Monday, December 21, 2009

Health care reform: It all comes down to reconciliation

There is a scene in "The Godfather" (arguably Francis Ford Coppola's masterwork) wherein Don Vito Corleone reveals what he has learned from a meeting of the Five Families.  Up to that point, the Corleone family had thought the rival Tattaglia family was behind the gangster aggression that had killed Vito's eldest son, Santino.  But at the meeting, Don Corleone learned the truth.  On the ride home, he tells his consigliere, Tom Hagan:  "Tattaglia is a pimp.  He could never have out-fought Santino.  I should have known that it was Barzini all along."

As the health care debate in the US Senate lurches toward its ugly conclusion, the progressives among us are left feeling much as Don Corleone must have felt during that car ride.  All this time we had thought the Republicans were the prime enemies of real health care reform.  But it turns out that, like Bruno Tattaglia, Senate Republicans are just pimps.  (I'm being charitable).  The real enemies have been  Stinky Joe Lieberman (CT) and Ben Nelson (NE) all along.

Both of these "esteemed" senators have used the precarious balance of power in the Senate to pursue their own agendas, have leveraged their positions to the utmost.  Well, after all, this is the US Senate, and senators will do that.  But Lieberman, in particular, has been crass and overt about it:  changing his position on the so-called Medicare expansion, which he supported as recently as September, in order to extract the most benefit he can from the process.

The news came down last weekend that Harry Reid now believes he has the 60 votes needed to invoke cloture on the debate and pass a health care reform bill.  But the bill that he will pass does not include a public option, nor does it include an expansion of Medicare, the two most attractive provisions of reform (from a progressive point of view).  Some progressives, including former Vermont governor and presidential candidate Howard Dean, have gone so far as to call for liberal senators to kill the bill.  (Dean has since backed off on that.) 

I believe that, without a public option, or some kind of expansion of a publicly-run health care system, any so-called health care reform will be nothing more than another sop to health insurance providers.  And, indeed, stocks for health insurance companies hit a 52 week high last Friday on the news that an agreement may have been reached that did not include a public option nor an expansion of Medicare.  The bill that is proposed would mandate that individuals buy health insurance from private companies.  Get it?  We would all be required to pay money to health insurance companies so that they can continue to deny our health care claims.  Salad days ahead for insurance company executives!

The Obama administration has been pathetic and detrimental to the progressive cause.  I grant that President Obama sees himself as a facilitator and a shepherd, but after all, a well-placed word or two would be enormously beneficial.   I ask again, "What's it gonna be, Barack?"

But don't despair yet, progressives.  Remember that the bill passed by the US House of Representatives includes a strong public option.  (Thank you, Nancy Pelosi.)  After the Senate passes its monstrosity, the two bills will go to conference and undergo reconciliation.

I don't understand all the parliamentary procedures involved, but I believe that the reconciliation process provides alternatives that would allow for the bill to be presented to the two legislative bodies such that it can be passed by simple majority, rather than require that it overcome a Republican filibuster.  So, if my understanding is correct, we could still come out of this with either a real public option, or with an expansion of Medicare.

This entire process has been educational, certainly.  We've all heard pundits liken the legislative process to sausage-making:  the result might be good, but the procedure is ugly.  Well, this nightmare debate has proven the truth of that analogy.  But I'm still holding my breath, hoping that real reform that diminishes the power of the insurance companies and the corporate plutocrats will emerge.

If that happens, we're on our way.  If not, it is hard to imagine that we can ever again wrest power from them through political means.

1 comment:

Anonymous said...

thanks Dade for that beautiful explanation. I am not sure I am holding out any hope for these folks to do the right thing but as we all know i am a die-hard so i'll hang in there........jeanne