No, it's not a typo. As the health care debate quickly becomes a core schism between tweaking the current private insurance scheme and establishing a robust public option to compete against it, not only are the President and Oregon's senior Senator currently holding opposite ground on the matter, both are beginning to harden their rhetoric and dig in their heels. What's even more surprising is that Senator Wyden is slowly emerging as the standard bearer of REPUBLICAN opposition to a public option, gathering supporters for (or allowing them to hide behind) his significant but ultimately nontransformational proposal for reform.
Think I'm making that up?
{Jump below for the case...}
Read what The Hill wrote three weeks ago on the subject, in an article I missed at the time but which retroactively adds a lot of weight to the current analysis:
And while Democratic Sens. Edward Kennedy (Mass.) and Max Baucus (Mont.) may chair the committees charged with shepherding the bill through the Senate, Wyden, a 6-foot-4 former college basketball player, has his own advantage: a standing invitation to play hoops with the president at the White House, which may come in handy when hashing out the final details behind the scenes.
For Wyden, the key to passing lasting healthcare reform is finding a legislative solution that can win at least 70 votes in the Senate — and he’s not shy about letting Democrats know that means dropping thoughts of a government-run public plan for the entire nation.
OK, let's back up a moment and establish the fault lines in the discussion.
Former Labor Secretary Robert Reich set the tone late last week with a post that measured mood and progress among the various options now being bandied about on The Hill. For those of us who think a robust public option is a must for any reform bill, a group that Celinda Lake asserts through polling includes even 63% of REPUBLICAN voters, the description of Big Insurance/Pharma and their allies gearing up is unsettling:
[The health care industry is] pulling out all the stops -- pushing Democrats and a handful of so-called "moderate" Republicans who say they're in favor of a public option to support legislation that would include it in name only. One of their proposals is to break up the public option into small pieces under multiple regional third-party administrators that would have little or no bargaining leverage. A second is to give the public option to the states where Big Pharma and Big Insurance can easily buy off legislators and officials, as they've been doing for years. A third is bind the public plan to the same rules private insurers have already wangled, thereby making it impossible for the public plan to put competitive pressure on the insurers.
Enter Olympia Snowe. Her move is important, not because she's Republican (the Senate needs only 51 votes to pass this) but because she's well-respected and considered non-partisan, and therefore offers some cover to Democrats who may need it. Last night Snowe hosted a private meeting between members and staffers about a new proposal Pharma and Insurance are floating, and apparently she's already gained the tentative support of several Democrats (including Ron Wyden and Thomas Carper). Under Snowe's proposal, the public option would kick in years from now, but it would be triggered only if insurance companies fail to bring down healthcare costs and expand coverage in the meantime.
All this will be decided within days or weeks. And once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal -- Snowe's "trigger" or any other -- the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well. [emph mine]
Sounds ominous, doesn't it? If you want more evidence than some former Cabinet Secretary with a blog, the Axis of Benevolent Evil known as the "Third Way" group had their plans for (or against) reform leak out this morning:
Whether health care reform should include a "public plan" is an issue that now threatens to fracture the emerging consensus on health reform. If left unresolved, the debate over a public plan could derail the broader reform agenda while other pressing issues central to reform are put on hold.
The proponents of a public plan seek the right goals—to broaden access and lower costs. But there is a very real danger that an overly intrusive public plan can ultimately undermine these very goals and destabilize the private-sector coverage that middle-class Americans—i.e., Harry and Louise—depend on and are largely satisfied with.
Progressives who believe in both the power of markets and of government to work together in bettering the lives of the middle-class should embrace the notion of a hybrid plan that can energize and enhance the current market.
Whether he explicitly aligns with this thesis or not, it is very clearly Wyden's plan that most fits the mold--the one with "the power of markets" going for it. Nevermind that all that terrific market power is why we pay 18% of GDP for our health care while more civilized nations squeeze by on about half that. If there is one seriously considered plan out there that does the most to cement the primacy of private health care delivery for a generation or more, it's Wyden's.
Wyden has a unique response to the charges that his plan lacks one of the few things most Americans seem to agree they want: I actually have two public "options" in my plan! Except in this case, "option" means both that it's optional, and at each state's option--which will surely thwart many citizens from even becoming eligible, particularly in the South, and will fragment purchasing and negotiating power into 50 smaller bites. Which turns out to be exactly what the industry and the GOP want, because the health-profit complex has been extraordinarily good in the past about rooking individual states.
Another reliable nail in the coffin for Wyden's plan is that The Oregonian is firmly behind it. And their rationale is frankly bizarre--equating the flap over (accurate) union charges that Wyden's plan would tax health benefits, that also (inaccurately) implied it would be a net cost for workers, with the "Harry and Louise" ads of 1993.
