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Bipartisanship Lost

I give David Brooks a hard time sometimes, but I really do wish the conservative movement would follow his example. "If I were in Congress, I’d figure there’s an 80 percent chance of something like [the Baucus bill] passing anyway," he writes. "I might as well get engaged as a provisional supporter to fight to make it better, or at least to fight off the coming onslaught to make it worse."

To make this more concrete, consider a guy like Utah's Bob Bennett. As the lead co-sponsor of Wyden-Bennett, he's clearly interested in health-care reform, and willing to take risks to achieve it. But despite his best efforts, Wyden-Bennett is not a viable proposal. But he has shown no interesting in bettering, or even involving himself, with Baucus's legislation.

But why? I've read Wyden-Bennett. It is, undoubtedly, a better bill. But its advantage comes because of its radicalism, and its radicalism has denied it support. Baucus's bill, however, doesn't include much that should be appalling in principle to a supporter of Wyden-Bennett. In a way, it's an incremental step towards Wyden-Bennett. Like Wyden-Bennett, it creates insurance exchanges. Unlike Wyden-Bennett, it does not make them the main option. But they could certainly grow, which is, in theory, better than them not existing at all. Like Wyden-Bennett, it relies on an individual mandate, and insurance market reforms, and subsidies, and it eschews a public option. Like Wyden-Bennett, it changes the tax treatment of health-care insurance so that more expensive plans cease being subsidized.

There are certainly elements of the bill that Bennett dislikes, and elements of the bill he'd like to change. But as a potential Republican vote, he'd actually have a real shot at changing them. Wyden has been fighting a lonely battle to include the Free Choice amendment in the bill, which would make the legislation a lot closer to Wyden-Bennett. It looks like he's going to lose that battle, but if he'd been able to leverage Bennett's vote, he might well have won it.

It's not just Bennett, though. No Republican save Olympia Snowe has actually come forward with a concrete set of proposals that could permit them to sign onto the final legislation. Which is a shame, as there are actually places where conservative ideas and Republican cover could have bettered the bill. Conservatives have long wanted to end the preference for employer-based insurance, which would've been an important step forward. Many Republicans have been big proponents of moving away from fee-for-service medicine, which is a needed change. Republicans have been big proponents of making the insurance market more consumer-focused, which would be important in the context of the insurance exchanges.

But all those opportunities were lost. Because Democrats had no Republican cover, they could not sacrifice a single member of their party. That's meant that they couldn't be courageous on taxes, and they couldn't tell the unions to stuff it when they demanded that the exchanges remain constricted. Republicans complain that the bill is too liberal (though the Senate Finance Committee's bill is actually not very liberal at all), but that's in part because no Republicans were willing to offer their votes in return for making it more conservative.

By Ezra Klein  |  October 9, 2009; 12:05 PM ET
Categories:  Health Reform  
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Comments

I've read Wyden-Bennett. It is, undoubtedly, a better bill. But its advantage comes because of its radicalism, and its radicalism has denied it support. Baucus's bill, however, doesn't include much that should be appalling in principle to a supporter of Wyden-Bennett. In a way, it's an incremental step towards Wyden-Bennett.

It's called "politics" and this is exactly the reason why government doesn't do well making rational and efficient choices in any endeavor. They make political decisions instead of common sense decisions.

Now, let's flashforward in a universe where the federal government is in charge of your healthcare. Do you think the government will make decisions that are common sense and efficient, or do you believe that they will do as they have always done and make political decisions?

Posted by: WrongfulDeath | October 9, 2009 12:25 PM | Report abuse

Why would anyone support a bill that:

1. Increases taxes
2. Does nothing to decrease costs
3. Fails to insure over 20 million people
4. Proposes spending cuts that will never materialize

The ONLY reason to support such a terrible bill is to say, "We passed healthcare reform." No bill is better than a bad bill.

Posted by: kingstu01 | October 9, 2009 12:26 PM | Report abuse

You always have to read the last paragraph of a Brooks column to know what he's really getting at.

He basically advises Republicans to pretend like they might vote for it, so they can get more of their ideas in the bill.

Which is exactly what Snowe is doing.

Posted by: bmull | October 9, 2009 1:02 PM | Report abuse

Two reasons Republicans are reluctant to support Baucus.

