Senators Have Agency

In today’s column, Paul Krugman lamented the circular arguments you sometimes see presented as a reason for watering-down reform:

And Senator Kent Conrad of North Dakota offers a perfectly circular argument: we can’t have the public option, because if we do, health care reform won’t get the votes of senators like him. “In a 60-vote environment,” he says (implicitly rejecting the idea, embraced by President Obama, of bypassing the filibuster if necessary), “you’ve got to attract some Republicans as well as holding virtually all the Democrats together, and that, I don’t believe, is possible with a pure public option.”

Timothy Noah had a great example of this near the end of a recent column offering a tour of health care systems around the world:

Afterward, Sen. Ken Salazar, D-Colo., who has since become interior secretary, noted that other countries saw a conflict between profits and health. How could the United States possibly persuade insurance companies to give up profits? [Author T.R.] Reid answered that Switzerland, home to many powerful insurance companies, had done it in 1994 when it adopted the Bismarck model. The insurers fought it tooth and nail, of course, but now they compete energetically to sign up people for basic care on a nonprofit basis because they constitute a customer base for supplemental insurance that they’re allowed to sell on a for-profit basis. This answer didn’t satisfy Baucus. “Perhaps you don’t know how much money [U.S. insurers] have,” he told Reid.


Which would be an amusing and apposite remark from Baucus were it not for the small part that Max Baucus is the most powerful legislative voice on health care policy in the country. It makes sense for Tim Noah or Paul Krugman or Matt Yglesias or TR Reid to ironically step outside the debate and start talking about the political obstacles to really hitting the insurance companies where it hurts. But Max Baucus chairs the Senate Finance Committee! “Political reality” is something pundits and activists need to adjust to, it’s something powerful Senators create.