Adam Serwer on liberal discontent over the state of healthcare reform:
I think this is basically right. For all the havoc Joe Lieberman has caused, it’s worth remembering that an ideal bill for liberals, with a robust public option, was always a longshot even with his participation. A couple months ago, Latoya Peterson and I got into it over the necessity of the public option; for her it was public option or nothing at all, while I argued that the votes weren’t there and that the bill sans the option would still be a massive improvement over the way healthcare insurance works now. A few months on, the sad truth of that senatorial math has been borne out. The best chance for getting even a modified, weakened option through the Senate required either Olympia Snowe or Susan Collins breaking ranks with the Republicans or Lieberman refraining from being a petulant child. Obviously, neither has happened, and that second part now seems particularly naive given the senator’s assholish behavior over the last few days.
Anyway, here’s Nate Silver:
Suppose the following scenario plays out when you’re trying to buy a used car:
Dealer: The price of the car is $2,000.
You: For that beat-up Honda Accord? I’ll give you $1,200.
Dealer: Nope, it’s $2,000.
You: How about $1,500?
Dealer: I’m going to stick with $2,000.
You: Will $1,700 get it done?
Dealer: My best and final offer is $2,000.
You: Give a guy a break! $1,875?
You: $1,995 and a Slurpee coupon?
Dealer: Now we’re talking — step into my office.
Is that a negotiation in bad faith? Is the dealer moving the goalposts? No. He’s being very stubborn and very firm — but he’s also being very explicit about what he wants. It’s possible that you were an incompetent negotiator and that maybe if your first offer had come in a little lower, or a little higher, you could have gotten a better price. But more likely the dealer simply had more of the leverage and ultimately $2,000 is an acceptable price to you, even if it’s more than you were hoping to pay.
Progressives did just about everything in their power to try to get a decent public option into the bill. They threatened. They bargained. They complained. They organized. They persuaded. They begged. There was the opt-in, the opt-out, the trigger, the Medicare buy-in. There was no lack of initiative or creativity. And they actually had quite a bit of success: from 43 votes in August, they got up to perhaps as many as 48-52 for a strong-ish public option, and 57-59 for a weak-ish one. People like Kay Hagan, Tom Carper and Kent Conrad, to varying degrees, came on board.
But just because you perceive yourself as being in a negotiation with another party doesn’t entitle you to win that negotiation, or even to split things halfway. Sometimes your adversary doesn’t think there’s anything to negotiate at all. Sometimes they would in theory be willing to negotiate if you could find the right leverage point, but there’s nothing that fits the bill, for all your best efforts. Sometimes their first offer is pretty much as good as it’s going to get, and not merely a negotiating ploy.
So yeah. The math ain’t really changed. This bill will be imperfect in a lot of ways. A public insurance option would have given the government the ability to negotiate lower prices with hospitals, which would have in turn lowered the cost for people insured privately. Even a Medicaid buy-in, the last, best compromise on the table after the all the public option stuff was killed, would have been a considerable improvement over what this final bill will look like. But it’s worth remembering that Social Security, a landmark piece of progressive legislation, was a mess when Roosevelt signed it into law. In its original form, it effectively excluded women, people of color, farmers, nurses and tons of other folks. These were horrible exemptions, but to mix metaphors, the safety net was expanded as legislators added meat to the original skeleton.
This is hardly the end, and we should look at this imperfect bill — still a major achievement in historic and human terms — as a first draft.
UPDATE: From Jonathan Cohn at The New Republic:
Disappointed progressives may be wondering whether their efforts were a waste. They most decidedly were not. The campaign for the public option pushed the entire debate to the left–and, to use a military metaphor, it diverted enemy fire away from the rest of the bill. If Lieberman and his allies didn’t have the public option to attack, they would have tried to gut the subsidies, the exchanges, or some other key element. They would have hacked away at the bill, until it left more people uninsured and more people under-insured. The public option is the reason that didn’t happen.
And if public option supporters lost in the Congress, they won in the country as a whole. The underlying political problem for liberals remains what it has been for a generation: profound and widespread distrust of government. But polls consistently showed voters thought the public option advocates were right–that, at least when it comes to health insurance, government can be trusted. It was a small victory, but it’s on top of such small victories that political movements are built. Someday in the future, that movement may be powerful enough to win more sweeping changes. Who knows, maybe those changes will include a government-run insurance plan.
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