Facing Reality

| Wed Jan. 20, 2010 5:03 PM PST

Over at the Economist, some random unidentified blogger says that Democrats should modify their healthcare bill in order to attract some Republican votes:

Suppose you had just woken up from a year-long hibernation and somebody gave you the logistical picture described above. You would come to one of two conclusions: 1) the bill in question was deeply flawed, because otherwise surely at least one member of the opposition would support legislation that seeks to improve what is almost universally accepted to be an expensive and slipshod health-care system. Or 2) The country has been paralysed by party politics, such that not even one rogue or idiosyncratic or centrist or mischievous Republican would cross party lines to support the Democrats' bill. Option two strikes me as more unlikely, but we're all operating as if it were the case.

I see an opportunity, however miniscule, for the Democrats to take this time to re-work the bill in a way that would have broader appeal — not a way that has more giveaways to business, as they seem to have that under control all on their own — or, at the very least, to make a stronger case for the bill they do have. Optimistic, or dangerously naive?

Of all the fantastical notions that have been floating around today, this is the one that strikes me as the least grounded in reality. (Which, in fairness, the Economist's blogger seems to dimly grasp.) So as long as we're waking up from a year-long hibernation, let's recall a little bit of history.

For starters: Republicans have never had any interest in serious healthcare reform. George Bush was president for eight years and never proposed anything. Congressional Republicans never proposed anything either — and when Democrats took power, they opposed even incremental changes like SCHIP expansion. The Republican candidate for president in 2008, John McCain, was plainly uninterested in healthcare reform, and when he finally felt like he had to propose a plan of his own, it was so transparently weak and unworkable that no one took it seriously.

Now fast forward to 2009. Congressional Democrats start work on healthcare and Republicans have two choices: (a) work with Dems to try to produce a bill that's a little more to their liking or (b) try to kill it completely and run the risk that Dems pass a more liberal bill on a party line vote. Option B was a big gamble since healthcare reform seemed likely to pass, but they chose it anyway because killing reform completely was their preferred outcome.

The idea that there are even a handful of Republicans who are interested in improving "what is almost universally accepted to be an expensive and slipshod health-care system" just isn't supported by the evidence. That's because this is nowhere near universally accepted. Republicans think we have the best healthcare system in the world. Their unanimous preference is to leave it alone, and Democrats really don't have any bargaining chips big enough to get them to change their mind. As Jon Chait put it in response to a Mark Penn column that also suggested a bipartisan approach: "I'm trying to think of what it would take for them to accept a public plan. The total abolition of all taxes on income over $200,000? Even that probably wouldn't be enough."

This fantasy that there are Republican votes for a more moderate bill really needs to end. There are no Republican votes for healthcare reform, no matter how moderate or conservative it is. They're opposed to healthcare reform. They've always been opposed to healthcare reform. They're Republicans! There's nothing wrong with them being opposed to healthcare reform. And they are. Full stop.

Going down this path would be dangerously delusional. It would waste time, piss off voters even more, and accomplish nothing. It's time for House liberals, labor unions, lefty activists, Blue Dogs, Democratic pro-lifers, and fence-sitting centrists to all face reality: the only way to pass healthcare reform of any kind is for the House to pass the Senate bill as is and then work to improve it later during the budget reconciliation process. It's not perfect, but it will work. Nothing else will.

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