11/21/2009 05:12 am ET Updated May 25, 2011

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.