Obama, They Want You to Fail

After last year's elections, a Democratic operative told me that if the
Democrats got to 59 seats in the Senate, it would be easy to peel off
one or two Republicans to pass key legislation like serious health care
reform. I was left wondering what political planet he'd been living on
for the past three decades.

For almost as long as I've been in Washington (I arrived for the
Associated Press in 1977) it has worked the other way. Even when the
Republicans appear to be on the defensive and outnumbered, they band
together and vote as a bloc, while Democrats bend over backwards to be
"bipartisan."

This dynamic has continued into Barack Obama's presidency as he and the
Democrats have watered down their proposals with the hope of winning
over a few Republican votes so they can claim they achieved some
bipartisanship, even if it means passing bills that are half-hearted
half-measures.

That process
dominated the debate over the $787 billion stimulus bill that the
Democrats diluted with Republican tax cuts and shrank in size despite
warnings from top economists that the package would fall far short of
the needed boost in jobs, a bleak prediction that now appears to be
coming true as unemployment climbs toward 10 percent.

In exchange for the weaker stimulus bill, the Democrats got three
Republican votes in the Senate and none in the House. (The Republicans
then drove one of those GOP senators, Arlen Specter, out of the party,
though Specter still won't count himself as a reliable Democratic vote.)

The pattern of belligerent Republicans and timid Democrats is now
repeating itself on health-care reform. Democrats first excluded from
the debate the one measure that probably could save significant money -
a single-payer system - and they now appear poised to trade away
Obama's proposal for a "public option" to possibly garner a couple of
Republican votes.

Though enacting a public option is favored by nearly three-quarters
of the American people - and has the potential of at least saving some
money by pressuring private insurers to rein in costs - Democrats are
so entranced by the siren song of bipartisanship that they appear on
the verge of scuttling it.

In
doing so, the Democrats could well recreate the worst mistake of
Hillary Clinton's failed health insurance plan of 1994. The fundamental
flaw in her complex scheme was that it tried so hard not to harm the
insurance industry that it wasn't clear how it would make matters any
better - and the industry still torpedoed it with a misleading public
relations campaign.

Today,
the Obama administration and Senate Finance Committee Chairman Max
Baucus have been so proud of getting all the players to sit down at the
table (with the exception of single-payer advocates who were excluded)
that they have lost track of the hard reality that if the nation is
really going to address its health care crisis, there will have to be
some financial losers.

Right
now, the losers are the tens of millions of uninsured and under-insured
Americans, the doctors and nurses who are appalled at the cruelty of
the U.S. medical system, and the U.S. businesses that pay for their
employees' health insurance and thus are put at an economic
disadvantage to their foreign competitors operating in countries that
have single-payer systems.

Helping the Industry

For the status quo to change significantly, the private health
insurance companies and other parts of the medical industrial complex
must be compelled to extract savings from their bureaucratic waste and
excess profits. To do that would require, at minimum, a robust "public
option" that forces a revamping of the private health insurance
business model.

Not
surprisingly, the health insurance industry doesn't want to undergo
such a transformation, so its lobbyists have leaned on the Republicans
and a handful of "centrist" Democrats to either kill the "public
option" or in Baucus's phrase "sculpt" it into something that doesn't
threaten the industry.

That's
where Sen. Kent Conrad's scheme of setting up "cooperatives" comes in.
The North Dakota Democrat has proposed building from scratch a network
of non-profit "cooperatives" that would lack both the size for
administrative savings and the bargaining power to negotiate lower
prices.

While a public option
could piggyback on the Medicare bureaucracy to maximize savings and
have the advantage of simplicity, the emerging Baucus-Conrad scheme
would add an array of cooperatives to the already confusing mix of
insurance plans. For many Americans, these new entities won't present
an appealing alternative to private insurance.

If such a "compromise" emerges, a few Republicans might vote yes; the
industry would be happy; and the Obama administration could have a
"bipartisan" signing ceremony.

But the American people might find themselves left out of the
celebration. The federal government might even compel the uninsured -
under penalty of fines - to sign up with an existing insurance company
whether they feel they can afford it or not. Mandated coverage could
mean a big windfall for the insurance industry, pushing nearly 50
million new customers into its arms.

Eventually, however, the reality would sink in that very little had
improved. Millions of Americans would understand that Washington
protected the interests of a cold-hearted industry rather than fashion
a health-insurance plan that would do the people much good. With that
realization, many Americans would blame Obama and the Democrats.

On the other hand, if Obama demanded a public option and insisted on
the support of his party, the dynamic might go very differently. If the
Democrats assembled 59 votes for a strong plan - even if Republicans
continue their obstruction of Al Franken's Senate election in Minnesota
- that could turn the tables on "centrist" Republicans who would have
to decide which side to take.

To get the Democrats to behave in such a disciplined and serious
fashion, however, might require a backbone or brain transplant for many
of them. But it's way past time for the Democrats to recognize that
their obsession with bipartisanship is unrequited.

The Republicans have a very different agenda. Indeed, with the
continuing pratfalls of their supposedly top-tier candidates - like
South Carolina Gov. Mark Sanford's Argentine holiday with his mistress
- they have only one genuine hope for the future of their party:
President Obama must fail and the Democrats must take the blame.