This item is crossposted from The New Republic.
I wrote a piece the other day examining the ideological underpinnings of the left/center split in the Democratic Party over the propriety of a universal health care system based on regulated and subsidized private health insurers. I suggested there was a burgeoning, if questionably workable, tactical alliance between “social-democratic” progressives and some conservatives to derail much of the Obama overall agenda. Then I made this observation:

[O]n a widening range of issues, Obama’s critics to the right say he’s engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. They can’t both be right, of course, and these critics would take the country in completely different directions if given a chance. But the tactical convergence is there if they choose to pursue it.

This statement has drawn considerable comment from people on both the Right and Left, mainly objecting to the argument that Obama’s critics can’t all be right.
Conservative theoretician Reihan Salam, writing for National Review, first argued that there’s not much substantive difference between the “New Democrat” deployment of private-sector entities in public initiatives and that favored by the privatizers of the Right. But then he pirouetted to make common cause with Obama’s critics on the Left:

It is entirely possible for both sets of critics to be correct. The concern from the right isn’t that the Obama approach will literally nationalize for-profit health insurers. Rather, it is that for-profit health insurers will continue evolving into heavily subsidized firms that function as public utilities, and that seek advantage by gaming the political process. Profits, including profits governed by medical loss ratios, can and will then be cycled into political action, which leads to the anxiety concerning a “corporate takeover of the public sector.”

Salam’s friend Ross Douthat of The New York Times added an “amen” to this argument:

The point is that the more intertwined industry and government become, the harder it is to discern who’s “taking over” whom — and the less it matters, because the taxpayer is taking it on the chin either way.

But do conservatives really oppose this intertwining of industry and government? Rhetorically, yes, operationally—not so much. Consider the default-drive Republican approach to health care reform, such as it is. It typically begins with federal preemption of state medical malpractice laws and health insurance regulation, the latter intended to produce a national market for private insurance (while also, not coincidentally, eliminating existing state provisions designed to prevent discriminatory practices). But the centerpiece is invariably large federal tax credits, accompanied by killing off the current tax deduction for employer-provided coverage, all designed to massively subsidize the purchase of private health insurance by individuals (with or without, depending on the proposal, any sort of group purchases for high-risk individuals). Another conservative pet rock is federal support for Health Savings Accounts, which encourage healthy people to pay cash for most medical services, perhaps supplemented by (very profitable) private catastrophic insurance policies. And most conservatives, when they aren’t “Medagoguing” Democratic proposals to rein in Medicare costs, favor “voucherizing” Medicare benefits—another gigantic subsidy for private health insurers.
Now some conservatives will privately tell you that all these subsidy-and-deregulation schemes are just an interim “solution” towards that great gettin’ up morning when tax rates can be massively lowered, all the tax credits, vouchers and other subsidies can be eliminated, and the government gets out of the health insurance business entirely. But don’t expect to see that on any campaign manifestos in the foreseeable future. In the meantime, Republicans generally support huge government subsidies to corporations without any public-spirited regulatory concessions in return.
Do anti-“corporatist” progressives really think they can make common cause with conservatives, beyond deep-sixing Obama’s agenda in the short term? Well, sorta kinda. Salon’s Glenn Greenwald, who rejected my “incompatibility” argument about left and right critics of “corporatism” as strongly as did Salam, is smart and honest enough to acknowledge there’s no real common ground with conventional conservatives or Republican pols. He instead offers a vision of an “outsider” coalition that includes anti-corporatist progressives and Tea Party types. This is, of course, the age-old “populist” dream (most famously articulated by Tom Frank in What’s the Matter With Kansas?) of a progressive takeover of the Democratic Party that attracts millions of current GOP voters (or nonvoters) who don’t share the economic interests of the Republican Party or the conservative movement but have seen little difference between the two parties.
All I can say is: Good luck with that, Glenn. Short of a complete and immediate revolution within one or both parties, complete with blood purges and electoral chaos, it’s hard to see any vehicle for a left-right “populist” alliance other than a Lou Dobbs presidential run. Barring that unlikely convergence, wrecking Obama’s “corporate” agenda would produce little more on the horizon than a return to the kind of governance we enjoyed during the Bush years, or maybe a bit worse given the current savage trajectory of the GOP.
Part of my intention in the original essay was to suggest that pro-Obama Democrats take seriously the views of intra-party rebels on health care and other issues, instead of insulting them as impractical and childish or obsessed with meaningless totems like the “public option” (which in the anti-corporatist context isn’t meaningless at all). But said rebels really do need to think through where they are going, and where they would take Democrats and the progressive coalition.
Meanwhile, conservatives need to be far less pious about their alleged objections to “corporatism.” Cheap rhetoric aside, their own agenda (when it’s not just preserving the status quo) is largely corporatism with any clear and enforceable public purpose cast aside whenever possible.

