A Double Trojan Horse

by: Matt Singer

Tue Aug 18, 2009 at 16:03:35 PM MST

That's what Jon Kyl thinks co-ops are, in a Huffington Post story that laid plain, once more, what an indescribably ridiculous political party the GOP has become.

First, the public option was a terrible idea because it is supposedly a Trojan Horse for single-payer. Now private co-ops are a terrible idea because they are a Trojan Horse for a public option. I imagine soon we'll be outlying private insurance because it is just a Trojan Horse for health insurance cooperatives. Or something.

Bottom line, though, if the co-ops are off the plate because Republicans won't back them generally and Grassley won't back anything that a whole bunch of Republicans won't back and, don't forget, a whole lot of Democrats think the cooperative idea is kind of inane anyways since cooperatives are already legal and some currently exist, I think this just reemphasizes my earlier point: we're getting steadily closer to a good bill as we get a little closer to a chance of no bill at all.

Kathleen Sebelius Defends Public Option, Opposes Single-Payer

by: Matt Singer

Fri May 08, 2009 at 10:51:03 AM MST

I've gotten a few emails and seen the single-payer protest clip that is below. I have to admit to being underwhelmed. If I was in Congress, I'd be inclined to give single-payer a look. But I'd probably also end up where I am now, supportive of a mix of public and private insurance options for people.

The strangest thing, though, is this idea, both here in Montana and nationally, that Max Baucus is thin line standing between America and single-payer health care. That if only Max Baucus would invite a single-payer advocate to a Finance Committee meeting that Chuck Grassley's perpetual frown would turn upside down and that we'd all move to candy mountain with Charlie the Unicorn and the healthcare would be free and have sprinkles.

But I digress.

The place we're at in health care reform right now is that there is some broad consensus among leading Democrats, ranging from Barack Obama to Kathleen Sebelius to Ted Kennedy to Max Baucus to Howard Dean, of what health care reform looks like. It includes some Medicare reform; a "connector" or "exchange" to help people navigate the insurance market; significant regulation of private insurance including guaranteed issue, community rating, and some guaranteed benefits package to be determined; and a public health insurance option in some form. To various extents, all of these players are negotiating with Republicans, pharmaceuticals, hospitals, doctors, insurance executives and others to work out something that can get passed. I'm not privy to all of those negotiations or strategy. In all likelihood, most of the readers of Left in the West aren't either.

But that's the consensus framework. There are other approaches we could, in theory, take. We could try the McCain plan. We could try single-payer. We could model the French limited multi-payer or the British NHS system. Or whatever. But we're not doing those things either.

Occasionally, people ask me why I'm supporting what I'm supporting, as though what Matt Singer supports is newsworthy in the slightest. I don't think what I support is either interesting or important.

To some extent, the constant "I have a plan" nature of policy discussions in America is good in terms of promoting serious long-term policy thought. But it isn't very useful in terms of actually getting something passed this year, which is what we're currently trying to do. For most of us, the relevant conversation on November 1st of last year was Barack Obama or John McCain, Denise Juneau or the crazy lady, etc., etc.

At some point in politics, the questions we face become binary. Healthcare reform isn't quite there yet where we crunch down to: vote to pass it or vote for the status quo. But we're at least to the later portion of the primaries, where the contestants have been winnowed down to a narrow field and, perhaps unsurprisingly, those candidates are marked more by their similarities than their differences.

Big changes in American politics take years and huge amounts of work. Even unsuccessful attempts at big changes in American politics take years and huge amounts of work. And the most incredible thing about is that even the most "powerful" players -- people like Barack Obama, Ted Kennedy, and, yes, Max Baucus -- are more caught in the storm than creating the winds.

That isn't to say we don't have power. All of us have a lot more power to kill reform than we do to get something passed. It is easier for Barack Obama to veto a bill than to pass one, for Ted Kennedy or Max Baucus to shut down an option than to get consensus for one, for a single Senator to help filibuster than to get cloture, and for activists decide that they would rather demand a full loaf than get 2/3 of one and as a result not even get a crust.

This has turned into a rant, so I'm going to stop. I'm more than happy to take feedback in comments here and, as folks may have noticed, the diary and comment options give even single-payer advocates (and even libertarians) the ability to write whatever the hell they want here (although the community can shut down comments). So by all means, let 'er rip.