Is Baucus Plan Good Enough?



Dave Mann

There’s a saying you often hear at the Legislature when compromise has been reached, and no one’s happy with it:

“Don’t let perfect be the enemy of good.”

In other words, this deal is the best you’re going to get, and don’t oppose a good plan because it doesn’t contain all you might want.

Which brings me to the debate over health care reform. Yesterday the Senate Finance Committee passed the Baucus plan.

The outlines of the final health care reform bill are starting to become clear, and it will likely contain (or lack) something that will upset nearly everyone:

Conservatives will hate the cost and the huge expansion of Medicaid to cover the uninsured.

Liberals will hate that the plan won’t insure everyone, that it will deliver many new customers to the insurance industry, and the lack of a “public option.”

Libertarians will hate the government mandate for all Americans buy health insurance — perhaps the first time in American history that government would require citizens to purchase a product from a private industry.

And that’s just a few of the disputed parts of the plan.

Moreover, the business lobby has had its way in D.C., as the New York Times reported on Sunday.

As a result, some experts are saying the plan wouldn’t control the spiraling cost of medical care.

So there’s much not to like.

But consider the many good outcomes:

1. The bill would provide health insurance to tens of millions of Americans currently without coverage (I’ve heard estimates of 25 million receiving insurance). Millions of Americans would lead healthier lives and be more productive in the workforce.

2. Insurance companies would no longer be allowed to exclude so many Americans because of “pre-existing conditions.” That would also lower the cost of insurance.

3. Government subsidies. Yes, we’d all be required to buy insurance, but many lower- and middle-income families would receive government subsidies to pay for it (workers making as much as $40,000 a year might be eligible.)

4. The price of premiums would come down. (How much they would drop is open to debate.)

All that would mark a huge change from the current system and improve the lives of millions.

On the other hand — as many liberals have pointed out — this year marks the height of Democratic power. If a public plan can’t pass now, will it ever? Under that thinking, shouldn’t progressives shoot for the moon? 

There’s risk in that too. If going for a public option scuttles any chance of reform, it might be years before another opportunity arises. Should liberals take what then can get now?

Conservatives and libertarians will despise the plan’s expansion of government, but providing insurance to so many Americans may save taxpayer money in the long run. If we’re not going to get more market-driven reforms — I doubt health savings accounts are coming any time soon — should conservatives and moderates support a bill that improves the system a bit? (I’m going to ignore the doomsday scenarios spouted by some on the far right.)

For good background, the Times published its take on the Baucus bill on Sunday.

So, what do you all think? If the final plan is some version of the Baucus framework, would you be for or against it?

It ain’t perfect — far from it — but is it good enough?

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