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Do Democrats Realize They're in Charge?


By this point, I could write the transcripts in advance. Every interview with members of the administration involved in health-care reform goes the same way: A reporter asks if they support the public plan. They do. Then the intrepid reporters asks if it's non-negotiable. And, like everything else in health-care reform "except for success," the public plan turns out to be negotiable. And that's the headline.

Today, everyone is up in arms about a Wall Street Journal story in which Rahm Emanuel goes through those motions. I'm not particularly up in arms about this, because it's not a change in rhetoric. At all. They've been saying the same thing since the first day. Barack Obama has said this. Kathleen Sebelius has said this. Nancy DeParle has said this. And Rahm Emanuel has said this previously. As it has been, so it still is.

But I was struck by the rationalization Emanuel provided for the so-called "trigger" public plan. This is not an argument I've heard before:

Mr. Emanuel said one of several ways to meet Mr. Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.

Putting aside the success, or lack thereof, of Medicare Part D, this is a bit of a weird comment. In 2003, Republicans controlled the White House, the House of Representatives, and the U.S. Senate. As such, when they tried to pass their legislation adding a private prescription drug benefit to Medicare, they allowed a small concession to Democrats: a weak public plan that would be activated if certain conditions weren't met by private industry.

What Emanuel is saying here, however, is that in 2009, when Democrats control the White House, the House of Representatives, and the U.S. Senate -- and have larger margins than Republicans ever did in the latter two -- that they are interested in settling on the same policy compromise: a weak public plan that would be activated if certain conditions aren't met by private industry. That's a bit weird. Weren't elections supposed to have consequences?

Photo credit: Getty Images.

By Ezra Klein  |  July 7, 2009; 12:08 PM ET
Categories:  Health Reform  
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Maybe they're thinking about the consequences of the next election.

Posted by: whoisjohngaltcom | July 7, 2009 12:23 PM | Report abuse

Probably, but you have to ask yourself if the American people are more likely to punish them for watering down the public plan or for including a robust public plan. I think they are less likely to notice the former--the people who notice that are lobbyists.

Posted by: Castorp1 | July 7, 2009 12:41 PM | Report abuse

I think the weakness of Democrats to assert the authority they've won by getting the Presidency, a filibuster-proof majority in the Senate and an overwhelming majority in the House is well-documented. The same tendencies that make Democrats choose dialogue over war and sanctions abroad (to their credit in that case) makes them avoid confrontation with Republicans domestically, too (to their fault).

If they were really looking to the elections, they would pass something (whether Republicans liked it or not) that had the ability to truly bring down costs and open up access to healthcare, whatever that happened to be.

Posted by: bmrobert64 | July 7, 2009 12:43 PM | Report abuse

Elections do have consequences. We elected Obama; these are the consequences.

Posted by: eRobin1 | July 7, 2009 12:45 PM | Report abuse

Good politicians are always wary of really stupid ideas like the public option even if they are popular. Ideally, they would like to vote on it right before an election so that the consequences won't be obvious. I think this just shows that they know it's a stupid idea. If they actually had any confidence in it then they would be pushing for it. Populist policies are good when campaigning but if you actually enact them then you'll inevitably be in political trouble when the stupidity shines through.

How do you like my Krugmaneque style? I said stupid a lot.

Posted by: fallsmeadjc | July 7, 2009 12:58 PM | Report abuse

I'm afraid a public option just isn't in the cards. Look at the numbers. About 38 senators have expressed open support for the public option. 22 still need to be convinced to achieve 60, and that includes two senators who have openly opposed it (Landrieu and Lieberman), and the likes of Ben Nelson and Max Baucus. It's an uphill fight against the private insurance lobby.

Posted by: CarlBentham | July 7, 2009 1:01 PM | Report abuse

The Democrats have always represented such a diverse group of interests that they will never follow strict orders like a bunch of Republicans will. Right out of the gate the "public option" plan was a compromise from the kind of effective reform that the country really needs. Oh, to have a real, viable, useful third party in this country, one that isn't just a curtain for another bunch of xenophobic right wing weirdos.

Posted by: fishermansblues | July 7, 2009 1:19 PM | Report abuse

Or maybe a public option with a trigger when lack of competition exists is the best policy option and a majority of the people who do health care lawmaking for a living are coming to that conclusion.

If you believe in competition, that policy option is most likely to bring competition to the current health care insurance market and keep it over the long-term by not running private companies out of the market.

Posted by: lancediverson | July 7, 2009 1:53 PM | Report abuse

I could rant on this all day. The takeaway is just that while all politicians are slimy manipulators, the democrats are slimy, manipulative pansies, while the republicans are slimy, manipulative bullies. Bullying makes for more effective passing of legislation...

Posted by: nokona13 | July 7, 2009 6:48 PM | Report abuse

The Dems may be in total charge now but they are too wussie to pass some of the smelly legislation that is coming from the White House. 44 Dems voted AGAINST Obummer's Cap and TAX boondoggle and I don't think there will be too many eager to sign on to a 3 Trillion dollar health care bill that could get their miserable butts tossed out of office in 2010 or 2012.

Posted by: priley8104 | July 7, 2009 7:42 PM | Report abuse

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