Tuesday, June 30, 2009

Anonymous Liberal's Got It ! Right

Bipartisanship on Health Care Makes No Sense

Whenever I hear someone call for a "bipartisan solution" to the health care crisis in America, I just want to pull my hair out. It makes absolutely no sense whatsoever. It's like calling for a bipartisan solution to the next presidential election.

Health care policy is a definitional issue in American politics. For as long as I can remember, the Democratic party has fought to increase the government's role in providing health care coverage for Americans while the Republican party has fought to reduce the government's role. The Democrats are responsible for Medicare, Medicaid, and S-CHIP; the Republicans fought all of those initiatives. On a policy level, the Democrats believe that the best health and cost outcomes can be achieved by increasing access and encouraging widespread use of routine and preventative medical care. Republicans, on the other hand, have routinely identified the problem as over-consumption of care. Their proposals to fix the system inevitably involve significant deregulation with the goal of encouraging the use of high-deductible policies to try to discourage personal consumption of health care. Nearly every Democrat (including the blue dogs and "centrists") believes this to be bad policy.

In other words, there is virtually no common ground between the parties. The parties don't even see eye-to-eye regarding basic goals and policy assumptions. So why on earth would anyone believe that there is a bipartisan solution to health care? If one side believes the answer is behind door #1 and the other believes it is behind door #2, the correct answer is never to walk into the wall between the doors. Yet any conceivable "bipartisan solution" to health care would amount to exactly that.

Furthermore, as a simple political matter, it makes no sense to seek Republican support. First, it's a quixotic quest. Putting aside the fact that the Republicans are determined to uniformly oppose any significant Obama initiative, on this particular issue, there are actual principles and core beliefs underlying that opposition. Yes, there is a lot of standard Republican propaganda and demagoguery as well, but beneath all that disinformation is an actual philosophical disagreement. I happen to think that Republicans are dead wrong about health care, but I don't question that their beliefs are genuinely-held.

At the end of the day, no matter how willing the Democrats are to water down their proposal, they are unlikely to get any Republican support. And even if they were able to woo a few Republicans, it would not provide any meaningful political cover. The Democrats would still own the final bill.

Which is fine, because there is virtually no political downside here. The Democratic party is already identified with the issue of health care. It's one of its chief strengths. Despite their reluctance to support anything progressive, the reason red state Democrats like Ben Nelson get elected at all is because of issues like health care, where most people side with the Democrats. And it's not like what's on the table now is particularly radical. We're talking about providing people with a choice, giving them a public health insurance option if they want it. Not only is that idea already wildly popular, but it has virtually no political downside. Republicans and the insurance industry will do their best to demonize such a policy, but at the end of the day, no one is going to be upset that they are being presented with more options, and many people will be immensely thankful for it. Once the dust clears and the bill is passed, there is almost no political risk.

So the goal here should not be bipartisanship. The goal should be come up with the policy that is most likely to be effective and then browbeat every last Democrat in the Senate until they're on board. I don't say that about every issue, but on this one, there is no other sensible option.


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