Poor communication between doctors and patients is widely seen as a problem in American healthcare. Now more and more healthcare providers are giving patients new ways of accessing doctors to ask questions or express concerns. In the age of email, texting, video chatting and social media, a look at the promise and limitations of digital communication to improve patient experiences and outcomes.
A panel of journalists joins Diane for analysis of the week’s top national news stories, including: The House Republican impasse over the Affordable Care Act shuts down the government. Health care exchanges roll out with strong interest and technical glitches. And the Justice Department sues North Carolina over its new voter ID law.
- Jeff Mason White House correspondent, Reuters.
- Ari Shapiro White House correspondent, NPR.
- Lori Montgomery financial reporter, The Washington Post.
The U.S. Capitol was on lockdown for part of the day Thursday as police responded to a car chase that ended with the driver shot and killed. Washington Post reporter Lori Montgomery was inside the Capitol during the shooting, and she described the scene and what measures police took when instructing people to “shelter in place.”
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MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Police shot and killed a woman after a car chase from the White House to the Capitol. Obamacare's health insurance exchanges launched during the first government shutdown in 17 years. And Democrat Wendy Davis announced she's running for governor of Texas.
MS. DIANE REHMHere with me for the domestic hour of our Friday News Roundup: Ari Shapiro of NPR, Lori Montgomery of The Washington Post, and Jeff Mason of Reuters. You're invited as always to be part of the program. Give us a call, 800-433-8850, send us an email to firstname.lastname@example.org, follow us on Facebook, or send us a tweet. Hi, everybody. Good to have you here.
MR. ARI SHAPIROGood morning.
MS. LORI MONTGOMERYGood morning.
MR. JEFF MASONGreat to be here.
REHMAnd good to have you here. I must say, Lori Montgomery, you were at the Capitol yesterday when all hell broke out.
MONTGOMERYYeah. It was pretty scary for a little while there. We were in the basement about to get lunch when the cops just came rushing out of the House deli, running up to the first floor. They slammed shut the doors, locked it down. There were staff members outside pounding on the doors, trying to get in.
MONTGOMERYSo -- and it wasn't clear. Were the shots right outside in the parking lot?
MONTGOMERYWere they in the Capitol? So there was a lot of chaos, and they finally told us to go shelter in place. And we wandered up to the Senate side.
REHMYeah. What does that mean, shelter in place, when you're at the Capitol?
MONTGOMERYYou get to your office. They close all the doors.
MONTGOMERYThe Capitol police were wandering -- not wandering. They were rushing through the first floor there locking down all the doors to the outside. They were pushing people into offices and locking the doors in the hallways. And one lady police officer looked at us and said -- she just, like, looked very alarmed. And she took up a deep breath, and she said, we're sheltering in place. Get to your offices immediately. You know, we have no idea what's going on. Shots have been fired.
REHMAnd what do we know about what happened, Ari?
SHAPIROWell, we now know that a 34-year-old woman from Connecticut named Miriam Carey drove her car first into a post right by the White House and then went a mile, a mile and a half to the Capitol where she ran into another security post...
REHMGoing about 80 miles an hour, apparently.
SHAPIROYeah. And in the process injured two people, a Secret Service officer, a Capitol police officer, both of whom appear to be OK. The shots that were fired apparently came from the law enforcement officials who ultimately killed her. She had a 1-year-old child in the backseat who apparently is fine and in custody right now -- being taken care of right now. The woman's mother in Connecticut has said that she was suffering from depression, but other details are still coming out.
REHMAnd, Jeff, the question becomes the Capitol police who work so hard to protect everyone, are they furloughed? Or were they there acting without pay?
MASONYeah. Well, we were just discussing that. It sounds like the Capitol police are getting paid. But, like lots of people in Washington and across the country right now, because of this government shutdown, people are not getting paid or may get delayed pay for doing their jobs. And it just sort of put a focus on that yesterday on sort of the absurdity of what Washington is facing when events like this happen at the same time.
REHMAnd just to say, how awful for this poor child and perhaps even for this poor woman. We have no idea why she behaved as she did. We are in the fourth day of a government shutdown. What is the latest? Is there an end in sight, Lori?
MONTGOMERYNo. There is not an end in sight. And I told a fellow reporter at the Post the other day, who was planning to go to Assateague, don't go. It's not going to be open. At this point, Republicans are completely dug in on the idea that they have to get something. They can't just collapse. So they're now trying to force Democrats to come to the negotiating table over the debt limit.
MONTGOMERYThat would allow them to not deal with the question of whether or not we open the government without tackling Obamacare and do it all in one big deal. And Democrats are resisting. And Boehner said yesterday -- or Republicans were telling us yesterday that Boehner has privately assured them he will not let the country default on Oct. 17...
REHMHe will act on the debt limit.
