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A Rare Instance of a Working Legislative Process

It's nice to see a compromise resulting in actual good policy:

Moderate House Democrats and a key committee chairman emerged from a three-hour meeting at the White House on Tuesday with a tentative agreement to give an outside panel — rather than Congress — the power to make cuts to government-financed health care programs.

OMB Director Peter Orszag called it “probably the most important piece that can be added” to the health care bill in the House, and the deal between the Blue Dog Coalition and House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) was the first positive development Democratic Party leaders could claim since the American Medical Association endorsed their bill last week.

"Cuts" isn't quite the right word here. The Independent Medicare Advisory Commission would make reforms to government-financed health care programs. Some of those reforms would be cuts. Some of them would be about physician disclosure. Some would be about quality. In any case, it's good to see the Blue Dogs calling this a win. And it gets to a dynamic I keep hoping will play out, where passage of health-care reform begins to look assured and so various legislators who don't support the overall bill decide to work toward a better bill rather than simply obstruct the bill.

Republicans, for instance, have made unwinding the employer-based market core to many of their proposals. It was in John McCain's proposal and Tom Coburn's proposal and every other GOP draft I've seen. It's also central to the Wyden-Bennett plan that has attracted a number of Republican cosponsors. But it's likely to drop from the final Democratic plan because, well, it's a hard sell. Republicans have one of two options here: They could ensure that this priority is present in the final proposal by supporting it and promising either some votes for the bill or, at the least, for cloture, or they can ensure that this priority is absent by attacking the bill and forcing Democrats to retrench around its most popular aspects and drop any pieces that aren't broadly popular. Their choice.

By Ezra Klein  |  July 22, 2009; 11:46 AM ET
Categories:  Health Reform  
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Next: What's in It for Me?


were Republicans opposing this idea? This is another one where I don't understand why it has taken so long to implement if Democrats were on board with it.

Posted by: spotatl | July 22, 2009 12:27 PM | Report abuse

Congress hasn't wanted to give up this power, because traditionally it's been a way of handing out money. Cost control is going to be politically unpopular, so it has to be shielded from accountability to the people if it's going to happen.

Posted by: tomtildrum | July 22, 2009 1:27 PM | Report abuse

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