Snowe-Landrieu

Snowe and Landrieu

I don’t know why I bothered. Leaked trial balloons from the Senate Finance and HELP Committees on their respective versions of a public insurance option tell me Senate Democrats have no intention of adopting a robust public plan or any other reforms that will challenge the corrupt structure of the current system.

When the Senate Finance Committee leaked its first proposal two weeks ago, Think Progress/Wonk Room’s Igor Volsky summarized its dismal failure, calling it a medium-well "nothing burger."

But it’s not even a burger; burgers usually have meat or healthy veggies. There’s no meat or veggies between these buns of forcing people to buy insurance while doing little to make private insurers reduce spiraling premiums (now spiced with subsidies!) or worry about losing market share.

Baucus’ Finance Committee can’t even agree on a helpless co-op concept, while Olympia Snowe, supposedly one of the last two sane Republicans in the US Senate, still insists on some vague never-to-be-pulled "trigger." Her trigger means never having to tell the insurance industry you’re sorry. Consider her logic:

In an Associated Press interview in Portland, Snowe said it would be unfair to include a government-run health insurance option that would take effect immediately.

"If you establish a public option at the forefront that goes head-to-head and competes with the private health insurance market … the public option will have significant price advantages," she said.

Well, yes, Senator, that was the point. But this don’t-harm-private-insurers disease has also infected the Senate HELP Committee.

As I predicted weeks ago, Chuck Schumer’s offer to "level the playing field" has led the HELP Committee to produce what I call a hobbled public plan. Wonk Room’s Volsky summarizes the features.

The plan will charge artificially inflated premiums — the average of what private insurers in the area charge. But since the average would be heavily weighted and affected by the dominate insurers who are price leaders, no price competitors in their respective regions, this means their price leadership is unlikely to be challenged. [Correction: The averaging refers to payments the plan would make to providers, preventing the public plan from simply using Medicare payment rates. While argubly making it more likely providers would sign on, it would undercut the potential for cost saving and the ability to push for reforms in how medicine is practiced.]

The logical goal of producing a public plan that people would actually want to choose and that would thereby put real competitive pressure on private plans to reduce costs and clean up their anti-consumer acts is missing. As Volsky notes,"some of the public plan’s inherent advantages — i.e. its ability to use Medicare rates and Medicare leverage — are intentionally dulled."

Why is this happening? The Republicans’ obstructionist conduct made them irrelevant and gave bipartisanship a bad name. That gave the Dems an open running field to solve the fundamental problems of a rogue industry and runaway costs. But instead the Dems have chosen to fumble the ball, mollifying their own confused members who want to kick it in the wrong direction.

Who’s coaching this team? Who did the recruiting? As Bernie Sanders told Ezra Klein,

The Coalition of the Willing sounds a bit strange to me. You have a Democratic president and a Democratic majority in the House and 60 votes in the Senate, and the coalition that is determining health-care policy are seven people, including four Republicans? . . .

So I think, with all due respect to Max and his hard work, it’s the wrong strategy. I think the strategy should be to say to all 60 members of the Democratic caucus that even if you don’t want a public plan in the final bill, you should commit to ending the Republican filibuster. You don’t need 60 votes to pass legislation. You need 60 votes to end the filibuster. And if we do that, we can get a strong public plan that will be real change.

Reform requires the Democrats to challenge a deeply entrenched industry, it’s structure, it’s market power, and its incentives. Pretending to do so doesn’t get it. But apparently there is no leadership in the Senate that cares enough about genuine health care reform.

So the President needs to explain why any of us should support an effort that looks increasingly like a multi-trillion dollar bailout to those who’ve been fleecing America’s businesses and citizens. Why should Americans give trillions more to a failed system and bloated industry that is literally bankrupting the nation and killing its people?

More: Klein interviews Bernie Sanders on "coalition of the unwilling"
Jacob Hacker and Rahul Rajkumar make the case for a public plan