HEALTH CARE: As we mentioned last night, House Speaker Nancy Pelosi is nearing the 218 votes she needs to move a "robust" public option through the chamber early next month. The "robust" public option would allow the government to reimburse providers at Medicare rates plus 5 percent, and would save the government money over the next ten years. The Big Picture gave a very good analysis as to why the prospect of the public option has such renewed enthusiasm:
In the past few days I've changed my opinion from what Ezra Klein was saying (and I think Ezra has too) that the public option isn't the most important thing in this debate. On a purely substantive note, it's still true that we can't ignore or belittle covering millions of uninsured. But, two major points:
1) It seems so clear that the only way the bill can fulfill Obama's stated objectives of a) covering almost everyone, b) individual mandate, c) health insurance being affordable for all Americans, and d) bringing down the overall cost of health care and the cost to the government - is through the public option. That's the only way to square the circle. And it's why Republicans and centrists have created this insane game where they keep complaining that the bill doesn't do enough to make it affordable and hold down costs and cover enough people, but then are ideologically opposed to the only way to do that - the public option. Obama has GOT to call them out on this hypocrisy. It should be so easy. You just have to make that argument to the American people in terms that are easily understood.
2) Whatever the substance, it's very clear that this public option battle is THE battle for the direction of Obama's Presidency and the Democratic Party and in fact the country right now. THE ideological battle. Obama and co. can't keep trying to shoo it away - I generally agree with the "pick your battles carefully" theory, but in this case, this battle has become symbolic for what philosophy, and what groups, are going to hold sway. If we win here, it will embolden liberals. If we lose, it will embolden conservatives and big business. I think it's a real fork-in-the-road moment for the Obama Presidency. That has been created by the tireless effort of the liberal base - endlessly derided by Rahm and Co. - to not let this go away, and by Anthony Weiner and Raul Grijalva and now Nancy Pelosi to force this using the power they have. If we prevail here, it will set a tremendous tone for the rest of Obama's Presidency, it will embolden the liberal wing of the Democratic Party to set the agenda. If we lose it, we will be marginalized, shown to be weak when it really counted. This is about a lot more than the public option itself: it's about the role of government, the position of Obama and the Democratic Party, and which philosophy and which wing has the true power at the end of the day. The true litmus test.
And my response:
I mostly agree with you on these points. I think you would concur that we should not let a weak public option, or even the lack of a public option, bring down reform. But I think the recent CBO estimates have given new ammunition to the public option. I think the concept was really nebulous for awhile, but it has now become abundantly clear:
-allow people to buy into a Medicare-like program if you are under 65. The program will have low overhead costs, meaning it will be cheaper to consumers. This will force private companies to compete by offering lower prices or better services, which will in turn bring down the cost of health care for consumers, businesses and the government.
Obama was mostly right when he said that the public option is only a means to an end. If there were a better way to achieve these objectives, we should look into them. But objective analysis has clearly shown that only the public option, and particularly one based on Medicare rates (plus 5) can get us where we need to be.
You are right on though with the larger political considerations of the public option battle. I think the stakes are indeed that high, and we need to win on this.
What I think all of us need to do is to call a Blue Dog office and ask:
1. Do you believe in fiscal responsibility and reducing the deficit?
2. Do you believe in providing health coverage to as many people as possible?
3. Do you think the Congressional Budget Office is a reliable non-partisan source?
If they answer yes to all three, you have gotten them to admit that a public option based on Medicare rates is the right policy.
Just some food for thought on a day when there was little in the way of health care news.
THE SENATE: It was a surprisingly busy, though not terribly successful, day in the United States Senate. Majority Leader Reid tried to bring up a bill that would stop a scheduled pay cut to doctors under Medicare. The so-called "doc fix" is necessary because in 1997, Congress tried to cut the growth of Medicare by scheduling pay cuts based on the performance of the economy. Of course, Congress would never actually have the political courage to enact these cuts, so each year they would pass a temporary fix. This year, Democrats wanted to solve this problem once and for all by paying for the fix over the next ten years. This would have added $250 billion to the deficit, which knocked the socks off Republicans and conservative Democrats. Funny, I don't remember this deficit obsession when the $1.35 trillion Bush tax cuts passed!! Anyways, Senator Reid called a test vote today, called "motion to proceed." To cut off debate on such a motion, you need 60 votes, which gives a good indication of how many votes would be lined up on the bill itself. The effort failed miserably. Only 47 Senators voted yes, all Democrats, while 53 Senators voted no. Democratic defectors were Bayh (IN), Byrd (WV), Conrad (ND), Dorgan (ND), Feingold (WI), Kohl (WI), Lieberman (CT), McCaskill (MO), Nelson (FL), Tester (MT), Webb (VA) and Wyden (OR). Democrats will need to pass a temporary fix before the end of the year, or find a way to offset the spending.
Tomorrow, the Senate will vote on the Defense Authorization conference report, which contains the LGBT hate crimes bill. The House passed the measure a couple of weeks ago. The Senate's concurrence would send the bill to President Obama.
We don't need a full section for the House today, they just dealt with some suspension bills. They are on to substantive legislation tomorrow.
THE WHITE HOUSE: The big news out of the White House today was that the "pay czar" has decided to limit bonuses to executives of companies that received the most bailout money. This move comes after a week or so of populist outrage at executive compensation that was unearned. Count me as a supporter of this move. Politically at least, the further away Obama distances himself from the financial companies, the better.
The President also went to New Jersey today to campaign for embattled Governor Jon Corzine who is in a tight race in a couple of weeks. The results of this race, and the more difficult one in Virginia, will be a good (though not complete) picture of Obama's coattail power.
That's it for tonight, see you tomorrow!
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