Except...those attacks were some of the earliest astroturf ad campaigns, using actors pretending to be real people worried about health care--as opposed to the insurance industry writing up distortive scripts to stop reform. Is The O suggesting labor unions are surreptitiously trying to kill health care reform? Seriously? The O continues even more weirdly:
Everything, including the taxation of health benefits, must be on the table as Congress moves ahead on this enormously complex and difficult mission. As the nation learned so painfully years ago, once debaters start ruling things off limits, they start ruling other things out, and pretty soon there's nothing left to talk about.
Wyden gets it, too. He said this week he's open to talking about a public insurance plan to compete with his system of private plans, if his preferred approach doesn't gain traction.
According to the O's editors, an idea doesn't have to be a good one to make it onto the table, it can be any crazy ass thing you like--and the other side can't rule it out, because then they're like Bush starting a false war...? Ahhhh....yah. As for ruling things out, count the ways in this interview in which Chuck Grassley rules out principle after principle as simple anathema to his party. But for The O, it's unions and progressives who are holding things up by their intransigence.
But also note the passive tone evinced by the editors about Wyden's seeming nonchalance--hey, if we don't get my plan off the ground, sure I'll support one that mine specifically lacks, and lacks for the obvious reason that it would compete with my very deft and complex private scheme. No worries, mate!
Who else likes the idea of a plan that sets us on the road of taxing your benefits, and worrying about private plans not profiting so well with a robust public option? It's The Economist last week, which calls Wyden's plan "innovative" and clucks approvingly at mandates and the aforementioned benefits tax. Still, the talk is all about compromise--by liberals.
And then this Sunday the New York Times announced that the White House and the President were going to shift into a higher gear on reform--and a central theme Obama would be hammering from the bully pulpit would be a public option. Is Obama himself open to triggers or weak regional mini-Medicares in the final analysis? Perhaps; he's a cagey President that way so far and is keeping the details of "public option" close to his chest. But he's certainly not muffling enthusiasm for robustness to start with, which would only serve to undercut his own push.
Given this context--a refreshing acknowledgement that some political capital might have to come from the White House--Wyden chooses JUST that moment to shift from passive "hey, whatever" tone to "let's not get ahead of ourselves, here:"
Senator Ron Wyden, an Oregon Democrat who is a longtime proponent of revamping health care, said Mr. Obama seemed to be wrestling with how far he could push Congress.
“The president is very much aware that to bring about enduring change — health care reform that lasts, gets implemented, wins the support of the American people and does not get repealed in a couple of years — you need bipartisan support,” said Mr. Wyden, who was among two dozen Senate Democrats who met with Mr. Obama about health care last week. “So he’s grappling with, how do you do that?”
Gets repealed in a couple of...what the fuck? Is the assertion here that if we don't ditch the public option the Republicans are going to take over and repeal all health care reform in two years? Whether intentionally laid out in the NYT piece within the "NONONO" rantings of McConnell and Grassley on the subject or not, Wyden's comments sing the same notes, even using the same "bipartisan" code that means "the way the Republicans want us to do it."
Note also the implicit rejection of a reconciliation process in his comments. The hell with 50 or 60 or even two-thirds: Wyden literally wants SEVENTY votes for serious health care reform. Which either means he thinks there are 10+ Republicans who are serious about reform (hah!), or that giving Republicans exactly what they want is a way to get their votes on a bill Democrats will get credit for if successful. Like with the stimulus. Or the budget. Like that.
I wish I could use a more flattering word for a Senator I generally respect, but the one that comes most to mind is "dupe." I'm framing the battle as one between Obama and Wyden because while there are other Democrats who are itchy about a robust public option that actually competes with private industry to reduce costs, none of them have a popular plan--a plan popular with Republicans, much less. Reich says the true danger is Snowe, but in the end if Obama chooses to ignore the Republicans on health care he can ignore the "moderates" just as well as the nutjobs.
But what are they going to do about Wyden? Do we not think Wyden will become the useful prop of the GOP as this comes down to brass tacks? "We cannot tolerate this liberal Kennedy/Baucus plan, but we WILL support the fine bipartisan copout compromise created by our good friend Senator Wyden, which I guess we'll just HAVE to live with, if you force us." Snicker.
Don't mistake me--I don't mean to say that Wyden's plan will likely be the one adopted in the end. No, the battle is between a real public option now, and a fake one at BEST triggered a few years from now. The left has its position to win or lose--real public or fake public.
Wyden however, gets to use his plan--the one the Republicans like-- as the "compromise" to give up, such that a weak public option takes the pressure off industry in much the same way as Wyden's plan would have, but makes it look "bipartisan" because both sides "gave something up." And not only is Wyden letting it happen, he's apparently prepared to go to bat for it, warning off POTUS of all people. Might be some interesting one on one games at the Senate gym the next few weeks...
[Crossposted at LoadedOrygun, Oregon's Progressive Community...]