MONTGOMERYHe will. However, people seem to think that means, oh, he's just going to collapse and do a clean debt limit increase. But, in fact, they're looking at a short-term debt limit increase of, like, a couple of days, maybe a week. And, you know, if they start talking publicly about that sort of thing, it's going to get scary very quickly. And I think Democrats are going to face a hard choice about whether they open to negotiation.
SHAPIROIt's almost like, you know, you see these movies where a canoe is going down the river and goes over this terrifying waterfall and they make it, and it's OK. And we're over the waterfall, and maybe it's scary. But we made it. And then the camera pans back, and you see, like, you know, a five-story cliff looming right around...
REHMMany -- exactly.
SHAPIROWell, that cliff is the debt ceiling. And as bad as the economic fallout from the shutdown may be, breaking through the debt ceiling, defaulting on the country's debts, every economist says, would be a nightmare scenario.
MASONWell, and what's remarkable is how far apart everyone is, three or four days now until the shutdown. At the meeting at the White House just two days ago, the leaders came out and spoke to reporters afterwards and just showed absolutely no progress. And that continues. And the president, I mean, Lori, you mentioned whether Democrats are going to be willing to start negotiating. The president has said, absolutely not, not going to do it. And who's going to fold?
REHMBut at the same time, you've got some Republicans, increasingly and more loudly, expressing their own displeasure with members of the Tea Party.
SHAPIRORight. It's pretty clear that right now, if House Speaker John Boehner brought a clean continuing resolution to the House floor, it would pass with a combination of Democratic and Republican votes. Boehner does not want to violate what's known as the Hastert Rule, which is that something only comes to the floor if it can get a majority of the majority, that is, a majority of the Republican Party.
SHAPIRONow, if he raises the debt limit a couple weeks from now, as we're talking about, he would have to violate the Hastert Rule to do that. He does not have the Republican votes to do that without a significant lift from Democrats. But doing that, violating the Tea Party base of his party, means potentially losing his speakership, means inflaming the Republican civil war even more than it already is. So this is a really fascinating character study on House Speaker John Boehner. Unfortunately, the fate of the country also hangs in the balance.
MASONAnd just what happens to his job, I mean, if he does decide to ensure that the U.S. does not default by holding a vote in which Democrats make sure that that happens? What happens to John Boehner? What happens next?
REHMYou did an interesting story on the comparison contrast between Boehner and President Obama.
MASONYeah. You know, these are two men who are similar in some ways, different in profound ways, who have had their ups and downs over the last five years. But by all accounts, their relationship right now is as bad as it has ever been. They had this big falling out in 2011 when both of them saw an opportunity for a grand bargain where they could cut spending, reduce the deficit, raise the debt ceiling, et cetera.
MASONBut the bargain fell apart. Each blamed the other. Each felt personally betrayed. And there's been almost no personal relationship, no real negotiations between the two of them since then. Now, the problem right now seems to be more within the Republican Party than it is between the Republican Party and the White House. That said, even if a great relationship between these two men would not solve the problem, a terrible relationship between the two of them, which is what we have now, really doesn't seem to be helping at all.
REHMAnd, Lori, the president said he would not try to raise the debt ceiling on his own. But law professors say there are options.
MONTGOMERYWell, there are a couple of options. But I don't think any of them are particularly good. I mean, he could choose to argue that it is unconstitutional to default on the debt, and therefore that action would be a preferable to violating the law that require...
REHMHe could choose to do that?
MONTGOMERYHe could choose to do that. He could mint the platinum coin and, you know, deposit that in the Treasury so it would have more money. But I was talking to a law professor at breakfast the other morning who made a very compelling argument why that is such a terrible idea. Because, A, you would probably have impeachment proceedings initiated against the president, virtually immediately, but, B, you would have a suspect class of bonds being issued, legally suspect.
MONTGOMERYSo, you know, while -- A, would people come to auction to buy those bonds? B, what kind of an interest rate would they demand? And, C, how could they trade them? Because they're like currency, and you have to be able to trade them freely on the market. How could investors do that if they had no idea whether they were legal?
SHAPIROAnd the president has resisted pressure from people like Nancy Pelosi to use the constitutional option, to use that 14th Amendment option. And she came out and said Wednesday night, he's not going to do it.
MASONBill Clinton said the same thing a couple years ago, but the White House has pretty emphatically, pretty clearly said this is off the table.
SHAPIROAnd repeated it.
REHMHow could he be impeached for something that's in the Constitution? That's what I don't get.
MONTGOMERYWell, it's up to the Congress to set the debt limit. I mean, it's clearly their responsibility. And, you know, Republicans are ready to impeach at the drop of a hat, frankly, so I could imagine they would take that opportunity.
SHAPIROIt's also a controversial debatable interpretation of the Constitution, over which people disagree.
SHAPIROSo you could have a lawyer say, yes, my interpretation is that this is legitimate. But you can have other lawyers say it's absolutely not. You know, ultimately these are the kinds of questions that the Supreme Court answers. Nobody wants the Supreme Court to have to get in a position where it needs to answer this question.
