The Guns Of August

Now that Mad Max Baucus has dropped his pile of dung into the health care debate, it's an open question whether allowing the August recess to happen may be the only hope for the bill at all. The story of conservatives bird-dogging their representatives and striking the fear of God into them so that they never think about passing health care reform again is only one side of the story. Sure, the RNC will spend money on the air in certain Congressional districts, but so will the DNC, and key allies like MoveOn and Americans United for Change. And the ground efforts by teabaggers and right-wing front groups can certainly be matched throughout the country by heavy hitters like OFA. Robert Reich may be despondent but this could be the part where the game gets fun. However, the principles we're fighting for need to be delineated, and that's where things might break down. Calling for vague "reform" will get you vague reform, and also probably health insurance choices that are benefit-poor, unaffordable and too few in number. Everyone's idiosyncratic, but I think that Reich's options are a decent place to start:

First, the House must enact a bill before August recess even if the Senate is unable to -- and the House bill should include the four key elements that have already emerged from House committees: (1) a public plan option, (2) a mandate on all but the smallest employers to provide their employees with health insurance or else pay a tax or fee (so-called "pay or play"), (3) a requirement that every individual and family buy health insurance, coupled with subsidies for families up to 300 or 400 times the poverty level in order to make sure it's affordable to them; and (4) a small surtax on the top 1 percent of earners or families to help pay for this subsidy ("tax the wealthy so all Americans can stay healthy.")

If a tax on insurance company policies (which would really just incentivize them to offer less expensive ones, getting the federal government off the hook for the giant employer deduction) sells easier and raises as much money as a surtax on the wealthy, so be it. I think America is worth paying for, but YMMV, and you have to actually make the argument about progressive taxation to lay the groundwork. The public plan option, IMO, must be available to as many people as possible by breaking the firewall and allowing people with employer coverage to opt into it. It also needs a provider network. And the subsidies have to be at 400% FPL on a sliding scale.

The trouble is that nobody's working off the same script. What's most likely to happen, if successful, is that Congresscritters become terrified at the prospect of passing nothing, but pass something inadequate. That could have very negative consequences, or actually positive ones, considering there's four years until full implementation to rework what's bad and make it good.