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Democracy and the House Health Reform Bill

To make one metapoint, the legislation previewed by the health reform committees in the House of Representatives also offers an interesting political contrast with the legislation being considered in the Senate. In particular, this is what legislation looks like from politicians with more to fear from voters.

The House is not a perfectly representative body, but it's pretty representative. Particularly compared with the Senate. Its membership is a function of the population (so where California has two Senate seats and Montana has two Senate seats, California has 53 representatives while Montana has one). Each member represents fewer constituents and so, at least in theory, is more closely attuned to their preferences. Elections come every two years rather than every six, and so representatives cannot trust that their votes on large bills will be forgotten by the time their next election rolls around. There is no filibuster that can be used to insulate the views of the minority or excuse the failures of the majority.

And this is what their bill looks like: Not single-payer, or even anything close to it. But recognizably left-of-center, particularly on points of controversy like the public plan. Which makes sense: In the last two elections, voters have expressed a preference for Democrats, and so you might expect the views of Democrats to prevail in legislative tussles. As I argued earlier today, you can't answer the question of votes by pointing to the results of polls. These policies may not be able to pass the upper chamber. But it's noteworthy that the House leadership clearly thinks them defensible in elections across the country.

More: The opposite version of this post.

By Ezra Klein  |  June 19, 2009; 4:30 PM ET
Categories:  Health Reform  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati   Google Buzz   Previous: The House Shows Its Hand on Health Reform
Next: Did Alan Greenspan Make a Terrible Mistake?


Ezra, if your plan can't get passed when your party has just won a presidential landslide and has firm control of both houses of Congress, the problem isn't too little democracy. Your party has the freest political reign of almost any time in modern history.

The problems are that the Democrats (like any party would be) are divided on several points of health care reform and influenced by special interests such as doctors and seniors. Those problems would still manifest themselves no matter what the Senate's composition or rules.

Posted by: tomtildrum | June 19, 2009 5:43 PM | Report abuse

What Congress is doing to ruin Medicare, Medicaid and Private Insurance is
short of criminal. If the "public option" is passed the elderly on Medicare
Advantage plans will have to start paying extremely high premiums, with
drastically less coverage, and more and more out of pocket money from people
with fixed incomes! What happens when the elderly can’t pay the premiums?
They'll loose coverage altogether. With deep cuts proposed for Medicare &
Medicaid what will the poor and people on fixed incomes do? With government
bureaucrats and Congress on the sweet congressional plan we’re left with what
ever ‘Obama-care’ elects to give us. There is no mention of what other cuts
to Medicare and Medicaid will be made to help pay for the "public option." For
example what will happen to disabled people? What is to become of them? We need
the blue dog Democrats and Republicans to step up to the plate and tell
President Obama and the "progressive" Democrats (I say regressive),,HELL NO!

Posted by: dhobi2361 | June 19, 2009 6:26 PM | Report abuse

We need some big time education efforts if we are ever to get any real healthcare reform. Rightnow someone can throw out the word "socialized" and Democrats run to the hill. Single-payer and they start talking about Washington bureaucrat's dictating treatment. These tactics are effective because most people don't understand what "public option" or "single-payer" really mean.

We wouldn't need to cut Medicare if we went to Single-Payer, every US citizen could be covered 100% by the aggregate billions being spent on healthcare in this country today.

Posted by: Athena_news | June 19, 2009 10:15 PM | Report abuse

You are as clueless as the day is long. Putting your trust in the Blue/Bayh Dogs and the Republicans? Hahahahahahahaha!!!!!!

Posted by: Calvin_Jones_and_the_13th_Apostle | June 21, 2009 12:05 PM | Report abuse

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