REHMOK. Do you all really expect these things to merge, the debate over Obamacare, the debate over the debt ceiling? Or do you think we'll solve it before we get to the 17th of October?
MASONI think it'll get solved before the 17th. It may be on the 17th itself. I think this is absolutely going to go up until the very end. And I do think they're all converging. I think the big question we'll be watching in the coming weeks, how the Obamacare piece gets pulled out of the equation. Because the Democrats are not going to negotiate on that, and neither is the president. And the president says he's not going to negotiate on the debt ceiling. But at some point, they're going to have to talk about how to make sure that gets done.
MONTGOMERYThe Obamacare piece is gone. I mean, they're still publicly talking about it, but that's over with.
MONTGOMERYAnd they're not -- you know, nobody's in the House at least as coming flat-out and saying that, but Tom Cole, a close ally of Boehner, emerged from the lunch meeting yesterday and said, you know, they were very clearly sending the signal this is not about Obamacare. This is about resolving our budget issues.
SHAPIRORoss Douthat, the conservative columnist in the New York Times, calls repealing Obamacare a political goal that most elected Republicans believe is well, nigh, and possible to achieve.
REHMAri Shapiro, White House correspondent for NPR. Short break here. We'll be right back.
REHMAnd welcome back to our Friday News Roundup this week with Lori Montgomery, financial reporter for the Washington Post. Jeff Mason is White House correspondent for Reuters. Ari Shapiro is White House correspondent for NPR. We've had a number of emails concerned about the woman who was shot yesterday after being involved in that high-speed chase.
REHMStan in Gaithersburg, Md. puts it into context. "Am I justified to feel discomfort about the reaction from law enforcement officials, that they shouldn't be second-guessed about their handling of the situation at the White House and Capitol? It's difficult for me to understand how a lone woman in a passenger vehicle could pose a credible threat. Perhaps there was a mental health issue involved. I can't help but think the hypersecurity climate in Washington is creating overreaction." Ari.
SHAPIROWell, there may well be mental issue involved. We don't know. But the fact is, as any law enforcement official can tell you, a passenger vehicle is a deadly weapon. And if used appropriately, it can kill many people. And one obligation that law enforcement officials have is to stop people from using a deadly weapon if they seem intent to cause harm, which this woman seemed to be doing.
MONTGOMERYAnd, you know, she didn't stop. I mean, I imagine the officers themselves this morning are feeling terrible about having shot an unarmed woman in a car with a child. But repeatedly she did not stop. She was surrounded by officers with guns drawn at one point, and she nonetheless backed them over and sped off. I mean, there was no obvious sign from the vehicle that there was not ill intent. And a lot of this was captured on video.
MASONYeah. And that's just the difficult part is she was given an opportunity to stop. She was given an opportunity to get out. She was given an opportunity not to use the vehicle as a weapon, and she continued to do so. And it's also -- the mental health piece is really interesting in terms of how that plays in with the gun debate that we've been talking about all year long as well. I don't know if we'll see the president or if we'll see Congress try and talk about that again, but it is interesting how that ties in with the whole issue of violence that has been plaguing the country and Washington all year long.
REHMAnd, by the way, for listeners who are looking for live streaming of the program, the program is being videotaped and will be up in about an hour. We apologize. We've moved to a new facility. We're still ironing out all the kinks.
REHMHere's an email from Diana in D.C. who says, "I find it disingenuous not to call out the president, Reid, and Pelosi for being equally to blame for the government shutdown. While I don't agree with Cruz and the Tea Party's tactics, the left refused to acknowledge that America was a 51/49 country even when they held the majority and passed Obamacare with absolutely no support from the other side. They are only reaping what they have sown." Jeff.
MASONHere's the argument against that from the White House. Yes. There are controversies about Obamacare, no question. But it was litigated last year during the election. The presidential candidate for the Republicans, Mitt Romney, said he would appeal Obamacare, and he lost.
MASONThe law was upheld by the Supreme Court, and it passed through Congress. There's no doubt in my mind that people in the White House and elsewhere in the Democratic Party wished it had gotten more support from Republicans when it went through. But it was litigated. It was voted through. And they see it as a done deal.
REHMLori, how would you describe the rollout of the new healthcare law exchanges this week?
MONTGOMERYWell, we've been describing it as a more of a trickle than a wave. The enrollments themselves have been somewhat limited because of major glitches with the websites in many states. They're still trying to keep the websites up and running, California, for instance. But at the same time you've seen just an enormous outpouring of interest in these things. Some people...
REHMSo how much of the glitches came because of such high demand?
MONTGOMERYWell, it seems pretty clear that, in fact, people are just overwhelmed in these websites. The White House has said more than 7 million people have been trying to find out about their options on health.gov. And so you've got this situation where the websites are being a little bit overwhelmed. They're trying to keep them up and running. It seems pretty clear that there's great interest in finding out what, in fact, is on offer.
