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Brooks: Health Care and Constructive Compromise

After reading David Brooks’ column this morning, I had the same reaction Dave Schuler had:

I agree with this Brooks column probably more than any other of his.

And the line from Brooks’ column that most captured my attention was this one:

[Obama] has opened up many opportunities for intelligent Republicans and moderate Democrats to constructively offer amendments to improve the bill and bring it closer to fiscal sanity.

Among those “many opportunities,” Brooks’ identifies “credible amendment[s] to cut costs,” “amendments to impose a cap directly” on “the tax exemption on employer-provided health benefits,” amendments “to create separate malpractice courts and to otherwise reform the insane malpractice system,” and amendments “to beef up … wonky but important ideas like bundling hospital payments and increasing price transparency.”

Of those, I think Brooks might be overly optimistic about the chances for tort-reform amendments. In the President’s speech Wednesday night, I understood him to draw a clear line in the sand, i.e., his administration will study tort reform, but that’s not part of the near-term legislative effort.

Beyond that exception, Brooks’ list seems … about right. And Republicans who are sincerely interested in making the most of the deck of cards they’ve been dealt will seize these opportunities. Brooks calls them “intelligent” Republicans. That adjective, like Brooks’ list, seems … about right.

I once had empathy for GOP complaints that their health-care-reform ideas were not being given substantive consideration. But the more I’ve watched this debate unfold, the more I’m convinced their definition of “substantive consideration” is terribly skewed. When you’re the minority party — and especially when you’re the super-minority party — you don’t get to draw the framework or outline the starting point. The most you get to do (short of screaming “You lie!”) is chip away at the edges; tighten up the bill’s language; clarify its provisions. Republicans who appreciate this — who understand their position and make the most of it — are the “intelligent” ones.

In the days ahead, we’ll see how many, if any, of them are left.

  • shannonlee
    This would be a perfect chance for the guy I voted for in 2008 to take the lead. I know Presidential campaign "losers" tend to fall back into the shadows for a while, but McCain is a true bi-partisan leader with the influence and experience to get things done.
  • DLS
    Nobody takes Obama's words at face value. That some Republicans might participate if invited is a separate issue. I still view a get-together at Camp David over a weekend or several days (as I also wrote, something more constructive or involving "working" than people associated with Bush either in Crawford or in Washington) involving key Congressional Democrats in addition to Obama and his staff as a likelier scenario. That Olympia Snowe or John McCain might be involved to join, and join, I question.

    At this time the GOP is negligeable and the question remains if the Congress will take HR 3200 and apply some sanity in the Senate to it, or take the Baucus bill in the Senate and let the House augment it.

    Perhaps a hybrid product (and one with Team Obama's hands in and on it) at Camp David (or in the White House) is possible. Now that Obama chose to address the Congress (and the nation) to attempt damage control and recovery, it is more likely than not we'll see legislation crafted and passed this year.
  • shannonlee
    "Nobody takes Obama's words at face value. "

    When you start your comment like this, it is very difficult to take anything you write seriously. Insults are never a good way to start an honest debate. Sadly, this seems to be the status quo for many conservatives.
  • DLS
    "When you start your comment like this, it is very difficult to take anything you write seriously."

    If you're illogical, perhaps, but if you actually paid attention to the misstatements in Obama's address in addition to the few actual revelent position points he made...
  • Dr J
    "His administration will study tort reform, but that’s not part of the near-term legislative effort."

    Brooks's column helped me see Obama's speech in a different light. His challenge is he's not the legislative branch and has limited ability to define the legislative effort or to steer it out its ditch. What he can do is try to pave public opinion to make it easier for Congress to drive to more solid ground and, hopefully, past the finish line.
  • DLS
    "His challenge is he's not the legislative branch and has limited ability to define the legislative effort or to steer it out its ditch."

    Legality and propriety are mere encumbrances that can be cast aside, if necessary or convenient.

