I just really doubt Democrats aren't aware that if your opening position is half a loaf, your "compromise" is a quarter of a loaf. I have to believe that a quarter of a loaf is the goal.

Excellent post and argument for a public option to be included. Charles Grassley passed his usefulness as a public servant many years ago. Please, Iowa, bring him home for good next time around.

America is a center-right nation. If liberals try to turn us into Canada or France they will pay the price.

Sooner or later, Democratic policymakers -- on both ends of Pennsylvania Avenue -- are going to realize that they keep entering these talks with the fulcrum in the wrong place.

Exactly right.

Bipartisanship means giving DC Republicans everything they want.

"Sooner or later, Democratic policymakers -- on both ends of Pennsylvania Avenue -- are going to realize that they keep entering these talks with the fulcrum in the wrong place."

They'll realize that at around the time they figure out that it is a bad idea to be a center-right party in a center-left country.

I'm not particularly optimistic. When it comes to their cemented political positioning, they're as dumb and stubborn as the GOP. That particular chicken just hasn't come home to roost yet, because they aren't as far gone into crazy-land as the minority party.

The republican plan, don't get sick!

Why is it considered "bipartisan" if the Republicans get everything they want.

And yes, "no public option" is everything they want - or at least 90% of it.

This whole idea of "we'll talk as soon as you yield everything to us" is how Bush ran the White House and conducted his foreign policy and it got this country nowhere. Worse than nowhere - 8 lost years.

I'd rather not Democrats buy into it, especially if they are yielding to a now-regional party with a shrinking base. But, for obvious reasons, I don't have too much faith in them.

Grassley and the rest in congress pay $400 a month for a high dollar souped up Blue Cross/Blue Shield policy. I tell you what, if Grassley can cut a deal with Blue Cross/Blue Shield for every American to get as good a deal as he gets, then I will throw in with him. Oh, the $356 he and his wife are paying is just his share? Then why in the hell does the taxpayer pick up the rest. He can more easily afford over a $1000 per month than anybody making a minimum wage pays for a high deductible plan.

I forgot to say that I am nothing but a Repiglican automaton who can only splutter what it is told to splutter. I have no ability to actually think.

Oh, Bacus finally realized you don't give anything before negotiations start?

He's been a Senator for 31 fucking years.

Congratulations Captain Obvious.

Thanks to Steve for making the point about "the fulcrum". Single-payer is the prize and public option is the compromise. Damn right!

Any reason Baucus can't just turn to the Replicants and say, "OK, you obstructionist twerps, Single-Payer is back on the table"?

I mean, besides that he's more spineless than an amoeba?

I don't really know if I'm conservative or liberal. Certainly I'm both on different issues. I'd guess that the vast majority of people in this country are much the same. One thing for certain a gov't health care package for everyone has overwhelming support amongst the people. If your against that repubs you'll have hell to pay.

which just so happens to be the mainstream Democratic position right now.

You meant, "which just so happens to be the mainstream Independent position right now, and the plurality Republican position." It's so easy, isn't it? To fall into the habit of giving away half the store up front, when the Dems have been in the habit for so long of giving up three quarters of it up front, and two thirds of the rest during negotiations?

Sooner or later, Democratic policymakers -- on both ends of Pennsylvania Avenue -- are going to realize that they keep entering these talks with the fulcrum in the wrong place.

Yglesias had an unusually perspicacious post up yesterday on "Why Democrats love the filibuster". It allows them to keep their base happy by introducing progressive legislation, and keep their contributors happy by ensuring that the legislation always fails.

Matt could have made the same observation about the places the Dem "leadership" choose to place the fulcrum. You can only attribute it to inexperience for so long, and to stupidity for so long after that. Fill in the blank: "It's not a bug, it's a _______."

WORD. Great post.

they keep entering these talks with the fulcrum in the wrong place.

That's overly simplistic. The Republicans take these extremist positions and get away with it because they own the media. Dems don't and therefore can't make extreme arguments effectively. In this case, neither Obama, Clinton nor Edwards argued for a European style system. I suspect that was because they couldn't sell it. They realize they have to start out with an argument that the majority is already inclined to accept. But they should be doing a much better job of defending it.

bipartisanship != give the GOP exactly what they demand

I don't think that word means what Grassley thinks it means.

Like others above, mainstream Dem politicians DON'T believe "single payer" is the goal. They would be very happy to see nothing happen in health care policy, or compromise with a public option.

They are afraid of single payer - it is vulnerable to demagoguery by Repubs and lobbyist groups. It would be a radical change, and they know how easily their constituents will be persuaded by negative ads. Plus many have financial interests in keeping cozy with certain interested groups.

Better to talk about it, and get nothing done. Starting from a position of "public option" and compromising to "no real change" would suit them best.

Democrats gave us Medicare, Medicaid & CHIP. Great, one will blow up the federal budget (and note, even from yr one, assumptions about costs have turned out to be too low), while the other is wreaking havoc on state budgets.

And as an aside, how is it that the goverment controls costs in these programs? What specific policies in a fee-for-service program controls costs?

