Hope! (Justifiable.)

The fight over the public option has been sucking up the oxygen in the health care debate … and that's probably a good thing as an indicator of where the final compromise is headed: Progressives are playing on their own turf. Nancy Pelosi has cut off the Blue Dogs, and Olympia Snowe is feeling the pressure at home to support a public option. 

And in the meantime, there are some significant improvements to our health care system in all the bills, including the much-maligned Baucus bill. Now comes the flurry of amendments — 500+. But as well as being opportunities for legislative mischief, sabotage, and parochialism, many of these are real improvements. Ezra relates that Sen. Snowe herself is offering genuinely constructive input to the bill:

After reading every [amendment], I have to say: they're almost all worthy changes to the bill. Snowe vastly strengthens the exchanges, which is a huge deal. She expands subsidies to more people, sets limits on high deductible plans, and weakens the penalty in the individual mandate. If I'd read this list of amendments without an attached author, I would indeed have thought they came from a moderate, though not particularly conservative, Democrat.

Her public option “trigger” is one of her amendments. Depending on how it's designed and implemented — i.e. if it really puts the fear of God into the insurance companies — this could be the compromise that emerges from the eventual conference committee. The President has seemed almost reluctant to embrace the public option, per se; but the trigger, plus robust anti-trust provisions, could satisfy the president's criteria of creating competition and more options. 

Snowe's is not the behavior of someone interested in taking the whole thing down — unlike, say, Chuck Grassley. This is someone who wants to get the deal done, and take credit for working on it. That's how politics should work. (And it may have something to do with her background, as well: Snowe's parents died of cancer and heart disease, respectively; both when she was still a child.)

Bottom line: There has never been a shortage of good ideas about health care reform. Ted Kennedy himself said (via John Kerry) that there were “15 ways to do this”. Even bad, weak old Max Baucus has added some good ideas to the mix, especially regarding delivery-system reform and preventative care. Even Republican Olympia Snowe is adding value — who knew they could do that?? People are actually talking about emulating good systems, like the Mayo Clinic. (And, it must be said, the inept clowning and grotesque callousness of GOP leaders make the reformers' jobs easier.)

It's possible, very possible, that we might end up with a very big, and very solid piece of public policy coming out of the Senate and House.

Please share widely!

0

0