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No grand bargains

I was talking with a conservative deficit hawk earlier today, who said that the greatest disappointment in this debate has been that five or 10 Republicans didn't come together and create a voting bloc for a bill with better cost controls. That's right, and it's weird, too.

The relevant math of health-care reform has mainly been that six or seven senators are unsure whether they want to vote for it, and they're needed for the crucial supermajority. But you can flip that and say that the relevant math of health-care reform is that about 55 senators are firmly committed to its passage. As Paul Krugman wrote today, "think of it as a grand bargain: coverage for (almost) everyone, tied to an effort to ensure that health care dollars are well spent."

There never seemed to be much interest in that bargain, though. Even once passage of the bill seemed likely, Republicans didn't emerge to trade their votes for ending or capping the employer tax exclusion, or securing medical malpractice reform, or building a stronger Medicare Commission, or anything, really. They actually spent most of their time attacking efforts to bring Medicare's spending under control. So the bill is likely to pass with Republicans getting a lot less than they would if they were willing to give Democrats five or six votes. On a human level, it's very strange: These folks fought for years to join the country's most exclusive legislative body, and now that they have an opportunity to really change things for the better, they're too scared to actually do so.

By Ezra Klein  |  December 4, 2009; 4:05 PM ET
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Most surviving members of the GOP Senate membership are terrified of their base -- or more accurately right-wing radio hosts who motivate the base.

The Dems could propose a health care bill that consists almost entirely of tax-cuts and the GOP would find reasons to object. It doesn't really matter what the substance of the bill is.

This is just like McCain trying to become some kind of champion of Medicare. In 2008 he was proposing hundreds of billions of cuts that would have actually undermined the quality of service. Now he wants to "protect" hundreds of billions in waste. In the span of a year he's made over a $1 trillion reversal. Policy and principle aren't central to the reversal. Politics are. The McCain example is just the GOP writ-large.

These kind of games are going to lose the GOP a generation of voters. People may be easily distracted and things can be tough issues to wrap our heads around, but many of the GOP's tactics assume a level of stupidity on the part of its audience that suggests they have absolutely no respect for the people who actually put them into office.

Posted by: JPRS | December 4, 2009 4:18 PM | Report abuse

I dont think the problem is that they dont see the policy benefits in doing so. The real issue is that they have stirred up such a furor in the right wing fever swamps with talk of socialism, fascism, and death panels that any attempt now to participate in the health care bill would be met with instant primaries and conservative outrage.

The Republican senate caucus has decided, for better or for worse, that they are all in on obstruction and betting that it will fail.

And who knows, they could be right. Hopefully not, but this is such a fragile coalition right now anything could blow it up.

Posted by: chad6 | December 4, 2009 4:27 PM | Report abuse

Actually, they are changing the world for the better, at least from the perspective of their self-interest. Their unending, uncompromising obstruction is expertly designed to cultivate political nihilism and disillusionment--a process keenly abetted by radio and TV ravers--allowing them to ride a tide of bitterness and resentment to a legislative majority. Don't expect to see the filibuster stick around once that happens. And don't look past the fact that it's the left that's paralyzed by fear and corruption while a resurgent and empowered right wing slowly eats away at the heart of America.

Posted by: fumphis | December 4, 2009 4:29 PM | Report abuse

"These folks fought for years to join the country's most exclusive legislative body, and now that they have an opportunity to really change things for the better, they're too scared to actually do so."


Really? "They're too scared"? Not "they're intentionally hoping to crash the Obama presidency into the ground in order to emerge as the only alternative and then propose any radical cuts they want"?

Posted by: NS12345 | December 4, 2009 4:36 PM | Report abuse

JPRS, i'd go a step further: i don't think they are so much scared of the base as simply of the base.

you didn't get ahead in republican politics over the last several decades by cultivating a reputation for thoughtfulness or rigor or command: you got ahead by spouting talk radio.

and i think that's the issue: today's republicans are not interested in governance at all, they are simply interested in power.

