THE TREATMENT SEPTEMBER 1, 2009
David Frum was just on CNN, explaining that President Obama had blown it on health care by embracing the "hyper-ideological" House bill. He's not the first one to make this argument. But I don't really see it.
A single-payer plan might qualify as hyper-ideological. A plan like the one Congressman Pete Stark once proposed, in which everybody without employer-sponsored coverage ended up in Medicare, might also qualify as hyper-ideological.
But the House bill? It leaves the employer system largely in place, then creates a marketplace in which people without employer coverage can choose from among a selection of private plans.
In other words, it's nothing more than a fleshed out version of what Obama and the other Democraitc candidates proposed during the presidential campaign. It's also what Max Baucus outlined in a white paper he issued shortly after the presidential election. And Baucus is not exactly the first name that leaps to mind when you think "hyper-liberalism."
Yes, the House bill has a public insurance plan to compete with private plans in the exchange. But the the public plan itself is a compromise for lawmakers who'd prefer a true single-payer plan. And the House version is actually weaker than many proponents would prefer.
No, the plan doesn't entirely pay for itself, depending on how you count an adjustment in Medicare physician payments; beyond the ten-year budget window, most experts seem to believe, it doesn't move that aggressively on controlling costs. But I'm not sure that makes the bill particulalry ideological. After all, it's far more fiscally responsible than legislation that centrists championed during the tenure of the last presidential campaign.
Of course, Frum's argument is of a piece with the claim David Brooks made today, that Obama's political struggles reflect his decision to lurch left. But I agree with Kevin Drum, who suggests this is a strange reading of history:
You'd think that Obama had been working in a vacuum or something. There's not even the briefest mention of the primary cause for all this: the deliberate decision by the Republican Party to hand over the reins to its most extreme wing and adopt a scorched earth counterattack to Obama's entire agenda. He agreed to cut the stimulus package by $100 billion and put 40% of it into tax cuts. That cut no ice. Democrats proposed a cap-and-trade proposal for reducing greenhouse gas emissions because it uses market mechanisms instead of crude command-and-control directives — and then adopted hundreds of compromises to water it down. Didn't matter. Max Baucus has been "negotiating" over healthcare reform with Republicans in the Senate for months and Obama has been careful not to criticize. But that turned out to be a charade. Tim Geithner's financial bailout plan was limited and business friendly. No matter.
Believe me, I'd like nothing more than if Obama would sell out to the left. But it's not happening.
For the record, I think Brooks' interest in health care reform is sincere. I just think he's wrong about why it's not working out so far. Noam has more on this.
Update: And so does the other Jonathan C.