The big news coming out of the weekend was that the Senate invoked cloture on health care reform, as President Obama personally brokered an interim deal on climate change in Copenhagen after the negotiations had all but collapsed. Not a bad few days for the White House,
But at Politico, here were the two headlines on these developments this morning: “Health Plans On Collision Course,” and “Copenhagen Fizzle Won’t Help Bill.”
That’s some serious glass-half-empty analysis.

So: at about one o’clock this morning, the United States Senate, or at least the 60 members of its Democratic Caucus, passed the long-awaited cloture vote to proceed to a final consideration of a health care reform bill.
As one who has had an irrational faith that the Senate would get to this point somehow or other, I have to say it was still an improbable accomplishment.
As recently as a few days ago, Joe Lieberman looked all but unreachable for this vote. Then Ben Nelson looked unreachable, even as Republicans Olympia Snowe and Susan Collins made it clear they had decided that nearly a year of begging from the White House and Senate Democrats wasn’t enough to overcome the right-wing heat they were experiencing. Then Democrats like Sherrod Brown and Bernie Sanders came under intense pressure to hold up the bill from progressives determined to derail the latest deal and force a recourse to a 2010 reconciliation strategy.
More fundamentally, a 60-vote Democratic Caucus was an exceptionally improbable achievement. It took (a) a near-sweep by Democrats of winnable seats in 2008; (b) a complex deal to keep arch-apostate Lieberman in the Caucus; (c) a favorable resolution of the near-tie vote in Minnesota after months of GOP legal obstruction; and (d) swift action by the Massachusetts legislature to provide for an interim Senator to replace the late Ted Kennedy.
It all came down to a one a.m. vote after a rare Washington snow storm, with Republicans openly praying that someone (i.e., the infirm Robert Byrd of West Virginia) wouldn’t be physically present.
The current conservative caterwauling about a “rushed” vote is pretty hilarious, given the endless delays undertaken by Senate Democrats all summer and early fall in an effort to engage Republicans, the open and notorious GOP strategy of running out the clock (reminiscent of the Bush strategy for securing the presidency nine years ago), and the front-page status of every detail of the legislation since last spring. Does anyone doubt for a moment that if Democrats had gone along and delayed final Senate action until after the holidays, the same people whining about their spoiled Christmas would be demanding the legislation be put off until after the 2010 elections? Indeed, that’s what we will in fact be hearing in January when a House-Senate conference committee completes its work.
That conference committee, and the House and Senate votes necessary to ratify its report, is far from a slam dunk, given House Democratic resentment of Senate deal-making, and substantive disputes on issues ranging from the public option to abortion. But the struggle to get to 60 votes in the Senate makes the endgame of health care reform look manageable by contrast.

In the most predictable column you could imagine, today the New York Times’ David Brooks dances around the pending Senate health reform bill, moving hither and yon, touting up reasons to like it and reasons to hate it.
And then, of course, he sides with the GOP in opposing the bill–not really because he objects to its provisions, but because it falls short of his goals for health care cost containment, and might let irresponsible Americans continue to get too much health care.
It was the Brooks formula for thoughtfully disdaining both sides of messy debates, and somehow always lining up with the immediate positions of the Republican Party.
Brooks or his editors entitled the column “The Hardest Call.” Funny–it was a call that was amazingly easy to spot from a far distance.

