Fellow Kossacks, we have spent the last few months moaning, groaning, and gnashing our teeth over the progress of healthcare reform, and many still fear that no bill whatsoever will pass. Those that say that no bill is better than a bad bill are perfectly correct--but in fact the likelihood that we will have no bill is (IMHO) extremely unlikely. Our worries have resulted from a tendency to perceive this as an isolated political opportunity rather than a genuine political imperative, failing to recognize the heft of the external pressures that will continue to drive healthcare reform.
Recent statements by Tom Harkin, Jay Rockefeller, and Howard Dean (all detailed here) seem to suggest the outlines of a larger plan that is already in place. Remembering that poker is Barack Obama's favorite game, it appears likely to me that we have been fooled by a public "bluff"--the Obama Administration's alleged reluctance to pursue reconciliation, for God knows what reason--in a high stakes game of political poker.
By negotiating in advance with the pharmaceutical industry, the hospital corporations, healthcare providers, and major corporate employers, the Obama Administration has effectively isolated the health insurance industry as the only major player that wants to avoid reform. That is, of course, because the health insurance industry has historically been a major pain in the ass for ALL of the other players. Now only the teabaggers remain on their side.
If healthcare reform should indeed fail to pass now, the future is predictable. Hospitals around the country will fail because of the increased number of unfunded patients that have resulted from our current employment crisis. States that have burgeoning Medicaid budgets and limited economies (like Maine, where I live) will teeter on the edge of bankruptcy, or drastically cut their benefits, which in turn will threaten the revenue stream of hospitals and healthcare providers. All the other players can see this, and want to avoid it.
My prediction: As confidently stated by Rockefeller, Dean, and Harkin--who know quite a few things to which we are not privy--a healthcare reform bill will pass through reconciliation (we have the votes, why not?)with a potent public option, and minimal public anguish. However, this will not happen until Congress has completed negotiation of the fine points for an actual bill, and the Obama Administration have completed a public information campaign to sway the American public back to our side once and for all. Blue Dogs like Baucus et al. will probably vote for the bill just like Tom Harkin says, because it will have a whole lot of popular goodies in it (like "no exclusion for previous conditions") that no Democrat will want to vote against lest they be primaried and beaten. And the Republicans will have spent the last several months providing Obama with enough rope to hang themselves in the 2010 midterms--all those foolish video quotes placing them firmly on the wrong side of history.
And once again a poker-faced Barack Obama will have amazed us all with his skills at three-dimensional chess. Or poker. Or....