Brooks presented four reasons to support the bill and then six reasons to oppose it. Then he "confessed" that:
I flip-flop week to week and day to day. It's a guess. Does this put us on a path toward the real reform, or does it head us down a valley in which real reform will be less likely?On the same page, Paul Krugman acknowledges the anger of progressives and says: by all means, hang Lieberman in effigy, declare your disappointment in Obama, demand a change in senate rules.
If I were a senator forced to vote today, I'd vote no. If you pass a health care bill without systemic incentives reform, you set up a political vortex in which the few good parts of the bill will get stripped out and the expensive and wasteful parts will be entrenched.
Defenders say we can't do real reform because the politics won't allow it. The truth is the reverse. Unless you get the fundamental incentives right, the politics will be terrible forever and ever.
But then meanwhile, pass the health care bill.He says the good outweighs the bad; and he also claims that
. . . history suggests the answer. Whereas flawed social insurance programs have tended to get better over time, the story of health reform suggests that rejecting an imperfect deal in the hope of eventually getting something better is a recipe for getting nothing at all. . . . America would be in much better shape today if Democrats had cut a deal on health care with Richard Nixon, or if Bill Clinton had cut a deal with moderate Republicans back when they still existed.And, he says, then we need to change the senate rules on the filibuster. . . . but
But that's for later. Right now, let's pass the bill that's on the table.So there you have it. Perhaps the best conservative mind and the best liberal mind writing for the NYT both see both sides of the argument and come to different conclusions.
Now I don't feel so bad about flip-flopping from day to day myself.
Ralph
In today's Washington Post, Victoria Kennedy writes that Ted Kennedy would have voted for the senate bill, because he always said it would require compromise to get this difficult legislation passed and that an opportunity like this won't come for another generation.
ReplyDeleteAnd he always said: "don't let the perfect be the enemy of the good."
Here's a suggestion - if someone is willing to accept the compromised healthcare bill, why not also lobby for a better one until the final vote is taken? It seems like a relatively easy way to be comfortable with one's willingness to compromise, while also working to get something better up until the last minute. A tweak or two here might result in a few progressives coming back into the fold. As a therapist I know says, there's no risk in this approach, so why not try it?
ReplyDeleterichard
P.S. I am already hearing discussions about who to support in 2012 - Hillary? Wiener? Dean? This does not bode well for Obama, who has been in office less than 1 year.
I have no trouble with your suggestion. In fact I have kept hoping that the reconciliation with the House bill will produce some improvements, although I've given up the hope that I once had that public option would be restored.
ReplyDeleteAs to your PS: What will those discussions be about if the bill doesn't pass and it's seen as a huge defeat for Obama? The discussions will be exactly the same -- "who to support in 2012." It'll just be different people saying it. There are going to be people unhappy and outraged either way.
The trouble with all of this is that the voters gave Obama a pretty good mandate for real change; but we didn't give them a senate to go with it. And in fact you can't change the makeup of the senate in one election. Remember that we didn't even think we would gain the majority until fairly late in the campaign? It was a squeeker to get as close as we did.
ReplyDeleteOne small improvement in the final bill that they appear to have 60 votes for: approval of an amendment by Al Franken and Jay Rockefeller to require that insurance companies spend 80% of money they take in on health care -- that's true for individual and small group plans; for large plans it's 85%.
ReplyDeleteThis will help regulate the cost of premiums and seems to me a very big win -- insurance companies fought it. In their lingo, they refer to money spent on actual health care for their clients as "medical loss."
Allegedly, insurance company profits are half that amount now, so, IF that's true, this could actually lower the amount of money they actually spend on health care. I have not researched this, but I have seen the figures referenced, so I'm going on someone else's research.
ReplyDeleteI tried to research it but got lost in a maze. One article says we spend 31% or our healthcare dollars on administrative costs. The CBO says 12%. A federal agency, Center for Medicare and Medicaid Services, says only 7% of the $2.5 trillion we spend each year actually goes to insurance companies. I didn't have time to track down where the other 93% goes.
But limiting the percentage they can spend on something besides healthcare does not in any way limit their ability to raise premiums to maintain their profit levels. I'm more concerned that pre-existing conditions for adults will not be covered until 2014. Children will be covered now, but not adults.
I think Obama has to bear a good deal of responsibility for this. As someone on one of the shows - Daily? Ed? - pointed out, Bush, went before Congress and threatened to veto every bill they sent him to sign unless he got No Child Left Behind. He got it.
Obama never played tough.
Obama needed to do something similar with healthcare. We elected him to be a leader. He didn't lead. He turned it over to Congress.
One thing this has made me wonder is if in fact Governors may be more capable of functioning as Presidents than Congressmen, because of the requirements of their offices.
richard
Ralph,I've been all over the map with this healthcare bill but I do trust Paul Krugman. Like Victoria Kennedy said quoting her late husband Senator Ted Kennedy half a loaf is better than none. God help us all. Joy
ReplyDelete