In a post yesterday, I argued that some intra-progressive fights reflect ideological differences, particularly over the role of private-sector entities in pursuing progressive policy goals, that need to be taken more seriously, in part because failing to acknowledge them often makes such fights nasty exercises in name-calling and character attacks.
There’s another broad area where differences of opinion often originate, and that must be understood as well: differing political strategies.
Two Examples of Strategic Disconnect
Consider two examples: Democratic political operatives and progressive “issue” advocates.
Many full-time political operatives undoubtedly have a personal ideology, or more generally, a reason for being a Democrat. Some have the opportunity to reflect those views in primary campaigns, or in where and on whose behalf they practice their craft. But by and large, when a general election comes along, it’s all about Ds and Rs and Us and Them, and this orientation tends to color how they feel between elections. Anything that promotes the election of a maximum number of Democrats–any kind of Democrat–to public office is more or less the Prime Objective. There are obviously major differences of opinion about how to achieve this result, short-term or long-term, and ideology play a role there as well. But the bottom line is probably best expressed by an old ditty from the presidential campaign of 1892, when Grover Cleveland’s comeback election marked the end of a period of fierce partisan competition and very little ideological differentiation between the parties:
Grover! Grover!
Four more years of Grover!
Out they go, in we go,
Then we’ll be in clover!
Not much deep thinking there, eh?
At the other end of the spectrum, there are “issue” advocates who are involved in politics not out of some broad commitment to a progressive coalition but out of concern for a particular cause, often arising from or rising to the level of personal identity. The relationship of issue advocates to a political party is by definition conditional and instrumental: I support you if you advance my cause, or at least smite the enemies of my cause. Such relationships were much, much weaker in the many decades prior to the Great Ideological Sorting-Out of the two major parties that culminated in the 1990s. As recently as the 1960s and 1970s, supporters and opponents of civil rights for African-Americans, women’s rights, antiwar movements, environmentalism, and to some extent even labor rights, were found abundantly in both parties. So progressive issue advocates might be Democrats, Republicans, or independents, but were often functionally independent in their basic relationship to political parties.
Nowadays, when a politician’s position on, say, Union Card Check is a generally reliable predictor of his or her position on abortion or climate change, progressive issue advocates are obviously constrained, and must focus on maximizing influence within the Democratic Party alone. That can be done in noncontroversial ways, such as grassroots organizing, petitions, the cultivation of favored candidates and elected officials, and of course efforts to promote or modify legislation or executive actions. But in the end, issue advocates are largely prisoners of a polarized political system, and must rely in the extreme on threats to sit out elections or even defect from the coalition. That’s where some LGBT activists, some civil libertarians, and some antiwar activists, seem to be right now.
To those whose commitment to the Democratic Party is less conditional, such threats often look selfish, destructive, or even childish. But they are perfectly rational, if sometimes short-sighted: if you are engaged in politics for a cause, that cause’s prospects have to be paramount, and absent the occasional threat to defect, your cause and its advocates can be taken for granted, which is the death-knell of political influence.
But what if a variety of “cause” advocates reach this point of frustration simultanously? Then you can have a genuine “revolt,” which some Democrats fear or hope is in the process of happening out of progressive unhappiness with Barack Obama and the congressional Democratic Party on issues ranging from civil liberties and health care to LGBT rights, Afghanistan, and the financial system.