Posted by: howard16 | December 4, 2009 4:36 PM | Report abuse

I too have been a bit surprised that some Republican or two hasn't really tried to reach across the aisle on the defensive medicine issue---malpractice reform---in an effort to achieve greater cost-containment while signaling a willingness to possibly support the bill in the end. If one or more Republicans had done this, they might also have been able to gain influence on the public option negotiations.

I think the public option compromise that may be coming between liberals who want a more robust public option than what is currently in the bill, and moderates like Landrieu, Nelson, and Snowe who don't really want a public option immediately, is to include a "hard" trigger mechanism which would include some stringent goals or requirements for the insurance market to meet within a fairly short time-frame. If the market failed to modify itself to meet those requirements in the allotted time-frame, a public option would be triggered, and when triggered would be a much more robust public option that would be tied to medicare rates and would include even greater cost controls, while also allowing a much larger share of the public into the exchanges. This may get us closer to the Wyden-type system while also getting us closer to a stronger public option. This type of compromise might bring all the Democratic moderates plus Liebermann, Snowe, and Collins aboard.

Liberals like Sherrod Brown and Bernie Sanders could go to the base and say that the public option that was in the bill wasn't really worth preserving, that it was too weak so we bargained for a "hard" trigger with a "real" public option that is much closer to the liberal ideal of "Medicare for all" in exchange for allowing for 3-4 years for the insurance market to try to meet the new standards before the public option is actually triggered. Moderates can say that "hey we negotiated to get the public option out of the bill so that if the insurance industry does its part no public option would ever be triggered. The insurance industry holds its fate in its own hands." As a supporter for Medicare for all and true universal national health insurance, I would find a compromise like this preferable to passing a bill with a weak public option that never really has a chance to effectively compete with the private insurance companies.

Posted by: OHIOCITIZEN | December 4, 2009 4:53 PM | Report abuse

Yeah, you're making the mistake of assuming that Republicans care about "getting something" in a policy sense.

This isn't true; they're interested in getting something to use in talking points against Pres. Obama and the Democrats.

See how Chuck Grassley did a complete 180 on an individual mandate-- he supported it until the Dems did, at which point he denounced it as a threat to liberty. The GOP doesn't care about policy outcomes. It wants stuff to bark about on Meet the Press and at tea rallies.

Posted by: eelvisberg | December 4, 2009 4:59 PM | Report abuse

Our two-party system is curious. It seems to have morphed into this montage: our nation's finances are a car, accelerating slowly toward a cliff. Any time one of the two guys in the front seat tries to turn the wheel, the other one prevents him from doing so. They both then turn around and tell the person in the back seat that if they give them another chance, they will REALLY turn the wheel.

Posted by: steveboyington | December 4, 2009 5:14 PM | Report abuse

"These folks fought for years to join the country's most exclusive legislative body" and they want to stay there. You don't get to stay if you start rocking the boat too much. Just conserve the status quo, and collect the monetary rewards that come with the power and influence of the position.

Posted by: nylund | December 4, 2009 5:30 PM | Report abuse

Ezra, you have a faulty premise that is the source of your disappointed expectations. The faulty premise is that there are Republican political leaders who have an ounce of commitment to the best interests of the United States of America and possess a modicum of rationality and good will to pursue it. The Glenn Becks and Rush Limbaughs are playing the tune of nihilism and havoc that the right wing is dancing to, including and especially the 40 GOP Senators in Congress.

Posted by: cmpnwtr | December 4, 2009 5:40 PM | Report abuse

The Gop is in a massive ideological flux right now and is dominated by southern conservatives. Nobody is sure how the platform will ultimately shake out, but ever how it does, it will be an opposition party in the most pure sense, to anything dems, who are now more liberal, will propose.

Polarization is and will be, for some time to come, the rule, except for the most basic needs of the country like defense spending and the like.

And any possibility that the government could become more involved in anything it is not currently involved in regarding domestic policy, will be opposed by the repubs. All of them, with few exceptions. It is an ideological survival mechanism right now, with no real end in sight.

