Three Things to Remember About The Prez’s Role in Healthcare

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Chris Dierkes

Chris Dierkes (aka CJ Smith). 29 years old, happily married, adroit purveyor and voracious student of all kinds of information, theories, methods of inquiry, and forms of practice. Studying to be a priest in the Anglican Church in Canada. Main interests: military theory, diplomacy, foreign affairs, medieval history, religion & politics (esp. Islam and Christianity), and political grand bargains of all shapes and sizes.

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  1. Avatar Zach
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    says:

    I wouldn’t be all that surprised if Obama takes this opportunity to prove to Blue Dogs et al that Republicans outside of Snowe and Collins simply won’t vote for cloture let alone any bill no matter what the compromise. He could announce how disappointed he is that no one is willing to compromise (and damn Democrats as well in the process), specifically highlighting that the bills passed out of committee so far don’t reduce our future deficit, insure enough people, or provide enough assistance for people in a rough patch to insure their families. Then propose a completed bill a la Hillarycare and demand that it be voted on ASAP — that he’s open to a bill with any changes that don’t cost more, insure fewer people, or raise taxes, but will veto any bill that isn’t better than the one he’s proposing. This is essentially what he did with the stimulus and I think it’s a much better tactic. You don’t demand an up or down vote right away w/out change, but you get an Obama-branded package out there as the standard against which all other bills will be judged. The only legit argument against any package Obama would come up with is that it’s unfair to the insurance and drug companies and he can go all populist on that.

    Also, this is more than a little morbid, but it’s worth considering that Ted Kennedy could die any day and that this would probably grease the skids for the passage of any bill that comes out of the HELP committee.Report

    • Avatar Chris Dierkes in reply to Zach
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      says:

      interesting theory. so if the public option doesn’t come out of the conference, you think he would veto?Report

      • Avatar Zach in reply to Chris Dierkes
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        says:

        What I’m proposing is not to wed himself to one section or other of his proposal, but to come out with a specific proposal; one w/ at least as much specificity as the budget (ie not really a bill that’s ready to go into law, but something with all the pieces, cost estimates, benefits projections, etc). Announce it along with a panel of bipartisan, independent health experts who will score the bill in terms of projected increase in the number of insured, quality of care, and premiums for an average family in the individual market over the next 10 or 20 years. Also have the CBO score it and declare that it’s deficit neutral and does something to lower long term deficits.

        Then give it to Congress and say that they’re free to make any changes that don’t make the bill worse, and define worse as: taxes for people <$250,000/yr, fewer people insured, higher insurance costs for individuals, worse quality of care, increase in the deficit, decreases in Medicare/Medicaid benefits. Say that if Democrats or Republicans have ideas that make the bill better, you'll sign it. If they come up with a whole new bill that's better on this score, you'll sign it.Report

      • Avatar Zach in reply to Chris Dierkes
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        says:

        I wrote a long response to this that got lost in the ether earlier today. What I’m talking about isn’t what I think will happen, but what Obama could *do* if he wanted to take some risk in the hope of a more progressive bill. I think it could work if he were to roll out all on one day a complete proposal (a la the President’s budget) that’s scored by the CBO as being deficit neutral over 10 years and bending the curve over the next 50, and scored by an independent, bipartisan panel of health experts as lowering individual costs, increasing quality of care, and increasing the ranks of the insured. He should tell Congress that they’re free to come up with an entirely new bill or take his proposal and run with it as long as they get something to his desk within two months. If the bill he gets is worse on any of those scores, or if it raises taxes on people <$250k or cuts Medicare benefits, he'll promise to veto it. The key is to absolutely force Republicans to oppose the bill on an "it's unfair to insurers, providers, and pharam" basis. Obama's already shown he can win the tax debate, and he just passed one of the biggest tax cuts in history; he's got some leeway when it comes to generating revenue.

        What I actually think will happen is this: House passes a bill w/ a public option that's scored neutral by the CBO. Senate passes a bill w/ a ridiculously neutered co-op sort of thing b/c Dems compromise with thin air. The plan in the conference bill is called a co-op but run by executive branch appointees and funded at the same levels as the House public option. No way anyone supports a filibuster of the conference report… Obama's team will generate an astounding amount of momentum between the time it passes the House and Senate and when they vote on the bill out of conference. No one wants to be labeled as voting for it before they voted against it. Recall that this is exactly what happened with the stimulus. Essentially all of the spending in the House bill ended up in the final bill. The making-work-pay credit was cut by 25% to make the conference bill cheaper and satisfy moderates (appeasing blue dogs by getting rid of tax cuts… wild) and make room for the AMT patch that was inevitably going to be passed sometime this year anyway.Report

  2. Avatar E.D. Kain
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    says:

    Excellent break-down, Chris.Report

  3. Avatar Chris Dierkes
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    says:

    thank you gents.Report

  4. Avatar Michael Drew
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    says:

    This is a necessary and excellent corrective, Chris.Report

  5. Avatar James
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    says:

    Part on the future of the Republicans & absent spines of the Democrats is especially superb.Report

  6. Avatar Bob Cheeks
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    says:

    “The Constitution was written for the Legislative branch to be the dominant branch. You may think that a design flaw, but that’s how it is. A strong executive the US Constitution does not (on paper anyway) make.”

    Well, if they’d really wanted a weak executive they’d have kept that grand olde document, The Articles of Confederation. Why do you suppose the Constitutional Convention was a closed door, no public, no journalists affair? A little paranoia anyone?
    The only thing that gummint run health care will benefit is funeral homes and apparatchiks.Report

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