SHAPIROWell, Republicans describe it as a train wreck. Democrats describe it as the greatest thing since, you know...
SHAPIRO...since Medicare. There's a six-month enrollment process, and a lot of these glitches that we're seeing seem to be related to the initial rollout. The White House keeps saying they would love assistance in sort of tweaking and improving the system because nothing is perfect on its first launch. And there are ways to improve it. But on the whole, they seem pretty happy about the enthusiasm and pretty sanguine that over the six months people have to sign up, most of these initial problems will get ironed out.
REHMWhat about the people who are going to be left out of the program? You've got people on Medicaid who are not going to be part of this healthcare program, Jeff.
MASONOne of the options that states had was to expand Medicaid under Obamacare. And many states -- I think about 25 -- many of them led by Republicans, chose not to do that. And that is leading to a loophole that is affecting especially large amounts of poor people who otherwise would've had a chance to be insured. And that is definitely something that the -- I think the White House and Democrats are upset about. And it's something that we'll probably watch in the coming weeks and months...
REHMTo see whether anybody changes their mind.
MASON...see if they change their mind, absolutely.
MONTGOMERYAnd the White House argues that there is so much money on the table for these states that rather than, you know, a growing disparity between states who are choosing to participate in the program...
REHMTwenty-six states rejecting.
MONTGOMERYYeah, rather than seeing a growing divide between the blue states and red states, the especially local officials will begin pressuring reluctant state officials to take advantage of the federal largess that would allow them to insure their...
SHAPIROYeah, different parts of the healthcare law are more than less popular. And the expansion of Medicaid is an incredibly popular part of the law. So even in red states, you have people like Gov. Chris Christie of New Jersey coming under extreme pressure and eventually deciding, OK we are going to take this 100 percent of the funding from the federal government, at least for the first couple years.
REHMWhy wouldn't you? Would it be for ideological reasons, philosophical reasons?
MASONI think part of the reason is they're worried that that money's going to go away. So if they commit to it now, you know, it's something that their citizens will like. And then we'll have an expectation of continuing. And then a few years down the road, the states have to start funding that, and they don't feel like they have the money to do so.
REHMSo how many years down the road would states have to take it on? Do we know?
MASONI don't know how many years it is, but it is -- it's probably written into the law. It's something that...
MONTGOMERYI think it's something like five to 10. And, you know, you have to remember that Medicaid is already, like, the biggest stone dragging down many state budgets.
MONTGOMERYSo that makes people even more reluctant...
REHMBut that 100 percent is a pretty big draw.
SHAPIROPhilosophically, even if the federal government begins by paying for 100 percent of it, Republicans see it as the camel's nose under the tent of expanding the welfare state when they would really prefer to shrink the welfare state and get people off these roles.
MASONSo you can't ignore the ideological piece. That's obviously a big part of it as well.
REHMOK. Let's talk about what the president is saying about how the shutdown is affecting the economy, Ari.
SHAPIROHarm, harm, harm.
SHAPIROI mean, you know, he was in Maryland yesterday telling stories about the people who are not working. And, frankly, I think for all of us living in D.C. we hear these stories ourselves from people who say, if this is a couple days, a week, it'll be fine, but I don't necessarily have the savings. We don't have the certainty that the back pay will come through.
SHAPIROAnd this has ripple effects. People don't spend the money that they might otherwise spend in the community because they don't know when the next paycheck is coming. Some 800,000 workers are affected by this, not just in Washington but across the country.
REHMMany in Washington.
SHAPIROAnd economists say it's maybe 0.1, 0.2 percent off economic growth -- sorry, one-tenth of 1 percent or two-tenths of 1 percent off economic growth, which doesn't sound like a lot, but when the economy is growing slowly as it is and there's sort of uncertain confidence in what the future of the economy is, this really doesn't help.
REHMWhat do the data tell us, Lori?
MONTGOMERYThe data -- well, we don't have any data today. We're supposed to have data. This is Jobs Friday, but because the Bureau of Labor Statistics only has three of its 2,400 people on duty, we don't have a jobs report at all. We were expecting -- independent analysts were expecting that we would have slightly smaller job growth than we had in August. They were expecting the jobless rate to stand steady at 7.3 percent. But we won't know that for sure from the government for some time.
MONTGOMERYIt's important to remember here that we have shut down America's largest employer. The federal government is the largest employer with 2 million civilians, I think, and a million-and-a-half military. So, you know, the White House is justified in saying this is ultimately going to have some kind of impact if we don't resolve it soon.
MASONAnd there are some numbers. I mean, I've seen some economists say that it could shave 0.3 percentage points off of fourth quarter GDP. That's for real. And also in terms of talking about the Washington D.C. area, in Maryland alone, the state could lose up to $5 million per day in income in sales tax revenues. So it's -- that's affecting this region pretty acutely.
REHMAn awful lot of people are worried about tourism, how that's being affected. We saw the World War II Memorial being opened on Monday to a group of ex or former military men who had help opening the gate from a member of Congress. He was chastising the park police woman who refused to open the gate because she had been instructed not to open the gate.
