Thursday, December 17, 2009

Reconciliation?

Perhaps it is time to consider reconciliation to pass a meaningful healthcare reform bill. Virtually all "reform" has been gutted from the current Senate bill. President Obama, who has been rolled by the united Republican opposition in both houses, is now losing support among progressives in his own party. With neither support from the left nor right, and not much in the middle, he is rapidly becoming a lame duck after barely a year in office.

In the past I have questioned Obama's leadership, but have been willing to give him the benefit of the doubt, assuming that there was still some scheme or plan up his sleeve other than talking about bipartisanship. But now I have come to believe that "there is no there there." The president is smart and a very good speaker and speech writer, but he can't seem to commit himself to actual leading and taking risks. He may not be Karl Marx or Hitler, but just an Ivy-League Hamlet.

I still think it is essential that the Dems pass some sort of healthcare reform bill. I have now given up hope on anything meaningful coming from the Senate. The current bill will certainly cover more people, but it is clear that a lot of them will not be able to afford it, though they will be required to have coverage. Many of the protections that were necessary, like a cap on total annual out-of-pocket expenses and protection against unreasonable premiums, seem to have been removed. True, policies can not be denied on the basis of pre-existing conditions, but insurance companies can still make policies of this type impossibly expensive. Older Americans will be charged up to 4 times the premiums of younger ones.

The whole point of making insurance mandated was to obtain such a large statistical population base that the cost of unhealthy patients would be balanced out by the savings on healthy ones. That's what insurance is all about. Under the current bill the private insurers get the captive payers of premiums, but have no incentive whatsoever to keep rates low. -- 'cause there's no public option. If the insurance companies keep rates high (as they always have), they will still get payed, but now at the expense of subsidies from taxpayers. Sounds like the usual Bush transfer of wealth from the middle class to the wealthy. Is that what we elected Obama for?

Given that passing no healthcare bill will be a (well-deserved) terrible disaster to the Dems, and passing the current bill which everyone is beginning to hate will be simply a disaster for the Dems, they really have only two reasonable possibilities.

1. Have the Senate pass this nearly worthless bill and hope that some good things will be put back when it goes for reconciliation with the better House bill (good luck) or

2. Have the President and party leaders announce that good things ("public option", Medicare buy-in, cap on expenditures etc.) will be put back in the bill and the whole package will be presented as a "reconciliation" bill under the 1974 budget act. This will enable it to be passed by a simple majority in both houses. The Republicans will shit bricks, but they used reconciliation to ram through Bush tax cuts for the rich on several occasions, so too bad for them. Their opinions hardly should count for much these days.

I think that number 2, accompanied by a big ad campaign and strong attacks on the G.O.P. is the best choice. It may, just may, change Obama's image from eloquent wimp to winner. He should read some of F.D.R.'s old speeches and adapt his style and content accordingly.

The rap on the Democrats is that they can occasionally win elections but can't govern. I'm beginning to think that this is true. If it is, there is not much hope for this country, since the other party has already shown that it is willing to wreck us all in order to help the rich and greedy.

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