Monday, February 15, 2010

More on Feb. 25

The New Republic wondering about the Dem bill the Pres says will be released online prior to the summit. Ezra Klein writing up as well....many seemed to have originally missed the part about a new bill coming forth. The Republican leadership has been saying scrap past bills and start over, but that is not going to happen, nor should it. It seems as though the Pres is shoving the congressional Dems to say 'here is our compromise between House and Senate bills' and then saying to the Republicans, lets see not only your ideas, but your legislative language. In other words, shift from defense to offense. I submit the Republicans have no offense (but are impressive on defense). By that I mean that when they are in power, they don't take on comprehensive reform at all. They specialize in strident, ideologically driven defense, and in fairness the Dems haven't successfully countered in making the case to average folks that reform would help them.

So, we are stuck. The Dems seem to not have the nerve to finish the job. The Republicans can't seem to shift out of defeat the President mode.

Yesterday's Raleigh News and Observer had a bland AP story noting that the status quo given no reform proposal this year is quite bad. However, there is a key question for Republicans and the country buried in the story. Douglas Holtz-Eakin, who was John McCain's chief health policy advisor is a health policy guy and is quoted as saying this:

"...no one has the luxury of saying we aren't going to worry about this....(Republicans) are going to have to deliver something at some point. The question is whether they (Republicans) do something with this President leading, or wait for a Republican President."

Based on past history, I don't think there is any evidence that Republicans will take the politcal risk of driving the reform train, and I don't think we can wait. Stop for a second and see if you can imagine a candidate getting the Republican nomination for President in 2012 running on a platform of any type of health reform?

However, Republicans could jump in now and help the country, primarily by insisting on what I would say seems to be the closest thing to a shared notion among the Republicans who are interested in health reform: limit the tax exclusion of employer paid insurance. They may find an unlikley ally in the President on this. I think he has truly been won over by his health policy advisors who believe that limiting the tax exclusion is key if we are to slow the rate of health care cost inflation. The President took a lot of heat from a key Dem party constituency in Labor in insisting on the tax on high cost insurance. The deal exempting labor for a period of time was very damaging politically, but the Pres has had no option but to try and find something that can get 218 in the House and 60 in the Senate. If a few Republicans would jump in and say, we will vote for this if we limit the tax exclusion, etc. then we may actually be able to move ahead.

Here is what I suggested a week or so back about the route to a deal. The rhetoric aside, the plans before us are quite moderate, and should be able to be altered in a manner that could get some Republican votes if there is at least reasonable faith at work.

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