Read more…

The latest intra-progressive dustup over health care reform displays a couple of pretty important potential fault lines within the American center-left. One has to do with political strategy, and the role of the Democratic Party and the presidency in promoting progressive policy goals and social movements. I’ll be writing about that subject extensively in the coming days.
But the other potential fault line is ideological, and is sometimes hard to discern because it extends across a variety of issues. To put it simply, and perhaps over-simply, on a variety of fronts (most notably financial restructuring and health care reform, but arguably on climate change as well), the Obama administration has chosen the strategy of deploying regulated and subsidized private sector entities to achieve progressive policy results. This approach was a hallmark of the so-called Clintonian, “New Democrat” movement, and the broader international movement sometimes referred to as “the Third Way,” which often defended the use of private means for public ends. (It’s also arguably central to the American liberal tradition going back to Woodrow Wilson, and is even evident in parts of the New Deal and Great Society initiatives alongside elements of the “social democratic” tradition, which is characterized by support for publicly operated programs in key areas).
To be clear, this is not the same as the conservative “privatization” strategy, which simply devolves public responsibilities to private entities without much in the way of regulation. In education policy, to cite one example, New Democrats (and the Obama administration) have championed charter public schools, which are highly regulated but privately operated schools that receive public funds in exchange for successful performance of publicly-defined tasks. Conservatives have typically called for private-school vouchers, which simply shift public funds to private schools more or less unconditionally, on the theory that they know best how to educate children.
Now clear as this distinction seems to “New Democrats,” there are a considerable number of progressives who think it’s largely a distinction without a difference, in education policy and elsewhere. And we are seeing that fundamental divergence on opinion on other, more prominent issues right now. On the financial front, the Obama administration reflexively pursued a strategy of regulation and subsidies for the financial sector, without modifying the fundamental nature of financial institutions, even as critics on the left argued for nationalization (at least temporarily) of key financial functions. At the more popular level, critics of TARP from the left joined critics of TARP from the right in deploring “bailouts” of failed financial institutions, even though the two groups of critics held vastly different views of the right alternative course of action.
Similarly in the health care reform debate, the Obama administration pursued legislation that utilized regulated and subsidized private for-profit health insurers to achieve universal health coverage. This approach was inherently flawed to “single-payer” advocates on the left, who strongly believe that private for-profit health insurers are the main problem in the U.S. health care system. The difference was for a long time papered over by the cleverly devised “public option,” which was acceptable to many New Democrat types as a way of ensuring robust competition among private insurers, and which became crucial to single-payer advocates who viewed it as a way to gradually introduce a superior, publicly-operated form of health insurance to those not covered by existing public programs like Medicare and Medicaid. (That’s why the effort to substitute a Medicare buy-in for the public option, which Joe Lieberman killed this week, received such a strong positive response from many progressives whose ultimate goal is an expansion of Medicare-style coverage to all Americans).
Now that the public option compromise is apparently no longer on the table, and there’s no Medicare buy-in to offer single-payer advocates an alternative path to the kind of system they favor, it’s hardly surprising that some progressives have gone into open opposition, and are using the kind of outraged and categorical language deployed by Marcy Wheeler yesterday. As with the financial issue, there’s now a tactical alliance between conservative critics of “ObamaCare,” who view the regulation and subsidization of private health insurers as “socialism,” and progressive critics of the legislation who view the same features as representing “neo-feudalism.”
To put it more bluntly, on a widening range of issues, Obama’s critics to the right say he’s engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. They can’t both be right, of course, and these critics would take the country in completely different directions if given a chance. But the tactical convergence is there if they choose to pursue it.
For those of us whose primary interest is progressive unity and political success for the Democratic Party, it’s very tempting to downplay or even ignore this potential fault-line and the left-right convergence it makes possible. It’s also easy to dismiss critics-from-the-left of Obama as people primarily interested in long-range movement-building rather than short-term political success; that’s true for some of them. But sorting out these differences in ideology and perspective is, in my opinion, essential to the progressive political project. And with a rejuvenated and increasingly radical Right’s hounds baying and sniffing at the doors of the Capitol, we don’t have the time or energy to spare in dialogues of the deaf wherein we call each other names while getting ready for the elections of 2010 and 2012.
UPDATE: In discussing this post with several friends, I recognize I should be very clear about my motives here. I am not trying to promote an ideological fight within the Democratic Party or the progressive coalition, and don’t want to exaggerate ideological differences, either. But ideology, however muddled, is part of what makes most politically active people tick. And if we don’t talk about it–and about differences in strategic thinking as well, which will be the subject of future discussions here–then all we are left with to explain our differences on this issue or that is questions of character. And anyone paying attention must recognize there’s far too much of that going on. “Progressive pragmatists”–the camp with which I most often personally identify, as it happens–often treat “the Left” condescendingly as immature and impractical people who don’t understand how things get done. Meanwhile, people on “the Left” often treat “pragmatists” as either politically gutless or personally corrupt. This is what happens when you don’t take seriously other people’s ideological and strategic underpinnings; whatever you gain in ignoring or minimizing differences in perspective or point of view is lost in mutual respect. Sure, the character attacks on both sides are sometimes accurate, but nobody should assume that in any particular case without further examination of each others’ ideological and strategic views. That examination is what we are trying to promote here.

