Harvard College Democrats

The Fight for Health Care, and Legislative Philosophy

Posted 1/27/10 by Nikko Pomata

It seems that, even after Scott Brown single-handedly won the Senate, the health care discussion won’t go away, as evidenced by the three Crimson editorials on the subject.  And perhaps, in the closing off the bill, the Democrats will have learned from their mistakes that lead to the largely perceptional problems that plague them currently.  After all, health care reform is quite a delicious sausage, albeit not as savory as possible, but its discussion has been quite dominated by the making thereof, not to mention some conservatives who are trying to tell America that Democrats want to throw in dog nuts, rather than its actual contents.

According to a recent Kaiser poll, of all the provisions that are or could be in the bill (well, at least among the ones they chose for the poll), the most popular is a small business tax credit – but only 52% are aware of its existence.  Meanwhile, only 44% are aware that it will close the Medicare donut hole, 58% are aware that it will provide for an insurance exchange, and 40% are aware that it will not cover illegal immigrants (case in point, South Carolina’s own Rep. Joe Wilson).  These awarenesses range from 37% concerning the ban on gender rating of insurance plans to 72% aware that it would subsidize plans up to 400% of the poverty line – still, if you think about it, not particularly high given how much airtime this sausage has been given.  And, all things considered, everything seems to have drowned out the whole purpose of almost every part of the health care proposal: to reinforce the goal of health insurance – or, when generalized, all forms of insurance – specifically, that the healthy should pay for the sick.  (Brian Bolduc, however, catches this, and in his convoluted fifth paragraph seems to argue against it.  I don’t know, maybe he’d prefer eugenics.  In any case, I’d like to see his reaction, should he ever require a procedure costing a hundred thousand dollars or more, when he is reminded that most of the money for that procedure comes from the premiums of the healthy.)

But the American people are fully aware of the time that health care reform has taken, and they are aware of the ground that Democrats have ceded, and it is for this reason that support is weakening among many initial supporters of health care.  While Brian Bolduc cites that 51% of Massachusetts voters opposed the Democrats’ bill according to a Rasmussen exit poll, he neglects that Massachusetts already passed a bill even stronger than the Senate’s; unless we are to presume that these voters oppose their own law so, we must look into more detail at the reasons.  Hoping further that these voters did not base their opposition in the ways that superimposing a federal system on their state system might hurt them specifically, particularly in terms of federal taxes that would fund the rest of the country but not them, we need look no further than a Research 2000 exit poll which in general draws a similar picture to the Rasmussen poll but which also asks the question of the key voters in Brown’s victory (those that voted for Obama two years ago but this year either voted for Brown or stayed at home): do believe that the Senate bill goes too far or not far enough?  A plurality say not far enough (with a decent number also opting for “not sure”).

So what do we do now?  The Crimson staff op-ed advises that the Democrats compromise.  A good ideal, certainly.  But we run into problems when they advise Congress to “remove the provisions that make the bill most intolerable to Republicans in hopes that some middle ground can be reached.”  As far as I can tell, they did that a long time ago, only to find that what was truly intolerable to Republicans was the bill itself, and in particular the concept of such a major political victory for Democrats.  My own senator, Jim Demint, put it best: “If we’re able to stop Obama on this, it will be his Waterloo. It will break him.”  Which certainly explains some of what’s been happening on the other side of the aisle.  After all, I don’t expect that Senator Grassley really did think Democrats wanted to use health care to “kill Grandma” – although if he did, I sincerely fear for our democracy when twits like that can get elected (not to mention when a a comment so transparently, clearly, and more importantly provably false can be made by a Senator without considerable uproar).  And Republicans seem to have been using this end to turn the Senate into a partisan-controlled chamber like the House, rather than the individualistic, deliberative body it was intended to be, and has been for most of U.S. History.  And that’s precisely why Republicans have been overusing the filibuster, as Dylan Matthews points out.  After all, as far as I can tell, the filibuster was originally intended to prevent the passage of bills that Senators felt, more or less, entirely morally reprehensible: that is, to protect minority rights, rather than to shrivel majority rule.  All told, last time I checked Olympia Snowe was more liberal than Ben Nelson, so if he votes for a  bill then I can’t imagine her believing it to be morally reprehensible, yet that is the way she seems to have cast her vote.  And all of this belies a further flaw in the fundamental process that led to the development of the bill.  Ultimately, it seems, the bill was changed such that it should appeal precisely to the most conservative of Senate Democrats, and yet no Senate Republicans, even those of similar orientation, found the bill favorable enough to cast a vote in favor of it.  Yet I imagine those in favor of progress in any sort of ideal should seek the promotion of a bill that they should imagine preferable to the status quo – even if that is far from what they want.  After all, that’s the meaning of compromise.  Both sides give a little, and then they agree on the final proposal.  You don’t set a goal as a desired middle ground just to watch it be turned into precisely what the last person wants.  That’s not what happens when all persons involved are working towards the goals of the legislation, towards the common interest.  That’s what happened when all – or some – are concerned more for their own political gain than for good that the legislation could do.  And in this case, that “some” are liberal Senate Republicans, and the more conservative leadership that has been doing fairly well at keeping them in place.

You might meanwhile try to buy a few votes with the proposals Bolduc mentions.  You could allow insurers to sell across state lines, thus better enabling them to raise prices universally (or at least giving them the excuse), and inspiring them to move out of states that already have some form of reform in place in order to dodge those restrictions.  Or tax employer-provided coverage, thus encouraging employers to drop plans so that, even after individual tax credits, many more would leave the insurance system.  You could also cap medical malpractice, which accounts for the hefty total of about 3% of costs, in order to reinforce the necessary notion that, if you lose a loved one to an irresponsible action by a doctor, your suffering DOES have a price, and it’s less than what the jury said.  But the golden concept among these is “Mitt Romney’s suggestion that states lift their mandates on insurers that force them to cover particular services – like in vitro fertilization.”  Or like open-heart surgery, or maybe bone marrow transplants, or any of a number of expensive procedures that contribute so much to everybody’s premiums.  After all, no one thinks they’ll ever need them until they do.  (Which, I suppose, is the same with in vitro fertilization.  Who finds out they need it before they’ve tried already?)  None of these are progress.  They’re not even close.  And, when we leave them off, we can rest assured that, as long as some of the actual progress that the bill entails remains in it, their addition would gain absolutely no votes among Republicans; their leadership is too thoroughly decided, and from the last few months we can tell that, if they object to a bill, they can probably convince their party members to filibuster it.

Once we consider that the silver bullet of reconciliation would probably weaken a bill given that it can only be used to pass certain types of measures, subject to the judgement of the Senate Parliamentarian, the only options remaining are to drop it entirely or to adopt the House bill.  And Democrats have worked too long and too hard on this to not let Americans enjoy the fruits of their labor, to not permit this work towards the goal of ensuring that all who require treatment receive it.   It’s not, as Bolduc states, “control of a sixth of our economy,” a truly odd claim given that current proposals would merely subject the health care and health insurance industries to regulations already heard of in other large industries, rather than taking them over, in order to enhance the regulations that are necessary to the operation of the free enterprise system.  And it’s not fiscally irresponsible, as he claims, although if it were it would be worth the increase in coverage.  (Sometimes, believe it or not, money isn’t everything.)   It may not be perfect, but it is entirely worth passing.  After all, as Bolduc points out, “the current floundering is only trying people’s patience,” and it’s time to “focus on the economy.”

I only want to see his reaction when he realizes that the next step of Obama’s plan for recovery is to decrease the size of the banks that he no doubt one day plans to run (into the ground).