MASONRight. Go ahead, Lori.
MONTGOMERYThere's something just fascinating about this moment for the Republican Party. I mean, that was Randy Neugebauer from Texas who's yelling at this poor woman that she should be ashamed of herself. And then yesterday there was this incredible press conference where House Republicans were talking about poor children stricken with cancer being denied by Democrats treatment at the National Institutes of Health, which they have cut by billions of dollars over the last two years. So it's just this sort of...
MONTGOMERYYes, it's bizarre.
SHAPIROThe shift that we've seen is we've had this government shutdown that affects a wide range of different offices. And now Republicans see the opportunity to look like the good guys riding to the rescue of whether it's children with cancer or veterans visiting memorials. And so they're passing these small bills to open this part or that part of the government.
REHMTrying to pass these small bills.
SHAPIROThe Senate Harry Reid says we're not going to have it.
REHMNot doing it.
SHAPIROWe're not going to choose between whether kids with cancer or law enforcement officials get paid. And the Republicans, then that allows them to say, you're the ones standing in the way of these poor people getting the help they need.
MASONAnd it's turned into such a PR game. I mean, those bills alone, you know, they -- the Republicans try to use it to say we're doing the right thing. The Democrats say, we're not going to pass this because you don't get to decide what's the right thing. You don't get to decide what parts of government get to be open or not.
MASONAnd just the World War II Memorial itself has turned into a fight between Democrats and Republicans this week when the RNC said it would fund -- or provide the funding for that memorial to stay open and encourage the Democrats to join in, which, of course, led the DNC to say, look, that's just a stunt, and we're not participating.
MONTGOMERYCognitive dissonance -- that's the word I was trying to find.
REHMLori Montgomery, financial reporter for The Washington Post, and you're listening to "The Diane Rehm Show." Time to open the phones here first to Elkhart, Ind. Hi there, Jackie. You're on the air.
JACKIEOh, hi, Diane. You were just talking about what is on my mind as the hypocrisy of these people that are opposing the Affordable Healthcare Act, the Congress members and the Senate members. We subsidize their health insurance to a hefty maybe 70 percent. And I would like for the news media, not just NPR, but all of them, every time you talk to somebody from Congress or the Senate, as them how they pay for their health insurance.
REHMDo we know how members of Congress pay for their own health insurance?
MONTGOMERYWell, this has developed into a bit of a confusing issue. Members of Congress, like most federal employees -- I should say most members of Congress -- receive an employer-provided subsidy for their health insurance...
REHMFrom the U.S. government.
MONTGOMERY...from the U.S. government. The new healthcare law requires them to join the health exchanges. The Obama Administration has ruled that they can keep the employer subsidy, which is worth about $5,000 for individual coverage, 10,000 for a family. And the right has turned this into an argument that there is a special exemption for lawmakers and their staffs when in fact they're just keeping the subsidy they have long had. Now the caller is correct that in fact taxpayers do pay a giant chunk of health insurance coverage for lawmakers. But it's not changing in any way because...
REHMBut here's what I don't understand, Lori. If the American public was told they could keep the insurance they had if they wanted to, then why come in and say to that section of the federal employees, you're going to have to go to the exchanges?
MONTGOMERYOh, well, that's easy. Because Republicans were upset that Obamacare was passing without their votes. So on the day that it passed the Senate, Sen. Chuck Grassley, Republican of Iowa, offered this amendment that said, you guys have to join the exchanges, too, which means that members of Congress are, in fact, perhaps one of the few groups that don't get to keep what they have because they have to join the exchanges.
SHAPIROYou know, the fundamental objection that Republicans have had to this all along is that the government should not force someone to purchase a product, that product being healthcare. And this has gotten distorted over these months and years of fights over this where they say it's a train wreck and it's this and it's that.
SHAPIROBut basically, you know, it doesn't matter how many millions of people successfully enroll in this six-month period -- that the Obama Administration will then tout as a success -- it doesn't change the idea for Republicans that there's just something fundamentally wrong with the government saying, you have to have insurance.
REHMAll right. To Ormond Beach, Fla. Thomasina, you're on the air.
THOMASINAYes, thank you. You know, I remember the Medicare Part D drug bill. It took two hours of arm twisting by the Republicans in the House to get the votes. And it was a year before seniors could navigate through that plan. Regarding the shutdown, I believe the longer the shutdown lasts, it will weaken our economy.
THOMASINAI believe it's a continuing plan by the Republicans to undo any progress that the president has made, including his success in lowering the deficit. And let's not forget Republicans voted 46 times to repeal Obamacare. But how many yes votes did Republicans cast for the president's job bill for middle class and poor Americans? None.
REHMThomasina, thanks for your call. And Jeff Mason.
MASONI think the caller makes a good point in terms of how it's going to affect the economy the longer it goes. And that is the big question. The longer the shutdown continues, the greater the ripple effects will be both locally and nationally and potentially internationally.