It’s been an insanely busy and confusing week already on the health care reform front, but after a meeting between President Obama and the Senate Democratic Caucus, this much is clear:
(1) Joe Lieberman, for the moment at least, has prevailed, and the bill that will be submitted for an actual Senate vote (tentatively scheduled for December 23) will not include a Medicare buy-in or a federally created national non-profit plan for health insurance. Lieberman sounds like he will now support this bill. Ben Nelson, however, still seems to be holding out for some accomodation of his demands for additional restrictions on coverage of abortion services in plans offered through the health care exchanges.
(2) Most, perhaps all, key Senate liberals are going along with this pared-back bill, most conspicuously public option stalwarts Sherrod Brown and Jay Rockefeller. Russ Feingold and Bernie Sanders, however, are not officially on board.
(3) The House Democratic leadership is sounding confident about its ability to get a conference committee passed even if it strongly resembles the Lieberman-approved Senate bill. But the 77-member Progressive Caucus in the House still has to say or do something about its past threat to vote against any bill that doesn’t have a public option.
Meanwhile, in Progressive OpinionLand, a very fractious debate is erupting between those who view this bill, or virtually any bill, as significantly better than the status quo (and/or as politically necessary), and those who would prefer to kill it as insufficiently progressive or even as worse than the status quo.
The ballgame here is obviously whether or not “kill the bill” advocates can convince one Democratic senator or a significant bloc of Democratic House members to throw sand in the gears of the wheezing legislative engine that’s finally approaching the station.
The most notable figure in the “kill the bill” faction is Howard Dean, who is arguing that reform advocates in the House restart the process with a reconciliation bill that could then theoretically be moved through the Senate requiring only 50 votes.
In the blogosphere, Markos Moulitsas of DailyKos and Marcy Wheeler of FireDogLake appear to be leading the opposition to acceptance of the Senate bill.
Both Markos and Wheeler emphasize a point that a lot of their critics may be missing. It’s not the absence of a public option per se that leads them to the kill-the-bill position; it’s the absence of a public option in combination with an individual mandate to purchase private health insurance. From their point of view, the mandate represents a massive public subsidy for for-profit health insurance, which they, like most single-payer advocates, view as inherently invidious in the first place. Wheeler’s rhetoric pretty clearly expresses the sentiment which is driving the kill-the-bill movement:

I believe that if the Senate health care bill passes as Joe Lieberman has demanded it–with no Medicare buy-in or public option–it will be a significant step further on our road to neo-feudalism. As such, I find it far too dangerous to our democracy to pass–even if it gives millions (perhaps unaffordable) subsidies for health care….
It’s one thing to require a citizen to pay taxes–to pay into the commons. It’s another thing to require taxpayers to pay a private corporation, and to have up to 25% of that go to paying for luxuries like private jets and gyms for the company CEOs.
It’s the same kind of deal peasants made under feudalism: some proportion of their labor in exchange for protection (in this case, from bankruptcy from health problems, though the bill doesn’t actually require the private corporations to deliver that much protection).In this case, the federal government becomes an appendage to do collections for the corporations.

It would follow that elimination of the individual mandate–also a major bugaboo to conservatives–is the goal here as much as resurrection of a public option.
It’s fair to say that the majority of progressive health care wonks and political “pragmatists” don’t share this point of view; Steve Benen has a good round-up of their initial reaction to the kill-the-bill campaign. Matt Yglesias has the most direct response to Wheeler’s “neo-feudalism” claim, in a way that points out its similarity to conservative attacks on Obama:

I’ve seen Marcy Wheeler characterize the plan as an “industry bailout.” And, indeed, if I were a small government conservative one political tactic I would employ would be to start characterizing all initiatives involving government spending as a “bailout.” You could say that ARRA’s provisions funding K-12 education are a “bailout for teacher’s unions.” You could call ACES a “bailout for windmill makers.” And you can call the health care bill an “insurance company bailout.” But the mechanism by which insurers can get extra money under reform is that . . . more people get health insurance at a price they can afford. The bill will also expand Medicaid eligibility to include many currently uncovered poor and near-poor people.

The thing to watch for over the next few days (aside from what Ben Nelson decides to do) is whether the kill-the-bill argument finds a Democratic champion in Congress, beyond the ranks of those, like Dennis Kucinich, who haven’t been on board with previous legislation. But beyond that, the intra-progressive argument over the endgame of health reform legislation reflects a broader set of disagreements about the ideological character and political impact of Barack Obama’s leadership, which extends to issues ranging from Afghanistan to financial reform. I’ll have more to say about that subject directly.

