Thursday, December 10, 2009

Three Reasons to Be Happy About the Reported Deal by Senate Democrats on Health Care

[This article also appears on Huffingtonpost.com. You can access it from my author page here.]

According to reports yesterday, a group of 10 Democratic senators, five centrists and five progressives, has reached a deal to allow health care reform legislation to proceed. We don't know much about the compromise yet, as the senators aren't talking about it pending receiving cost estimates from the Congressional Budget Office. What seems to be the basic deal, though, is that the public option won't be a part of the legislation, but, instead, the bill will include an expansion of Medicaid and an opportunity for those 55 to 64 to buy into Medicare.

Many are lamenting the demise of the public option, but I thought of three things about the reported deal that actually make me happy:

1) Finally, the Democrats figured out that the power to make a deal lies with them, not with the Republicans. Back in September, I begged the Democrats to forget about the Republicans (who were only pretending to engage as a way of stalling progress), caucus, and come to a compromise that all 58 Democrats and the two independents could support. I have criticized the Democrats for failing to properly use the power of their majority in Congress and the mandate from an overwhelming victory last November, so it's only right I give them their props for finally taking charge.

My favorite element of this story, from a political gamesmanship point of view, is the statement from Republican Sen. John Thune of South Dakota that all 40 Republicans would oppose the Democratic compromise, even if the public option is off the table. It was such an entertaining moment, since Thune's statement meant absolutely nothing. How nice for you, Sen. Thune, that you and your 39 colleagues will stand together to support health insurance companies and oppose health care reform for Americans. But your opposition will have zero effect if the 58 Democrats and two independents agree to a deal. Thune and his 39 fellow Republicans will be powerless to stop health care reform from happening if the other 60 senators stand together.

Essentially, Thune's statement is like the temper tantrum of an eight-year-old who isn't getting what he wants: it's annoying but doesn't change anything.

It is quite enjoyable to read about a health care deal that doesn't involve what Olympia Snowe, Susan Collins or any other Republican whose agenda is to torpedo real reform wants. I don't care what they think. And if the 60 other senators really have made a deal, I don't have to.

2) I have come to the conclusion that no public option is better than a weak one. From the beginning, I have supported Rep. Anthony Weiner's proposal to extend Medicare to all Americans. The public option was meant to be a compromise between the left's desire for a single-payer system and the right's claim to oppose governmental intervention in health care. Somehow, the public option became the left's position in the debate, essentially taking the compromise position to begin with, even though the Democrats controlled both houses of Congress and the White House. Once it became clear that centrist Democrats (who enjoy riding on the financial coattails of health insurance and pharmaceutical companies) opposed the public option, it became clear that if such an option did end up in the legislation, it would be so watered down by triggers or other gimmicks that it no longer would have effectively done the job it was there to do: provide competition for private insurers and keep costs down.

If a weak public option became law, and it didn't work to bring down costs and expand coverage options (since it would have been set up to fail in the compromise), the perception would be that the idea itself failed (even though that wouldn't be the case). Given a choice between a weak public option destined to fail, and no public option with the reputation of the policy remaining intact, I'll take the latter every time. It leaves us with the opportunity to fight another day when those suffering under a system with lack of choice and high rates become more open to a governmental solution to address the crippling problem.

As an example, I offer the stimulus legislation. Democratic leadership allowed the Republicans and centrist Democrats to decrease the amount of the bill and to load it up with useless tax cuts. The result? Complaints that the stimulus bill didn't do enough to create jobs. Seems ridiculous, right? Make a proposal to address something, have your opponents water it down so it can no longer remedy the problem (or not work as well), and then blame the program for not providing a solution. I don't want to see the same absurd dance play out again with the public option.

3) A win is important both politically and in practice for those struggling without health insurance. The side of me that loves the game of politics thinks that if after a year of battling and enduring lies and other desperate measures thrown out from the right (death panels, funding abortion on demand, keeping Americans from seeing their own doctors, socialism, etc., I rounded up some of the crazy statements by Republicans in Congress here) the Democrats can get a health care reform bill through to President Obama's desk, something no other Congress has done in the last half century of trying, it will be a huge blow to the Republicans and conservatives who have fought this battle. Similarly, failing to pass health care reform legislation would be a deadly blow to the Democrats. So from the political point of view, getting something like the reported compromise through Congress would be huge for the Democrats.

More importantly, though, there are a lot of people suffering in the United States right now because they can't afford health coverage. According to the nonpartisan National Coalition on Health Care, 54 million Americans under the age of 65 lacked health insurance in the first half of 2007, with 7 million more estimated to lose their insurance by next year. The Republicans may want to protect their corporate benefactors, but something has to be done for the tens of millions of our fellow citizens in need. The current health care legislation may give too much to the health insurance and drug companies that have helped create the current mess in which we find ourselves, and it may not provide the kind of coverage and cost control many of us would like to see. But it will make life better for millions of Americans who are suffering right now with a lack of health care in a difficult economy. As much as I think politics is important, it is even more important to provide the citizens of our country with affordable health care, and the reported compromise is better than nothing for those in need. It may even represent a start, the first step in a process of true health care reform.

So I hope the reports of a compromise are true, and that 58 Democratic senators and the two independents who caucus with them have reached a deal to pass health care reform legislation. It may not be an ideal bill, but there are at least three reasons to be happy about it.