On U.S. health care reform, half-loaf may be all that's possible

By Money Matters Editors

Our friends in Europe, and our friends in Asia, too, sometimes must look at the United States and simply shake their heads in amusement.

The U.S. Congress – specifically a Senate panel with 3 Democrats and 3 Republicans – has just spent nine months negotiating a health care reform bill, and at the end of all their work, do know what the end result was?

A bill that no one likes, The New York Times reported. Unbelievable. U.S. Finance Committee Chairman Max Baucus’, D-Montana, backroom wheeling and dealing, compromising, and logrolling has resulted in a bill that many liberal Democrats are saying they can’t support because it doesn’t contain a public option, and one that conservative Republicans are saying still does not represent an affordable health care bill, nor one they can support. All of Baucus’ work and delays did not garner one vote from Republicans on the committee. Talk about spinning your wheels.



Smoke-filled rooms, but no agreement

Further, Baucus’ bill represents a bona-fide compromise: Baucus’s bill will still leave 18 million American citizens uninsured. At least 45 million people living now in the U.S. are without health insurance. It’s also the least expensive bill proposed so far - $774 billion - paid for by new taxes and fees, and by savings from Medicare. If passed, it would reduce the federal budget deficit by $49 billion for the next 10 years, according a Congressional Budget Office analysis, The Times reported.

But the bill appears to be dead-on-arrival, as they say for bills lacking substantial floor support as they work their way to a legislative chamber. Or at least it’s a bill that will be modified substantially on the Hill.

At this juncture, the health care reform bill appears to be a struggle between: 1) President Obama’s centrist tendencies – he apparently is willing to cut a deal, i.e. ‘settle for a half loaf of bread’ – in order to maintain support among moderate Democratic voters and Independents; and 2) liberal House Democrats, who apparently are determined to require a health care reform bill with a public option. There’s a strong probability liberal House Democrats won’t vote for a reform bill without a public option.

Meanwhile, don’t count on any House Republicans voting for the current bill. Will they vote for any bill? It’s hard to say: their stance to-date has been “every plan costs too much.” And Senate Republicans? The Obama administration will be lucky if the ultimate legislation garners 4-5 Republican Senators.

In the end, as is so often the case with major legislation in Washington, a simple majority is not big enough to enact substantive change (examples: Social Security, Medicare). For seminal, era-changing legislation, you need a supermajority - above 70% support. And with about 35-40 percent of the nation opposing the bill, it appears the Obama administration will have to compromise, and hope they can retain the support of enough liberal House Democrats, in order to get a health care reform bill passed this year. The political reality suggests liberal Democrats, along with President Obama, will have to settle for a half-loaf.