05 May 2009

Negotiating your way into irrelevance

Time's Karen Tumulty writes in her latest article:
When Barack Obama informed congressional Republicans last month that he would support a controversial parliamentary move to protect health-care reform from a filibuster in the Senate, they were furious. That meant the bill could pass with a simple majority of 51 votes, eliminating the need for any GOP support. Where, they demanded, was the bipartisanship the President had promised? So, right there in the Cabinet Room, the President put a proposal on the table, according to two people who were present. Obama said he was willing to curb malpractice awards, a move long sought by Republicans that is certain to bring strong opposition from the trial lawyers who fund the Democratic Party.

What, he wanted to know, did the Republicans have to offer in return?

Nothing, it turned out. Republicans were unprepared to make any concessions
(Emphasis added)

What an interesting anecdote. First, again, there is the promising tease that Obama is using liability reform, long-needed but consistently blocked by Dems, as a sweetener to try to win some GOP support for reform.

Second, how remarkable is it that the Republican caucus seems to have nothing whatsoever to bring to the table here? In 1993, Bob Dole made the decision to block health care reform at all costs, and he had the power to do so, with 43 votes (abetted by many recalcitrant Dems). But this year, gambling on obstruction looks like much less of a sure bet, given both the electoral reality and the greatly heightened consensus that real reform is needed.

So what's their game? I really don't get it. If they don't sit down with a real interest in compromise, then the Dems will steamroll them with somewhere between 51 and 63 votes, depending on a lot of things, and the GOP will wind up actually voiceless in the whole process. You can make an argument that they are effectively voiceless as it is, and there's an element of truth to that, but that's what happens when you are in a greatly diminished minority. The difference between having a small input into the final product and having no input seems to have enough value that you would expect them to swallow their pride and get to work salvaging as much as they can out of a bad position.

I dunno. Maybe they are just holding the line, reprising Dole's role as "Senator Gridlock" and hoping against hope that they can regain some relevance through obstruction. Maybe their diminished caucus is so amazingly ideological now that all the moderates have been purged that there is no capability for compromise any more. Maybe McConnell really is just not up to the task of leadership. From a purely partisan view, this is not altogether bad, since it means that there is less incentive for the progressives in our party to collaborate with conservatives and weaken the final product.

It would be nice, though, if the GOP could at least hold out for that malpractice reform clause...

[Addendum: though the Senate GOP Leadership is not participating, it should be noted that per report, Chuck Grassley, the Senate Finance Ranking Member, is doing good work at the committee level. Whether he signs on to the final product is an open question, and he probably will not. But there is (at least) one Republican interested in the grown-up mechanics of governing.]


  1. The GOP does not want socialized medicine; Obama has made clear through his proposals that that is exactly what he wants. Obama offered malpractice reform as a gimmick to trick Republicans in supporting the complete socialization of healthcare, a trick which has been shown by you to be a failure.

    It is pretty clear what the GOP wants: a removal of the atrociously unfair practice of tying healthcare with employment and giving individuals the fair ability to purchase health insurance in a free market. Since this is an anathema to the will of the President, it is obvious why it would never pass His desk.

  2. Peter,

    You are using "socialized" as a pretty loose slur on government involvement in health care. If Obama were a socialized-medicine dude, why isn't he pushing single payer?

    But back to simple tactics. The GOP has lost -- they don't have access to any of the levers of power. This means that not only do they not get to write the bill, but also they probably can't prevent Obama from enacting his dream plan, or something close to it. So why not make the best of a bad situation by either tempering down the more radical proposals from the Left, or at least getting a key policy of your own advanced?

    Seriously, if Mitch McConnell said "the Republican Caucus will sign on if you kill the public option and give up malpractice reform," wouldn't that be a better outcome (from their point of view) than the bill with a strong public option and no med mal reform?

  3. Obama has already stated that he is indeed a single-payor proponent, but he is pessimistic that it will happen any time soon.

    “If I were designing a system from scratch, I would probably go ahead with a single-payer system,” Obama told some 1,800 people at a town-hall style meeting on the economy.Since he is not starting from scratch, how does he achieve socialized medicine without being overt?

    Step 1: Force/mandate every individual to have insurance.

    Step 2: Force insurers to take every individual regardless of pre-existing conditions or risk factors. (You have cancer and require $1,000,000 in anti-neoplastic agents? Your new insurer will have to pay for you.)

    Step 3: Force every individual to pay the same premium as everyone else regardless of risk. (You are 24 years old and are healthy? Too bad, you will be paying the same as an obese, diabetic, smoker in his 50s.)

    Step 4: Create a public option which is paid for by taxpayers which can also draw upon the Treasury for a limitless supply of funds to be paid off by future taxpayers.

    Step 5: When private insurers collapse because they can not survive due to government regulations, only the public option is left.

    Step 6: Socialized medicine. Not a slur, just a way of describing the system Obama wants.

    Walks like a duck and talks like a duck...

  4. Peter,

    Yeah, Obama has endorsed Single Payer in a very hypothetical setting, and in the very same statement, he acknowledged that it's not happening and that we have to focus on improving the system we have. (You accidentally left off that part of the quote, I assume.)

    As for Step Five, that's a mighty big assumption -- that private insurers will collapse. If private industry is so innovative and more efficient, won't they find some way to survive? Won't their allies in Congress, as bipartisan and bought off as the Bankers' allies, find some way to save them? Of course, this neglects the secret Step 4.5 where Obama's Secret Muslim backers implement Sharia Law in the US.

    Seriously, you're assuming the conclusion here, and it's unwarranted. You also assume, as do most skeptics, that the Public plan will be funded by the Treasury. In fact, it needs to be an actuarially sound program paid for by premiums (with means tested subsidies for the poor). If the public plan is across-the-board premium subsidized, that would be awful and would be unfair, and would ruin the insurance industry. It would also be ten times more expensive than the trillion-dollar plan on the table now, which is why not even the ultra-liberals are proposing such a thing.

  5. To answer your question, SF, I think that they've gotten used to getting things exactly as they want them (no matter how ridiculous their wants). Like a young child who suddenly receives a new brother and is no longer the center of his parents' universe, it's going to take some time before they stop throwing tantrums and start to realize that compromise is the only way to get what they want.

    Until then, they're going to get sent to their room without their supper quite often.

    (Oh, and Peter, you forgot to shout "BOOGA BOOGA" after "socialized medicine". It's just not scary any more unless you shout "BOOGA BOOGA" after it.)

  6. Shadowfax,

    Step 5 is simple. Here is a link to a video that shows Obama's fellow healthcare reform proponent's, who is a Democrat, view on the direction of healthcare reform lead by Obama:

    Jan Schakowsky's video.

    If this represents where the rest of the Democratic Party is and it likely is, it only confirms what I have predicted before.

  7. Schakowsky? Are you kidding me? Sure, why don't you hold up McDermott and Sanders as representative of the Democratic party while you're at it. And I'll return the favor and assume that Inhofe and Paul represent the mainstream of Republicans.

    She's a cosponsor of HR 676, for pete's sake!

    She's also entirely irrelevant. No disrespect to Schakowsky. I wish there were more dems like her. But she is not in the mainstream of Democratic thinking in these policy issues, and she (as well as the Progressive Caucus) are not in a position to exert much influence. The folks who will be the architects of the plan are Kennedy, Baucus, Stark, and Waxman. Not a single single-payer advocate among them.


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