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Policy compromise is easy. Political compromise is impossible.


If you want to see why bipartisan compromise on health-care reform is impossible, read this article by David Herszenhorn. The article's thesis, to be sure, is not that bipartisanship is impossible. In fact, its intention is to imagine how Democrats could "rewrite the bill in such a way that lawmakers in both parties would find it virtually irresistible." It just can't figure it out.

First, it asks retiring, knowledgeable conservatives about where the two parties could compromise. The reply? High-risk pools and selling insurance across state lines. It's true that the two parties could compromise on those issues. In fact, they did, and the Senate bill includes versions of both policies. That compromise may or may not be good enough. In any case, neither policy matters very much. The Republican health-care bill included both ideas, and the CBO scored it as leaving 52 million Americans uninsured. As Herszenhorn says, it would "barely make a dent."

The policy was so poor because the Republican leadership decided against doing anything about coverage. They were worried it would make the plan look too expensive, which would muck up their messaging. And that's been a problem the whole way through. "In private conversations," reports Herszenhorn, "with reporters or with colleagues, all of these lawmakers acknowledge that their efforts to work on health care have been hampered by Republican leaders in both chambers of Congress who are focused on the political ground game."

Herszenhorn also brings up the Wyden-Bennett bill. But he neglects to note that Republicans evinced no interest in pushing the bill this year or importing any of its elements to the health-care reform bill.

So that's where we're left: The policies that Republicans are willing to compromise on are meaningless, and arguably already included in the bill. Beyond that, the GOP's leadership is against further compromises because total opposition fits better with the electoral ground game. And they're probably right about that.

At the end of the article, Herszenhorn brings up the compromise proposal developed by Tom Daschle, Howard Baker and Bob Dole. That's two Republican Senate leaders and one Democrat, for those keeping count. It's pretty similar to Obama's proposal, he says.

And that's the underlying reality of health-care reform. Substantive compromise is easy. In fact, the bill is a substantive compromise. It's a deficit-neutral, universal-coverage scheme that relies on the private insurance market and looks like one of the Republican alternatives from 1994. What's hard is political compromise. Because there, the two positions are that Democrats are helped if a bill passes and Republicans make gains if a bill fails. There's no way to split the difference between those positions.

Photo credit: By Mark Wilson/Getty Images

By Ezra Klein  |  February 2, 2010; 1:42 PM ET
Categories:  Health Reform  
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Next: What Susan Collins's explanations don't explain


"the two positions are that Democrats are helped if a bill passes and Republicans make gains if a bill fails"

Democratic legislators that are squeamish about passing health care reform should ask themselves this simple question:
Why are all Republican so dead set against it?

It cannot be a matter of principles, since it is close to their preferred plans not so long ago. The answer has to be the quote above: they know that passing this plan will be good politically for Democrats, and failing to pass it will be good politcally for Republicans. How can they not see, then, that is more dangerous for them to not do anything on Health Care Reform?

Posted by: CarloP | February 2, 2010 2:15 PM | Report abuse

Well said Ezra.

Posted by: JPRS | February 2, 2010 2:47 PM | Report abuse

The reason that healthcare has become a win or lose effort is because Pelosi was hell-bent on developing a partisan bill and, wrongly, ignored the Repub's suggestions. She is the single most responsible person for the failure of Congress to pass reform and polarization of the voters. I know she will be re-elected with her ultra-liberal base, but, truth be known, she caused the problems with her arrogant approach to a complex issue. She (and Obama's inner circle) misread the will of the public and misread their ill-perceived mandate.

Posted by: my4653 | February 2, 2010 3:41 PM | Report abuse

"The reason that healthcare has become a win or lose effort is because Pelosi was hell-bent on developing a partisan bill and, wrongly, ignored the Repub's suggestions."

Keep telling yourself that. I'm sure it makes you feel better.

Posted by: adamiani | February 2, 2010 3:46 PM | Report abuse

my4653, how does your statement square with the admission in that article by Republican legislators that their leadership stopped them from dealing on healthcare because their leaders thought it would help them in the election? And as Ezra says, this bill was a compromise from the start, and the Dems only compromised further as the process went along. If the Senate bill had delivered 5 Republican votes, and would deliver some significant number more if the House passed it whole, we wouldn't even be talking about the House passing the Senate legislation because it'd already be done.

Posted by: MosBen | February 2, 2010 5:06 PM | Report abuse

The amazing thing in all of this truly is why dont the House Dems just pass the Senate bill. It is obvious that the GOP thinks that passing health care helps the Dems and they are right. Here we have a GOP that is willing to villify the Prez and Dem party and the House Dems can basically call them on it and make them pay by passing the Senate bill and they just cant seem to do it. That says something about the House Dems-but what? It seems like we are all waiting for the House and Senate leadership to figure out how to combine reconciliation changes with the underlying bill if it is not passed and signed into law first. And yet it seems clear that once the bill passes, reconciliation should be fairly easy. The whole GOP goal is to prevent passage. Once it is passed, they have little motive to make reconciliation difficult. In fact, Dems could put the GOP in the position of looking like supporters of the Nebraska compromise for making reconciliation difficult since by then health reform itself would already be law. What is going on here?

Posted by: gregspolitics | February 2, 2010 11:36 PM | Report abuse

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