HEALTH CARE: On Saturday, as you know, the Senate voted 60-39 to begin the debate on health care legislation. Despite the victory of getting the bill to the floor, Democrats are now faced with the fact that they're going to have to compromise, yet again, in order to get the 60 votes needed on the bill itself. At least 2 Democratic Senators have threatened to filibuster the bill as it is currently written. The most likely victim of these compromises is the public option. After all of the concessions we've already made, the public option is no longer among the most important policy changes in this bill. Since payment rates will not be based on Medicare, the public option will not put great downward pressure on the prices charged by private insurance companies. Additionally, it will only be available to about 10 million people, those who would qualify for the health exchange. Since the public option won't discriminate against customers the way private companies do, it is likely to attract some of the most high-risk customers. This, in turn, will raise the public option's premiums above the levels of private companies. The public option, though, would still do a lot of good and is definitely worth fighting for.
It's extraordinarily frustrating for all of us progressives that even after the public option has been stripped down to what it is now, we STILL can't get centrist Democrats to support the bill. There's really nothing we could have done to prevent this. These Democratic holdouts have no legitimate policy objections to the public option. They simply found the liberal's most prized provision, and chose to oppose it for political purposes. It would be so satisfying to overcome these bogus objections and pass a bill with a strong public option. And I don't think we should give up. But we should start preparing ourselves to be disappointed by even more compromises. Even without a public option, the bill does enormous good, and the lack of the public option does not justify scuttling the whole effort. History teaches us that sometimes policy changes are incremental. It does us far more good to make progress now, so we establish something to build on with future legislation. Doing nothing would just embolden the status quo. Here's The Big Picture's take. We'll have much more on this later in the week. In the mean time, make sure you catch this great entry from Nate Silver, who gives an interested perspective on how red-state Democrats should conduct themselves in the health care debate.
It was obviously a necessary step for the Senate to get 60. And (and I know this is the 378th time I've changed my mind on this) after reading about all those great delivery-system reforms, plus considering that we're covering the uninsured, ending discrimination, recissions, lifetime caps, and we're paying for it all, and we're paying for it by taxing the rich and bending the cost curve ... when you compare all of that to what the public option has been reduced to already, I wouldn't feel it was a defeat if we gave up the public option to pass the bill. Although I am more worried about it symbolically, as a measure of who has the power, liberals (and popular will) or the swing-vote centrists in the ridiculously designed Senate (and their corporate powers). In that sense it would be a big defeat. But substantively, compared to all the good that's in this bill, and the crucial importance of getting something done (as Ezra says, the only way to get better health care reform down the road is to notch a victory, get momentum now), then not having the public option isn't horrible.
This afternoon, the President held a meeting with his full cabinet to discuss the economy and Afghanistan. The President gave his aides thanks for getting through a "difficult year." No reports on exactly what was discussed during the meeting.
That's it for now, I will see you tomorrow night. I'm flying to San Francisco tomorrow evening, so the entry may be posted later than usual.