The most complicated thing about health care reform is figuring out how it could possibly fail.
I mean, again.
If you read the polls, people overwhelmingly want reform. They back the so-called public option — a public health insurance plan that would compete with private insurance. They want universal coverage. They’re even apparently willing to pay more in taxes to make reform work.
But I just read this piece in The New Republic by Stan Greenberg, who was the Clintons’ pollster back in the day, saying that in 1993 — when health care reform lost — people wanted pretty much the same things they do today.
We know how health care lost back then. It was the time of Hillarycare and Harry and Louise and the ever-present threat of socialized medicine.
And now?
People are smarter, you figure. Things are worse, you figure. Health care costs more. We’ve seen the numbers on health care and bankruptcies. Unemployment is growing and, without employment, you lose that employee-subsidized health care. There are all those millions who remain either uninsured or underinsured. Barack Obama is certainly more popular now than Hillary Clinton was then.
So, how could reform fail? I mean, again?
Maybe because there are, at last count, nine competing plans rattling around Congress.
Maybe because a few centrist Democratic senators won’t support the public option — and they’re prepared to compromise on health care reform to the point where it isn’t reform anymore. (Check the argument ongoing over the co-op compromise plan, as Michael Riley describes in his front-page piece in The Post today. The co-op plan would resemble the public plan, but not too much, because if the government gets too involved, Republicans wouldn’t support it — and, then, what would be the point of the plan, which liberals won’t support anyway?)
Maybe because the country is suffering from crisis fatigue and doesn’t have the will to fight off the insurance companies and their enablers, especially the ones sponsoring the next round of TV ads.
We’ve got, let’s see, two wars, the crisis in Iran, a recession, GM, Chrysler, the banking disaster, the housing-market implosion, the Mark Sanford mystery and, of course, the Jon and Kate story.
Where does health care fit on that list? It’s there, somewhere, but if you’re going to pass something that fundamentally changes the way we pay for health care in America — and that’s the whole point of the process — it has to be at or near the top of everyone’s list.
Once upon a time, like during the last presidential campaign, health care was the issue that got every Democrat out of his or her seat, second in importance only to Iraq.
When was the last time you gave serious thought to Iraq? We move on. You don’t need to be a historian to know that events control politicians far more often than politicians ever control events.
But if health care is going to pass, it is Obama who has to control events. He has made it a signature issue. You just have to turn on the TV to hear somebody say that if health care fails, Obama fails.
At his news conference Tuesday, Obama gave his strongest support yet for the public option. He made the argument that the best way to drive down costs — and to force bureaucratically challenged insurance companies to do the same — is with the weight that a public option would afford.
Obama made the obvious point that if private insurance companies didn’t think a public option would work, they wouldn’t be so worried. In a letter to a Senate committee delivered Tuesday, two insurance industry groups warned that the public option would ruin them. I can see your empathy meter rising now
“Why would it drive private insurance out of business?” Obama wondered. “If private insurers say that the marketplace provides the best- quality health care, if they tell us that they’re offering a good deal, then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical.”
It’s more complicated than that, of course, as Obama concedes. If choice is the issue — and both sides argue that it is — the concern is that employers will dump their health-care plans, leaving employees, again, without any real choice.
Obama said the real issue is what happens if nothing happens, if no bill passes, if no reform is made, again.
You can guess what happens, because it’s what keeps happening: Your insurance gets more expensive. More employers have to decide whether they can continue to afford to offer insurance. And 16 years from now, we start over.
Mike Littwin writes Sundays, Wednesdays and Fridays. Reach him at 303-954-5428 or mlittwin@denverpost.com.
