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.
34 Responses to “Baucus Health Plan”
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November 12th, 2008 at 4:02 pm
Paging Petey: We have found you a new hero! Baucus ‘16!
November 12th, 2008 at 4:17 pm
Pass the smelling salts. It looks like universal insurance might pass.
November 12th, 2008 at 4:29 pm
Krugman approvingly suggests Obama’s anti-mandate position was a political sweetener all along, even though during the primary he savaged him for it on the argument that not running on the mandate would foreclose any possibility of his having a change of view and including one in a bill.
Now that he’s got his prize and the election is over, can we agree that for all his brilliance he really was a consistently toxic Hillary hack for basically the entirety of the last 18 months?
November 12th, 2008 at 4:31 pm
It’s Landrieu, no X.
And I maintain that Democrats can buy her vote on almost any progressive legislation with money for coastal restoration and levees.
November 12th, 2008 at 4:40 pm
I don’t think the public plan component is really worth anything. We’ve seen such public plans in other areas (such as student loans), and they always get watered down and debilitated through special interest lobbying.
The only way to have a public plan for health insurance is to simply grant it to everyone whether they ask for it or not. Then there will be a constituency to resist privatization, as is the case with Social Security.
As for mandates, I find it truly sad that the “left” of the American health care debate is defined in terms of forcing poor and middle class people to give money to insurance companies who will then screw them over and deny them coverate.
November 12th, 2008 at 4:41 pm
So I guess Toblerone the chocolate is shaped to look like anti-tank fortifications? Just had a moment of epiphany…
November 12th, 2008 at 4:45 pm
So I guess Toblerone the chocolate is shaped to look like anti-tank fortifications?
Apparently so. What really made my day in that link was discovering there exists a Swiss town named “Gland.”
November 12th, 2008 at 4:47 pm
I’m self-employed, and my favorite aspect of the Obama plan was the option to buy into the federal employee insurance plan. That seems to be absent from the Baucus proposal – am I missing it?
A two-tiered proposal where federal employees get one thing, but I get something else if I want to buy into the public plan won’t cut it for me.
November 12th, 2008 at 4:49 pm
Alli: I’m sure Matt meant that ALL Landrieux are to the right of Baucus.
November 12th, 2008 at 4:52 pm
Using the reconciliation process is clearly the key to getting anything passed — does Baucus’ position at Finance make that more likely?
November 12th, 2008 at 5:20 pm
But Baucus differs from Obama in including a universal mandate to purchase health insurance.
Then it’s dead in the water. Baucus to America: “Buy this health insurance even if you don’t want it, don’t need it, and can’t afford it, or we’ll throw you in jail.”
Can’t wait for the Baucus-Obama smackdown.
November 12th, 2008 at 5:36 pm
I’m glad that I’m not the only one who did a double take on Baucus being the guy to push universal health care. Baucus is a known conservative Dem and is probably to the right of Snowe, Collins and Specter. That being the case, this deal is probably done, with Obama taking out the mandate to make him look moderate. Awesome.
November 12th, 2008 at 5:46 pm
You had me at Toberlone Line.
November 12th, 2008 at 7:35 pm
If you are going to do that, you should also see Rutli, where the Rutli oath was supposedly sworn. This is widely considered to be the founding act that lead to the creation of Switzerland.
In 1940 the Swiss General Guisan had the inspired idea of squelching the pro-German sentiment in the (mostly German speaking, and partially Nazi sympathizing) Swiss officer corps by bringing every single one of them to this location, telling them that Switzerland would never surrender, and asking them to swear the Rutli oath of brotherhood and defiance to tyranny in the same place where it was originally sworn. Thankfully, there never was a Swiss Anschluss, and I think that the Rutli oath was one of the major reasons why.
November 12th, 2008 at 8:02 pm
You should read the Kos diary on why Mandates are a bad idea.
November 12th, 2008 at 8:35 pm
“Paging Petey: We have found you a new hero! Baucus ‘16!”
Ain’t it the truth.
And who woulda thunk it? Can anyone imagine a more unlikely Great Progressive Hope?
