Why HCR has to pass

by db

Current thoughts on the state of HCR as it wends its way through the legislative labyrinth:

1. The Admin misinterpreted the lessons of the Clinton round of health care reform and entrusted far too much to the legislative process.

2. Common misconception that Clinton couldn’t pass HCR when times were “good,” (’91-’92 recession is what helped get Clinton elected in the first place), but times are much worse now. People are freaked, jobs continue to disappear, and the deficit is becoming a legitimate concern. (Even I’m starting to get worried. No matter how we got here, we’re here. The American people, rightfully, allow a new President 6 months to blame the last guy before the problem is his to own.) This is a toxic environment in which to talk about any spending other than on jobs. And the Administration’s purported plans for an increase in Afghanistan isn’t going to help on that front; money we don’t have for a war many, if not a majority, of Americans don’t support. (Not saying that’s my opinion, necessarily; just that it is the commonly-held view out there.)

3. Obama may have campaigned on HCR, but D’s like Landrieu, Nelson, and certainly Lieberman didn’t. Of course Reid’s going to have to coax them with pork. All of them. That’s the way it works with big votes these days. (Did the GOP do any less to pass Medicare Part D? There was a lot of pork there, if memory serves.)

4. And this is the most important lesson I have drawn: HCR is so nasty an issue, so horrendously screwed up, impacts so many people that they only way to repair it may be to endanger the majority that attempts to do so, and, potentially, the President as well. This is one point upon which I agree with the Admin’s strategy entirely: Obama has said he will risk his reelection to pass it. He may well and that may be the only way to make any progress on this.

I think HCR will pass, if only because there’s a very real threat that to not do so will present more harm to incumbent D’s. If they don’t pass HCR, the Democrats may, rightfully, lose the House and suffer losses in the Senate. The Admin will be hobbled and will be left to passing parochial, trivial regulation and legislation a la Clinton post-HCR in his first term. Obama may well be reelected, but significant HCR will never be attempted again for a generation.

So, passing HCR is going to take a ton of pork and plenty of back-room dealing to boot, but those incumbents may well go down anyway, and I’ll take some pork and convoluted language that we can clean up later to claim a victory over nothing, losing even more seats and potentially electing a GOP demagogue cum populist pretender in 2012. The polls don’t necessarily reflect only fear on the part of voters of the eventual outcome, they reflect a lack of faith in the Congress to do anything right. And the most wrong thing would be to pass nothing. If you think approval ratings are low now, wait until the Democratic base abandons Congress entirely. No, the bill will pass because it has to. It won’t include the Public Option and that may not be such a bad thing, but it will pass and we (the American people), the party, the Congress and the Admin need it to pass.

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1 comment so far

  1. florida medicare on

    We pay approximately 40% from the physicians in this nation higher than Medicare reimbursement rates based on political expediency. Doctors who work in States with democratic legislatures receive money greater than Medicare rates. This helps to ensure that we the insurance providers will invariably have their grass roots support against single payer, public option, etc. or any action by the States to dilute out our Federal Subsidies. 60% of the Doctors in this nation are paid by our industry at or below Medicare reimbursement rates. These are the physicians who’ll really suffer when the Congresspeople we own act to decrease Medicare reimbursement to physicians.


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