Jon Cohn and Kevin Drum ring the alarm bells about something that I think the Democratic Party leadership is overlooking to a dangerous degree—the possibility that by the time they’re done trimming Barack Obama’s health care philosophy down to something acceptable to Max Baucus and Kent Conrad that you’ll be left with something that the public doesn’t actually support. A public option, for example, is wildly popular with the public and supported by almost seventy percent of voters. But it doesn’t have nearly so many fans in the United States.
And as Kevin says, absent a public plan or really generous subsidies, “[m]ost people will just see higher taxes funding better coverage for the poor, and you don’t have to be the world’s biggest cynic to understand that this isn’t going to be overwhelmingly popular.” Now to be clear, people actually would, under this scenario, benefit from a variety of regulatory changes that congress wants to make. But the benefits of those changes would be cumulative over time, and not like a nice Christmas present to voters. Under the circumstances, you could easily imagine any number of Senators who have thus far not been allowed to dominate the political process—ordinary, mainstream Dems who don’t sit on the Finance Committee—looking at the final bill and kind of shrugging. Reducing the long-run trajectory of health care costs is an obsession for DC health policy wonks, but there’s very little evidence that it’s high on the public’s list of concerns. If you don’t do anything to make middle class health care cheaper in the short run, or to open up some new options to people, then you may have appeased some of reform’s critics at the cost of producing a bill with few real fans.