From all reports, it sounds like both parties are planning their best impersonation of Madonna (the singer, not the Blessed Virgin) at the health care summit at Blair House on Thursday. Her 1990 song "Vogue" was all about striking the right pose.
My sympathies are, of course, more with the President and the Democrats than with the Republicans. But, I worry that the President’s political radar has gotten him to a place where it is difficult to win at this point. There appears to be no prospect of achieving bipartisan consensus, even if by bipartisan we mean no more than picking off Senators Olympia Snowe or George Voinovich from the GOP. I am not sure why negotiations broke down with Snowe in the first place. She had been insisting that there be a trigger for any public option, giving the private markets time to try and lower costs on their own before introducing a government competitor. Now, there is no public option in the President’s plan so it is unclear why the Democrats have not reached out to the Senator from Maine anew.
Be that as it may, the prospects for compromise are looking slim. The other day, California’s Governor Arnold Schwarzenegger urged both sides to keep negotiating, to find that "sweet spot" and arguing that "there is always a sweet spot." This is not true: Sometimes there is no sweet spot. The Republicans do not want health care more subject to the federal government and while their cries of "government takeover" are not true, it is true that the proposed Democratic legislation has a lot of "The Secretary of HHS shall" in its many pages. Where are the policy compromises to be found?
The key to any bipartisan compromise is not to split the difference but to weigh it. The GOP argues that its market-based reforms will cover more people and lower costs. They argue that the states should take the lead in reforming health care. Let them. But, if in four years, health care costs have not been lowered by a given amount, and a given number of Americans have not been covered, then everyone can buy into the federal employees health benefit package or Medicare. And, if after four more years, the Medicare buy-in has not covered everyone or reduced costs, future lawmakers will have eight years of experimentation and results to decide how to move forward. The GOP will have to vote for an eventual public option, in short, but that public option only takes effect if their own proposals fail to achieve the goals they claim they can make. In short, don’t take a little from the GOP proposals and a little from the Dems and try to shove it together into the policy equivalent of goulash. Put both plans to the test.
The more I think about this, the more I like it. The President’s plan, after all, would not be fully implemented for years so he really is not giving up very much. And, the GOP can hardly oppose a measure that says, "Fine, we will try it your way!" and even let's them go first. If they have the strength of their convictions, if they really believe their proposals will work, they have nothing to fear. The Democrats will have a form of single-payer system, an incipient one at least, if the GOP’s market reforms fail. That should be a compromise all sides can live with.
Michael Sean Winters