Saturday, April 25, 2009

Door's Open for Single Payer - Push Hard Now

As Jonathan Cohn wrote, Reconciliation is a game-changer. We can stake out a position so far to the left of the Blue Dogs that it'll blindside 'em coming up on the right.

... it means the Democrats will have the ability to pass health reform with just fifty votes, if they choose, rather than the sixty required to break the inevitable filibustering by Republican opponents.

It's hard to overstate how radically the reconciliation option would shift the dynamics of debate. It's not just that it would make passage of a bill more likely. It's that it would utterly redefine the conversation.

Put yourself in the shoes of a health care industry group--say, for example, the insurance industry. You probably have the power to swing at least a handful of senators your way, through advertising, astroturf organizing, and direct lobbying. If it's sixty-votes-or-bust in the Senate, reformers will probably need those senators to pass a bill. That means you have enormous leverage. You can hold out for the best possible deal and, barring that, simply walk away.

In other words, you know that there will eventually be two options on the table. A bill you like or no bill at all.

Now imagine Democrats have the option of using reconciliation. They need just fifty votes, which means they may not need your support after all. If you demand too much, they may just ignore you altogether--and craft a bill, perhaps with the help of more cooperative lobbyists, that is not in your self interest.

In this scenario, there are three options on the table. A bill you like, no bill at all, and a bill you really hate.

So what do you do? Chances are, you concentrate a lot harder on trying to get that bill you like.

"Reconciliation instructions" on the budget means that if the universal health care plan negotiated in the Senate doesn't have 60 votes by October 15, then passage will require only a straight majority - 51 votes.

Even if nine DINOs throw hissy fits over the government spending - vapors! - money to help people, the plan still passes. Harry Reid can tell Evan Bayh and Joe Lieberman and Blanche Lincoln and Claire McCaskill and the rest of the repug-fellators to fuck off and die, we don't need your cowardly Blue Dog votes.

So NOW is when we need to carpet-bomb Congress with demands for single-payer.

Repugs know that with reconciliation, President Obama and Congressional Democrats are going to get the universal health care plan they want. We have to make sure that the Democratic opening negotiating position is a plan that will so terrify the repugs that they'll agree to anything else.

In order to get something really super-fabulous, like Medicare For All, let's demand perfection.

  • Full coverage, cradle-to-grave, for everything short of cosmetic surgery. No co-pays, no deductibles, no limits.
  • Full power of the federal government to negotiate payments for everything including prescription drugs.

Drop a pressure anvil on every member of Congress to pass single-payer so that Democrats can point to that public pressure and say, "Gee, guys, we'd really love to go back to the public/private plan we asked for back in March, but now with a majority of Americans demanding single-payer, Medicare For All is the best we can do."

Right now, Democratic members of Congress, progressive activists, liberal policy wonks and advocates for the uninsured are in the strongest position we've ever been in. We have an almost unimaginable amount of power to sweep the board and take it all.

If we don't use that power to secure for Americans the basic right to health care that is enjoyed by every industrialized nation on earth, then we might as well hand the government back to Dick Cheney, because we'll have proven we can't do anything.

Cross-posted at They Gave Us A Republic ....

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