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What's Behind the Liberal Revolt on Health Care?

PH2009071702264.jpg

There's been some liberal discontent over the deal struck between Henry Waxman and the Blue Dogs yesterday. In particular, House progressives are angry that the public plan, which previously could use Medicare payment rates (with some exceptions) in its first three years of operation, now has to negotiate its own payment rates from the outset. Substantively, this isn't a particularly big deal. But then, it's not really about this.

House liberals are afraid of the dynamic in which good bills face Blue Dog opposition in the final mile and are aggressively watered down. Senate liberals are afraid of the same. And throwing this final compromise with the Blue Dogs into doubt is a show of strength. After all, House liberals feel they've already compromised plenty: Coming down from single-payer is a compromise. Cordoning the public plan off on the Health Insurance Exchange is a compromise. The whole bill is one big compromise, and every subsequent iteration is a compromise stacked atop a compromise placed upon a compromise. At some point, the compromises have to stop. Or, better yet, they have to go in the other direction.

In recent years, the Blue Dogs have developed a reputation for being willing to scuttle major pieces of legislation if their demands aren't met. Their approach to the congressional process is to render it a hostage situation. This has made it relatively easy for congressional leadership to go to liberals and regretfully ask for one more concession, lest those cursed centrists kill the whole bill. What liberals want, however, is for House leadership to be able to go to the Blue Dogs -- the very politicians who will be most vulnerable if health-care reform fails and the country turns against the Democrats -- and regretfully say that those nutball liberals will kill the bill unless they get their way on the public plan.

Photo credit: AP Photo/Charles Dharapak.

By Ezra Klein  |  July 30, 2009; 1:32 PM ET
 
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Comments

mmm... sausage

Posted by: mezcalero | July 30, 2009 1:41 PM | Report abuse

I read on Americablog that the Repubs on the committee are now saying there is no deal. What gives?

Posted by: mightywombat | July 30, 2009 1:43 PM | Report abuse

That would be the case if the Blue Dogs had actually gotten any concessions. They didn't really. They got the vote pushed back to after the recess; that would have happened anyway, thanks to Baucus.

They just need the optics; they needed the appearance of arguments, they need breathless Politico articles about a split with leadership, they need Rahmbo to drop some F-bombs so they could go back to their constituents and say, "see? we're moderates!"

In my opinion, liberals want the same sort of optics for their constituents, that's all.

The partisan dynamic has distorted everything in Washington. More and more it seems lawmakers don't care what the bill actually is as opposed to stamping their name on making it more moderate. For cap and trade, we should start with a bill that bans carbon and outlaws grandmothers, and work from there.

Posted by: CarlosXL | July 30, 2009 1:46 PM | Report abuse

is there anyone naive enough, to look around at the faces in congress, the polarization in this country, the special interest groups that are embedded with roots like redwood trees, and actually think we were going to get a utopian health care plan passed?
for those who operate in an all or nothing universe, i just wonder, where does it work in life that you get everything that you want?
not on this planet.
the world isnt a fair place.
who manages to get through a day, or a year or a lifetime without making oftentimes, extreme compromises?
do what you can, where you are with what you have,
or you end up with nothing.

Posted by: jkaren | July 30, 2009 2:05 PM | Report abuse

CarlosXL: "For cap and trade, we should start with a bill that bans carbon and outlaws grandmothers, and work from there."

I recall Bush, after winning as a "compassionate" centrist conservative, came out of the gate with a succession of fairly extreme right wing proposals. Most got watered down to end up passing as only "really" right wing policies. The current Dems are trying the opposite approach and starting the bidding with pre-watered down weak tea stuff. It's a little too early to know the results, but I doubt whatever comes out of conference is going to somehow end up more liberal than it was going in.

Posted by: jeirvine | July 30, 2009 2:14 PM | Report abuse

For more on Obamacare and the bureaucrats in charge, read the article titled "Are you willing to die for your government?" posted at http://www.cliffyworld.com

Posted by: Cliffyworld | July 30, 2009 2:51 PM | Report abuse

For more on Obamacare and the bureaucrats in charge, read the article titled "Are you willing to die for your government?" posted at http://www.cliffyworld.com

Posted by: Cliffyworld | July 30, 2009 2:52 PM | Report abuse

Stupidity?

Posted by: fallsmeadjc | July 30, 2009 3:52 PM | Report abuse


Well, what's weak about the deal is that private insurers aren't going to need to negotiate new rates in some cases. If the public plan has to start negotiating rates from ground zero; it'd be best to throw something in saying that existing private companies looking to participate in the exchange can't use any existing provider contract language that deems providers into new products at existing rates. That's a true level playing field.

Posted by: ThomasEN | July 30, 2009 4:53 PM | Report abuse

sam reyburn and lyndon johnson had to deal with their era's version of blue dogs - southern democrats - they had their successes and they had their difficulties

i will give pelosi a little more time before making a judgement, i do not think harry reid is an effective majority leader

Posted by: jamesoneill | July 30, 2009 8:27 PM | Report abuse

Why do I have the feeling that on 'Cliffyworld' there's not likely to be much to move the health care debate forward?

Posted by: leoklein | July 30, 2009 11:56 PM | Report abuse

And throwing this final compromise with the Blue Dogs into doubt is a show of strength.--

I think their fear is that this is not nearly the final compromise with the Blue Dogs.

Posted by: eRobin1 | July 31, 2009 11:02 AM | Report abuse

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