The White House seems to have breathed new life into the health insurance reform debate by releasing its own bill, using the Senate bill as its base. The Senate will use reconciliation to pass some elements of the bill to bring it closer in line with the House bill — the favorite of the two among liberals. I haven’t read the nearly-300 page epic poem, so let’s turn to Krugman to see what he thinks:
Since the House bill is better than the Senate bill, and the Senate bill is much better than nothing, this should be a go.
What I hear is that at this point the House is a bigger problem than the Senate. Pelosi — and Obama — have to drive home the following points: 1. This is the last chance to do HCR for years to come, and America desperately needs this 2. For their own sake, Democrats have to run on a record of having achieved something.
I’m not in a position to do nose-counts, but I’m guardedly optimistic.
I’m certainly sympathetic to that idea. The bill, however it eventually stands, will provide massive subsidies to poor people to help them afford insurance.
Over the past week, the public option had been gaining some steam, with 20 Senators signing a petition in favor of it. Matt Yglesias has a post detailing the many, many reasons why you would want the public option in the White House’s new bill. He concludes:
So putting the public option back in seems like a no-brainer.
An important part of the subtext here, I think, is that interest-group opposition to a public option is considerably broader than most people realize. Insurers don’t like it, yes. But the voters hate insurers. But there’s a very broad array of stakeholders who benefit from the inefficiencies of the status quo—everyone from doctors to hospitals to medical device makers—all of whom like the idea of more customers (mandate/subsidize) but dread the specter of reduced per-unit insurance payouts. [emphasis added.]
It has long been clear, however, that the WH has no interest in going to bat for the public option, and it shouldn’t surprise anyone that it’s not being considered right now.
Ezra Klein describes the maddening paradox of the public option in this way:
What you’re seeing here are the weird politics of the public option at play. It’s popular in the country. It’s wildly popular among the base. It’s the subject of obsessive interest in the media. There is little downside to supporting it publicly, huge downside to opposing it, and no one is allowed to ignore the issue, or even take a few days to see where the votes are.
But it’s divisive on the Hill. Bringing it back energizes all the narratives that Democrats fear most: That they’re cutting secret deals without Republicans in the room, that they’re building an extremist bill, that health-care reform is a government takeover.
Wherever one chooses to lay the blame for this stalemate — the revolting corporate media, the ineffective Democratic leadership, the fact that the GOP mindset oscillates between deranged psychopath and coma patient — Klein’s description seems to me to be accurate.
And, because the writers at FireDogLake have been fighting the good fight for so long, and I tend to agree with most of them most of the time, I’ll give the last words to that website’s Jon Walker:
There are several things that could likely be passed through reconciliation that might hold the insurance companies honest. Things like a public option, Medicare/Medicaid/Tricare buy-in, possibly tougher minimum medical loss ratios, and/or maybe even a national exchange. That fact the Obama’s health care proposal contains none of these potentially Byrd rule-proof ideas to “hold the insurance companies honest,” but instead contains a new agency unlikely to become law, is highly disappointing.
It sounds like a classic Rahm Emanuel idea of a win-win. Republicans are forced to take a difficult vote. Democrats get to pretend they supported something popular, but, in the end, Democrats don’t need to worry about hurting a potential donor because the insurance companies also win when Republicans kill the idea. Of course, in the end, regular people are the big losers because they are forced by the government to buy a poorly regulated product from private insurance companies.