Friday, January 22, 2010

Passing the Bill

Colin and I have been going back and forth in comments here. Below is my argument for passage.

The crux of what I'm saying is: Healthcare reform is not unpopular; the healthcare reform process is unpopular. The two are difficult to disaggregate which is part of the reason why I discount the polls that say Healthcare reform is unpopular. Given the wide agreement that the healthcare system in this country is too expensive and broken to a greater or lesser degree, I think that the passing the bill and putting some reform in place may ex post facto render Healthcare reform popular. I may be wrong and, whether it becomes popular will depend on the ability of its proponents to present it convincingly in a popular light, but three things are true today: 1. The healthcare reform process is unpopular; 2. the duration of the healthcare reform process has hurt the Democrats politically; and 3. healthcare reform is necessary. If the Democrats are going to pay a political price regardless of its passage—and they will—then passing something, giving them the opportunity to change the conversation and demonstrate an ability to govern, is the better tactic.

UPDATE: David Plouffe writes in today's Washington Post:
[P]olitically speaking, if we do not pass [healthcare reform], the GOP will continue attacking the plan as if we did anyway, and voters will have no ability to measure its upside. If we do pass it, dozens of protections and benefits take effect this year. Parents won't have to worry their children will be denied coverage just because they have a preexisting condition. Workers won't have to worry that their coverage will be dropped because they get sick. Seniors will feel relief from prescription costs. Only if the plan becomes law will the American people see that all the scary things Sarah Palin and others have predicted -- such as the so-called death panels -- were baseless. We own the bill and the health-care votes. We need to get some of the upside.

1 comment:

Colin said...

I think that the passing the bill and putting some reform in place may ex post facto render Healthcare reform popular.

I'm just not sure about that given the way health care legislation is being structured. Normally with legislation you are going to make some constituencies angry and others pleased. With this bill I just don't see it, given that the costs are immediate and the benefits deferred until after the 2012 election. Handing someone a bill while promising benefits several years away -- I am just not sure how that will change a lot of voter's minds.

I can see liberals being pleased. Passing HCR would certainly excite the base. But, conversely, it will rile up the opposition base (granted, I'm not sure opposition can get much more fervent than it already is) and turn off a lot of independents, who seem less than thrilled with the bill. So you've secured one vote but given the opposition two.

I suppose how the bill will be received depends a lot on whether it is in fact the process that is upsetting people or the actual substance of the bill. I suspect it is the latter. When I read quotes from angry voters on health care they usually consist of things like "my Medicare is going to be taken away" or "I am going to have less choice" or "I don't want to be forced to buy insurance." I rarely see more process-related complaints such as the lack of C-Span or the Cornhusker kickback, which strikes me as a little inside baseball anyway. And I'm talking about stuff I read in the NYT and WashPost, not But maybe I am looking in the wrong place.

All of this may be moot, however, as frankly I don't see how Democrats can get health care passed anyway. I simply don't know where the votes come from -- the House won't pass the Senate version and the filibuster makes the Senate a legislative graveyard (if Collins or Snowe haven't caved by now, I don't see them changing course following what happened in MA).

I also don't think the reconciliation process will work. Maybe Dems can get something passed and call it health care, but not the current bills. And starting all over again would drag the process along for months more and keep health care in the headlines -- the very thing you say Democrats need to avoid.

I'm probably not totally objective on this, but I think Dems are facing a lot of bad choices. If they proceed with current legislation -- assuming they even can -- I think they will get walloped. If they do nothing they'll be attacked.

Maybe the best bet is what David Brooks says (, just opt for a middling route in which some modest health care measure is passed and try to move on. Full throttle with the liberal agenda, however, seems like a recipe for making John Boehner speaker of the House next year.