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The Persistent Nudge to Compromise
I suggested this morning that (1) the “co-op compromise,” as an alternative to the “public option,” was DOA, given the intransigence of Republican leadership; and (2) the public option — perhaps with tweaks, but largely as proposed in House Commerce and Senate HELP — would likely become law.
Others — here, here, and here — suggest a non-public-option compromise remains viable and/or advisable.
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UPDATE: The so-called “Gang of Six,” if they’re listening to anyone, are apparently listening to the latter voices, not mine. Good.
16 Responses to “The Persistent Nudge to Compromise”
Persistent nudge to compromise followed by an audible “whack!” of the axe falling next election cycle. You politicians screw us out of this one and you're in for a rude awakening. You can stuff your coops “That Congress can build on [read: revise to our enjoyment while your not looking]” right where the sun doesn't shine. Yeah I've seen the ad and know about clever semantics. Well, you weren't actually lying when you said Congress can “build” on those co-ops later right? What is building if not revising?
I hope you're wrong about the coops, Pete.
It depends on what those compromises are.
160 amendments to the Senate version of the bill by the Republicans resulted in? Um, that would be ZERO change from their previous position.
Anyone who has EVER negotiated any type of contract, be it for material, credit, labor, etc. will wake you up to that type of negotiation for support from the other side. You could just about give the Republicans 98% of what they are asking for, in terms of changes, and they still would vote NO.
Secondly and more importantly, since Obama became President do you have an example of ONE, better yet TWO, items where the Republicans have compromised on anything.
The Democrats need to get their act together and ignore the Republicans. If the Blue Dog Democrats refuse to come along, cut them off at the knees. Let them see what type of “deals” they'd get from the Republicans.
Since the political blogs love to hyperbolize (yes, I make up words in the interest of time) every iota of movement, you never know whether what is the “big blog news” today is largely irrelevant tomorrow.
Liberals are obviously falling over themselves thinking they have now turned the tide completely……..but after watching this thing for 4 months now…..this whole “public option now for sure” could just be another one of the myriad ebb and flow moments.
What's the advantage of a co-op, aside from simple distaste for government?
Chris — as I understand the concept, a coop is run by a patient-designated governing board. They are able to make choices about their own care (in theory). They can also be self-contained — meaning they could have in-house doctors / labs / surgical solutions, etc etc. And they are non-profit.
To my mind, this idea needs fuller discussion. I don't, for instance, think a coop is much different from a “public option” if the legislature tries to set it up on a national scale. Furthermore, I think such an enormous size (national) would negate most of the advantages a coop holds in the first place.
However, I could see a number of regional coops — or even state-level coops (and even cities, I suppose, depending on population density).
I can see the regulation governing coops being relaxed as soon as the GOP gets a toehold in Congress again. And guess what that means? Yep. Right back where we are now.
So you oppose them because the GOP might come back one day?
None of that matters if the result is a better policy.
Co-ops are a better policy than government control.
“The advantage of a co-op is that it allows a channel for government subsidies to allow coops to extend coverage to the 47 million uninsured without producing the incentives for employers to dump their employees onto a government-controlled system and other perverse incentives that would lead to a slippery slope to a dysfunctional single-payer system.”
Serious question here Jason. Are we giving up on the idea that co-ops can help lower costs somehow? I'm not confident that a public plan drafted in Congress would be able to cut costs (at least not while health care lobbyists have the upper hand), but at least in theory it would through gov't buying power.
And, if we can't find someway to rebalance costs on the insurance/co-op side, how do we cut costs so it doesn't eat all of our wages?
Chris, I know you asked your question of Jason, but… isn't one of the factors in the co-op discussion that they'd be non-profit? Leaving aside the whole snarled question of how to cut health care costs themselves, one of the primary arguments I've heard is that the insurance company profits add to the higher costs. I don't dispute that at all.
So wouldn't costs go down automatically with a non-profit?
I oppose the coops because from what I've seen, it can take years (if not decades) to get them to work right. As such, they're not viable competition to private insurers, and that's what we need.
Almoderate — where have you seen them? Do you belong to one? What causes the problems?
There's a longer answer to your question, but this is it in a nutshell:
http://usgovinfo.about.com/b/2009/08/17/what-ar…
Almoderate, thank you for the link. I read the pros and cons (the pros I expected, the cons sound like things that the current reform discussions could address). But I didn't see anything there about how / why they take years or decades to set up and work right.
The ones that I've seen reported on that were featured as working well… They're all pretty old. And the people belonging to them cautioned that the reason they were in such good shape was because they'd spent so long getting it set up and working right. In fact, considering that we have already had coops for some time, I can't seem to find an example of a coop that took very little time to get going right. It's likely possible that one exists that took very little time to set up and become effective, but judging from what I've read on existing coops, I'd say it's the exception and not the rule.
Here's a small article about an existing coop that kind of makes my point, but nothing is going to come right out and say that because it's not intentional that it takes that long to become effective. It's not exactly part of the design of the program; it's just how it happens to come about.
http://healthcare.change.org/blog/view/health_c…
http://www.kaiserhealthnews.org/Daily-Reports/2…
And again… We're proposing something that already exists. We already have coops, and it's done nothing to lower health care costs for the middle class on private insurance. We don't have to guess what the results might be if we had coops because we HAVE the results NOW.