Why stripped-down "consensus" health reform probably won't happen.

How to fix health policy.
Jan. 21 2010 6:12 PM

There's No Such Thing as "Health Care Lite"

Why a stripped-down "consensus" bill probably won't happen.

Click here for a guide to following the health care reform story online.

Barack Obama. Click image to expand.
President Obama

Have you ever seen a cat chase its tail? Watching Democrats try to save health care reform since Republican Scott Brown won Ted Kennedy's Massachusetts Senate seat is a bit like that.

How about passing the Senate bill in the House and then improving it in a reconciliation bill that requires only 51 votes? The House's liberal Democrats might go for that. But its pro-life Democrats won't buck the U.S. Conference of Catholic Bishops to support the Senate abortion compromise, and unfortunately abortion coverage is one issue everyone agrees can't be handled in a reconciliation bill. (That's because, pace Rep. Bart Stupak, D-Mich., his church-approved House abortion provision doesn't involve the spending of federal dollars—which under existing law may not fund abortions—and reconciliation is allowed only for issues affecting the federal budget.)

What about ramming a House-Senate conference bill through the Senate during the 10 to 15 days before pro-reform Sen. Paul Kirk, the Democrat named to replace Kennedy, must vacate his seat? Majority Leader Harry Reid says no, possibly because it would violate Senate precedent. (Ted Kennedy himself, who like Brown first came to the Senate via a special election, was seated two weeks before the commonwealth of Massachusetts formally certified him the winner!)

OK, then. How about sucking up to swing-voting Sen. Olympia Snowe, R-Maine? Sorry, she won't play, maybe because she's irritated that Reid blabbed to the New York Times Magazine that, last time around, Snowe negotiated in bad faith ("It was a waste of time dealing with her"). Or maybe she's just proving his point.

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The latest notion to seize Democrats' imagination is to scuttle the current bill and instead pass "health reform lite." In a Jan. 20 interview with George Stephanopoulos of ABC News (to whom this episode must seem an acid flashback to the 1994 elections, when Stephanopoulos, then a top aide to President Clinton, saw his ambitions go up in smoke) President Obama said:

I would advise that we try to move quickly to coalesce around those elements of the package that people agree on. We know that we need insurance reform, that the health insurance companies are taking advantage of people. We know that we have to have some form of cost containment because if we don't, then our budgets are going to blow up and we know that small businesses are going to need help so that they can provide health insurance to their families. Those are the core, some of the core elements of, to this bill.

That was enough to make health reform lite the lead story in the nation's papers. But no sooner were these words out of Obama's mouth than he started explaining why health reform lite is probably unachievable. He started with politics:

I think it's important to remind everybody that part of this process was having conversations with Republicans for months and asking them what exactly they wanted to do and what their solutions were to these problems. … I thought that the urgency of the moment would allow us to join together and make common cause. That hasn't happened. Some of it, frankly, is I think a strategic decision that was made on the side of the opposition that ... some of it had to do with a sense that the best political strategy was to simply say no.

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