As Jed Lewison reported on the front page yesterday, Tom Carper has offered his entry into this year's Most Stupid and Counterproductive Statements by a Senate Democrat about Health Care Reform Sweepstakes," and it looks like a definite contender:
I’ve said all along with Mike Enzi, from Wyoming, we agree on 80% of this stuff, maybe more. And at the end of the day what we need to do is focus on the 80% that we agree on, maybe set aside the 20% that we don’t agree on for some other day. And I hope at the end of the day that’s what we’ll do.
All right, Sen. Carper -- I might be able to live with that. Let's ask, though, what 80% do we agree on?
We agree on reforms regarding pre-existing conditions. We do not agree about a universal mandate for people to buy their own health insurance. I can explain the reason for you in four words:
"Man. Date. Wind. Fall."
Now, admittedly, this is actually two words, but as the concept seems to be a bit difficult for you to get thus far, I thought I had better break it down into words of one syllable each.
"Mandate windfall" is a term that was introduced by Koster War on Error over two months ago and has since been banged on like a fine drum by Koster good grief, including, I'm proud to say, in at least one of my diaries. As that last link suggests, we both believe that the key to winning the health care debate is to stressing to people the unpalatable nature of the universal mandate if it is not tied to a public option. (You don't have to buy that it is a tax, but you ought to buy that it will seem to people like a new tax -- as the recently polling on the universal mandate with and without the public option bears out).
In other words, talk about the mandate before the public option. That 80% that Carper is talking about? That's insurance regulation reform. What Carper doesn't seem to get yet is that it is only insurance regulation reform that is widely accepted by both the public and the Senate.
Here's an analogy to help thinking about our proposal:
Pre-existing condition reform = dessert (yay!)
Universal mandate = bill for dessert (uh-oh!)
Public option = steep discount on that bill (yay!)
What Carper does not understand -- perhaps because he spends his time with industry leaders who no doubt strain to avoid appearing that way -- is that health insurers have a terrible reputation these days to which the Democratic Party must not -- and I predict will not -- bind itself.
Essentially, Carper does not understand that in the public mind, health insurers are largely villains.
Now, the health insurers have already won some huge victories in this year's battle. There will be no single-payer plan, meaning that they will continue to exist as more than just companies providing the equivalent of "Medi-Gap" insurance. Even under a robust public option, they will continue to thrive as a quite viable industry, so long as they can compete with fair competition from a plan that doesn't exist to generate profits.
The public can live with that. But what it cannot live with is the idea that health insurers are going to use the power of the government to suck consumers dry. The public cannot accept that insurers may get a mandate windfall.
THAT is what will kill us, if it is allowed to happen. Not the mandate itself, the notion that -- without Republican support -- Democrats will pass a bill that offers a lot of vague promises but only one actual guarantee: that health insurers will make a huge amount of new money. We cannot shovel that windfall to corporate lobbyists. And we won't.
So, Sen. Carper, by all means: pass the "80%" -- the health insurance reforms -- without the supposedly controversial "20%" of a universal mandate and a public option. Do that, and we're in the catbird seat: insurers, rather than seeing their businesses ruined, will be begging us to pass a universal mandate -- even at the price of including a public option. But if we include the universal mandate within that 20%, they have no incentive not to drag their heels.
Man. Date. Wind. Fall. Mandate windfall. Maybe we just need to repeat that phrase often enough for Sen. Carper to understand it. If he doesn't understand it, he is asking for more trouble than he can imagine. Luckily, we're never going to let such a horrible "80% of a proposal" pass.