Health Care End Game

Tomorrow the President holds his summit with Republicans. His strategy is somewhat mysterious, but here are some speculations.

What is the purpose of the summit?

We know what the President does when he really wants to broker a deal: he meets behind closed doors, with Democrats. The invitation to the summit that was issued to Republicans made it clear that only some version of the existing House and Senate bills would be entertained. The President's own proposal, too vague on numbers to be scored by the CBO, is an example. The length of the summit, six hours, makes it pretty certain that few Americans will watch it. It is designed to provide a lot of material out of which clips and bites can be excerpted in order to paint an unflattering picture of the opposition. There is nothing wrong with any of this. The President is playing the cards he has, and this is his best chance to gain some ground on the GOP. But it's helpful to realize what it is.

What does the President hope to gain by it?

Barack Obama clearly has a high opinion of his own rhetorical powers, so perhaps he thinks he can swing public opinion behind the Democratic legislation. He has utterly failed to do so in dozens of speeches so far, but perhaps his rhetoric will be more persuasive with the Republicans present to compare him to. A significant shift in public opinion at this point would be a heroic achievement and it's conceptually impossible. More realistically, the President can hope to make the Republicans look bad.

Caveat

The President might attempt a game-changer by offering the GOP a major concession or two, like real tort reform or interstate competition for health insurance markets. That would require, however, that he is in a position to make those offers. It would also allow the Republicans to call for rewriting the bills.

What is the strategy after the summit?

Short of a sudden and more or less miraculous change in public opinion, the Democrats collectively and individually have to decide whether they are better off passing health care legislation or letting it die. Collectively they think they are better off passing it.

This is not because they still believe that the public will punish them for doing nothing; rather, the Democrats think they have lost pretty much everyone for whom voting Republican is thinkable. They can't do any more damage to their brand among independents, let alone moderate conservatives. What they have to fear now is that a lot of liberals and those further to left will sit this fall's elections out. Passing legislation would likely energize the remaining base, and that might make the difference between a merely terrible election and an apocalyptic defeat.

Besides, this is as close as they have ever come to realizing their ancient dream of government controlled health care. If not now, then when?

Can the Democrats pass a bill?

Reid, Pelosi, and company say they are prepared to move ahead with legislation and try to pass it by means of a reconciliation bill. Short of a Captain Kirk rhetorical victory at the Summit, this doesn't look likely.

The real trouble now is the House, not the Senate. The House bill passed with only a handful of votes to spare. Even if it looks like the Democrats need to pass a bill, the House is full of individual Democrats who have to wonder how they can get their butts back into the next Congress. It appears that the House will have to go first in passing the Senate bill and an accompanying reconciliation bill. There are still parliamentary procedures that might allow Republicans to then stall the bill in the Senate. So Pelosi must ask House members to go out on a really shaky limb and vote for a deeply unpopular bill, knowing that it still might not pass.

House Majority Leader Steny Hoyer let slip that the votes just aren't there. I am guessing that means the votes just aren't there. John Judis, in the New Republic, gives us a glimpse at why.

According to the Franklin and Marshall poll, which surveyed 1,143 residents of Pennsylvania, former Representative Pat Toomey--a Republican disciple of Steve Forbes and the Club for Growth--leads Democratic Senator Arlen Specter in the senate race by 44 to 34 percent among likely voters. He leads Democratic Representative Joe Sestak by 38 to 20 percent. If you want to get really worried about Democratic prospects, look at the breakdown. Toomey leads Specter among whites by 53 to 24 percent and among voters from union households by 44 to 41 percent. The only groups among whom Specter does well (besides registered Democrats) are non-whites and people with no religious affiliation. He's got that vaunted McGovern coalition wrapped up.

Is this Strategy or Inertia?

The summit is brilliant, tactically. The Republicans are surely afraid, thinking they can't wiggle out and can only lose. But tactics are useless unless they contribute to a strategy. If the President cannot change the whole board, all the way down to the ground in Pennsylvania, then it's hard to see what the strategy is. Failing to pass an unpopular bill means the Dems get blamed for the bill's unpopularity without getting much reward for their effort. Perhaps this isn't strategy at all, but mere inertia. The Democrats know they are racing toward the precipice, but they can't get out of the sled.

Comments

[Dr. Doom]

Obama's "healthcare reform" is the biggest fraud and scam yet perpetuated against the American people. Healthcare is nothing but a huge power-grab to pay off cronies and the "chosen few" such as General Electric (GE).

Did you notice that GE is already running television commercials praising how they're going to "help" facilitate healthcare? I think GE's commercial of the guy sitting in his underwear while about 200 people are staring at him says it all. Do you want ALL your medical records available to ANYONE that can hack a computer?

[KB]

Dr. Doom: There are indeed a lot of compromises in the Democrats' reform plans, but that doesn't mean that the plans as a whole are fraudulent. They really do want government controlled medicine, out of principle. And yes, I do want my medical records available to anyone who can hack a computer. Anywhere records are kept they can be snatched from by a person with access.