Wouldn’t It Have Been Better For Republicans If They Cooperated With Health Care Reform?

By Justin Gardner | Related entries in Democrats, Health Care, health care reform, Legislation, Republicans

I noted some months back that it was smart politics for Republicans to compromise on health care. Yes, they’re the minority party, but if they had worked with Dems the size and scope would have been more to their liking. And they could have easily peeled off 2 or 3 moderate Dems so Reid and company couldn’t get to 60 votes.

From way back when…

Here’s another incentive for the Rs…their ideas get into the most important health care reform legislation in the past 50 years. Listen, they had the opportunity FOR DECADES to do something about health care and yet they sat on their hands and let millions go without health insurance, go bankrupt as a result of skyrocketing costs or simply were refused insurance because of pre-existing condition clauses. Well, now Repubs are seriously outnumbered and they’re in danger of not having a say if they don’t back the Baucus bill…which absolutely gives them a serious seat at the table. And, by the way, Dems don’t have to do that. And yet they are.

Instead, the party of “no” agreed to nothing and now they’re ending up getting even more of what they didn’t want.

Jonathan Chait notes this as well

But Republicans wouldn’t make that deal. The GOP leadership put immense pressure on all its members to withhold consent from any health care bill. The strategy had some logic to it: If all 40 Republicans voted no, then Democrats would need 60 votes to succeed, a monumentally difficult task. And if they did succeed, the bill would be seen as partisan and therefore too liberal, too big government. The spasm of anti-government activism over the summer helped lock the GOP into this strategy — no Republican could afford to risk the wrath of Tea Partiers convinced that any reform signed by Obama equaled socialism and death panels.

And you want to know who pushed moderate Dems over the edge?

You’ll never guess…

Lawmakers who attended a private meeting between Mr. Obama and Senate Democrats at the White House on Tuesday pointed to remarks there by Senator Evan Bayh, Democrat of Indiana, as providing some new inspiration.

Mr. Bayh said that the health care measure was the kind of public policy he had come to Washington to work on, according to officials who attended the session, and that he did not want to see the satisfied looks on the faces of Republican leaders if they succeeded in blocking the measure.

Yes, Mr. Centrist himself, Evan Bayh. The same Evan Byah who threatened to filibuster the bill with Republicans a few months ago.

My gut tells me that the GOP really overplayed this one and they’ll be feeling the aftershocks of not compromising for a long, long time. Especially if the CBO scores are right and this bill cuts trillions from the budget deficit in the next 20 years.

More as it develops…


This entry was posted on Sunday, December 20th, 2009 and is filed under Democrats, Health Care, health care reform, Legislation, Republicans. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

14 Responses to “Wouldn’t It Have Been Better For Republicans If They Cooperated With Health Care Reform?”

  1. kranky kritter Says:

    What number of democratic seats lost in the 2010 mid-terms would it take for you to change your tune? Pick a number.

    the bill would be seen as partisan and therefore too liberal, too big government. The spasm of anti-government activism over the summer helped lock the GOP into this strategy…

    Exactly. And we don’t know what the outcome is going to be as measured by public perception. So, presuming the bill passes, it is probably going to be seen as partisan and liberal according to Chait.

    Now, the GOP has to avoid overselling this. Looking over in the side column, I see someone saying “power-drunk” dems. That sort of stuff won’t sell, IMO. It’s obvious that the GOP wanted no part of this reform, so they ought not to waste time pretending they actually wanted to participate and make a deal. They didn’t. What the GOP needs to do is stress they they favor a fundamentally different approach, and describe some concrete instances where that approach needs to be applied, and how folks could benefit.

    This reform will be seen as the democrats’ baby, and Obama’s, for better or worse. I totally agree with you that the GOP will suffer if the CBO’s projections of savings are correct. But I have zero expectation that it will.

    Medicare reimbursement growth rates won’t track wishes in bills. They’ll track reality, which is to say they’ll track along the same growth rate in other healthcare spending…6, 7, 8 percent annually. If they don’t, we’ll start to see serious troubles with people on Medicare trying to find willing providers in some places.

    What would come after that? Easy! Droves of angry old people on medicare voting to punish democrats. So, we know that the democrats won’t let that happen. They’ll change the reimbursement rates to whatever level keeps sufficient providers on board medicare. So, no big savings from medicare cuts, folks. IMO, it’s fantasy, and I don’t believe it for a second. It’s pure bullshine.

  2. superdestroyer Says:

    Any Republicans who would have supported the health care reform (nationalization of health care) would be blamed for any future failures and given the Democrats a scape goat to blame. Now the Democrats have sole ownership of the reforms and will be responsible for the future outcomes. That is why the Democrats are worried.

    Now the Democrats have to hope that any failures come so far into the future that people will forget that they are solely responsible for them.

