Senate Compromise on Health Care Reform: Political Genius?

Joe Flower PrefferedDemocrat Roland Burris, the sudden senator who replaced Barack Obama in that august body, has now joined those who are pledging to filibuster any bill that does not have a “public option” – joining of course those, like Connecticut’s infigurable Joe Lieberman who will filibuster if it does have a “public option.” But the compromise that is brewing may turn all such pledges inside out. The compromise would allow 55 to 65-year-olds to buy into Medicare, while letting under-55s without insurance into the Federal Employee Health Benefits Plan, along with mandates to buy in, and subsidies for those who can’t afford it. If this does indeed emerge, liberal Democrats in both houses may have some trouble defining what they mean by the “public option” they are so strongly demangin. Is it a “public option” for 55-and-overs if they can buy into Medicare? Sure sounds like it – a government-run plan that people can buy into, in competition with private plans. Is it a “public option” if the federal Office of Personnel Management runs an exchange called the Federal Employee Health Benefits Plan (FEHBP) setting the rules and transparency for private plans, with subsidies and tax credits for those 54 and under who can’t afford a health plan?Sounds close, but not quite. Close enough for confusion, at least.

And that, in a way, is the point. The political intelligence behind the compromise is precisely that, on an issue where the two sides had come to sharply differing opinions, with both sides digging in their heels, the compromise fuzzes the lines. It replaces the bland phrase “public option,” which has come to mean “the savior of the people” for some and “creeping socialism” for others, with Medicare, which politicians regularly praise and promise to save, and the FEHBP, which politicians have often praised, saying that everyone should have one at least as good as Congesspeople and the President get.

The compromise, like all real compromises, is a kludge and a mess and a camel made by committee, but politically it has a certain genius. If the goal is to get a bill passed, this just might work.

13 replies »

  1. According to the National Health Expenditure Projections 2008-2018 (http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2008.pdf) it is estimated that in 2008 these expenditures will amount to $2.4 trillion dollars and increase 6.2% annually, surpassing the annual national growth rate by more than 2%. The report says that it is projected the national growth rate will be –0.2% while health care costs will increase 5.5%.
    “This expected difference in the 2009 growth rates would result in the largest one-year increase in the health share of GDP in history …” The writing on the wall is clear. If we do not do something soon and let the details destroy our intentions, we may be headed for an even bigger mess.

  2. wow so what was the purpose of this health care reform going on for almost a year all they accomplished was to let this senator lieberman get what he wanted that is let the insurance company make more money on people and it will be mandatory to have insurance none of theses politicians care for the regular jo smo so now at the mid term elections let the lobbyists vote because i sure will not!!!!!!!!!!!!!!!

  3. Expanding Medicare while making $500 Million in Medicare cuts seems a bit silly.
    I love how politicians try to make things that are bad sound good. We need Free Medical for everyone.

  4. “DB we already eliminted pre-ex for everyone except those trying to game the system. HIPAA ended it years ago, pre-ex is a dead boogyman”
    Well if you’re arguing that insurance will insure you no matter what – if you can afford the premium, then I guess in an insurance world that would count for ending pre-existing. In a healthcare world eveyone would have access to healthcare no matter what and at the same AFFORDABLE price, but all would be required/mandated to contribute to the system.

  5. DB we already eliminted pre-ex for everyone except those trying to game the system. HIPAA ended it years ago, pre-ex is a dead boogyman

  6. Our Congress is acting like they run a state, not a federation of states. They have far exceeded their Constitutional authority for decades. If that does not matter, then welcome to the UCA, the United Counties of America. We will see the South rise again, only this time it might be the Midwest. States rights are being erased. Just what do they see for the country a hundred years from now when we are all dead?

  7. I just wish they would pass something that would eliminate pre-existing conditions as a barrier to coverage for those of us who are under 65. Obviously as you get older you are more likely to have a pre-existing condition – and oh, by the way, you are more likely to truly need health insurance. And, I hope at least that part goes into effect immediately or in the next year.
    This compromise kluge would work, I think.

  8. I agree that politicians will do what ever it takes to get “their” version of health care reform passed but I think that what has been lost in all of the talk of health care reform is what will actually be the best approach to assure that all people recieve good quality of medical care. Forcing people to buy health insurance I think is unrealistic when there is a rise in unemployment. The reason that many people don’t have health insurance is because they can’t afford it. If the government raises their taxes to provide insurance for everyone, that is still taken more money out of the pockets of the people who are the backbone of consumerism in this country. The less money they have, the less they will spend on anything.
    As far as any form of socialized medicine, one only has to look to other countries to see that while coverage is provided for everyone. Quality of care drops dramatically because there will be a shortage of physicians (many doctors are already deciding to get out of the business of Medicare and health care and have private ‘cash based’ clients for which they are able to spend more time and provide better care for.
    Your average person won’t have any other option but to go with govenment mandated insusrance.
    Once medicine is socialized then scarcity of health care resources become a problem. People will have to wait a long time to see specialists and receive surgery.
    Eurpeons have put up with it for years but we are Americans and when it comes down to reform that adversely starts affecting people personally, people will protest.
    With the first of the baby boomers reaching their elder years, they will expect the same kind of service that they have had in all areas of their lives.
    I already see a growing health care consumer movement and I don’t think the government should discount the power of the people.

  9. Expanding Medicare while making $500 Million in Medicare cuts seems counter-productive. Moreover, such an expansion would threaten the viability of a program teetering on the brink of insolvency.

  10. Anything they can do to push this bill through before the end of the year! I would not put anything past the politicians these days. The lies will be spread about how it’s for “the greater good” and how “they did their best with what they weere given” but at the end of the day it’s bullshit – they just want to push it through and if that means they write a useless, worthless, waste-of-time bill; then I assure you – that is what they will do.
    They are all excited about this bill and want it done ASAP because of the significance of it. It is a ground breaking thing going on to over-haul and entire industry and they all want their names attached to it so they go down in history – that’s all they want, they couldn’t possibly care less if the health care system remains broken, so long as their names are spread like mad cow disease.
    my $0.02
    great article by the way.
    checkout http://darkn3ss-californiamadmanblog.blogspot.com/ for more health care reform info/discussion!

  11. Thank you for your posting.
    It does seem like a political attempt at getting this bill past. I think that there are some politicians (both sides) are excited about the overall idea of the plan…they just want to have it their way.