We're Committed to Saying No, But Let's Debate at Length First

Many hurdles still exist, but yesterday, the Senate voted to bring their health bill to the floor for debate. From what I've seen so far, the House bill is better overall (apart from the Stupak amendment), and many progressive measures have been severely watered down, most of all the public option. Still, it's a big step.

There's plenty of circus to come, though. As Ezra Klein points out, there are many other votes to come, including many other cloture votes. Then there would be committee meetings about merging the bills, and a final vote in each house. DDay outlines several of the other pitfalls, made more perilous by Harry Reid's claim not to use the budget reconciliation process.

Meanwhile, as Steve Benen writes:

On Fox News yesterday, Senate Minority Whip Jon Kyl (R-Ariz.) explained, in no uncertain terms, that "every single Republican" in the Senate "will oppose" health care reform. Kyl conceded that the reform bill may change before a final floor vote, but every Republican already realizes that the legislation "will only get worse."

Benen quotes a good point from Sam Stein:

...Kyl's prophecy of across-the-board opposition does seem to undercut that other GOP tactic. Why do Senate Republicans need six weeks to debate and consider the legislation if they're already determined to vote against it?

As Benen concludes:

I'm going to go out on a limb here and guess that GOP demands for six weeks of debate has very little to do with genuine interest in good-faith deliberations, and everything to do with pointless delay tactics. Call it a hunch.

The need for reform is real and urgent. Benen also covers the recent free health care fair in Little Rock, Arkansas, and some of the other recent ones. There will be a bigger one on December 9th and 10th in Kansas City, Missouri. In an earlier piece I posted 60 Minutes piece on Remote Area Medical, and more recalcitrant legislators need to be forced to respond to pieces like this, and pressed on how they plan to fix it.

For most of the health care "debate," we've seen the conservative Blue Dog democrats fighting for bad (and corrupt) policies, and the Republicans offering almost nothing at all. (Benen does a great job of tracking and debunking politicians' claims if you search back through his archives, and he should be a regular read.) Back near the start of November, the Republicans finally unveiled their big plan, and... well... over to Ezra Klein (from 11/5/09):

Late last night, the Congressional Budget Office released its initial analysis of the health-care reform plan that Republican Minority Leader John Boehner offered as a substitute to the Democratic legislation. CBO begins with the baseline estimate that 17 percent of legal, non-elderly residents won't have health-care insurance in 2010. In 2019, after 10 years of the Republican plan, CBO estimates that ...17 percent of legal, non-elderly residents won't have health-care insurance. The Republican alternative will have helped 3 million people secure coverage, which is barely keeping up with population growth. Compare that to the Democratic bill, which covers 36 million more people and cuts the uninsured population to 4 percent.

But maybe, you say, the Republican bill does a really good job cutting costs. According to CBO, the GOP's alternative will shave $68 billion off the deficit in the next 10 years. The Democrats, CBO says, will slice $104 billion off the deficit.

The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan. And amazingly, the Democratic bill has already been through three committees and a merger process. It's already been shown to interest groups and advocacy organizations and industry stakeholders. It's already made its compromises with reality. It's already been through the legislative sausage grinder. And yet it saves more money and covers more people than the blank-slate alternative proposed by John Boehner and the House Republicans. The Democrats, constrained by reality, produced a far better plan than Boehner, who was constrained solely by his political imagination and legislative skill.

This wasn't much of a surprise. If the Republicans had ever been serious about health care reform, they could have done it while they were in power, or they could have engaged in serious debate during all of 2009. Apart from a few exceptions, that just hasn't happened.

As for the politics of reform, and the hostage-taking tactics of the Blue Dogs and their ilk, Matthew Yglesias summed up my frustrations very well back in October when he wrote "Compromise is a Two-Way Street":

Al From has one of these op-eds where you urge liberals to drop hopes for a public option in the interests of being pragmatic and passing health reform. I sort of agree with this—reform is worth doing even without a public option. But what these exhortations to practicality always miss is that this is a two-way street. If you think the public option isn’t that big a deal and it’s not worth spiking health reform over it, then you ought to think that it’s not worth spiking health reform in order to kill it either. But here’s Joe Lieberman not only expressing opposition to a public option, but saying he might filibuster any health reform package that includes a public option...

So far there’s been basically no pressure in the media on members who take this position to justify their extreme level of opposition. I get, for example, that Kent Conrad supports the Finance Committee version of health care and opposes adding a public option to it. But suppose a public option does get added. Does that suddenly take a vast package of reforms that he played a key role in crafting and turn it into a terrible bill? Why would that be? Surely Conrad is as aware as anyone else in congress that in order to pass a large, complicated health reform bill many senators are going to have to vote “yes” on a bill that contains some provisions they oppose. After all, the health reform bill contains hundreds of provisions! Are moderate members really so fanatically devoted to the interests of private health insurance companies that they would take a package they otherwise support and kill it purely in order to do the industry’s bidding on one point?

This is what drives me up the wall, in legislation and its coverage – the "debate" is so skewed, and it has everything to do with Beltway Convention Wisdom about hippie-punching, the establishment and reform, and little to do with reality. If Olympia Snowe, Max Baucus, Chuck Grassley, or Joe Lieberman has a position, fine. They get their say – that's how the process works. But they shouldn't be able to hijack the entire process, opposing both good policy and the will of the people, including their own constituents. At the very least, the obstructionists should be grilled on their positions and their reasons for them. It would great if Lieberman had to explain his massive conflicts of interest and constantly shifting, incoherent reasons for opposing reform. The media constantly trumpeted that the public option was dead, but never seemed to ask an obvious question - if four of the five initial bills on health care contained a public option, why should the one that be the one to prevail?

Why are Lieberman, the Blue Dogs and the entire Republican party treated as if they're acting in good faith, even when there's glaring evidence to the contrary? And why must the media treatment of health care reform always be so skewed when it's not outright inaccurate? For that matter, did they completely forget how disastrous the past eight years were, on almost every front? On the recent Senate vote, NBC's Chuck Todd claimed the vote wasn't "momentous" for health care reform - but also claimed it would have been news if the vote lost. As John Cole put it:

Shorter Chuck Todd: It’s only big news if the Democrats fail!...

Can anyone imagine the feeding frenzy for the next two weeks if they had failed to get 60 and advance the debate? Can you imagine the Sunday shows tomorrow? Can you imagine all the headlines speculating if Obama was a lame duck? “Senate fails to advance health care reform. Is Obama’s entire agenda at risk?” and “Obama’s signature legislation killed in Senate. Can he recover?” and “Republicans, spurred by sagging Obama poll numbers and grass roots support from tea party, stop Obama administration in their tracks.”

And Chuck Todd would be leading the goddamned charge with that crap.

Exactly. Our politicians are neither wise nor representative, and our media is in love with a conventional wisdom they manufacture without regard to (and often in contempt of) reality. Despite all this, the Senate can now debate the bill. There are many obstacles to go, but that vote was a positive step.