  3. Frank Hagan Says:

    The CBO has to score the bill as written, so if the Congress completes everything it proposes, then the estimate has validity. The problem is that no one expects Congress to complete the “doctor fix” (reducing payments to Medicare providers by 20-some percent), and no one expects all the nearly 600 billion in tax hikes to go through either.

    And the hard part is still ahead for the Democrats. The Senate bill, which is much more moderate than the House version, is unpopular in polling. In Conference, where the two bills are to be merged into one, any movement toward the House version makes it even more unpopular (and that much harder to get the final bill out of committee and on to the floor of the Senate).

    The GOP will delay as long as possible because sunlight is the best disinfectant, and people are just starting to understand the impact this bill will have. The looming election year for all of the House, and one third of the Senators, means the tightrope walking will be on the left side of the aisle, not the right. Republicans have very little to lose.

  4. Nick Benjamin Says:

    @kk
    Again under your scenario we should give up on America. If we cannot control health spending without killing people when we spend twice what anyone else does per capita we’ll be bankrupt in the next few decades. In that case the smart move is moving to England, because it’ll take a few more decades for them to run out of money.

    Moreover there are plenty of ways to cut costs without reducing what we pay providers for a given procedure. The most radical (which gets pilot programs in this bill) is to pay for results not treatments. ie: a Family Doctor who has x happy patients this year gets $x*y. Note that in hospitals this would be really helpful. Right now a hospital that has terrible sanitary practices has a competitive edge over everyone else because they get paid to treat all the infections they cause.

    Another is to deal with waste. And there’re some pretty big examples of waste in Medicare:
    http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

    It’s theoretically possible hat stuff won’t cut costs, but strictly speaking we don;t have to cut costs. We have to cut cost growth, and if we do that medical inflation will be cut (by definition).

    @Frank
    You got any polling on the House Bill vs. the Senate version?

    I’d bet that movement towards the House Bill actually makes it more popular. The Left likes the House bill, but is badly split on the Senate version. The right hates both. That leaves moderates, and apparently there’s no massive cohort of moderate voters who agree with Ben Nelson on policy because the entire package (aka: what Ben Nelson wants) always polls worse than the public option (the thing Ben Nelson says is too extreme).

    That doesn’t mean I think moving towards the House Bill is a good idea. We need Lieberman to win, and Lieberman has decided to turn this into a fight over who is alpha dog in the Senate: Progressives or Lieberman.

    IMO it’s tricky to see how this will play out in 2010. In 2010 the “American people” are irrelevant. Almost 2/3 of them simply won’t vote. The people who matter are crazy extremists. The crazy extremists on the right are apparently pissed off in general, ergo passing (or not passing) health reform won’t affect their turnout.

    The crazy extremists on the left are very pissed off today. But there’s almost a year between today and the next election. I believe they will conclude that it is not the Democrats fault that their pet public option died, it’s Lieberman’s, therefore they will show up.

    BTW, as of the 2010 election pretty much the only elements of the bill that will be implemented are things everyone likes. Rescission will be banned, kids will be able to use their mom’s insurance longer, the donut hole will close some etc.

    The other question is whether the GOP will splinter like they did in NY23. IMO if the tea-party types win most of their nomination battles it will be a mixed blessing for the Republicans. They’ll vote GOP rather then going for a third party candidate, but the small group of moderates who actually show up in 2010 will be pissed at them. But if the TP-faction loses all (or even some) of it’s primaries they’ll happily run their own candidates, which will screw the GOP.

  5. John Burke Says:

    Setting aside the merits of all versions of these bills, it’s very unlikely that the GOP would have made more headway in moderating the final bill by offering support. Had even one GOP Senator supported the Senate “floor” bill as conceived by Reid a couple of weeks ago, niether Lieberman nor Nelson nor any other Democratic Senator would have had the leverage to demand the modifications they secured. Looked at another way, a bipartisan bill forged by Obama and Reid with a few GOP supporters — necessarily a more moderate measure — would have made it impossible for moderate Dems not to sign on.

    In any case, Snowe did support the “Baucus bill” and was humiliated and shunted aside for her trouble. The simple fact is that with 60 members, the Dems never needed any GOP votes and never seriously sought them (except to make a tactical show). Instead, the Dems were always focused on sorting out their own significant differences to hold the 60.

    The result seems to be a deeply unpopular measure which will either be changed dramatically or become even more unpopular as it takes effect. In that sense, the GOP has insulated itslef from the fallout and positioned itself to flail Dem candidates with their own handiwork.

  6. Paul Says:

    It’s called political savvy and a lot of the Republicans do not have it. You get more bees with honey than you do with vinegar. Where is there a statesman among the GOP ?

