As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Monday, July 20, 2009

Wading Through The Concern Troll Maze

Nobody wants to kill health care reform. OK, I guess Bill Kristol does. But nobody else. They're just very concerned with the speed of the legislation, and some of the provisions and they just want to take the time, do it right, we can do it bay-bee.

You'd expect the RNC to weigh in on the side of the status quo. But Michael Steele is so clueless about the topic of health care that, as you can see from this compilation, he would probably be stumped if you asked him what a doctor does.

Later on, he didn't understand the individual mandate, only the central issue in the most intensely watched primary campaign in American history. He has found his metaphor, though, calling it a reckless and risky "experiment," both in his remarks and in this new ad, which I think makes the point that Barack Obama is experimenting on children.

Not really a new argument, nor is the idea that the new health care plan would "ration" care. Peter Orszag parries that nicely.

ORSZAG: This is the biggest canard that is floating throughout this debate. The fact of the matter is right now politicians and insurance companies are making decisions. We're saying we want doctors to be making decisions, and I think that will lead to a higher-quality, lower-cost system over time.

WALLACE: But when you say they're making decisions, they would be saying, you can have this treatment, you can't have that treatment.

ORSZAG: Do you think that politicians are currently rationing care, are insurance companies currently rationing care? There's no set of decisions that this commission would have that is not currently resting with either members of Congress or insurance companies.

WALLACE: So they would be rationing care.

ORSZAG: No! Because I don't think we're rationing care today, and similarly they would not be in the future. What they would be doing is setting reimbursement rates and moving towards a higher-quality system.

These arguments from the right are both silly and transparent. They are designed not to advance any debate about health care or create some alternative set of proposals. They are, as Orszag said on a different Sunday show, designed simply to kill any bill. They not only want to break health care, but break Obama, as Jim DeMint very clearly stated. Delay equals defeat in this case.

Which is why it's so disconcerting to see Democrats engage in the same tactics. For example, Gov. Brian Schweitzer of Montana criticized the expansion of Medicaid in the bill because it would leave an unfunded mandate for the states, but under the House bill, at least, the federal government picks up ALL of the costs for that expansion, at no cost to the states whatsoever. Schweitzer may consider this a slippery slope, and in that case, he should advocate for taking state participation out of Medicaid entirely. But instead, he's chipping away at Congress' bill, as are other governors of both parties, and eventually that tactic leads not to getting the policy right, but burying it.

If moderate Democrats have legitimate concerns with the bill, they have every opportunity to address them, but they seem more concerned with shooting arrows at it, which will only destroy the bill, and probably their political future as well.

But the question isn't whether Republicans understand the power of successful opposition. It's whether Democrats understand the dangers of failure. And that's most true for the Democrats who are most likely to weaken the effort: The Democrats who are cool to health-care reform because they fear the conservative tilt of their state are the Democrats who will lose their seats if Obama loses his momentum and the Democratic majority begins to lose on its major initiatives. Legislative defeats will not threaten Henry Waxman's seat. But it will imperil Mary Landrieu's. And Ben Nelson's.

Bill Kristol is right that defeating Obama's health-care plan is a first step for Republicans who want to pick off vulnerable Democrats in the 2010 midterms. But the converse is also true: Passing health-care reform is the first step for vulnerable Democrats who want to save their seats.

In the end, I'm not sure that those moderates really want universal health care. So they concern troll it and ask for delays and we eventually spend another couple decades with a broken system and no progress. I'm hopeful that isn't the case this time, as Obama steps to the front of this debate. But at this point, turning away from the sausage-making is probably best for my heart.

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