Health Care Reform: Irreconcilable Differences?

The blades in the health care reform grinder go round and round, and as time passes, I’m starting to be concerned that we have a Senate who is really not all that interested in taking this to the finish line. By Senate, I mean the Senate Democratic caucus, not the Democratic and Republican senators alone. And then there is Joe Lieberman, who seems to think he’s in his own country, master of his world and ours.

What follows is my analysis of others’ analysis of where things might be right now. I welcome thoughts, strategies, rants, and whatever else you are thinking down in the comments section.

Lieberman and Reid, kissing behind the bleachers?

M.S. Bellows suggests Harry Reid and Joe Lieberman are in collusion with each other in a not-so-nice good cop, bad cop drama.

According to emails exchanged between the Senate Majority Leader’s office and the Huffington Post, Harry Reid keeps making progressive healthcare proposals despite knowing, in advance, that they will be filibustered by Joe Lieberman and will be cut from the final bill. Are the two working together to kill the public option and other progressive reform while letting Reid keep his “progressive” credentials?

On its face, I suppose it could be true. After all, we now have all sorts of competing stall tactics dancing with each other on the Senate floor. While everyone waits breathlessly for the CBO estimates to come in for the newest compromise, we’ve got PhRMA-busting amendments sponsored by both sides being consigned to the green room, secret negotiations over new, stronger, better abortion restrictions, and Republicans seizing press cycles with long-winded arguments over the Constitutionality of health care reform while they wet their pants over the CMS actuary’s suggestion that even one senior citizen might have to wait a couple of days to see the doctor for non-life threatening conditions.

Yet, a couple of things feel strange to me about this. First, Reid doesn’t need Lieberman to stall while looking progressive. All Reid would have to do is continue to support the public option all on his own, refusing to back down on it. He’d have Republicans stalling for years, if not decades, by their own admission. Time is the friend of the Republicans and conservatives; the enemy of progress. Since the odds of getting even one Republican vote on cloture are slim to none at this point, Reid has everything to gain, nothing to lose by playing to the strongest caucus bloc. Lieberman, on the other hand, is just playing lone ranger power play games as if he’s the only guy on the ice, which could land him flat on his ass sliding toward the penalty box.

Second, why Lieberman? There’s already Nelson, Conrad and Lincoln. He doesn’t need to play potsie with Lieberman to kowtow to the three of them, particularly when he represents a state that’s mostly red, and only slowly turning blue. Reid’s sudden attack of ‘progressivism’ isn’t going to light fires under many voters on his ticket anyway.

Finally, if it were all a grand conspiracy, why would the five progressives in that Gang of 10 play the ‘compromise game’? It presumes an utter lack of good faith on everyone’s part, which may in fact be true, but I guess that I have some difficulty believing everyone is that cynical.

Let’s make a deal

Let’s review the bidding:

1. Republicans have had three days to stand on the Senate floor, huff, puff, distort and lie.
2. Back at the ranch a ‘compromise’ is in the all-powerful hands of the CBO (because as a country, we haven’t really grasped the idea that health is more than a dollars and cents decision). Assuming it scores well and there is no grand conspiracy, it appears that the plan is to put forth the compromise as a ‘manager’s amendment’, move to close debate (presumably knowing he’d have 60), and that would be…that.
3. Meanwhile, it appears that an unspecified benefit cap has slid into the Senate version of the bill — a very bad thing indeed.
4. Insurers are paying people to oppose health care reform on Facebook and social networks.
5. Senator Burris has now inserted himself into the debate by promising to filibuster any reform bill without a public option.

Might be an understatement to use the term ‘impasse’ to describe what we have right now. The Senate is a very, very broken place, it seems, where the health and welfare of a country matters less than re-election prospects and the chance of censure by one’s own party, a la Lindsey Graham last month.

Deals or no deals, failure to act right now will yield the same result we had in 1994 – nothing. We will still have discrimination against sick people, we will still have bankruptcies due to medical bills, and we will still have a health care system that tilts toward the rich and the employed, while the ranks of employed people thin even further.

Unacceptable.

Is reconciliation possible?

On a human level, perhaps, though I will find it exceedingly more difficult to reconcile myself with any Republican for a long, long while. On the other hand, the official ‘procedure’ of reconciliation might open a door that I hadn’t considered before.

Mark Kleiman suggests that the impasse be broken by forcing through a reform bill under Senate reconciliation procedures that includes a public option, not to finish reform, but to put a bargaining chip on the table to finish it after passing the part with the public option, but likely not with the real reforms, like banning pre-existing conditions exclusions (not directly related to budget reconciliation). And see…this is the problem. COBRA passed via reconciliation. The best they got was that stupid 18-month continuation period, no true comprehensive reform.

Under Mark Kleiman’s scenario, they pass what they can pass, then circle back and negotiate the rest:

In this scenario, reconciliation isn’t a substitute for ordinary legislation but instead a prelude to negotiations about such legislation. As Al Capone is supposed to have said, “You get more cooperation with a kind word and a gun than with a kind word alone.”

Hmmm. I guess I’m still not seeing how you slide elimination of pre-existing conditions and rescission into a reconciliation measure. Also, under reconciliation, Conrad is at the helm, hardly a progressive Democrat with hearty support for a public option. I can’t even imagine what kind of public option would limp out of a reconciliation measure that would be any less meaningful than what they could negotiate with 60 right now.

Ideas? Thoughts?

Bonus: Imagine the conversation stonewalling Democrats could have with their consituents.

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