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.
October 9, 2009; 12:05 PM ET
Categories: Health Reform
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