President Obama has always been very clear on what he wants to see in healthcare reform: 1.) ensure that all Americans have insurance that will provide them with the care they need. 2.) Make reform deficit neutral. And 3.) bring down the costs of healthcare expenditures for families, businesses, and the government in the long term. Being a pragmatist, Obama has remained open to different methods of accomplishing these goals. If the answer lay in a single payer system, he would probably support that; if the answer required as little government intervention as possible, that would be acceptable to him also.
However, there came a point at which universal healthcare has turned into “incremental” healthcare—out of concern for fiscally conservative Democrats and Republicans. But now, each passing week that the Senate Finance Committee cannot come up with an outline for a new system is time in which town hall protestors, Fox News commentators, and the general dynamics of next year’s midterm elections may prevent reform from occurring at all.
Obama has given the Finance Committee negotiators until September 15 to come up with a bipartisan bill, at which point he presumably will press for action without the Republicans. While I worry that imposing such a deadline may alienate any GOP senators who are thinking of supporting reform, there comes a point at which thoughtful deliberation turns into purposeful obstruction. There is no point in watering down reform in order to meet Republicans at some imaginary middle point where they will say, “Okay, that’s good enough for us.”
That point probably lies somewhere to the right of insurance cooperatives—a proposal that the small-state senators in charge of the negotiations have proposed in lieu of a public option. Critics on the left say that co-ops will be too small to be effective competition and will have to negotiate rates with healthcare provides like private insurers. Critics on the right, like Sen. Jon Kyl (Ariz.) are calling co-ops a “Trojan horse” that are just disguising a planned government takeover of healthcare.
If GOP senators feel that even a concept as weak as a cooperative is too much government intervention, then I think that it is time to pull the plug on bipartisanship and return to the public option commitment. The public plan is a compromise that liberals made after a single payer system was taken off the table. What exactly have conservatives compromised? The fact that they seem not to be willing to support anything other than the status quo is hardly a commitment to improving the healthcare system.
To be fair, some Republicans are taking the reform effort seriously. Sen. Olympia Snowe (Maine) was the only Republican on the Finance Committee not to draw a line in the sand in opposing a public option. Like the president, she remains open-minded on the means to the overall end of accomplishing the three key goals. Sens. Susan Collins of Maine and George Voinovich of Ohio may also be open to the Democrats’ plan.
Realistically, the Democrats have 60 senators; they do not have 60 votes, however—meaning support from GOP moderates is key. But in looking at the record of the current Congress, the most important votes were taken with almost solid Republican opposition: the Lilly Ledbetter Fair Pay Act in January, the stimulus package in February, and Sonia Sotomayor’s confirmation in August. Although I don’t believe in the helpfulness of drawing strict lines, President Obama should seriously enforce the September 15 deadline. Otherwise, he may not have another opportunity to build momentum to pass this crucial legislation.