Health care finance reform: looking brighter?

A party that controls the White House and has working majorities in both Houses has so much control over process that your best bet is that Obama, Reid, and Pelosi are mostly going to have their way.

I don’t follow the health care debates professionally, and I’m always ready to believe that any Congressional process will end in tears. Consequently, I’ve allowed myself to be infected by the widespread gloom in the left blogosphere and the mainstream media, even though the predictdion of disaster implied that Rahm Emmanuel had allowed himself to be outsmarted by Max Baucus: not a theory I’d usually accept without considerable evidence on its side.

But now things are looking brighter.Waxman got a bill out of Energy and Commerce: that’s more progress than Hillarycare ever made. Baucus (presumably with some nudging) has thrown down the gauntlet: Finance is going to start marking up a bill September 15, with or without Republican support.

A party that controls the White House and has working majorities in both Houses has so much control over process that your best bet is that Obama, Reid, and Pelosi are mostly going to have their way. Having made an obviously good-faith effort to accomodate Republicans and insuranced-industry-owned Democrats, they’re in a good position, if things break down, to use reconciliation to ram through an extremely Democratic bill, the best that can get 50 votes in the Senate and 218 in the House, and then go back to the table on a non-reconciliation measure.

If the reconciliation version is bad enough for the insurers and Big Pharma, then suddenly the bargaining shoe is on the other foot: it’s the Republicans and “centrists” who will be desperate to get something passed.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com