Health Care Reform: Got Id?

Health Care Reform: Got Id?

Health Care Reform: Got Id?

A mostly political weblog.
Nov. 10 2009 3:11 AM

Health Care Reform: Got Id?

TTAC asks: Will today's recyclable cars fall apart ? ...  5:36 P.M.

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Are you as sophisticated as Politico ? Spot the weak point in Carrie Budoff Brown's optimistic health care reform report :

Reid also said he will deliver a final bill to the president by Christmas, meeting the White House deadline.

"We sure hope so," Reid said.

2:18 P.M.

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"Abortion Dispute Could Derail Health Bill": Do you really think an abortion dispute will derail the massive health bill? Me neither. I think if the Democrats are scared to pass the health bill they will let an abortion dispute derail the massive health bill. If they aren't too scared, the abortion issue can be finessed with a variety of possible compromises. ( Sample: The Stupak Amendment with an opt-out for states that vote explicitly to allow private insurance premiums (on federally subsidized policies) to fund abortions.)
 
That goes for all the allegedly difficult House/Senate sticking points. Timothy Noah lists four , in addition to abortion: the public option, the government's ability to negotiate drug prices, the size of the lower-income subsidies, the tax that will pay for it all. I'm not impressed. It would take a conscientious conference committee, working in secret, maybe, what, two days to split the difference on most of them? Even if differences can't be split, they can be finessed, or kicked down the road. And even if that' s impossible--well,nobody really believes that the left is going to sabotage a once-in-a-lifetime chance at health care reform over abortion, or the "robustness" of the public option, or the ability of illegal immigrants to get insurance.
 
The problem facing health care reform, as Dick Morris and others have been arguing for months, isn't these tediously subtle legislative complications. They're what we see on the surface. The problem is the crude, primal politics underneath them -- the legislature's' "id." It's the fear, among power-lusting Democratic Congresspersons, that if they vote for health care they won't be Congresspersons much past November, 2010 (or that even if they win, they will no longer be in the majority party). They're not worried about Cadillac plans. They're worried about castration.
 
Note that Obama's House pep talk, according to John Dickerson , focused on the primal politics:
 

Before the House vote last Saturday, Obama made two key political points to Democratic House members. First, they needed to vote for health care because it would motivate the party base in 2010. Second, those who think they can run away from the president by voting against his signature legislative effort are kidding themselves. The president believes that a key lesson of the Republican rout of Democrats in 1994 was that Democrats who oppose their president can never get far enough away to survive politically. So if you're going to get stuck defending the president, you should get behind his plan and benefit from the political cover he'll work to give those who support him.
 

Of course, if the fate of health reform in fact turns on such non-wonk, non-policy analysis, reform supporters couldn't help but notice at least two danger signs:

1) The size of the House majority. 220-215 votes. It's hard to believe it was this close--that Pelosi didn't have more votes she could have called on in a pinch. But if (as reported) she really needed to agree to the anti-choice Stupak amendment in order to get past 218, maybe she did pull out nearly all the stops. If so, yikes! The thinness of Pelosi's House majority is a very bad sign-- not because it shows the House doesn't have any room to negotiate with the Senate. (If the bill moves to the right by, say, dropping the public option, they'll cave.) It's a bad sign because it shows that even in the heavily Democratic, disciplined, liberal House the primal drive for health care reform just isn't that high . There is no room for more fear.

2)   "[Y]ou should get behind his plan and benefit from the from the political cover he'll work to give those who support him," Dickerson has Obama saying. You mean like the cover he gave Jon Corzine in New Jersey? ...

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Update: Matt Yglesias clarifies some of the Kabuki --

[I]nsofar as there are members who don’t want to take the political risk of voting "yes" on a comprehensive health care reform bill, but also don’t want to be seen as spiking the initiative, then developing a hard line position on abortion can be convenient . Like say Ben Nelson and Bob Casey say they can’t vote for health care unless it contains Stupak language, and then Joe Lieberman (Freedom of Choice Act cosponsor!) and Olympia Snowe say they can’t vote for health care unless it doesn’t contain Stupak language. Well, then health care dies. And yet nobody has to take the blame for having killed it if a constituent gets mad. [E.A.]

It's also true that if you don't want to take the political risk of voting "yes" on a comprehensive health care reform bill and also don't want to take the political risk of developing a hard line position on abortion then it's in your interest that others , like Ben Nelson, develop that hard line position and cause a train wreck . You can't be blamed, of course. You supported health care! You were nowhere near the scene of the crash! It just kind of happened. Terrible thing, just terrible. ... But maybe you will quietly thank Nelson in your prayers. ... Senate Majority Leader Harry Reid, of course, was accused of engineering just this kind of train wreck on "comprehensive immigration reform" in 2007. ... 2:23 A.M.

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Is it an accident that Rep. Alan Grayson, despite his respectable resume, turned into a flamboyant hey-look-at-me bombthrower  after hiring famously intemperate blogger Matt Stoller as "policy adviser" ? (Here's Stoller displaying his laid back personality on bloggingheads.tv . ) The NYT , which puzzled on Grayson's transition a week ago, missed this angle. ... Or was Grayson intemperate before--and that's why he hired Stoller (and why Stoller went to work for him)? Hard to see which way causality runs. Could run in all directions, of course. A vicious circle of hotheadedness . ... 1:48 P.M.

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