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The Problem With Deals

On Sunday, former senator Bill Bradley took to the New York Times to outline a grand compromise on health care. "The bipartisan trade-off in a viable health care bill is obvious," he wrote. "Combine universal coverage with malpractice tort reform in health care."

That would be an obvious trade. It would be so obvious a trade, in fact, that if it were on the table, it's a pretty safe bet that some Republican would have mentioned it, or some Democrat would have broached it, or some White House official would have floated it. The problem is that there's no evidence that any Republicans support that trade -- or any other trade, for that matter.

When conceiving of a deal to offer Republicans, you have to ask why they would prefer that deal to a scenario in which they vastly strengthen their power in the Congress, and can thus demand better deals, and maybe even control the process going forward. All things being equal, Republicans would like to see malpractice reform. But would they like to see malpractice reform more than they'd like to defeat the health care bill and pick up dozens of seats, and maybe even control of the Congress? Probably not. But that's the historical precedent of 1994, and the explicit premise of their current strategy. That's the bar a policy deal has to pass if it's going to be bipartisan -- which is why the Senate leadership is increasingly looking at reconciliation, and the possibilities of a partisan deal.

By Ezra Klein  |  August 31, 2009; 9:44 AM ET
Categories:  Health Reform  
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Next: Why Seniors Oppose Government-Run Health Care (Except for Their Own)


So the basic question that remains now is - is President Obama going to take the bet which Bob Dole mentioned? Basically authoring at least core part of the bill in details and publicly advocate that.

Or we are still going to see the listless parade of Baucus and Grassley's of the world?

Man we are tired of this Senate show. They are LDP of America.

Posted by: umesh409 | August 31, 2009 10:15 AM | Report abuse

The Urban Institute report you linked to a few weeks back had some good figures on potential savings from tort reform ($250B total over 10yrs, w/half of that impacting public payers). Seemed fine in their report but I'm sure there's more to it.

Posted by: ThomasEN | August 31, 2009 10:21 AM | Report abuse

the problem with deals here is that (and Senator Bradley doesn't really say this in his report) the thing that Republican's fear most is the public option and an ability to eventually overtake the system with it. Conversely if the public option was out many liberals and progressives would be against it as well. The question is who is going to blink first.

Posted by: visionbrkr | August 31, 2009 10:53 AM | Report abuse

In addition to trying to devise a grand compromise despite the obvious fact that one side isn't interested, Bradley also ignores the important difference in context: in 1986 the Democrats did not hold the White House or a majority (let alone a 60 seat majority) in the Senate. Nor was tax reform a first-tier Democratic priority. In other words, the 1986 tax reform is a pretty useless example for the current situation. See my comments yesterday at:

Posted by: jonathanbernstein | August 31, 2009 11:12 AM | Report abuse

Trade tort reform for health insurance reform? Great idea! I get to have surgery, and the doctor gets to leave his watch in my gut!

Bradley is a flake. His assertion that "Malpractice tort reform can be something as commonsensical as the establishment of medical courts" proves it. Does anyone believe that the Republican Party would support that reform?

The Republican Party doesn't oppose the current system because of its reliance on juries or its supposedly inconsistent results. They oppose the current system because it occasionally takes money from insurance companies and gives it to someone sick people. And they will oppose any reform that continues the practice.

Really, given the utterly cynical and insincere rhetoric from the Republican Party of late, if the Democratic Party proposed that reform, the Republican Party would attack the reform for depriving Americans of their fundamental right to a jury trial.

Posted by: dcamsam | August 31, 2009 11:26 AM | Report abuse

Bill Bradley's op-ed was idiotic. He failed to ask himself why Republicans prefer to stop reform than trade or barter in a constructive way. His discussion was pointless because he failed to see how his scenario did not fit at all in the existing context.

Furthermore, he indicates that Reagan's "reform" of the tax system was a good deal. I don't think collapsing 15 marginal tax brackets into 3 is a good deal.

Finally, the trade off he praises is asymmetric because it's easier to bring back loopholes while reintroducing new and higher tax rates is more difficult.

Posted by: bcbulger | August 31, 2009 11:43 AM | Report abuse

Frankly, I'm surprised the White House hasn't made greater mention of this incident:

"When Barack Obama informed congressional Republicans last month that he would support a controversial parliamentary move to protect health-care reform from a filibuster in the Senate, they were furious. That meant the bill could pass with a simple majority of 51 votes, eliminating the need for any GOP support. Where, they demanded, was the bipartisanship the President had promised? So, right there in the Cabinet Room, the President put a proposal on the table, according to two people who were present. Obama said he was willing to curb malpractice awards, a move long sought by Republicans that is certain to bring strong opposition from the trial lawyers who fund the Democratic Party. What, he wanted to know, did the Republicans have to offer in return?

Nothing, it turned out. Republicans were unprepared to make any concessions, if they had any to make." You can read the rest at,8599,1895706,00.html.

Posted by: ngrabowitz | August 31, 2009 12:30 PM | Report abuse

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