First, everytime a Republican centrist provides "cover" for a Democrat, the DCCC nominates a blue dog, separates the Republican from their base, and often defeats them. There simply are not many Republican centrists left and the few remaining have caught on to the idea that no good deed goes unpunished.

Ironically, the Blue Dog Democrats are often more reluctant to support health care reform and/or environmental reform than the moderate Republicans they replaced.

Second, the Baucus bill is a camel's nose bill and everyone knows it. Almost every leading Democrat has tried to make the point to their liberal base that passing any form of health reform now is only the first step toward a European style single payer plan. The liberal base may not be recieving the message but the conservative opposition has heard it loud and clear.

Wyden/Bennett has the advantage of holding itself out as a final solution; not an incremental step.

Posted by: WoodbridgeVa1 | October 9, 2009 1:11 PM | Report abuse

It's the very political plausibility that makes the Baucus bill unacceptable to people like Bennett. Like Bill Frist and others, Republicans are happy to lend their support when it costs them nothing.

Posted by: roquelaure_79 | October 9, 2009 1:12 PM | Report abuse

WoodbridgeVa1: "Wyden/Bennett has the advantage of holding itself out as a final solution; not an incremental step"

You don't think Wyden would have a Too Big To Fail problem too? I see the plan requiring endless government bailouts.

Posted by: bmull | October 9, 2009 1:43 PM | Report abuse

bmull -- I recognize W/B has its problems and in reality just about any bill would lay the ground work for additional increments. But both Wyden and Bennett are trying to base the appeal of their bill around the idea of "lets make the tough choices once, get them behind us and put further reform on the shelf for at least a generation." All the other health reform advocates are saying "Lets make easy choices now that will start us down an irreversible slope to something we could never pass if we offered it as the ultimate outcome."

So far, the "easy choices" are not proving very easy at all and opposition to health care reform is hardening around fears of what is at the bottom of the slope. In many ways, W/B might have been easier to pass precisely because the debate would have been over what is actually in the bill rather than what might be waiting at the end of the road.

Posted by: WoodbridgeVa1 | October 9, 2009 2:02 PM | Report abuse

"had no [...] cover"

Right again.

Posted by: rmgregory | October 9, 2009 4:19 PM | Report abuse

They were going to give the Nobel Peace Prize to Rush Limbaugh, but they were afraid he would use the prize money for Oxycontin and Twinkies.

Posted by: republican_disaster | October 9, 2009 6:53 PM | Report abuse

Can someone explain to me why Wyden/Bennett is "radical"?

Wyden is totally sold on the idea of competition being the motive force of healthcare reform which is not substantiated by any of the experience of other countries with healthcare reform. He is just pumping up the volume on the competition meme. Competition among health plans has not proved to be terribly effective for cost containment:

http://healthcarecostmonitor.thehastingscenter.org/josephwhite/competition-and-health-care-costs/

I comment on this here:
http://healthcare4us.wordpress.com/2009/10/04/consumerchoice101/

Posted by: michaelterra | October 9, 2009 11:44 PM | Report abuse

michaelterra, feel free to comment on this:

http://findingourdream.blogspot.com/2009/09/wyden-offersfreedom-to-choose-very-good.html

Posted by: HalHorvath | October 10, 2009 2:05 AM | Report abuse

We should not be requiring companies to provide funding for abortions.

Bennett's bill already has an abortion provision. There is an exception for companies such as DMBA, but the rest of the insurance companies are out of luck.

http://thomas.loc.gov/cgi-bin/bdquery/z?d111:s.00391:

Bennett's bill, S.391 Healthy Americans Act:

(3) COVERAGE FOR FAMILY PLANNING-

(A) IN GENERAL- Except as provided in subparagraph (B), a health insurance issuer shall make available supplemental coverage for abortion services that may be purchased in conjunction with enrollment in a HAPI plan or an actuarially equivalent healthy American plan.

(B) RELIGIOUS AND MORAL EXCEPTION- Nothing in this paragraph shall be construed to require a health insurance issuer affiliated with a religious institution to provide the coverage described in subparagraph (A).

Posted by: Utah1 | October 11, 2009 6:56 PM | Report abuse

I believe it was G.K. Chesterton that said: "The whole modern world has divided itself into Conservatives and Progressives. The business of Progressives is to go on making mistakes. The business of the Conservatives is to prevent the mistakes from being corrected."

Posted by: bgrahamMA | October 12, 2009 6:44 PM | Report abuse

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