It is far from certain at this point whether health care reform will succeed. Most insiders believe that Congress will enact some form of comprehensive health care reform but it is easy to envision scenarios where they are not successful. The opposition comes mainly from the right, but there is also the view (perhaps as this is more of a man bites dog storyline) that it is the left which will cause health care reform to fail. Cici Connolly of The Washington Post examines how some activists are targeting Democrats:
In recent days — and during this week’s congressional recess — left-leaning bloggers and grass-roots organizations such as MoveOn.org, Health Care for America Now and the Service Employees International Union have singled out Democratic Sens. Ben Nelson (Neb.), Mary Landrieu (La.), Ron Wyden (Ore.), Arlen Specter (Pa.) and Dianne Feinstein (Calif.) for the criticism more often reserved for opposition party members…
Much of the sparring centers around whether to create a government-managed health insurance program that would compete with private insurers. Obama supports the concept, dubbed the “public option,” but he has been vague on details. Left-of-center activists want a powerful entity with the ability to set prices for doctors and hospitals.
But in the Senate, where the Democrats do not have the 60 votes needed to stop a filibuster, members are weighing alternatives such as a nonprofit cooperative or a “fallback” provision that would kick in only if market reforms fail.
Pushing for the public plan does have popular support but Connolly notes that this does not mean that a majority supports the entire agenda of those on the left who see a public plan as a means of transitioning to a single payer plan. She notes that, “While recent polls show high initial support for a government option, the number declines if told the insurance industry could fold as a result.” Many who support providing the option of a public plan also desire to continue with their current insurance.
There are signs that this pressure is influencing some Democrats but others fear this is counterproductive:
One Democratic strategist who is working full-time on health reform was apoplectic over what he called wasted time, energy and resources by the organizations.
The strategist, who asked for anonymity because he was criticizing colleagues, said: “These are friends of ours. I would much rather see a quiet call placed by [Obama chief of staff] Rahm Emanuel saying this isn’t helpful. Instead, we try to decimate them?”
If this effort is based upon pushing Democrats to support the public plan there should not necessarily be adverse consequences on the success of health care reform. Of greater concern is talk among some progressives of voting against a health care reform bill which does not contain a public plan. I can envision scenarios where Republicans have enough votes to filibuster a bill which contains a public plan, but a bill without a public plan could also fail if both Republicans and some progressives vote against it.
The goals should be to reduce the number of people who lack insurance and to reduce insurance problems such as people being cut off when they develop a serious illness. These are serious problems which need to be addressed and there are multiple possible solutions. Ideological battles such as over whether to have a single payer plan should not be used to prevent meaningful reform, even if the reform will inevitably fall short of what some desire.