The Southern Strategy come home to roost, with it's end product./

Posted by: arnold104 | December 4, 2009 6:11 PM | Report abuse

It really makes you wonder what kind of personal attributes make it most likely someone will succeed in becoming a senator (or elected to any major office).

If I were elected Senator, I would purely try to maximize the amount of good I could do, not the amount of terms I could stay in office. If I could do the most good with one great term of votes for things like universal healthcare, global warming measures, etc., even if that would prevent me from being re-elected in my particular state (probably purple in this case), I would still do it if the good for the country of one great term outweighed the good from several far far poorer terms, barely different from what you would get with a Republican.

But with that kind of attitude would I have the burning drive and ruthlessness, and superficiality, that's so helpful in getting elected, unfortunately with the way things are today?

Of course, it's like sales. I was at one time a top salesperson. The fact that I was extremely honest and ethical hurt my sales, but I much more than made up for it in other ways with competence, caring, persuasion (for more on this see:

In any case, I think there are probably ways that we can tilt strongly the kinds of traits that increase the odds of being elected towards positive ones and away from negative ones, so that we get better Senators. Some of these ways are greatly increased public campaign finance and measures to improve the press, such as here: (These really are good posts. They were both in Mark Thoma's links)

Posted by: RichardHSerlin | December 4, 2009 8:22 PM | Report abuse

This bill was totally mismanaged by Obama and the Democrats. If they knew they couldn't hold their caucus, they should have made a Republican proposal like Mike Enzi's the starting point for debate and maintained a wide bipartisan consensus. Now we have a pro-industry Republican bill with no Republican votes. It's a disaster for progressives, a disaster for Democrats, and a disaster for the country.

Posted by: bmull | December 5, 2009 2:59 AM | Report abuse

bmull, i'm willing to be i'm considerably older than you: i've been hanging around leftist circles for 40 years now. and if there's one thing that's been consistent over those 40 years, it's the inability of the left to understand the differences among perfect, decent, and lousy. your post is an excellent example of political fantasy masquerading as insight, and your conclusion is simply wrong. purer-than-thou leftism is fine for college bull sessions; it's not fine for dealing with the actual political realities we have in america.

Posted by: howard16 | December 5, 2009 10:40 AM | Report abuse

I don't know any moderate Republicans, so I can't shed much light there, but I can say what the very conservative Rs I know are saying.

First, they're against reform because they think the current bill moves in a fundamentally wrong direction.

They want to privatize everything and force consumers to encounter prices every time they go to the doctor. Everybody should be pushed into a high-deductible plan and a health savings account, so they can pay their own costs. Medicare is turned over to HMOs. Most important, they genuinely (if crazily) believe this is the *only* way to cut costs, and that any of the plans being talked about on our side of the aisle are just going to grow an already massive, sclerotic bureaucracy. Inefficiency and rationing.

So, they could tinker with the current bill, but that would only make their Ayn Randian heaven less likely. Also, of course, they really don't give a fig about expanding coverage. ("Everybody has health care - you can go to an emergency room.")

Posted by: Sophomore | December 6, 2009 10:22 AM | Report abuse

Good, Sophomore. You seem to be the only person in this echo chamber who has a clue what the other side is thinking.
It's not so complicated. Conservatives are not cooperating because they think this bill will 1/6 kill their country. You see it differently. But you-all should be smart enough to be able to understand a different point of view.

Posted by: MikeR4 | December 6, 2009 3:15 PM | Report abuse

Sophomore and MikeR4: Great reality-based comments. Why should Republicans be part of this Rube-Goldberg-on-steroids monstrosity?? The budget numbers are based
on a pack of lies. The savings from Medicare cuts and the doc fix are never going to happen. It's all about the government taking over our lives.

Despite his holier-than-thou attitude, Mr. Klein has been exceeding disengenuous in making his arguments for "re-form." See Mickey Kaus:

Posted by: dturnerc | December 6, 2009 8:38 PM | Report abuse

Thanks also to howard16 for his reality-based comments that all sweetness and light doesn't exist on the left side of the political arena.

Posted by: dturnerc | December 6, 2009 8:43 PM | Report abuse

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