LET IT DIE?
In light of reports that Senate Dems may strip the public option and the employer mandate from the health-care bill, Steve M. asks a good question: "Is this even worth it? Is it even worth fighting to pass a compromised, inadequate bill?"
I largely agree with his take on the politics. But even if getting any bill called "health-care reform" passed would be good short-term politics, it's worth further emphasizing that signing a bill without (at a minimum) a public option would be a substantive disaster. Such a bill would not be "reform" in any meaningful sense.
The normal justification for passing a compromise bill is that once a new system is entrenched it can be tweaked later. But I don't think it applies in this case. The public option is the core of the reform; a Blue Dog bill isn't so much half a loaf as a few meaningless crumbs. And far from making a public option more viable in the future, if anything, passing something that could be called health-care reform will reduce the impetus to pass actual reform. And, worse, a bill with no public option will further entrench the insurance industry and make it easier for them to block actual reform in the future.
There's no inherent value to passing a health care bill, per se. If it doesn't contain the elements that make it worthwhile, progressives shouldn't let it out of Congress, and Obama should make clear that a Blue Dog bill would be vetoed. A bad bill would be worse than no bill.
--Scott Lemieux
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COMMENTS (25)
Oh, for the baby jesus's sake. The "reports" about the public option and employer mandate being stripped from the bill are Politico's overreaction to the provisions being removed from the Senate Finance Committee's version. The provisions are being stripped so the bill will actually make it out of committee. It still needs to be reconciled with the HELP committee's version, not to mention amended once it reaches the full Senate. In other words, stop buying into the hyperventilating of people who know little about health care or how Congress works.
Posted by: Jennifer | July 28, 2009 3:32 PM
Jennifer, that is not responsive to what Scott actually wrote. He said IF a bad bill comes out of the process it should be deep-sixed. Do you agree with this or not? Because even if you think it's an unlikely contingency (many others would disagree, but I'll grant you that premise for the sake of argument), it's certainly a POSSIBLE outcome which needs to be planned for by advocates of real reform.
Posted by: Steve LaBonne | July 28, 2009 3:42 PM
I think you are wrong 100% on the politics. No bill equals Democratic Party Failure in 2010, a major issue for Republicans...."See? They can't govern."
In fact, I argue that any bill is better than no bill. Repackage it as "a step forward." (of course, full disclaimer: I want a public option..but I also want to keep winning elections.)
Posted by: Frank C. | July 28, 2009 3:46 PM
and Obama should make clear that a Blue Dog bill would be vetoed.
Does this seem remotely realistic at this point? This is the guy who won't tell even tell us which lobbyists have been to the White House to make their cases.
Posted by: Anonymous | July 28, 2009 3:48 PM
Frank, if a Democratic Party that controls the White House and Congress can't even make a decent start at addressing this country's huge problems according to its own supposed principles, then I for one will consider it totally useless and therefore won't give a damn whether it keeps winning or not (and if it does it'll be without my vote.)
Do you have ANY principles beyond electing any hack willing to put a "D" next to his or her name?
In any case, a bad bill will fail visibly and spectacularly to deliver access to health care at affordable cost, and therefore will turn the public AGAINST both the party and health care reform. So even your crassly political calculation is stupid.
Posted by: Steve LaBonne | July 28, 2009 3:56 PM
Steve, Scott's post is premised on the idea that what is coming out of the Senate Finance Committee is predictive of what will happen in the full Senate. This is a false premise, which is what I was responding to.
Posted by: Jennifer | July 28, 2009 3:56 PM
I agree with Jennifer. People are freaking out about reports of one committee and completely ignoring all the other committees that have included the public option language -- plus the fact that the public option is one of Obama's three principles.
We have to get something passed, even in the very unlikely case that a public option won't be there. Every day people pay for individual health insurance that is VOIDED if they actually get sick. It's shocking that it's not outlawed yet, but it needs to be.
