Marc Ambinder on Saturday wrote a blog entry regarding his conversation with Jonathan Gruber, "a leading health economist at the Massachusetts Institute of Technology who is consulted by politicians of both parties." Ambinder's blog entry is here: http://politics.theatlantic.com/...
Ambinder asked Gruber about the Senate bill which was facing a crucial cloture vote that evening. Gruber is particularly concerned about "bending the cost curve" and was one of about 20 leading economists who wrote to President Obama last month insisting that HCR must control long-term health care costs. Gruber's response to the Senate Bill:
Gruber likes what he sees in the Reid proposal. Actually he likes it a lot.
When the Senate Finance Committee was working on it's bill, many on the left were critical of the effort. But the Committee, with White House assistance, was focusing on the crucial issue of long term costs. Max Baucus and Kent Conrad and the other oft-reviled members of that committee quietly incorporated the best thinking of health care reform advocates. The result is a bill that will make a difference.
"I'm sort of a known skeptic on this stuff," Gruber told me. "My summary is it's really hard to figure out how to bend the cost curve, but I can't think of a thing to try that they didn't try. They really make the best effort anyone has ever made. Everything is in here....I can't think of anything I'd do that they are not doing in the bill. You couldn't have done better than they are doing."
Ambinder credits both Baucus and Reid:
Both the Senate bill's priority on controlling long-term health care costs, and its strategy for doing so, represents a validation for Senate Finance Committee chairman Max Baucus (D-MT). When Baucus released his health reform proposal last September, after finally terminating months of fruitless negotiations with committee Republicans, Democratic liberals excoriated his plan as a dead end. And on several important fronts--such as subsidies for the uninsured, the role of a public competitor to private insurance companies, and the contribution required from employers who don't insure their workers--Reid moved his product away from Baucus toward approaches preferred by liberals.
But the Reid bill's fiscal strategy, and its vision of how to "bend the curve," almost completely follows Baucus' path from September. Baucus' bill was the first to establish the principle that Congress could expand coverage while reducing the federal deficit; now that's the standard not only for the Senate but also the House reform legislation. And, perhaps even more importantly, the Reid bill maintains virtually all of Baucus ideas' for shifting the medical payment system away from today's fee-for-service model toward an approach that more closely links compensation for providers to results for patients. In the Reid bill, there is some backtracking from Baucus' most aggressive reform proposals, but not much.
Some liberals decided early on that the Baucus bill was unacceptable, but those commenters were largely focused on mandates and the public option, not considering the most important issue of all: underlying health care costs. Nothing will affect premium affordability or universal access -- or our nation's financial solvency -- more than the underlying cost of providing health care.
Some, like Ezra Klein, were more generous, dubbing the SFC bill "Baucus's not-that-bad bill." http://voices.washingtonpost.com/...
It may well be that the final product (with or without an untriggered public option) may be much better than not-so-bad. The sausage, thanks to the hard work of Democratic Senators of all stripes, may end up being nourishing after all.