The horizon is not so far as we can see, but as far as we can imagine

If Pharma is for health care reform…

First it was the AMA supporting health reform, now Pharma. Pharma has spent 4 million on Harry and Louise ads in support, and are considering spending 120 million during the August recess in support.

If both Pharma and the American Medical Association are for something, well, let’s just say that any liberal with sense should be thinking not just twice, but thrice.

Robert Reich noted a while back what Pharma will probably get in exchange for their support:

  • Not allowing drug reimportation from Canada
  • Not allowing the government to negotiate drug prices

Add to that forced enrollment of Americans into a insurance plans, and I’d lay long odds that Pharma has calculated that they’re going to make a bundle off of the new medical system, much more than the 80 billion they’ve promised to give up (a promise that isn’t worth much in the first place.)

At this point in time the strategy to get through a reform bill appears to be to bribe every powerful interest opposed to one enough to get rid of their objections.  If the goal of this is to significantly reduce costs, every major participant deciding that they’ll make more money under the new legislation rather than less is not a good sign.

The method is simple enough.

Use the Senate conservatives and blue dogs.  Obama may have the ability to move much of this under reconciliation, but it’s clear than neither he nor Reid want to do so.  The Senate HELP bill is weaker than the House bill, and the “bipartisan compromise” coming out of the Justice bill is going to be even weaker (it most likely won’t even have a public option, but instead co-ops, which are too weak to work).

Blue dogs, in my opinion, are the lesser threat.  I believe Pelosi when she says she can move a bill through the House.  I could be wrong on that, but so far Pelosi has proved very good at winning crunch votes.

The only way a good public option will happen is if progressive in the House are willing to buck Pelosi, Rahm and Obama and spike a bill.  There are more progressives than Blue Dogs in the House, more than enough to kill the bill.

The reason conservatives get a much larger voice in legislation is because they are willing to vote it down. Rahm and Obama whip progressives far harder than they whip Blue Dogs.  If progressive representatives actually want a good public option enough to fight for it, they need to make Rahm and the White House whip the Blue Dogs.  If Democrats are unpopular in 2010 because of a failed legislative agenda, it’s not progressives who are going to lose their seats, it’s conservatives in swing districts.  And White House threats to turn off money, staff and volunteers are much more effective against people who run in swing districts.

I know the idea of actually whipping conservative democrats the way progressives are whipped is crazy-talk in modern Washington and to Obama and Rahm, but maybe it’s just crazy enough to work.

Or maybe we’ll just get a lousy health care “reform” bill with no public option or one that’s completely crippled.


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  1. The Progressive Caucus in the House has already stated bluntly that they are *not* going to vote for any bill that does not have a viable public option. Period.

    The problem is what the Progressive Caucus views as a viable public option. The one originally proposed in HR3200 is somewhat weak but the PC signed off on it. They are not, alas, health care economists, and thus things can slide past them unless we educate them, which I’m doing with my own Representative (a member of the PC and co-sponsor of HR606).

  2. Ian Welsh

    They’ve already voted for a bill which was less than “robust” (their word). The current plan is to call co-ops the public option. We’ll see if they can live with that.

  3. This outcome was very predictable. As long as a large number of politicians need a lot of money for a long time to sustain a lifelong political career, there was no way that they would attack the interests of the major lobbies who can afford to keep them in campaign money. And not just for one campaign.

  4. jawbone

    Nobody is willing to define what they mean by the terms, phrases, descriptions they’re using in this whole debate…except fot single payer supporters. The rest, progressives included, just keep repeating the same or slightly different “principles,” words, terms. Infuriating.

    I smell con job when I’m being asked to sign or buy something and the offering party will not explain specificially what is on offer. Or is unable to do so.

    Now, the job of a confidence man in running a con is to gain, yup, the confidence of the mark so that the victim of the con will go along with just about anything. Just have to retain a bit of logic and some slight touch with reality.

    Bamboozling with side issues also helps, sometimes.

    This deal? Stinks to high heaven. Individually we can turn it down, but since it may become law we’re completely screwed.

    Mandated BOHICA.

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