I think the prospects for Obama signing a health care bill still look good, albeit not a slam-dunk by any means. But the Republicans have successfully whittled down the bill to a point that they can have some success in attacking elements of the reforms. Most obviously, as many of us have been saying for a year now, the Republicans will argue that it’s an unconstitutional impingement on our rights to compel us under threat of fine to buy a product (health insurance) from a private corporation. On the flip side, the Democrats will promise young, healthy people that don’t want to spend any percentage of their income on health insurance that they’ll lower their rates by increasing their subsidies.
Obama is still negotiating against himself, making changes to the bill that Republicans claim to like without getting any Republican votes in return. He’s trying to create political cover for his members by painting the Republicans as unreasonable. Maybe it will work, and maybe it is necessary, but it isn’t going to be very helpful in the long-run when people have to defend these health care reforms. A stronger, more popular bill would be preferable from a policy and a political perspective.
I don’t mind going after the trial lawyers a bit and getting some malpractice reform, but it should be remembered that trial lawyers are one of the Democratic Party’s most important constituencies. If you’re going to make them take a loss, you ought to get something in return, like maybe a single Republican vote.
I suppose the point is simply to get the bill passed now. If it does pass, I will be interested to see how it affects the differential enthusiasm of the two party bases. I suspect the Republicans will be a bit demoralized for a while. But maybe they’ll just ramp the anger up to eleven.
Policy aside, I wonder what effect it will have on the Dem base. They’re sure not going to pass anything else that’s big ticket before the mid-terms. I can’t use myself to extrapolate obviously, Obama hasn’t governed for me since inauguration.
Maybe they’ll change the rules in the next Congress (as Bowers says) if they are still in the Senate majority, I don’t know. It might prevent them having an essentially useless governing majority.
l think it extremely unlikely that any health care/insurance reform bill will get any republican votes, regardless of what obama does, short of scrapping the bill and starting over…which ain’t gonna happen. he’ll just keep giving it all away without receiving anything in return.
according to pelosi, who was just down the road speaking today, it’s about to get watered down some more:
all he’s poised to accomplish is pissing everybody off even further. he lost control of this when he didn’t get a bill before the august recess, then blew it completely by not going straight to reconciliation in october. the entire process has been a year long clusterfuck.
l keep hoping to see some leadership, but it seems to be in short supply.
Pelosi’s spokesperson said this wasn’t true:
About defending a compromised bill – I’ve learned two lessons recently:
As I remember it, progressives fought against concessions on the stimulus bill, on the grounds that they would make the stimulus less effective. But most progressives became its defenders as soon as it passed. Coherence has been the price of loyalty.
I helped my mother sign up for Medicare Part D. I was sure it was going to cost the Republicans the next election. It was a needlessly complicated process to find out which plan gave the best cost-benefit ratio, and I reasoned that every older person and every younger person who helped them would make Republicans pay for the stupid and onerous way they set up the system. I was wrong.
As soon as HCR passes, progressives will defend it fiercely. But nothing is more discouraging to me than knowing that we’ll be enacting policies that cost more than necessary and cover fewer people than necessary.
Having burned out on tea leaves several months ago, I’m waiting to see what Obama actually produces.
The major reason the malpractice system needs reform isn’t that it costs too much but that it’s a terrible system for preventing medical errors. If Obama proposes a reform that replaces malpractice with a better alternative that is more likely to prevent errors, I’ll support it.
If it’s a brainless giveaway to Republicans, I won’t.
I really don’t care about how it affects trial lawyers except as it helps me understand the inside baseball – so thanks for the explanation.
I read that Obama and Hillary wrote an article for the New England Journal of Medicine together regarding malpractice reform. It wasn’t what Repugs want now which is caps on awards. It basically approached caps for nuisuance claims, but left serious injuries open to settlement which I could live with. It was more complicated than that, but the general idea.
Good tip! Link is here.
I suspect the real source of the push for “malpractice reform” has less to do with the lawyers and more with the profit margins of the insurance companies — the ones who sell malpractice insurance, and want the same kind of big profits from that that they get from, say, health insurance.
They want to limit what they will have to pay out, either in medical malpractice suits, or any kind of liability suits, for that matter. Then it becomes a simple business expense for them, something they can write off… while still raking in profits. And nothing else needs to change, except that it’s harder to sue them.
“I suspect the Republicans will be a bit demoralized for a while. But maybe they’ll just ramp the anger up to eleven.”
It’s not up to 26 already?
I’m with you on the effects on the respective party bases. I actually think that the GOP base will get worked up right after it passes, then fizzle. The Democratic base is a little trickier. It’s been a messy process, full of progressive consessions. The liberal base is pretty pissed off, and saw what this bill COULD have been. But all the crappy aspects of this bill, and there are many, there really is a LOT of good in there. This won’t be the complete overhaul we were hoping for, but it’s still a big step forward. One wonders if the base will be willing to accept a win and actually be proud of passing the largest social legislation since the creation of Medicare.
Looking back at this first year or so, especially if Pres. Obama passes HCR, there’s a lot to get pumped up about. Let’s just hope people take a breath and realizes it.
The Public Option is the only thing that will save the Democratic base. We now have 30 Senators for it. Shifting the cost to the government to pay for the runaway health insurance industry is not the answer because it will just get worse. The Public Option for everyone would break the back of this insurance rip-off and the Democrats will be real heroes of the people. If it comes to a vote and does not pass, we will know which Democrats will need a forced retirement and maybe the base will keep working. Without a vote on this the base will say `why bother’.
As far as I can tell from reading various versions of the proposed legislation, the penalty — added to your income tax — for failing to comply with the mandate is “affordable,” I think… So there’s always that option and paying all your medical expenses out-of-pocket which can still be less than you’d pay for a health insurance policy. It’s not like losing your driver’s license when you fail to buy auto insurance — and that’s an existing example of being forced to buy from private providers.
I hope it all works out like auto insurance which is generally well-regulated by the states, highly competitive and usually affordable. There are, of course, fairly worthless junk plans that barely meet the minimum standard and are pretty worthless when you actually need them to, you know, fix your car after an accident. If there are similar health insurance plans that are cheaper than the penalty, people could go with that and still pay most of their expenses out-of-pocket.
At this point, they keep changing the details almost daily and I really don’t know what’s going to be there when the president finally signs it into law. I’ve had to take a wait-and-see attitude, thinking we can just continue with our uninsured purchase of medical care as we can afford it with the added expense of the fine, if it turns out that all this doesn’t produce health insurance we can actually afford.
Oh and, please stop calling it Health Care Reform; it stopped being that months ago. Yeah, yeah, I heard there is some good stuff in there… But, the main thing I see on the table is Health Insurance Reform. Perhaps, I’ll be pleasantly surprised if I’m wrong.
Still the best source for Health Care Reform news. Thanks BooMan!