Matt Yglesias has a sober post about the Baucus proposal for healthcare reform legislation. While much of the blogosphere has been furious about its timidity, Yglesias sees value in that it would move the ball forward and improve the healthcare system in the United States. He justifies this, in part, by saying that while Massachusetts and Switzerland aren’t ideal models we should use to shape reform policies, they are notably better than the healthcare system elsewhere in America.
Sure. Fine. Whatever. No one who has been has an active advocate for massive reform (be it single payer or a public option) has ever said that it wasn’t possible to put together some package of changes that would constitute an incremental improvement of the healthcare system in America. It’s not surprising that the Baucus proposal would reduce the number of uninsured America and do some things to provide a higher degree of regulation of the insurance industry than we currently have. But this is not to be mistaken for leadership and therein lies the real critique of Baucus as I see it.
The challenge wasn’t for Baucus to take his position as chair of the Senate Finance Committee and create legislation that produces marginal change. The challenge to Baucus, and in reality to all members of Congress and the President, was to produce legislation that essentially solves the crises of the healthcare system: coverage, affordability, access, and quality care. The needs for reform exceeds the benefit of incremental change.
So when I look at the Baucus compromise, which I would concede is better than I thought it would be and has a likely price tag of a couple hundred billion more than DC conservatives want, I am stunned by the refusal of Baucus to attempt to solve the healthcare problem by showing, at minimum, a comparable level of leadership to Chris Dodd and the three House committee chairs. Yglesias is right that the Finance proposal would make the healthcare system in the US a bit better than it currently is. But we need leadership, not incrementalism. And right now it will take leadership to overcome incrementalism put forward by Baucus.
There’s also the question of while conceding that the Baucus plan is an incremental step, it may not be a step in the right direction. That seems to be Chris Bowers’ take. Obviously there is danger in pushing a piece of legislation that lowers the quality of coverage, increases risk, and is a handout to insurance companies. Whether or not this incrementalism is positive or negative, it is clear that it is nonetheless not leadership.