Wednesday, February 24, 2010

Is Healthcare Reform Really Dead?

I don't like resorting to questions for post titles, but I simply can't figure out whether we really have come to the end or not.

The latest gambit is that the previously passed Senate bill will be passed by the House and then both House and Senate will use the reconciliation process to revise the bill.

Democratic Senator Kent Conrad (SD) recently said that the Senate won't act on a reconciliation bill until the House passes the Senate bill. The only problem is that reports suggest Speaker Pelosi won't act on the Senate bill until the fixes are in place. When told of this, Conrad is quoted as saying then healthcare is "dead."

This congressional chicken-and-egg story really has left me wondering. Is Conrad making a point about the political reality of passing healthcare reform, or is he making a parliamentary point, and that the Senate is actually prohibited from taking up reconciliation until the House passes the Senate bill? Apparently, my confusion puts me in some good company. Even the Open Congress blog is having trouble deciphering Conrad:

I see three possible ways to interpret what Conrad means.

1) Conrad thinks debating a bill that would amend another bill that is not yet law would lead to a procedural point of order objection that would be sustained by the Parliamentarian of the Senate.

2) The Senate doesn’t have the votes to pass the reconciliation bill unless they are certain that the House will seal the deal by passing it and the underlying Senate bill.

3) David Waldman of Congress Matters speculates that it may be that the CBO would want to score the reconciliation bill in conjunction with the underlying bill so that the budgeting numbers for the reconciliation bill would be insanely high, and that the budget numbers could actually affect what the Democrats can do on a procedural level.

Why he’s so confident about the current strategy not working is unclear. It is totally uncharted legislative territory — never been done before. I share Waldman’s frustration with the lack of detail here.

I don't support the current health reform because I think that by further entrenching the current health insurance model of employer sponsored, first-dollar coverage, it fails to achieve any of the goals that we so desperately need: Reducing the cost of health care for routine and chronic care; mitigating financial suffering due to a catastrophic medical incident; increasing the ability of our work force to adapt to changing conditions; insuring the continuation of innovation in medicine.

None of these issues is going away, so it's clear that the question I started with isn't the correct one. Really all we can ask is whether or not the current healthcare reform effort is dead or not. For that answer, I guess we will just have to wait and see.

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