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Tuesday, November 5, 2024

Has Health Reform Failed?

The question is not intended substantively.  The bill that is being debated by the Senate is an ugly mess from the perspective of any reasonable observer, left, right, or center. However, as inefficient and messy as it is, it will still do a much better job than the status quo of providing healthcare to the people in the country who lack it.  The crucial question here is tactical.

Health care reform was meant to be passed by August.  I recently happened across a blog post by Robert Reich, Clinton’s Labor Secretary, who argued that if that deadline was missed healthcare would die a slow and agonizing death without ever making it to the floor.  Well, here we are.  The chances that Obama will sign health care reform before Christmas are nil; Lieberman’s torpedoing the Medicare buy-in deal means that the CBO just wasted a week scoring a deal that won’t happen.  If a deal is reached, which will be a painstaking process in and of itself, it still needs to be subsequently scored.  Then it will need to go through the laborious process of actually passing the Senate cloture vote process.  Then it has to be reconciled with the House bill, and trying to settle on a version will actually pass both the Senate and the House will be a truly nightmarish process.  I don’t envy the negotiators in that room.  Then it actually has to pass both houses again. I guess the passing it by Christmas is hypothetically possible…but I don’t really see the plausible path for that to happen.
Failure could occur very easily at every single step in the process.  Lieberman might simply repeat his performance this week, rejecting the next proposed deal.  The CBO score might serve as an excuse for vulnerable Senators like Blanche Lincoln to bring the whole thing down.  If the conference committee doesn’t put in enough abortion restrictions the pro-life House Democrats might bring it down.  As time goes on, the bill will get less popular, the Democratic Party will look more and more ineffectual (and see it get less popular as an effect), and Democrats from conservative states will start to freak out more and more.  Probably no one could tell you today if the healthcare bill will pass.  However, the state of the bill today looks much like the failure state Reich predicted, though that’ll only be made clear in hindsight.
As a semi-related note, I’m pretty curious about how precisely the Democratic Party intends to keep its position in Congress in 2010.  There are a number of things they could do which would energize the rank-and-file.  Pass a strong public option through reconciliation after this thing is done, repeal Don’t Ask Don’t Tell, pass strong financial regulation, a climate change bill, withdraw from Iraq in a meaningful fashion, all of which would be very well-received by liberals as well as being generally great ideas.  None of these, however, look likely or even possible.  The Democratic Party has thrown exactly zero bones to the base so far, while simultaneously really pumping up the Republican Party. That’s not a winning strategy.
Photo Credit: Flickr stream of  Mike Bitzenhofer

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