Thursday, December 10, 2009

Learning to live with the compromise

If, like me, you're not terribly happy about the (no public option) compromise Senate Democrats have worked out, make sure to read Chris Bowers's post at Open Left on how there has actually been "real success" here:

While it looks like we didn't get a new public option program, we have received at least:

  • 4 million more people covered by Medicaid, which is a public option, than the July version of the House bill
  • 1-2 million covered by a Medicare buy-in, which is also a public option, and which was entirely absent in the July version of the House bill
  • An increase, from 85% in the July House bill to 90% now, in the percentage of money companies receive on health insurance premiums that must be spent on health care.
These are all concessions directly made to progressives in return for dropping a Medicare +5% public option that would have covered 10 million people. Not bad.

True, not bad. And, of course, any Senate bill would still have to be reconciled with the House bill, which includes a public option. (And there is still the possibility of reconciliation, which would require not 60 but 50+1 votes in the Senate.)

As I said yesterday, I suspect that the public option is dead, but even the compromise package, if passed as is, could lead to more substantive reform down the road. Here's how the Times (linked above) explains it:

Under the agreement, people ages 55 to 64 could "buy in" to Medicare. And a federal agency, the Office of Personnel Management, would negotiate with insurance companies to offer national health benefit plans, similar to those offered to federal employees, including members of Congress.

If these private plans did not meet certain goals for making affordable coverage available to all Americans, Senate Democratic aides said, then the government itself would offer a new insurance plan, somewhat like the "public option" in the bill Mr. Reid unveiled three weeks ago.

In other words, no public option now, but maybe, just maybe (probably?), later. That's not bad either, is it?

Look, I'm just trying to be optimistic.

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