Posted by: evie | July 28, 2009 4:00 PM
Here is what you really need to know:
A bad bill would be worse and it shouldn't be passed.
The commercial insurance industry is dying as we speak. Its record profits are attributable to business units that provide something other than commercial health insurance (like Medicare Advantage). The number of commercially insured individuals has plateaued. Increases in Medicare and Medicaid enrollment mask this.
The dirty secret is that insurers want reform, but they want it on their own terms if that's possible.
Which is to say: an individual mandate without a public option is basically a disaster because it doesn't have a prayer of reducing costs and it will force people to pay the insurance piper.
I would rather take my chances in 2010 than take what appears to be Max Baucus's shitty version of the health care "well we'll give you an itsy bitsy bit of reform" bill. I hope it doesn't make it out of his own committee.
Posted by: Anonymous | July 28, 2009 4:01 PM
No. See the anonymous comment after yours. Getting a bad bill passed- a taxpayer-funded insurance company boondoggle a la Medicare Part D (which is exactly what the Blue Dogs want)- would actually be a disaster.
That's why, if you and Jennifer turn out to be wrong- and again, that's a contingency that has to be planned for no matter how unlikely you think it is- then the progressives in both houses MUST stick to their pledges to torpedo it.
Posted by: Steve LaBonne | July 28, 2009 4:12 PM
Reid seems to think his job is to get 60 votes (according to a comment from him today). To me, his job is to get 51 votes and just use reconciliation. That's why Obama put the option in the budget an warned Repubs he was willing to use it. I guess we'll see how serious Obama is about using reconciliation if his core principles are not met in a "bipartisan" bill.
Posted by: evie | July 28, 2009 4:27 PM
From today's townhall, according to Politco:
- Obama reaffirmed at least twice his desire for a public option in a final bill. In explaining “the exchange” will allow Americans to select private option plans, "but we also want to have a public option that’s in there," Obama said.
Posted by: evie | July 28, 2009 4:32 PM
Yes, lets have an individual mandate that forces everyone to pay out of pocket for health insurance, and lets not force employers to offer health insurance. I'm sure thats going to be extremely popular.
Also, you people are idiots who haven't spent 5 minutes thinking this through. You could pass a bill that did nothing, call it healthcare reform, and some people might buy it.
You can not, however, pass a bill that takes 5-8 thousand dollars out of the pockets of a group that overwhelmingly votes for you, call it healthcare reform, and have people go along with it.
You people are idiots.
Posted by: soullite | July 28, 2009 5:06 PM
I believe this health care plan, without a public plan, will never be implemented. The entire country will rebel--from both sides. Its not like the bailout-- we actually have to cooperate with this one, which we will not.
AND if it is just "health insurance reform", that's fine. It can be done by passing laws and SPENDING NO MONEY. What's stopping that?
We will get public health care but I feel it will come after Obama and the present Democratic leadership. This president started his public debate already conceding too far to the right. That would have been o.k. if the public had not ALREADY decided that the right had messed up badly. I guess he missed that.
But he started in concession mode and has only to move, at their whim, more and more toward the right. Its like a game now. Anyone can get Obama to move center (wink, snicker), oh, and apologize. This is why both sides hate him now. The right doesn't respect a total wimp, just as much as the left, although the left hates his torture-protecting, warmongering and secrecy. Most of the right know they were criminally wrong during Bush. That is why he was able to even get elected. But we are all are amazed at how weak he really is, after all, and how he surrounded himself with so many opportunists with their own agendas, with right wing media publicly laughing at him now... This weakness makes people uncomfortable, tending back toward the right.
But a man or woman (not Hillary), with more backbone and a better understanding of where the problems are actually coming from (ins co's, fee for service), and a real commitment to the truth of how to fix it, will be able to do it if they JUST BELIEVE IN IT as 70% of the American people do. Truth, remember that?
Imagine if Lincoln had set down both sides to "negotiate" the freeing of the slaves in the "finance committee".
