Yglesias on the Grayson bill:
Progressives should be working to pass this bill, then working to pass Grayson’s Medicare buy-in law down the road. That’s a possibly feasible path to the preferred progressive end-state that has the benefit of making things better as we go along. Kucinich’s bold defense of the status quo isn’t going to change anything.
Is that really a feasible plan? What makes it feasible? How does this claim of feasability fit in the argument that this is the last chance to do health care reform for 20 years? Why is it not a more feasible plan to try and get something like the Grayson bill in the CURRENT legislation. After all, 44 Senators now say they support adding a public option through reconciliation.
Frankly, I think there is something completely disingenuous about Yglesias' position. To wit, he does not mind the idea of Medicare Buy In or some other form of a public option -- but he does not really care if it happens. That happens to dovetail nicely with the Beltway Dem view of the matter. Is this a question of "capture?" I do not know, but I do not think that Yglesias can credibly claim to be representing the "pro- public option" position. Similarly, Ezra Klein writes:
Comprehensive visions for reform and incremental visions for reform have been at odds throughout this process. That was proper, in many ways: When you're building a new structure where the different parts work together, you have to be relatively comprehensive about it. But once that structure is constructed, incrementalism makes a lot of sense. Want a public option? Write the bill. Want to outlaw fee-for-service in the exchanges, or give a tax break to insurers who are constructing networks where the doctors have a different payment structure? Offer it in committee. Think subsidies should be higher, or maybe lower? Amendments are a wonderful thing.
A lot of these reforms become easier to implement when there's a place to put them, and incentives you can offer to encourage their adoption. The exchanges are a big step forward in that regard. The public option is a good example. If we passed a public option now, how would you get it, exactly? Call the government? And how would you handle the adverse selection problem, where sicker people who were rejected by private insurers would use the government's offering as a last resort?
There are a lot of other good ideas that wouldn't work very well in the current system, but work a lot better when you've got a simple marketplace where a lot of different insurers are competing with transparent prices, standard descriptions, and some basic rules of the road. You need a comprehensive bill to set that up, but it can play host to a lot of incremental legislation going forward.
You see? Now that Ezra's preferred plan (the regulatory reform framework centered on the exchanges) has been adopted, he is all for "good ideas" within that framework. Indeed, he argues, this framework will help you get what you want if you are a public insurance proponent. Hell, Ezra even says you could not have a public option without his preferred framework. (Never mind the actual existence of Medicaid, Medicare, the VA, etc.)
This is clearly a Beltway Dem's perspective. To repeat - they will mouth the words of support for the public insurance framework and even raise no objection to it so long as any proposal or advocacy for that proposal does not jeopardize THEIR preferred framework. They are "very reasonable" in that way.
Thus Grayson's proposal is "good" and they are all for it, as it won't jeopardize what they want. (And honestly, everyone knows it is pretty meaningless anyway. It will never happen.) But they hate Dennis Kucinich because, different from Grayson, Kucinich wants his point of view to prevail now. To be fair to Grayson, I am not convinced that he dislikes the situation now. He may be getting exactly what he wants - good graces with Beltway Dems and "street cred" with progressives. Pols are pols, my friends.
Different voices should point out that this is just another form of rolling progressives on health care. I understand it. Politics is like that. But progressive activists should understand what is happening with the Grayson bill. And that it will never even come up for a vote. Beltway Dems and Village Bloggers can't and won't tell you that. Is it a capture problem? I'll let someone else answer that one.
Speaking for me only
