Legs on a Pike: Understanding Baucus' Healthcare Bill "Improvements"

Senate Finance Committee chair Max Baucus (D-MT), primary sponsor of the healthcare reform bill that President Obama and Senate Majority Leader Harry Reid (D-NV) seem to consider the template or starting point for any reform legislation that ultimately emerges from the legislative process, has announced some amendments to his own bill, supposedly intended to satisfy the concerns of more progressive Democrats.

Baucus' amendments, however, fall far short of what most Progressives seek. Most notably, they do not insert the provision that is rapidly becoming the litmus test of Obama's progressivism: a publicly-administered healthcare plan that would operate by the same rules as private insurers (and would be fully premium-funded, not taxpayer-funded), but would have lower overhead and administrative costs and might be able to join forces with Medicare and other government health programs to gain tremendous negotiating power with providers, saving the government and taxpayers money. Instead, Baucus' proposed concessions consist primarily of modest financial givebacks to middle class taxpayers who would be hit hard by his bill's proposed penalty on the uninsured.

Baucus' original bill appears to be the White House's preferred model for three reasons: (1) it appears less expensive, under CBO scoring rules, than any alternative other than single payer, which Obama has decreed is off the table; (2) unlike any of the others working their way through the legislative process, it meets the terms of an apparent agreement negotiated privately among the White House, Democratic conservatives, and the pharmaceutical manufacturers' lobby PhRMA (headed by Blue Dog co-founder and Democrat-turned-Republican Billy Tauzin); and (3) it may win the vote of Republican senator Olympia Snowe (R-ME), which will allow Obama to claim nominal "bipartisanship" and, more importantly, may set the stage for Snowe to follow Arlen Specter's example and switch parties, becoming a Democrat. Baucus' bill is, in other words, a center-right compromise, far from ideal but politically satisfactory to the coalition of interests Obama thinks are critical both to passage of healthcare reform and to future legislative success in other areas.

As an obvious compromise, however -- and an illiberal one -- Baucus' bill always was certain to draw fire from most Democrats, and it predictably would face amendments that would dilute its centrist core. The only way to keep such amendments from rupturing the strange-bedfellow alliances that the bill seeks to preserve is for Baucus and his allies to "liberalize" the bill themselves. For that reason, Baucus' original bill intentionally carried a CBO pricetag nearly $100 billion less than the $950 billion needed for deficit neutrality. Baucus, with clever foresight, gave himself leeway to add relatively insignificant improvements so that he could pretend he is flexible, and pretend that his bill can be made adequate, and thereby mollify progressives.

But those improvements are not enough to make his bill good, and his strategy -- pretending to improve a bill that is unacceptable at its core, and hoping we're too dumb to notice -- are both transparent and disingenuous.

Baucus' bill, and his new amendments, are like this:

God: "I want you to build me a horse."

Satan: "OK, here's a Northern Pike."

God: "But Northern Pike can't run, carry people, or eat grass!"

Satan: "That's OK, I left enough room to put some legs on the pike."

A fish, even with legs tacked on, is not a horse. And Max Baucus' tepid vision of reform, even as amended, is not a true healthcare solution.

Follow M.S. Bellows, Jr. on Twitter: www.twitter.com/msbellows

Comments

[hsr0601]

Even with some benefit for primary practitioners, the baseless scheme does not come with "fundamental" payment reform, or a pay for value reimbursement formula. It means that the insurer-friendly scheme is not cleaning up the concerns over a quality issue and $9trillion of deficit over the next decade.

((Here is some of CBO analysis : While the costs of the financial bailouts and economic stimulus bills are staggering, they are only a fraction of the coming costs from Social Security, Medicare, and Medicaid. Over the next decade, the Congressional Budget Office (CBO) projects that each year Medicaid will expand by 7 percent, Medicare by 6 percent, and Social Security by 5 percent. These programs face a 75-year shortfall of $43 trillion--60 times greater than the gross cost of the $700 billion TARP financial bailout)).

For Medicare & Medicaid system to survive from the most wasteful structure on earth, "enough and sufficient" savings by way of fundamental changes need to be secured, in return, the savings thereof suffice to meet the goal of well-planned public option.

For the record, prior to nation-wide deployment of reform, The State Of "Yes We Can", Minnesota influenced by Mayo clinic spends "20 percent" less per patient than the national average and 31 percent less than in the highest cost state.

Thanks !

[Chazet2]

Its been three days. You know what fish does after three days...

[Ventoi]

They will not put your animal to sleep...
they will put your animal on special heart food...
and heart pills...
and give your animal surgery.

VETS make more money off of people who can't afford to have children than we can imagine...

Now, there's one!
Subsidised health care may cause a baby boom among the yippies.

[Ventoi]

Fish can slow horses down.

[TomDegan]

I would ask all of you to think of me as Dr. Degan, your loving and trusted family veterinarian. After a complete and thorough examination of your beloved pets, it grieves me to offer you this final diagnosis:

Your Blue Dogs must be put to sleep.

The Democrats are not going to distinguish their party by trying to sell themselves as Republican Lite. They're not going to turn America around by foolishly preserving the policies of the last thirty years. They need to educate their constituency by showing them the folly of their abhorrence of things "Left" and "Liberal". Three-quar­ters-of-a-­century ago, American democracy was saved by a government that was decidedly left-of center in all but a few areas. It can happen again. But it's only going to happen if WEEDA PEEPOLE refuse to turn right at the next crossroad. It is only down the road.

Now if you'll excuse me, Dr. Degan has some Blue Dogs on his table that need to be put out of our misery.

http://www.tomdegan.blogspot.com

Tom Degan
Goshen, NY

[arktig]

Good commentary. Thanks for keeping us up to date with the latest developments in this Theatre of the Absurd.

[M.S. Bellows, Jr. - Huffpost Blogger]

Thanks, Arktig and the other commenters! This is one of my stranger posts, but reading tea leaves is important as citizens try to affect the direction our leaders are taking.

[Hopeington]

With or without the legs,without the public option, it's just not working for me.