Obama is just not the man for the job, thats all. It will happen, just not with him.
Posted by: tropicgirl | July 28, 2009 5:28 PM
"Here is what you really need to know:
A bad bill would be worse and it shouldn't be passed.
The commercial insurance industry is dying as we speak."
ANONYMOUS IS COMPLETELY RIGHT. THIS BILL IS BEING REDUCED TO AN EXPENSIVE BAILOUT FOR INSURANCE COMPANIES, THATS ALL.
Posted by: tropicgirl | July 28, 2009 5:31 PM
I agree that the bill is controversial, but I think it's important not to take our eyes off the ball as far as foreign policy is concerned.
The Borgen Project has some good info on the cost of addressing global poverty. $30 billion is the annual shortfall to end world hunger. $550 billion is the U.S. defense budget.
Posted by: Benjamin | July 28, 2009 6:23 PM
If it provides universal protection against catastrophic loss, and prevents any further use of pre-existing conditions to deny coverage or price it, the rest is icing on the cake. Failing to recognize that those two elements alone would be revolutionary, and losing interest as a result because we don't get everything we want, is grossly irresponsible.
Posted by: urban legend | July 28, 2009 7:44 PM
Urban, fuck you. It's grossly irresponsible to keep blaming people to your fucking left because scumbags like you refuse to write bills we can support.
go fuck yourself. You don't get to decide what is and is not 'responsible'. Don't be talking about 'we'. You and I aren't on the same fucking side, so stop fucking pretending that we are.
Posted by: soullite | July 28, 2009 8:40 PM
Urban, Benjamin. Our goals aren't the same. I could give a shit less what you all think is 'the prize' here.
To a lot of us, the Public Option was as far as we were willing to compromise. That's not what we wanted, but we were willing to accept it. world hunger? thats your fucking issue, I don't give a damn because it's not America's problem. Taking care of Americans, thats America's problem. Making sure you get a plan YOU think of as good enough? Thats not my fucking problem either. thats YOUR problem.
I see no reason to support Obama's reelection right now. I see no reason to support having Democratic majorities right now. I See every reason to blow up the party because fuckwads like you think you can take people like me for granted.
Posted by: soullite | July 28, 2009 8:44 PM
I find myself in complete agreement with the angriest commenters here. I am almost dysfunctional with rage. In particular, I agree with soullite's declaration of seeing no reason to support Obama or Democratic majorities. Why? New blood in the old veins won't do shit.
It's over. Health reform, Obama, the Democratic party. It's just o.v.e.r. They aren't going to get us back, not after this. And no, just any bill won't do it. There has to be a public option, or every last one of these bastards can go straight to flaming hell.
Posted by: John Hamilton Farr | July 28, 2009 9:56 PM
Kill the effing bill. I thought Waxman-Markey was bad? Not close.
And, the American public and Democratic-enabling voters elected Kumbaya instead of William Jennings Bryan, reminded them they're being crucified on a cross of spiraling insurance costs and denied claims.
Glad I saw through him 14 months ago and voted Green. Again.
Posted by: SocraticGadfly | July 29, 2009 12:07 AM
Health Care reform died with the DNC's decision to instate Obama over the voters' actually electing Clinton...remember? the one actually FOR universal health care...you were warned then.
Don't blame me; I wrote in HRC.
Posted by: the pumas were right | July 30, 2009 10:56 AM
Anyone who's worked for the Federal government, contracted with them or fought with them over legal issues knows they have no business running the entire health care system. It is bad enough we have to live with Medicare when we get old.
Fortunately the American people are smarter than Obama, Pelosi and Reid, and the likelihood of this disaster becoming law is dying quickly.
Now that a conservative has thrown his two cents in, feel free to use personal attacks; its what liberals do best these days.
Posted by: ReaganRules | July 30, 2009 4:14 PM
Reagan Rules...yeah in Hades!
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