Wednesday, October 14, 2009

The Sausage Factory

It’s anybody’s guess as to what kind of healthcare bill will emerge from the other end of Congress, but the one thing you can be sure of is that it won’t look a lot like what passed through the Senate Finance Committee yesterday. The focus was all on Sen. Olympia Snowe (R-ME) because she was the one Republican to vote for the bill, and whether or not she’s the trend-setter or the one and only is unknown, even to her.

Now that Snowe’s on board, conservative Democrats have greater cover (or believe they have greater cover) to vote with their party on a divisive issue. Good news for reformers, right? Not necessarily. Nobody really knows what will happen, but there’s at least one potential fear. Look out in the coming days (even hours) for centrist senators declaring or hinting that their continued support for reform hinges on Snowe’s continued support for reform. And it seems very likely that Snowe’s continued support for reform hinges on either a). no public option, or b). a public option affixed to a trigger mechanism, or c). a public option compromise that would allow states to opt-out, or opt-in to a public option. But no true public option, as reformers define it, let alone one that uses Medicare reimbursement rates.

That gives her significant leverage.

And then there are, of course, the lobbyists for every group out there from the insurance industry, undaunted by the clustasrophe of their bogus analysis by PriceWaterhouseCooper that only audited the costs of the bill without taking into account the savings. They will be out in force to maintain the status quo and spend enough money on boogedy-boogedy commercials (and salting campaign funds) to keep the pressure on the Republicans and blue dogs. By the time this is all over, what will likely emerge will be a pale imitation of what went in, and if you had hopes of an unfettered public option that actually gives the insurance, hospital and pharmaceutical industries something to contend with and gets them to lower costs, become accountable, and stop the ridiculous practices like refusing to insure a healthy baby, then you need to visit a slaughterhouse and see the difference between what goes in one end and comes out the other.