Baucus Health Plan


One of my first print articles ever was dedicated to bashing Max Baucus so let’s say I’m a Max Baucus skeptic. But earlier today while I was out on the Toblerone Line (anti-tank fortifications, not candy) and the global financial system continued to melt down, he released an ambitious blueprint for health care reform. Such things are too important to be left to someone like me who can’t give it full attention. So consider some links:

All are fairly enthusiastic. Which turns out to be because Baucus’ plan is basically Hillary Clinton’s plan which was basically John Edwards’ plan. And, indeed, those plans were quite similar to Barack Obama’s plan. But Baucus differs from Obama in including a universal mandate to purchase health insurance.

One point that illustrates to me is that it was always a bit misleading to construe the mandate debate as one pitting a “more ambitious” mandate-laden plan against a more politically timid mandate-free plan. Rather, I think it’s better to look at this as pitting two different theories of political expediency against each other. To the man on the street, things probably look better if your plan can be attacked as forcing people to do stuff. But of course to an insurance company executive or his lobbyists, things look better if your plan doesn’t allow the young and healthy (i.e., the actuarially desirable clients) to opt out of buying your product. Max Baucus is not much of a political risk-taker, but he is very attuned to the moods of insurance company interests and feels, plausibly, that the kind of quid pro quid structure of a mandate/regulate plan is the best chance to get things through even if it’s also more vulnerable to rhetorical assault in some ways.

The surprising thing to me, however, is that Baucus’ plan retains the public/private competition aspect of the generic Democratic health care proposal. That’s always seemed to me to be a very important goal that would probably need to be bargained away in order to pass a bill. But Baucus is one of the most conservative Democrats (Johnson, Landrieux, and Ben Nelson were to his right in the last congress) and if he’s really willing to back that idea, and especially if he’s willing to contemplate moving through the reconciliation process, we may well get it.