one, the biggest problems threatening America's future prosperity, but he needs to fashion nothing less than "a new social contract between the generations."

That means, said Brookings Institution scholar Isabel Sawhill, gradually shifting the balance of federal spending from seniors to children to enable them to support both themselves and their elders in the future.

Investments in young people are necessary, she said, because, as a United Nations study found in 2007, American children rank 17th out of 21 major countries in material well-being, 21st in health, 12th in education and 18th in overall well-being.

The...]]> Fri, 15 May 2009 00:00:00 -0500 With as few as 20 percent of voters identifying themselves as Republicans in major polls, the GOP is in a bad way, for sure. But is it dead? No way.

While former Vice President Dick Cheney and radio rabble-rouser Rush Limbaugh try to isolate the party to an even smaller core, saner GOP leaders, "big tent" types, are trying to broaden the party's appeal with ideas.

Two of them, conservative Rep. Paul Ryan (Wis.) and moderate Rep. Mark Kirk (Ill.), will be out next week with health reform alternatives to the government-heavy proposal being developed by the Obama administration and Congressional Democrats.

Kirk, from the left of the party, told me that Ryan, on the...]]> Fri, 08 May 2009 00:00:00 -0500 If President Barack Obama really is a pragmatic problem solver and not a liberal ideologue, he will stop pushing for a government-run insurance plan as part of health care reform.

And Democrats in Congress, instead of trying to drive all Americans into a Medicare-style, single-payer health plan, should first figure out how to reform Medicare itself, which is rapidly going broke while failing to serve all the medical needs of seniors.

As several studies show, if health reform includes a "public" insurance plan to "compete" with private insurance, it will mean the end of private insurance in America - all at once or gradually, depending on the design. If the model is...]]> Fri, 01 May 2009 00:00:00 -0500 If President Barack Obama really meant what he told CIA officers on April 16 - "this is a time for reflection, not retribution" - then he needs to snuff out the witch-hunt atmosphere that his subsequent actions have created over the issue of "torture."

"Nothing will be gained by spending our time and energy laying blame for the past," he added in his letter to CIA employees.

When he wrote the letter, Obama already had decided on the first step that has led to an orgy of demands for retribution against former officials of the Bush administration - the release of top secret Justice Department memos justifying use of "enhanced interrogation techniques" on selected high-level...]]> Fri, 24 Apr 2009 00:00:00 -0500 President Barack Obama and Education Secretary Arne Duncan are dedicated school reformers, and two new reports show how urgent it is that they succeed.

The reports, by McKinsey & Co. and the America's Promise Alliance, show anew that the failure of American schools is hugely costly to children, the nation and local communities - both morally and economically.

McKinsey matched education scores to economic data and declared that the underperformance of U.S. schools "imposes the economic equivalent of a permanent national recession."

If U.S. children had matched the top nations in the world on math and science tests over the past 20 years - instead of ranking 24th...]]> Fri, 17 Apr 2009 00:00:00 -0500