Derailed by Barack Obama and saved by Max Baucus. Human sacrifice, dogs and cats living together… mass hysteria! (About 2:20 into the video…)
November 12th, 2008 at 8:43 pm
“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…”
…being an enactable universal healthcare plan.
I know Matthew is too concerned about spending his inheritance to furnish his new real estate investment to worry about progressive legislative priorities, but it is a basically crucial difference…
November 12th, 2008 at 9:14 pm
Wouldn’t it be a lot simpler to just accept that there’s Medicaid for the poor & Medicare for the old already, & just make it so people that are somewhat above poor and not old enough for Medicare can buy into a basic gov’t plan in the middle? I mean, if government plans really work better as is commonly claimed, why not let people decide?
November 12th, 2008 at 9:32 pm
Here’s the Daily Kos diary on mandates. MNPundit is right. It is excellent:
http://www.dailykos.com/storyonly/2008/11/12/11410/086/271/659780
November 13th, 2008 at 9:04 am
Personally, I never figured that under a President Obama, Obama’s own plan would be the only plan under discussion. I assumed all along that either it would be modified as it passed through the Senate and House or other plans would be introduced in one or other and surge to the forefront.
At this stage it seems most relevant to note those things which Obama claims as either absolutely necessary or absolutely prohibited as a deal killer, and see what the best leaders in Congress can come up with.
After all, there was a time that people thought of Congress as a body empowered to make laws & stuff, so, you know, that might be cool.
November 13th, 2008 at 9:22 am
It’s a good day for you and me, Petey.
Derailed by Barack Obama and saved by Max Baucus.
In the end, health care may be too domestic for a Democratic nominee to derail merely by making a foolish positioning choice. It’s among the reasons why I chose foreign policy and Barack over domestic policy and Hillary. The president has lots of control over foreign policy, but there are other actors who can exert control over domestic policy.
November 13th, 2008 at 9:30 am
“Personally, I never figured that under a President Obama, Obama’s own plan would be the only plan under discussion. I assumed all along that either it would be modified as it passed through the Senate and House or other plans would be introduced in one or other and surge to the forefront.”
But, of course, we’re not talking about the possibility of Obama’s plan being “modified” in Congress. We’re talking about a radically different plan possibly emerging, a plan that Obama relentlessly demagogued against during his entire campaign for President.
Again, we’ve never seen an entitlement expansion emerge out of the legislative branch, rather than out of the executive branch. If the Baucus plan becomes law, (and I don’t think we’re anywhere near slam dunk territory on its prospects), we’ll be seeing that course of events happen for the first time.
November 13th, 2008 at 9:44 am
“It’s a good day for you and me, Petey.”
No doubt. I’m stunned by this turn of events, and few things in politics really surprise me. But we’re not out of the woods yet.
“there are other actors who can exert control over domestic policy.”
I’m beginning to think John Podesta is the single most important person in American politics.
November 13th, 2008 at 8:02 pm
No, he merely says he heard Obama was lying for partisan advantage. Now that mandate has be reintroduced seriously into the discussion, it shows that Krugman and Clinton were correct to call for it in the first place. It’s a given that ObamaFanBoyz eagerly swallow lies the precious dishes out.
If you want universal coverage, it has to cover everyone. If you want to have affordable coverage, it must, according to theories of insurance, collect from all in order to cover all. There is a reason one can not buy fire insurance for a burning house, flood insurance when the river is rising, and why life insurance is more costly for the aged: adverse selection. If health insurance is optional, only the needing will want to buy in, others will ’self-insure.’ Of course, they won’t self insure in the traditional sense of setting aside funds to cover contingent needs, but will take the chance on not becoming ill or paying out-of-pocket for minor expenses.
The Kos article is a silly strawman exercise that assumes because there are problems at the state level, solutions are impossible at the national level.
The question becomes how the mandated premium will be collected. Can people be forced to buy a policy at $100 per month or would it be more efficient to have a payroll deduction like we have for Medicare. Obviously, the latter is enforceable; the former is not. Just as obviously, the federal government is more able to establish a fund to cover low income individuals and families than a state. Mandates can be in effect a single payer with a universal pay-in to an insurance fund by anyone filing income taxes. How this is accomplished in the devil-in-the-details aspect and why industry tools like Baucus have to be taken cum grano salis.
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