SHAPIROBut also the caller referred to President Obama's success at lowering the deficit. And, frankly, that happened partly because of the sequester that President Obama didn't want -- well, that nobody wanted. But if the Republicans hadn't pressured President Obama to do that -- he had a long range plan to lower the deficit and involved raising taxes, which Republicans didn't like. But one could argue that if Democrats had control of every branch of this government, the deficit might not be going down.
REHMAri Shapiro, Lori Montgomery, Jeff Mason, they're all here to answer your questions. When we come back, we'll look at more email, your phone calls, your tweets, your postings on Facebook. Let us hear from you.
REHMAnd welcome back to the domestic hour of our Friday News Roundup, and this week with: Ari Shapiro of NPR, Jeff Mason of Reuters, Lori Montgomery of the Washington Post. Here's a tweet: "Is a government shutdown encouraging people to consider the concept of a third party?" Jeff?
MASONUnlikely. I mean, this is a country that has been a two-party system basically since its founding. I think I have seen some questions about whether the Tea Party would create its own party separate from the Republicans. But I think that's probably wishful thinking.
REHMAll right. Here's an email from Jake who says, "If Obamacare tanks as bad as Republicans say it will, then why did they want it repealed? Wouldn't that give them ammunition for the next primary?"
MONTGOMERYWell, that's one of the arguments Democrats are making, that Republicans are not afraid that it's going to be a disaster. They're afraid it's going to be a huge success. And our previous caller mentioned Medicare Part D, which may turn out to be a good analogy. Medicare Part D, everybody said, oh, it's going to be so complicated, all this competition, seniors aren't going to be able to figure it out, and now it's like a hugely popular benefit that, you know, both parties are trying to enhance, not take away.
REHMHere's an attempt at clarification from Kevin in Lynchburg, Va. who says, "The federal government picks up 100 percent and gradually reduces to 90 percent. So the expansion of coverage will be covered by 90 percent. So the refusal to expand is predominantly ideological." Is that correct?
MONTGOMERYHe's talking about Medicaid?
SHAPIROHe's talking about the expansion under the healthcare law, the expansion of the rules.
SHAPIROThat we were saying we didn't know exactly how much was funded for how long.
REHMExactly. And he says 90 percent. I do not know if that's correct. Do you know?
MONTGOMERYI do not know.
REHMAll right. We will see if we can find that out. Then, finally, email here from Keith in Gainesville, Fla.: "This is really true. Stop calling it Obamacare. It's the Affordable Care Act. Many uninformed people dislike Obamacare but liked the Affordable Care Act, and polls showed that."
MASONYou know what? President Obama likes it to be called Obamacare.
REHMI know he does.
MASONAnd it was interesting last year when we saw -- during the campaign, when we saw him start using that term. It's -- he wanted to adopt what was supposed to be a pejorative and make it into a positive. And I think that they sort of succeeded in doing that during the campaign.
SHAPIROAlthough there is still a gap in polls when you ask people how they feel about the Affordable Care Act. It polls much better than Obamacare.
REHMExactly. But the president has also said, if it succeeds as well as he believes it will...
MASONThen Republicans won't be calling it Obamacare.
REHMExactly. All right.
MASONHe doesn't mind having his name on it then.
REHMExactly. Let's go to Bruce in Dallas, Texas. Thanks for waiting.
BRUCEHi there. A couple of quick things, you know, I think we all probably recall that the Republicans had plenty of time to participate in the crafting of the ACA. They, as usual, you know, they didn't want to cooperate. And so this complaining about it now is kind of ridiculous. But setting that aside, if they do care so much about the American people and their healthcare, you've got to wonder why they never passed anything to help the 40 million who didn't have insurance.
BRUCEAnd lastly, I think Ari cited the Hastert Rule, which I hear a lot. And yesterday you may know that Denny Hastert came out in an interview and said, well, there really is no such thing as the Hastert Rule. I worked with Democrats when I had to. We passed legislation. And John Boehner does not like to reach out (unintelligible) to me.
REHMThat's an interesting point.
MASONAnd, frankly, John Boehner has adhered to the same principle. He ignored the so-called Hastert Rule to renew the Violence Against Women Act, to pass the debt ceiling legislation. I think Hastert Rule is convenient shorthand to refer to the speaker's refusal to bring something to the floor when he doesn't have a majority of the Republican votes to back it.
REHMAnd here's an email from John who says, "It seems the media is intent on portraying both Republicans and Democrats as equally to blame for the shutdown when the facts don't bear that out. The GOP's only fallback position is to hope the media continues this narrative." Lori?
MONTGOMERYWell, I think that there is a legitimate argument to be made that the Republican Party is more at fault. What we're talking about to reopen the government is a six to 10-week government funding bill. It is not a funding bill for the entire year. It's a temporary bill. And in that bill Democrats have agreed to maintain the deep cuts known as the sequester.
