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What's the Matter With Jason Altmire? 

Congressman Jason Altmire is a symptom of everything that has gone wrong with the health-care debate. He may even be a symptom of everything that has gone wrong with American democracy. 

But the worst part is ... he's only a symptom. 

Altmire, a Democrat who represents areas north and west of Pittsburgh, has angered progressives with two mean-spirited health-care votes. The first was for the Stupak Amendment, a GOP-sponsored "wedge issue" bill that would make it all but impossible for the uninsured to buy policies covering abortion. The amendment passed, but Altmire voted against the rest of the reform anyway. It "failed to effectively rein in rising health-care costs," he contended.

For that, Altmire is taking all kinds of flak from the left, including TV attack ads sponsored by MoveOn.org

I doubt the ads will hurt him. Altmire's district supported John McCain in 2008; being attacked by MoveOn.org probably bolsters his standing. Nor are the ads likely to change his position. When I first interviewed him during his 2006 campaign against Republican incumbent Melissa Hart, he said that being pro-life was a political necessity in his district. "It's the conversation you have right at the door," he told me. And without a pro-life answer, "you never get inside."

So it's natural to ask: Why bother supporting him?

Well, there's this. In 2006, just before Altmire beat Hart, the American Conservative Union scored her lifetime voting record at just under 90 percent. Altmire has scored a 26. Among the Altmire votes conservatives hate: expanding housing for the poor, providing additional insurance for children, and making it easier for women to sue employers for pay discrimination.

I know, I know: Altmire is counting on people making such excuses. Exactly one day before his Stupak vote, he sent out a fundraising letter to Democrats. The letter recycled the month-old news that former U.S. Attorney Mary Beth Buchanan might -- might! -- run against him. Altmire pleaded for support, urging Democrats not to "turn this seat back over to another Bush-era partisan ideologue."

So yes, we're being triangulated here. But maybe we wouldn't have to attack Altmire today if Democrats had pushed health-care reform harder six months ago. While progressives watched Democrats dither in Washington, the right held tea parties everywhere else. Which is tragic, because many of the communities dead-set against reform would benefit from it most.

Consider: According to a 2008 survey by the state's Insurance Department, the five Pennsylvania counties with the highest percentage of unemployed residents are Union, Bedford, McKean, Potter and Fayette. All voted for McCain in 2008. 

In his book What's the Matter With Kansas, Tom Frank described such swaths of America as "a panorama of madness and delusion worthy of Hieronymous Bosch: [a landscape] of devoted family men [ensuring] their children will never be able to afford college or proper health care." 

That landscape, Frank argues, has been shaped by the fact that the right-wing "understands the central significance of movement-building" far more than lefties do. As Barack Obama's 2008 election proved, progressives have made in-roads, but so far, they don't reach far enough from the interstates. 

Of course, there's one other thing that makes Altmire's district a tough nut to crack: For much of it, the current system works pretty well. 

Late last year, the Insurance Department's survey found that Southwestern Pennsylvania had the lowest percentage of uninsured residents in the state. And that's just looking at people under age 65. In five out of the six counties that make up Altmire's district, at least one in five voters is age 62 or older. (Nationwide, the ratio is less than one out seven.) Which means that in large swaths of Altmire's district, disproportionate numbers of people already receive, or will soon qualify for, benefits like Medicare and Social Security. 

In fact, the ads we should be worried about are the insurance-industry spots targeting older voters -- the ones insisting reform will cut into their government-sponsored benefits. Maybe Altmire is just protecting his government paycheck ... but in that sense, too, he may simply be representing much of his district.

Even if we ousted Altmire, the dishonest scare tactics would remain, as would the voters who respond to them. Spending money and energy attacking Altmire, rather than the moneyed interests who pay for scare campaigns, could be a cure worse than the disease.

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