The big political problem with health care, I think, is that on the one hand pushing for major cost-savings is a more “moderate” policy goal than is just expanding coverage. But on the other hand, pushing for less reform is also more “moderate” than pushing for more reform. But the nature of the current health care system in the United States is that you achieve more savings by pushing more reform; by becoming less moderate and more radical. Thus, as Steven Pearlstein writes in today’s Washington Post if the Blue Dogs are really concerned that the draft House legislation doesn’t do enough to control cost growth they ought to be pushing for more outside-the-box ideas, not just carping around the margins:
A better vehicle would be the new government-run insurance option that has become a political must-have for House leaders and President Obama. In return for dropping their opposition to such a “public option,” the Blue Dogs could have insisted that it not be structured as a fee-for-service plan along the lines of Medicare but rather offer services through a network of high-quality, lower-cost hospitals and clinics that use teams of salaried doctors to provide coordinated care, along the lines of the Mayo and Cleveland clinics that Obama is always touting. In a competitive market, the success of such a government-run plan would force other insurers to follow suit.
That’s a good idea! Pearlstein concludes:
The problem with the Blue Dogs is that they tend to confuse centrism with splitting the difference between the warring camps, or making policy by choosing one from Column A and one from Column B. The more effective centrists use their political leverage to create a Column C.
Maybe that’s the problem, or maybe the problem is that the Blue Dogs are busy raking in health care, financial services, and energy sector corporate cash. After all, in addition to difference-splitting or column-grabbing, one thing you can do with your pivotal position in a legislature is block reform in exchange for money from interested parties. You hear a lot about Blue Dogs coming from “conservative rural districts” but it’s not as if major financial services firms are wildly popular among rural conservative voters.