MONTGOMERYSo Democrats are now realizing that their early agreement says, yeah, OK, just keep the sequester for a little while longer while we work the rest of this out. They're realizing that they needed to make a bigger deal out of that concession so that they can demonstrate that they are trying to be reasonable. And Republicans are asking for the sun and the moon and the stars for a six-week spending bill.
SHAPIROHarry Reid, after the White House talks on Wednesday, came out and said, John Boehner won't accept yes for an answer. And his point was that the Democrats had given him the number that he had asked for for that budget and then started asking for more. So I think that reinforces your point.
MASONThe problem is that Boehner can't negotiate with Democrats until he negotiates with the right of his own party in the House. And it's not even clear exactly what they want at this point. A full repeal of Obamacare is more or less of the table. They feel they have to get something out of it. But as one Republican this week, they're not even sure exactly what that is.
REHMAll right. To Kalamazoo, Mich. Hi there, Jean. You're on the air.
JEANHi. I call this bill, saying something to the media, like, why are the media so afraid to say the Tea Party is the problem here? If it wasn't for the Tea Party, Boehner would have had this thing done, and we would have been OK. And what is there to negotiate? This is a law, and part of the law is how it's funded.
JEANIf Barack Obama was going to negotiate, that's the thing you'd have to give up because that's the only issue.
MASONWell, I can't speak for all of the media, but I would disagree with one of your -- the caller's points. I mean, I think the facts do show that it's the Tea Party that has insisted that John Boehner not be willing or able to negotiate and has insisted that Obamacare or the Affordable Care Act be the thing that keeps the government from opening over the last couple weeks in their negotiation. So I think the coverage has actually let the facts speak for themselves. And it is not really debatable that that is largely because of the Tea Party's activities.
MONTGOMERYWe've reported, you know, endlessly, ad nauseam that Boehner himself, you know, told his rank and file not to try to fight Obamacare on the government funding bill. That was his preference. But you had this campaign led largely by outside groups, like the Jim DeMint-run Heritage Foundation and Sen. Ted Cruz and Sen. Mike Lee, who are Tea Party-backed guys. All summer, they were beating the drum against Obamacare. And they turned the heads of enough Republicans that Boehner could not proceed with a clean CR.
MASONAnd they thought this was their last chance to really do something, and that's the president kept saying, even if the government shuts down on Oct. 1, it's not going to shut down these exchanges, and it didn't.
REHMOK. But are you all saying that Republicans are really coming to the conclusion, as we speak, that arguing about Obamacare is not going to get them anywhere? Would that bring us closer to conclusion of this government shutdown?
MONTGOMERYI think it helps a little bit. Sen. Bob Corker yesterday called Obamacare a shiny object that we need to look away from and return to, you know, discussion of the debt at large. However, it's not clear that Republicans aren't still going to demand something very difficult for Democrats in order to lift the debt ceiling.
SHAPIROWell, Lori also referenced outside groups which are a huge factor on this, which has gone under-remarked upon. Any Republican who acknowledges reality, that Obamacare is not going to be repealed, that at some point government funding is going to have to go into effect, that they probably will not get their fullest of demands. Any Republican who comes out and says that right now has a target painted on their back by some of these conservative groups that are very intent on funding primary challengers to force Republicans to adhere to this ideology that says we won't budge.
REHMWell, you've got gerrymandering that's gone on that makes that more of a realistic threat.
SHAPIROOh, absolutely. I mean, you know, so many of these Republicans represent these blood-red districts where the demographic trends are going in the opposite direction from the rest of the country. The rest of the country is getting more diverse. It's getting younger. These districts are getting more white. They're getting older.
SHAPIROThey represent districts where Romney beat Obama by a huge margin. And so the American people that they are representing do not necessarily look like the rest of the American people, and they have no incentive to negotiate with Democrats because that just means they'll get primaried and kicked out in the next election.
MASONWell, and exactly. It also means that they won't get punished for what some people think is really irresponsible behavior. It's quite the contrary. What they're seeing is that their political base is quite happy with the government shutdown and quite happy with the stand they're taking on the Affordable Care Act.
REHMBut how much longer can that continue to make them happy?
SHAPIROUntil redistricting in 2020.
MONTGOMERYWell, it's -- the caller that asked previously about a third party, I mean, it almost feels like we're starting to see a third party. I mean, you've got Republicans, outside groups as well as office holders, saying these guys are not just far right conservatives. They don't care about winning. Grover Norquist who, you know, used to be the icon of the far right is like, these guys, you can't build a party based on legislative failures.
MONTGOMERYBut they don't seem to care about achieving something because what Club for Growth and Heritage Action and these other outside groups want and are encouraging is the fight, the fight against Democrats, and it almost doesn't matter what you win.
REHMAnd it's the fight against government as we know it. They want it shrunk to what?
MONTGOMERYAnd the fight against establishment Republicans who are weak-kneed in the fight to reduce the size of government.
