The End Of Obstructionism?
by dday
Henry Waxman is refusing to let the Blue Dogs make chicken salad out of the House health care bill. He's talking about bypassing his committee entirely and bringing the bill already voted out of two other committees to the floor.
As it turns out, I was on NPR's Tell Me More this morning talking about health care, and one of my co-guests was Henry Cuellar, a Blue Dog. 30 minutes goes fast with three guests, so I didn't get to confront him and his arguments as much as I wanted. For instance, McAllen, TX, is in his district, and that was the subject of the widely touted Atul Gawande piece in The New Yorker about disparities in health care delivery and effectiveness. But Cuellar pretty much harped on costs, costs, costs as an impediment to getting something done. I countered that cost control and expanding access, in many cases, are complementary. This makes the Blue Dog argument incoherent. They want to cut costs, but they are reluctant to enact the reforms that actually would do it. Not to mention the fact that they talk of fiscal responsibility while trying to carve out funding for rural health care, for example, which is the exact opposite of cost-cutting. And Steven Pearlstein picked up on this today.
The challenge for the Blue Dogs is that they want an America where everyone has insurance but are reluctant to force workers to buy it or employers to help pay for it.
They understand that achieving universal coverage will require subsidies for low-income workers and small businesses, but they insist that none of those changes add to the federal deficit or raise anyone's taxes.
They want to introduce more competition into the private insurance market, but not if it comes from a government-run insurance plan.
They complain constantly about the need to rein in runaway Medicare costs while at the same time demanding higher Medicare reimbursement rates for doctors and hospitals in rural areas.
You see what I mean about mushy centrism?
Yes. Yes I do.
The truth is that the Blue Dogs are slaves to entrenched power, serving the interests of powerful lobbies rather than the middle-income voters in their districts. Cutting subsidies to 300% of poverty level from 400% would make health care less affordable to working people - and it's only being considered in the House because Blue Dogs want to protect those making half a million a year from a surtax.
Which is why Waxman is absolutely in the right to do this. The Blue Dogs, cheered on by Republicans, are simply standing in the way of progress. You can tell because their arguments lack logic and coherence. They apparently got the President's MedPAC proposal in the bill, as part of a larger deal over reducing regional disparities in Medicare reimbursements, but other measures that reduce costs they resist. And measures that increase costs they favor. They exist at this point to be nothing more than sand in the gears.
At some point, I think you do have to pull the trigger. Matt Yglesias makes the moral case, that good legislation matters more than good process.
Something a lot of progressive legislative leaders seem to have forgotten until this Congress actually got under way is that historically congressional procedure is a challenge to be surmounted when you want big change to happen. It’s not actually a fixed feature of the landscape that people “have to” accommodate themselves to. For years you couldn’t get a decent Civil Rights bill because segregationists controlled the Judiciary Committee that had jurisdiction. This problem was “solved” by just deciding to bypass the Judiciary Committee. When you decide you want to get things done, you find a way to get them done. Even the allegedly sacrosanct filibuster rule has been changed repeatedly over the years. The law is the law and the constitution is the constitution, but the rules of congressional procedure are not law. They’re internally made rules, they’re subject to change, and the criteria for a good set of rules is that you want rules that produce good legislation and good governance.
If the internal rules are in place you should work to change them if they obstruct a change both the majority of Americans and the majority of the Congress clearly want.
...and now, the Blue Dogs are claiming that talks fell apart this afternoon. I don't know how that squares with the "breakthrough" earlier in the day, but it looks like something's amiss. Will Waxman just report out the bill anyway and move it to the floor?
...I have to say that Mike Ross, head Blue Dog negotiator in this case, appears to be full of it. He says that Waxman took things off the table that, an hour before, Waxman was hailing in public as part of a breakthrough agreement? Doesn't pass the smell test. Someone's lying.
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