Health Reform Obstruction

It's summer bipartisanship is rearing its ugly, unprincipled head in Washington.

ABC's The Note reported on June 17 that three former Senate Majority Leaders- South Dakota's Tom Daschle, Kansas' Bob Dole, and Tennessee's Howard Baker- have offered a health plan without a public option. Daschle, the one Democrat of the three, rationalizes- uh, er, explains

While I feel very strongly that consumers should have the choice of a national, Medicare-like plan, my colleagues do not. . . But we were concerned that the ongoing health reform debate is beginning to show signs of fracture on the public plan issue, so in order to advance the process of developing bipartisan legislation and to move it forward, it's time to find consensus here.

We've come too far and gained too much momentum for our efforts to fail over disagreements on one single issue.

To be fair, their plan would "create a Network of State or Regional-Level Health Insurance Exchanges," as this summary from their Bipartisan Policy Center indicates. This is probably as bad an idea as that of Senate Budget Committee Chairman Kent Conrad, who favors health care purchasing cooperatives, which Jacob S. Hacker notes

have been hard to establish or extend, and when they have been established, they’ve been under constant siege from doctors and insurers and eventually largely operated as private insurance plans or weak purchasing arrangements. It is hard to see how any sort of decentralized cooperative model could do what a public plan can do.

And attorney Ellen Beth Gill of ellenofthetenth.blogspot.com explains

The cooperative idea is the one where you get together with your neighbors to create a health care plan. Have you gotten together with your neighbors to decide to prune the trees on the block yet? Do you have to beg people to run for president of your homeowner's association like they do where I live? How well do you think the average condo board meeting goes? Do you think the guy that walks his cocker spaniel down the block without picking up after her knows how to set up a health care plan?....

Insurers will take advantage of the lack of insurance expertise in these coops and find new consulting services and products to sell them at high prices. That's if this thing actually goes well. More likely, these coops never get off the ground, or get off the ground, but are controlled by groups you wouldn't want to have control over your health care or access to your health care information. Our friend over at Ill and Uninsured in Illinois tells us where Rep. Conrad likely came up with this notion, health ministries run by religious groups. They are religious organizations of neighbors making moral judgement on each others' lifestyles based on their very public medical records. At best, those groups seem to be little more than the church bake sale for that sick kid down the street, if as IUI points out, he's popular.

Conrad is pushing his idea because he believes that between skeptical Democrats and recalcitrant Republicans, a reform proposal with a public option could not garner 60 votes. It could, and probably would, get 51 votes, the minimum required under the reconciliation process. Conrad is opposed to reconciliation, a tactic embraced by George W. Bush when he used it in 2001 to gain Senate approval of his tax cut for the wealthy- with a Congress controlled by the opposite party. Now, with his party in control (or, rather, having a majority) with 59/60 votes (with/without seating Franken), some Democrats are intimidated by the prospect of passing reform without bipartisanship.

And the reason bipartisanship is preferred to principle? Thomas Frank, in his column in The Wall Street Journal, explained during the debate over the stimulus bill:

For the Beltway commentariat, however, transcending partisanship is the most meaningful of issues, more important, one senses, than the economic problems that trouble those people at town-hall meetings. "Nothing was more central to [Obama's] victory last fall than his claim that he could break the partisan gridlock in Washington," wrote the Washington Post's David Broder a few weeks ago, in an altogether typical expression of media perceptions....

The reason the Washington media think bipartisanship is the top issue, even when economic disaster stomps Americans like Godzilla, is because of the way it reflects their own professional standards. They are themselves technically impartial, and so it's only natural for them to wish for a hazy millennium in which everyone else in Washington is impartial, too.

It is supposed to be high-minded stuff, this longing for a bipartisan golden age. But in some ways it is the most cynical stance possible. It takes no idea seriously, since everything is up for compromise. The role of the political parties is merely to cancel each other out, so that only the glorious centrists remain, triangulating majestically between obnoxious extremes.

As it was with the stimulus, so it now is with health care.