Thursday, December 17, 2009

Kids, we're still not there yet

There still seem to be some Democratic senators who aren't happy with the Reid bill - at least we assume that there is a bill, although there doesn't seem to be one written. And we're still waiting for that CBO report. I guess it's hard to analyze the costs when the thing keeps changing.

Ben Nelson isn't there yet.
Centrist Democratic Sen. Ben Nelson (Neb.) said Thursday he won't vote to advance the Senate healthcare bill unless it is changed.

Nelson said more stringent restrictions on the use of federal funds for abortion must be included in the bill if it is to win his vote.

"If it's not at the point where I think it needs to be with the improvements that I'm pushing — and they've made a lot of them — then I will not vote for cloture on the motion to end debate," Nelson said in an interview on KLIN radio in Nebraska.

"There's a lot of improvement on the legislation but the basic question on funding for abortion hasn't been answered yet," he said.
And now Socialist Bernie Sanders is asking for some of that Lieberman-love.
I’m struggling with this. As of this point, I’m not voting for the bill. … I’m going to do my best to make this bill a better bill, a bill that I can vote for, but I’ve indicated both to the White House and the Democratic leadership that my vote is not secure at this point. And here is the reason. When the public option was withdrawn, because of Lieberman’s action, what I worry about is how do you control escalating health care costs?
It's not clear yet if that means he's going to vote against cloture or just against the final bill. But if Joe Lieberman could hold out and get what he wanted, others might see if it's worth it for them to be a bit obstreperous and see what it gets them. Let's see if the left unloads on him the way they did on Lieberman.

As Yuval Levin writes, what is left of the proposals is unappealing to both liberals and conservatives.
In essence, what's left of the bill compels universal participation in a system that everyone agrees is a failure without reforming that system, and even exacerbates its foremost problem — the problem of exploding costs.

Conservatives in this debate have argued that the tradeoff proposed by the original Democratic concept — massive spending, massive taxes, huge cuts in Medicare that don't address the problem with the program and instead fund a new entitlement, and a proliferation of additional bureaucracy all in return for a significant socialization of the insurance system — is not a wise bargain for the country. Democrats have argued that the bargain would allow the government to control costs and would make the system more fair. In the course of working to get the votes of various senators, however, the Democrats have given up not the downsides of the bargain but the reasons for voting for it from their own point of view.

What remains, as my Ethics and Public Policy Center colleague Jim Capretta has argued, is a bill that requires all Americans to pay large and growing premiums to our existing private insurance companies. It then prohibits those companies from charging people differently based on their health, age, and the like, which means they will just charge everyone more. The bill has some subsidies to help people who can’t pay their premiums, but that just means that most Americans will be paying the insurance companies more and more for premiums both as individual health insurance customers and as taxpayers. The bill is basically a massive subsidy to the insurers — it is not a reform of the system.

Liberals and conservatives in recent years have tended to agree that the health-insurance system we have doesn’t make sense. Several federal government policies, and most notably the structure of Medicare and the employer tax exclusion, lead to massive cost inflation. They have disagreed over how to move away from that system — with the Left arguing we should move toward a more socialized system of insurance, and the Right arguing we should move toward a genuine individual insurance market while reforming Medicare. But what is left of this bill doesn’t pick either of those options. It just subsidizes the existing system — which both sides agree is a failure. And it does so at very great expense, while also adding on some layers of bureaucracy and complexity.

For conservatives, this version of the bill is not as bad as what the Democrats originally proposed (because it involves less abject socialization of health insurance), but it is still significantly worse than the status quo (because of the spending, taxes, bureaucracy, and new entitlement involved). For liberals, it is not as good as the bill the Democrats originally proposed, and it is also worse than the status quo — because it funnels huge amounts of money to the insurance companies they hate so much and doesn’t really change the system.
So if both liberals and conservatives think that the bill is worse than the status quo, what is the logic in voting for it? Is it just to have that signing ceremony for Obama to crow about his historic achievement? Is the show that much more important than the substance? And do you think that voters are so terribly dumb that they can't recognize a turkey when they see it? If we ever get to see what it is that Reid has put together.

Crafting legislation is supposed to be like making sausage. But this is getting to be like the sausage in Upton Sinclair's The Jungle - totally unappetizing and bad for everyone.