It's looking more and more like the Gang of Six is going to fail. Every time the Democrats float a compromise (Coops instead of public option) the Republicans want more.
Obama and the Democrats need to face the simple fact:
No meaningful health care reform bill will attract more than 2 or 3 Republican votes in the Senate and 0-20 votes in the House. The list of items we will have to compromise away is pretty much all the meat and most of the potatoes.
Basically the GOP idea of health care reform boils down to:
- An unsubsidized individual mandate that will mostly force 47 million more people into the private insurance markets where they will have typically only have 1 or two companies to choose from. Most will be forced to buy plans that don't really cover anything leaving them worse off than before.
- In exchange for an endless source of profit, the insurance industry will agree to accept everyone regardless of preexisting conditions and will no longer rescind coverage on technicalities.
- Gutting state insurance regulation and allowing the lowest standard to become the national standard, just like in consumer financial services. All the insurers relocate to North Dakota and Delaware or wherever regulation is the most lax.
- "Tort reform" whereby the government further erodes a person's common law right to sue for damages from medical errors, malpractice and most importantly unjust insurance company denials and harm from drugs.
- A bigger federal deficit since they refuse to raise taxes or cut waste.
Things the GOP will oppose:
- Employer mandates
- Raising taxes on the rich to make it the bill deficit neutral.
- A public insurance option.
- Any co-op system, in lieu of a public option, that would actually put pressure on the insurers
- Subsidies large enough to ensure universal coverage and not just leave a worthless individual mandate that people can't afford.
- Medicare negotiating the price of drugs, despite it saving the government tens of billions, if they could.
- Comparative effectiveness research, even though there are no plans to use it for coverage decisions.
- Anything to do with female reproductive health care coverage (abortion, contraceptives, Plan B, or counseling about the above)
- Anything to do with end-of-life care and consultation towards that care, even though many Republicans previously supported this.
- Regulating a minimum standard insurance plan so that people are not tricked into buying insurance that doesn't cover anything.
Big insurance and Big Pharma get to keep looting the country for another decade or two until the employer based system collapses entirely.
Obama and the Democrats in Congress need to get on the train. They did not win by huge margins because their supporters wanted them to do whatever the GOP wanted.
The very first bullet point in the Democratic Party Platform for 2008 is:
Affordable, Quality Health Care Coverage for All Americans
Mr. President, that is why we voted for you. We did not think it was a typo. You ran as a pragmatist. Pragmatists solve problems. This problem has lingered for too long and everyone knows what a real solution looks like.
It's time to put up or shut up, because if this is not the issue for which you want to spend your political capital, then what is? If health care reform works well you will be reelected, if you let it become just another Congressional resolution expressing the sentiment of the Congress that it sucks to be poor then you are going to spend 2013 working for habitat for humanity, wondering how in the world whatever nutcase the GOP nominates managed to beat you.