  7. gerryf Says:

    I hate the Senate bill and don’t care for the House bill all that much.

    But I still think the GOP messed up.

    GOP Candidate: I opposed healthcare reform!

    Questioner: So you support a broken system that leaves millions of people without healthcare, allows for those with healthcare to be dropped for any reason, rewards insurance companies with insane profits?

    GOP Candidate: Uh, uh, uh….tax cuts! Bomb Iran! I love our country! Support the troops!

  8. Simon Says:

    Justin,
    Not so much.

  9. Justin Gardner Says:

    Simon,

    Really?

    In the end, when the history of the health care debate is written, I don’t think any of the choices that G.O.P. lawmakers made this year will loom particularly large. The choices that they made, or didn’t make, across the last fifteen years are what made all the difference. Between the defeat of Clintoncare and the election of Barack Obama, the Republicans had plenty of chances to take ownership of the health care issue and pass a significant reform along more free-market, cost-effective lines. They didn’t. The system deteriorated on their watch instead. And now they’re suffering the consequences.

    They could have defined the debate and yet the did nothing.

    Case closed.

  10. Nick Benjamin Says:

    @John:
    You’re argument is irrelevant. Yes if the GOP had been total obstructionists up until like yesterday, and then one of them had said “hey maybe I should not be an obstructionist” yesterday they would have have gained jack-squat.

    But Justin is not arguing that particular scenario. He’s arguing they should have been constructive in August and September, or perhaps supported something like Wyden-Bennett in January. Wyden-Bennett would have been tricky, because it totally breaks the link between a job and health insurance, which means unions and employers hate it. The fact that it’s paid for by taxing health benefits as income doesn’t help. But if, in January, 20 GOP Senators had signed a pledge not to filibuster it Wyden may have been able to overcome those objections.

    Or they’d demanded a lower price tag, better cost-controls, etc. they may have gotten them.

  11. mike mcEachran Says:

    The GOP’s hand was forced – to resist at all costs – specifically BECAUSE they’ve done nothing for the past 15-20 years or more. They have been hoisted on their own petard. If they started compromising on insurance reform now that the Dems are in charge, they would be implicitely admitting they f*&^ed up all those years, and handing the Dems a moral victory just by participating. They couldn’t do that, for heaven’s sake, so they were forced to go back to their old playbook and resist at any cost. Unfortunately for them, the cost is going to be very high.

  12. kranky kritter Says:

    Again under your scenario we should give up on America.

    Not sure what this is supposed to mean. Under my scenario. we do the realistic math, and then we plan accordingly. So you can place your insulting hyperbole in whatever cavity you deem appropriate. Because being unrealistic about the math is a very twisted and perverse way for YOU to give up on America. (Since we’re apparently impugning patriotism).

    It’s theoretically possible that stuff won’t cut costs, but strictly speaking we don’t have to cut costs. We have to cut cost growth, and if we do that medical inflation will be cut (by definition).

    Right. So? The medicare “cuts” are reductions in the planned growth rate of reimbursements to providers. Cuts in cost growth have been reduced (for the time being) by decree. You think that this is going to work, and that the deficit is going to be cut when we realize these future savings.

    I DON’T think this is going to work. Further, I don’t think it’s even going to be really tried. As time passes, congress will adjust medicare reimbursement rates to be in line with the average healthcare inflation rate. If they don’t come close to tracking this, they’ll risk problems with providers, and angry old people on medicare, etc., etc.

    Look, I’ve been simple and clear. Whatever else this reform does, I don’t think it will save money for the government. I’m quite comfortable that time will bear me out on this.

    I’m glad that more poor people will have access to medical care in a non-emergency environment. I’m glad for a few of the other proposed changes too. But these changes are going to be costly, and the money will have to come from somewhere. It will most likely come from taxes and decreased purchasing power for the dollar, and will probably adversely affect our standard of living in domains outside of healthcare.

    There are probably some fair-minded progressives out there who would respond to that by saying “So what? That’s a reasonable trade off.” And I’d say Bravo, because at least that would be an honest and defensible argument.

    It’s the trying to have it both ways that really frosts me. More people will get more healthcare, and the overall tab is going to go down? Ok. Sure. Spare me. You have to be innumerate to believe that.

  13. The Realities Of Passing Health Care & The Risks Of Not - Justin Gardner - Political Pulse - True/Slant Says:

    [...] care bill was more important than being involved in the process. I thought that was foolish, and still do. Sure, they’ll pick up some seats next year, but they weren’t involved in the most [...]

  14. Donklephant » Blog Archive » The Realities Of Passing Health Care & The Risks Of Not Says:

    […] care bill was more important than being involved in the process. I thought that was foolish, and still do. Sure, they’ll pick up some seats next year, but they weren’t involved in the most […]

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