Centrists have a choice to make:
The Defining Moment, by Paul Krugman, Commentary, NY Times: O.K., folks,
this is it. It’s the defining moment for health care reform. ...[L]egislation
... will almost surely pass. It’s not a perfect bill, by a long shot, but it’s a
much stronger bill than almost anyone expected... And it would lead to
As a result,... politicians, people in the news media,... whoever is in a
position to influence the final stage of this legislative marathon — now has to
make a choice. The seemingly impossible dream of fundamental health reform is
just a few steps away..., and each player has to decide whether ... to help it
across the finish line or stand in its way.
For conservatives, of course, it’s an easy decision: They don’t want Americans
to have universal coverage, and they don’t want President Obama to succeed.
For progressives, it’s a slightly more difficult decision: They want universal
care, and they want the president to succeed — but the proposed legislation
falls far short of their ideal. There are still some reform advocates who won’t
accept anything short of ... Medicare for all... And even those who have
reconciled themselves to the political realities are disappointed that the bill
doesn’t include a “strong” public option, with payment rates linked to those set
But the bill does include a “medium-strength” public option, in which the public
plan would negotiate payment rates... It also includes more generous subsidies
than expected, making it easier for lower-income families to afford coverage.
And according to Congressional Budget Office estimates,... 96 percent of legal
residents too young to receive Medicare ... would get health insurance.
So should progressives get behind this plan? Yes. And they probably will. The
people who really have to make up their minds, then, are ... the self-proclaimed
The odd thing about this group is that while its members are clearly
uncomfortable with the idea of passing health care reform, they’re having a hard
time explaining exactly what their problem is. Or to be more precise and less
polite, they have been attacking proposed legislation for doing things it
doesn’t and for not doing things it does.
Thus, Senator Joseph Lieberman ... says, “I want to be able to vote for a health
bill, but my top concern is the deficit.” That would be a serious objection to
the proposals ... if they would, in fact, increase the deficit. But they
wouldn’t, at least according to the Congressional Budget Office...
Or consider the remarkable exchange that took place this week between Peter
Orszag, the White House budget director, and Fred Hiatt, The Washington Post’s
opinion editor. Mr. Hiatt had criticized Congress for not taking what he
considers the necessary steps to control health-care costs — namely, taxing
high-cost insurance plans and establishing an independent Medicare commission.
... Mr. Orszag pointed out, not too gently, that the Senate Finance Committee’s
bill actually includes both of the allegedly missing measures.
I won’t try to psychoanalyze the “naysayers”... I’d just urge them to take a
good hard look in the mirror. If they really want to align themselves with the
hard-line conservatives, if they just want to kill health reform, so be it. But
they shouldn’t hide behind claims that they really, truly would support health
care reform if only it were better designed.
For this is the moment of truth. The political environment is as favorable for
reform as it’s likely to get. The legislation on the table isn’t perfect, but
it’s as good as anyone could reasonably have expected. History is about to be
made — and everyone has to decide which side they’re on.
Posted by Mark Thoma on Friday, October 30, 2009 at 01:32 AM in Economics, Health Care, Politics |