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August 30, 2009

Bipartisan Reform in Health Care

With the death of Senator Edward Kennedy, the Democrats do not have the votes just among their 57 members (and the two independents) to break a filibuster, and not all of these can be counted on to vote in lock step. If the Democrats want to enact health care reform this year, they appear to have little choice but to adopt a high-risk, go-it-alone, majority-rules strategy.

Mr. Obama should know from sad experience the pitfalls of seeking bipartisan cooperation from a Republican Party that has sloughed off most of its moderates and is dominated by its right wing. His stimulus package was supported by no Republicans in the House and only three Republicans in the Senate, so-called moderates whose support was won by shrinking the package below the size at which it would have done the most good.

Obama could likely insure millions of additional people in the United States in a bipartisan bill, just not all of them. He won't end up insuring all of them anyway, because undocumented workers won't be covered by any plan. The resulting plan may cover every legal immigrant and citizen, but I doubt that too. Instead many will pay fines and buy insurance only when sick, making it many things, but not insurance. Maybe more of an option to buy insurance. The bipartisanship discussion is really a debate over how many people to give up covering in order to win a certain number of Republican votes.

One reason why major social policies like social security, the tax deductability of home mortgage interest, medicaid, welfare, and food stamps enjoy robust support even when they don't work or work poorly is that when initially passed politicians in the right and left benches supported them. Once you start making policies with thin majorities you open yourself up to reversing them as soon as you leave power.

Posted by OneEyedMan at August 30, 2009 7:30 AM

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