REHMBut, I mean, how far can you realistically reduce the size of government and continue to have democracy as we know it?
SHAPIROWell, you know, I saw an interesting argument -- this is the second time I'm mentioning Ross Douthat in this program. But he was saying...
REHMHe's a good writer.
SHAPIROHe's a good writer. He's New York Times...
SHAPIROHe says, you know, what were seen as conservative victories in the past were slow downs in the growth of government where, you know, leveling off in the size of the welfare state. At no point has increased wealth in the United States meant decreased per capita spending on federal welfare programs and so on. So as they see it, there really has been no significant victory, the kind of rollback of the liberal accomplishments of the '50s and '60s, a great society, that conservatives have wanted to see for a long time. And the Tea Party is finally saying, enough.
MASONIt's interesting, though, to see some of the contradictions there. Despite wanting a smaller government, they also want free trade. They also want agreements that would improve the economy. And we just saw last night, the president had to cancel his trip to Asia because of this government shutdown.
REHMWhich you two were supposed to be on.
SHAPIROWe were going to be on a plane to Indonesia tonight.
MASONAri and I would have been on a plane tonight. That's exactly right. And one of the ramifications of that trip being canceled is the president can't go and tout U.S. businesses in Asia and try to work on trade agreements and try to work on things that could boost the U.S. economy.
MONTGOMERYAnd the other thing that's so interesting about this fight to reduce the size of government is that House Republicans have proven incapable of actually passing spending bills at the level that they say they want because it's too much.
REHMLori Montgomery of The Washington Post. And you're listening to "The Diane Rehm Show." Back to the phones to Denise in San Francisco. Hello.
DENISEGood morning. I've got two words, regular order. When the Tea Party creates these crises every year, every six months, however often that they've been threatening our government and our way of life. There's a place and a time to negotiate budget bills. And that's not in raising the debt limit, and that's not in shutting down the government. And John Boehner is a smart man. And he should realize that if he doesn't stand up to the Tea Party now, that the history of our country may be impacted.
REHMYou know, that's an interesting point she makes that the history of our country may be at risk here. What do you think, Jeff?
MASONWell, certainly if there comes -- if it results in a default, that would be a huge moment in U.S. history. It would raise the question of how strong the U.S. economy can be going forward.
REHMAnd not just the economy but power overall.
MASONFor sure. I mean, the status of the United States as a super power is not based just on military might. It's based on its economic might. And all of that is called into question if the United States doesn't pay its bills.
SHAPIROAnd leading up to this now-canceled Asia trip, I've been talking to some foreign policy analysts -- a preview of a story I'll have on "All Things Considered" tonight about whether dysfunction at home actually affects the perception of America abroad. And there's a widespread belief that, yeah, to be a global super power, you have to be stable and predictable. And, right now, the United States appears to be neither.
REHMTo Michael in Athens, Ohio. You're on the air.
MICHAELThank you for taking my call, Diane.
MICHAELThe woman who answered the phone was kind of amused at my comment that you all have been steadily over the hour working up to this is that the Constitution was supposed to be a framework for making a functional government. If the founders came back, they would think, well, you've turned that framework into a torture rack and that a dysfunctional democracy and economic system is one of the best arguments right now in favor of a monarchy.
SHAPIROWell, it's true that the American system was created on -- you know, it's not a parliamentary system. It was designed so that the person in charge cannot just push through their agenda. Gridlock is part of the design. It is not -- what's that -- you know, it's not an extra feature. But the gridlock has become more and more calcified, and the ability to do the most basic routine things has suddenly become a crisis point.
REHMI had a telephone call from a neighbor who said, Diane -- she left me a message. She said, "I'm really scared for our democracy, for our way of living." Has it really come to that where we should really be afraid?
MASONWell, I think people are scared. I was out to dinner with a friend last night, and we were talking about this very thing, that people are scared about what would happen if the debt ceiling isn't raised, what that would mean for their own interest rates, what it would mean for their own bills, let alone the United States' position in the world.
MASONThat's something that does cause fear among Americans. And that ties in to what we talked about at the beginning of the program whether, you know, something like that is driving people to do things like what we saw with that accident yesterday.
SHAPIROWell, or just more simply and more broadly, if Americans don't have confidence in the economy, they're less likely to behave in a way that will grow the economy quickly.
REHMOr in the ability of Congress itself to really begin to work together.
MONTGOMERYBut what's interesting this time compared with two years ago, when we last litigated the debt ceiling in a scary way, is that Republicans do not seem to have any energy, as one said, to default. You don't hear people saying, oh, it'll be fine.
REHMWell, I hope it would be fine.
REHMLori Montgomery of the Washington Post. Ari Shapiro, White House correspondent for NPR. Jeff Mason, White House correspondent for Reuters. Have a great weekend, everybody. Stay at home.
SHAPIROWe will. Thanks, Diane.
REHMAnd thanks for listening, all. I'm Diane Rehm.
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