Way back on March 5th -- a whole four months ago! -- President Obama seemed sure to push through a health care reform package to his liking this year. It was conventional wisdom that he had learned from the Clintons' earlier failure, which was widely attributed to their attempt to control the development of a plan centrally, leaving Congress and the public open to competing arguments. This time, by rallying wide-ranging support for the concept of "reform" and leaving it to the Congressional barons to develop specific plans, that wouldn't happen. Meanwhile, given Obama's popularity and a solid Democratic majority in both Houses of Congress, who would be able to stop the momentum behind a health care bill as one of Obama's highest priorities? “Those who seek to block any reform at any cost will not prevail this time around,” the President said confidently.
Maybe so, but there is still no bill, no sign of a bill, many signs of deep Congressional worry -- among Democrats -- over the costs of any program and how to pay for it, as well as how to get reelected if it works out badly, and to top things off, growing public skepticism about the whole thing.
In a new poll, 49% of voters don't like the plans being advanced by Obama and the Congressional Democrats, while 46% are favorable. In a really bad sign for the Obama team, support is slipping away just as it's needed most. Only two weeks ago, 50% favored reform and 45% did not.
No wonder it's being reported that Obama's deadline of August for bills to be reported out of both Houses will not -- and probably cannot -- be met. Some Democrats don't want to raise tax rates on high-income people to meet the minimum $1-trillion price tag for reform; others don't want to tax health care benefits to raise the dough; some are opposed to a public insurance option, while others insist on one as a sine qua non of their support; and few people believe that reform will result in significant savings to offset the cost of wider coverage. All that before you get to what price a few Senate Republicans might exact before signing on!
Yet, Obama and the Democratic leaders of Congress have far too much riding on passing a bill to get cold feet altogether. There are big and powerful constituencies in the country that want universal health care insurance coverage -- including scores of members of Congress and major unions that backed Obama. So one way or another, there will be a bill for the President to sign, even if it's a little late.
Therein lies the problem. As we've seen in connection with the stimulus bill and the cap and trade bill, when you want a bill -- any bill -- out of Congress, you're likely to get one loaded with contradictory provisions, loopholes for special interests, uncounted costs, and lord knows what unintended consequences.
So, what if a reform bill passes that is hugely expensive, does not provide enough real revenue or savings to pay the costs, reduces access to quality care for people who currently have coverage while jacking up their costs, and doesn't cover everyone anyway? That would result in a political fiasco, making life difficult for Democrats running for reelection in 2010, and likely diminishing Obama's popularity.
Could that happen? I wouldn't have thought so four months ago, but it looks like a real possibility now. What can prevent it? Only Obama's seizing control of the process and imposing his standards for a reform plan. That wouldn't magically make all the problems disappear, but it would inject some coherence into a process that is now spinning wildly and give him a better shot at rallying public support. Will he do it? Beats me.
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