For the first time since Harry Reid put together 60 votes for a motion to proceed to consideration of health care reform, the long struggle to enact this legislation has hit a wall in the Senate. And in what must seem like the ultimate nightmare to many progressives, the wall is the heresiarch Joe Lieberman, who hastened to the Sunday shows last weekend to make it clear he would not vote for cloture on any bill that included the proposed Medicare buy-in for selected near-seniors, or the kind of quasi-public option that offered consumers a choice of private health plans sponsored directly by the federal government.
Anyone cruising the news or blog sites yesterday was treated to an orgy of recriminations aimed at Lieberman, at his flip-flopping on the Medicare buy-in issue, and at the poor logic of his overall position, accompanied by considerable psychotherapeutic speculation on the motives for his destructive behavior.
But the fact remains that there are only 58 reasonably assured votes for cloture on the recently negotiated Team of Ten “deal” for health care reform. Assuming Ben Nelson can be brought aboard without highly divisive concessions on the abortion issue, that still leaves one vote to be secured from a universe of just three senators: Lieberman, Snowe and Collins. So what are the options left to the White House and the Democratic congressional leadership?
(1) Forget about Lieberman and go after Snowe and/or Collins. It would obviously be satisfying to most Democrats to deny Joe Lieberman the opportunity to be King of the Senate and Arbiter of Health Reform, or more to the point, the chance to screw up or kill the legislation down the road. But on the Medicare buy-in and quasi-public-option issues, there’s not much evidence that either of the Mainers is any more amenable to compromise than Lieberman. (There are also Democrats who dislike Snowe’s version of a “triggered public option” a lot more than what the Senate is now discussing). Both are also under intense pressure from their Republican allies to maintain a united front; the idea that they could be trusted to hold the line through a House-Senate conference and a conference report vote is questionable at best
(2) Give Lieberman what he wants and then fix the legislation later. The key argument here is that the very items Lieberman is objecting to–an option for some younger Americans to buy into Medicare, and any sort of public option–are budget savers which could without question be added later (say, next year) via the budget reconciliation route, which only requires 50 votes. Additional subsidies are also clearly budget-relevant, and could be added by reconciliation as well. The downsides of this strategy are pretty obvious: caving to Lieberman could create a huge backlash among Democratic activists, and/or backfire entirely by reducing Democratic support for the bill in both Houses (most notably Sen. Bernie Sanders, and any number of House Progressive Caucus members who feel they’ve already compromised more than they should have). “Manana” promises on future reconciliation bills will be difficult to sell, and –if Democrats lose a significant number of seats in either House in 2010–might be even more difficult to redeem beyond next year.
(3) Threaten Lieberman with loss of his seniority unless he votes for cloture. Without question, it was a major mistake for the Democratic Caucus to allow Lieberman to maintain his seniority after the 2008 elections without an ironclad pledge that he would support the Caucus on all procedural votes, including cloture votes. He had just campaigned for the other party’s presidential candidate. His vote was no longer needed for Democratic control of the Senate, and his contribution to a 60-vote Senate was largely irrelevant without a pledge to support the party on cloture votes. Now it’s not clear he is amenable to any sort of threats or inducements that don’t involve substantive concessions on health care reform. Moreover, at present he is a key player for the administration and congressional Democrats on climate change legislation, which the Senate is due to take up as soon as health reform is resolved. An ultimate score-settling with Lieberman is now a major psychological necessity for a lot of Democrats, but it’s unlikely it would do any good on health care reform, and there could be unpleasant repercussions on climate change and perhaps other issues.
(4) Reframe the bill to use reconciliation. This is the strategy many progressives have been urging all along, for the obvious reason that it gets rid of the need for more than 50 Senate votes and also would make it vastly easier to craft a Senate bill that’s close enough to the House bill to avoid friction in a House-Senate conference. The downsides are also pretty clear, and help explain why the strategy wasn’t pursued earlier: (a) a real if hard-to-nail-down number of Senate Democrats would strongly oppose use of reconciliation on principle (most visibly Sens. Robert Byrd and Russ Feingold); (b) big chunks of health reform, including essentials like private insurance regulation, would be highly vulnerable to an adverse parliamentary ruling in the Senate that they are non-germane to the budget–a ruling that would require 60 votes to overturn; (c) there are all sorts of problems associated with the normal five-year “window” of provisions that can be enacted through reconciliation, which could make the bill a budget-buster while also requiring a lot of future action in Congresses where Democratic majorities are by now means assured. Aside from those factors, shifting to a reconciliation strategy would take considerable time, and it’s already mid-December.
(5) Go back to the drawing board. Before resorting to any of the above unsavory options, health reform supporters will undoubtedly make some effort to devise yet another compromise that can obtain that 60th vote without losing existing supporters. After all, the Medicare buy-in was a freshly unveiled rabbit-out-of-a-hat just a week or so ago. But if Lieberman, Snowe and Collins really are dead-set against any feasible alternatives to private health insurance for the uninsured, there may be no more rabbits in the hat. And that’s aside from the strong possibility that all three senators are demanding not compromise but unconditional surrender as the price for their votes.
Maybe I’m missing something, but these seem to be the options at present, and none of them are particularly good. We may be once again at a crucial juncture where progressives–and most of all, the President–simply have to decide what percentage of a loaf is acceptable.