    There has been talk of his adminstration's drafting legislation, seizing the initiative and control of this effort, in order to maintain the (excessive) pace of "progress" and guarantee passage of legislation by the end of this year. There are plenty of people who not only see nothing wrong with this (and who are ignorant or contemptuous of the separation of powers in addition to constitutional federalism, for example) and in fact who would prefer it (because they want "progress" and this is a stronger means).

    There are precedents for this, not only in the growth of regulations and Congressional deferral of true legislative power to the executive (and to the judiciary), but in "active" executives since at least the 1930s. And certainly (as I've written before), we can think back to the scope of legislative activity that doesn't limit itself to members of Congress, their staffs, and consultants and other agents outside the Congress, but to the Bush and Cheney years, and the influence of the energy industry in legislating (or revising the federal regulations, with 11:59 PM-the-day-before-they-take-effect notices of changes to regulations, etc.).

    In today's light, follow-up to Obama's address (where he was more clear than the lib Dems in the Congress as well as the Blue Dogs) is logically for Obama to join or to lead an effort among the Dems in Congress now to keep the "momentum" in effect, and to make actual progress in choosing what is to be legislated, and to write the new laws. Hence the meeting idea (at Camp David). Ordinarily this would be scandalous (and there would be shrieks if the Republicans did it), but it's perfectly logical if the Dems want to make progress. I say "the Dems" because the Republicans have been bypassed intentionally and kept from having serious influence with (or interference with) pet Dem efforts this year, and this is obviously true with health care. Obama can say he'll entertain what he calls "serious" Republican suggestions, but nobody smart believes this for a moment (especially after Obama's misstatements in the address and reversing his stated position on Bush-Cheney torture political revenge sought by the lib Dems). This will be a Dem health care effort with an increased federal government presence, which is what the GOP has opposed. "Serious" GOP suggestions will meet current Dem criteria for "bi-partisanship," namely, that the Dems like and agree to them. ("Do it our way, or not at all.")

    "What he can do is try to pave public opinion"

    It's not succeding with the intelligent public, when misstatements, deliberate omissions, are part of it.

    He should just concentrate on wanting things to settle down and to proceed in a purposeful (Dem) way.
  • Dr J
    "Legality and propriety are mere encumbrances that can be cast aside, if necessary or convenient."

    I think that's much easier when what the president is trying to push through amounts to an executive order--to go to war somewhere, or to do more wiretapping, or something of that nature.

    I don't think it works so well with such a complex issue as health care. Hillarycare foundered on the shoals of administration micromanagement, and Obama is surely determined to avoid that mistake.

    But it does leave him talking this weird doublespeak, about "his plan" which doesn't exist in any solid form, and citing specific features that (if Brooks is right) are more coded messages to Congress than items he expects will become law.
  • DLS
    "I think that's much easier when what the president is trying to push through amounts to an executive order"

    Related to that: The following person is not the only one to think about this. [chuckle]

    "Second, he should declare the disfunctional and industry-polluted health reform plans in Congress dead and simply announce that by executive order, he is lowering the age for Medicare to 55, and is switching all Medicaid patients in the country over to Medicare (with the intention of lowering that age by five years ever year until all are covered), and shutting down the Medicaid program. He should then submit a bill to Congress establishing a government-owned insurance company, open to all, with no restrictions on its ability to set pricing and reimbursement rates or to negotiate discounts from hospitals, doctors and pharmacy companies. Or alternatively, the bill could enable anyone to simply buy into Medicare. He should tell Democrats and Republicans alike that any member of Congress who votes against that bill will not see any bill with her or his name on it get his signature in his remaining years in office. The government company would be phased out once Medicare covered everyone."

    http://www.baltimorechronicle.com/2009/083109Li...

    In the real world, though, I suspect Obama (and Emanuel, etc.) will be more like "partners" or "overseers" of what the Dems in Congress do now, if not more actively involved.
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