Can Dems get out of their own way and get a public health option?
After all the brouhaha about the competing interests in the Democratic party, and how the Dems were going to self destruct because they couldn’t agree on such elemental concepts as the public option, it looks like the give-and-take of politics may actually have a positive outcome. In the House, where 60 Democratic members have written a letter to Obama telling him that they can’t vote for a bill without a public option, word is that they’ll get the chance to vote for the bill they want. In the Senate, where, especially with the demise of Ted Kennedy, the trend is towards a “trigger” bill, in which the public option is delayed while the insurance companies have a chance to comply with preset savings and inclusion goals, scuttlebutt is that they’ll get the bill that they want. These bills will then go to conference, where the outcome will be a fairly robust trigger-based bill.
Why is this a good outcome? Well, that depends on whether you believe that the insurance companies have the remotest motivation or desire to actually “use the free marketplace to solve America’s health care challenges”, as the Republicans love to claim. Rather than banging our heads against a “public option now, or nothing” platform with a slim-to-none chance of passage, if we’re smart we can have our cake and eat it too. We can put hoist Republicans on their own petard of free market reform, which we know won’t work, and which they don’t really believe anyway. We can get a public option, albeit a bit later than we’d like, by allowing the triggers to kick in and force the reforms we need. And we can get out from under the mantra that “it’s Dems who are stopping reform”, which has been very effective politically for the Repugs, by using the natural divisions in our party to create a compromise that’s really not a compromise (except in immediacy of implementing the public option).
One of my sincerest hopes is that the Democrats can avoid the self-immolation that the Republicans are living through now, in which the right and far-right factions are tearing the party to shreds. If we can craft a scenario in which both of our factions, the “public option now” left and the “we can’t afford it with this $9 Trillion deficit” Blue Dog crowd can each vote their conscience, and we can end up, say, five years down the road, with a public option triggered by the insurers inability to control their own greed and ineptitude, and humiliate free-market Republicans in the bargain, someone help me understand why that’s a bad outcome.
Stumble it!
Tags: health care
September 7th, 2009 at 12:07 pm
Because the ‘triggers’ will be legislatively massaged in such a way that they will never get pulled.
September 8th, 2009 at 7:12 am
it is hard to have confidence that the bill will have real teeth, and real consequences for the insurers. very hard. but if it’s the best we can get, sigh.
if the dems had any messaging skills at all (or perhaps the real desire to use them in this instance) this wouldn’t even be a contest. as josh marshall said this morning, if rescission was as well known as death-panels, it would be toxic to vote for the insurers.
the whole thing is so very depressing. Goldman Sachs making our financial policy is bad enough. This seems so much worse. To not fix the health issues in this country is genuinely sinful.
September 8th, 2009 at 9:02 am
I’m with John, you’re not being cynical enough by half. I see this as a battle between honest-to-goodness representatives (progressive congress critters) and industry funded reps (blue dogs). And that might actually be a farce, with many of the progressives willing to be progressive as long as what they want is out of reach – the Dems love that tactic, very progressive as long as their in the minority. Republicans use the same tactic for Abortion (if they really wanted to make it illegal, instead of use it as an endless election club, they would have last time they controlled congress).
September 8th, 2009 at 11:06 am
mr freedman, yours is the most acute analysis i have seen (after much close following and reading) on the probable outcome of the health care reform bill…i came upon your site only today (from the gleen greenwald blog referrals on salon), but will follow you closely from now on…thanks for your very sharp analysis and sagacity…(i had been struggling with my own analysis and came close to what you suggest, but never quite got there)…is there any way, as an ordinary reader, that i can help promote your site?
September 8th, 2009 at 12:57 pm
I like the picture you paint, Rick, but I’m afraid John & Phaedrus probably have the rights of it.
September 8th, 2009 at 7:43 pm
Lawrence;
Thanks for the kind remarks…I’m really just a guest here, and have been posting very intermittently due to my other business and writing responsibilities (I’m writing a column for TechRepublic.com and working on a book)…but with this kind of encouragement maybe I should start opining some more…it cretainly seems to be the season for it…
Rick…
September 9th, 2009 at 9:23 am
Rick Freedman writes:
We can put hoist Republicans on their own petard of free market reform, which we know won’t work, and which they don’t really believe anyway. We can get a public option, albeit a bit later than we’d like, by allowing the triggers to kick in and force the reforms we need.
Just wow. Can anyone give me an example of how something worked out for the left in the past twenty-eight years the way Rick Freedman sees this working out? (I’m asking for an example other than those of careerists in the Democratic Party getting themselves promotions in 2006 and 2008.)
http://pnhp.org/blog/2009/09/07/on-the-status-of-health-reform/
On the status of health reform
Posted by Andrew Coates MD on Monday, Sep 7, 2009:
If Congress enacts reform, in 2013 individuals will be required to purchase health insurance. This is the centerpiece of the “reform.” The proposal has come straight from the insurance industry: criminalize the uninsured and subsidize unaffordable private insurance premiums with public funds…
An April 2008 New York Times business column about sagging profits at UnitedHealth carried a frank appraisal of the declining employer-sponsored private health insurance market. “It is never a good thing if many of your customers can no longer afford what you’re selling,” Reed Abelson wrote.
“In recent years despite soaring medical costs, insurers have made big profits by keeping premiums well ahead of health care inflation. But analysts say that business strategy may be reaching its limits, with companies finding it harder to raise prices without losing substantial numbers of customers.”
The article closed with a quote from a health business analyst: “The hail Mary may be that we turn to some sort of universal care.”