Lastly, anyone betting on disease management and wellness to control costs, I suggest that they take a look at the Medicare disease management pilots - they did not work! Good luck scoring those savings.

Oh, and I do have one last thing - why is it that the Senate HELP bill finds it worthwhile to spend $8B/yr on running trails, jungle gyms and streetlights in a healthcare bill that is supposed to be controlling costs and expanding insurance access?

Occam's Razor leads me, at least, to conclude that the reason many Democrats don't work to support the public option is because they don't support the public option.

They support the insurance companies and big Pharma.

Obama's mission, should he choose to accept it, is to make this support of the shareholders and executives of the "health care industry" politically untenable.

We need to redefine bi-partisan as getting liberal and conservative Democrats to agree.

Without a public option, there is no reform. So what is being said is there will be no reform. You can pitch expansion based on increasing taxes, but no reform.

We spend 2x what is needed on health care today (% of GDP) and cannot afford to extend that spending for everyone - plain and simple. So no reform means no expansion.

This is all bascially a catch-22.

Why can't someone in Congress write up a single-payer reform bill, introduce it, and get it budget-scored by the CBO? Just to see what happens, ya know?

Public Option is a deal breaker for me, too. The only way I'm willing to give it up is if it's replaced with the Single Payer option. I wouldn't mind writing a big RIP on all health insurance companies.

I would actually prefer a public option and private option, for awhile at least, over a straight move to single payer.
But what strikes me is that while Republicans have people repeatedly on tv staking out their most extreme positions, the progressives either don't have those guys or they never appear on tv.
I have seen Gingrich and Delay on TV more than I can say. Where are the out of office dem leaders that likewise have nothing to lose politically? Can't Gephardt and Daschle loudly advocate for single payer? Instead Daschle trys to give away even the public option when he does speak out.
We need some Dems to move the Overton window a little to the left as a broad strategy.

God I hope Grassley gets breast cancer and then his insurance gets cancelled.. It is the only way to make this fucking idiot see the light.

Despite their opposition I hope the Republicans in Congress will continue to talk to the Democrats if they have any suggestions to improve the bills. When the Dems pass a bill into law there will come a time (in the very very distant future) when Repubs will once again be in charge and they won't want a law which is unmanageable or seriously flawed.

I just read an item on TPM that mentioned:
1) the Bills being prepared in the House all include public option, and
2) Speaker Pelosi has already stated that no Bill without public option will be agreed to by the House.
Those two points lead me to believe that President Obama is again giving the Republicans enough rope to hang themselves. I also don't think single payer is completely off the table; if the Republicans try to stop public option there is nothing to stop the Democrats from going for the whole nine yards.
(Ok, maybe I'm wishing just a little with that last bit! So, surprise me!)

"I also don't think single payer is completely off the table; if the Republicans try to stop public option there is nothing to stop the Democrats from going for the whole nine yards.
(Ok, maybe I'm wishing just a little with that last bit! So, surprise me!)"

It *would* be a nice surprise. Unfortunately, the Democrats have proven over and over again that when they allow the GOP to win, they aren't going to be coming back with something stronger. They just cave in and let it go.

I don't want a bipartisan plan at all.

First, since the Republicans got pounded -- again -- last November, they've done nothing but impede. The Party of No. Their "alternative" versions of things -- like their budget plan -- are jokes, wholly without substance.

Second, the American people went to the polls and voted in Democrats in such large numbers because they expected them to stand up and do something for the little guy, whose been consistently screwed for the last 30 years. So instead of worrying about hurting the feelings of the poor Republicans on the other side of the aisle, why don't Democrats actually do their jobs & represent people and what they want.

"a public option was a deal-breaker for the minority party. Period."

No Public Option is a deal-breaker for me. Period.

MarkH: When the Dems pass a bill into law there will come a time (in the very very distant future) when Repubs will once again be in charge and they won't want a law which is unmanageable or seriously flawed.

I have to disagree. Other than doing nothing and continuing to line the pockets of their contributors to earn their gratitude, I think the Republicans would like nothing better than to have Congress enact an utterly flawed program which would achieve none of its goals. They could blame it all on the Democrats, ride the failure back into power, and repeal it without having to make any effort to make it work. Then they could continue to have spiraling healthcare expenditures as an excuse for why they have to eliminate any programs favored by Democrats (but never the insanely large tax cuts that are the true cause.)

Sure, it would be disastrous for ordinary Americans, but they don't give a damn about that, and if it gives them more of a basis for blaming everything on government, what possible downside is there if you're a Republican?

http://en.wikipedia.org/wiki/Overton_window

gop bipartisanship - circa 2004: Go F*ck Yourself

Max Baucus is wrong about taking single payer off the table. Obama is brilliant for doing it.

People should take Obama at his word that he doesn't think single-payer is the best way forward. France has better health care than Canada without single-payer so cries of "single payer, single payer!" are hardly the trump card they are made out to be in cost and quality from some advocates. And what would the compromise position be from single-payer? The mechanisms for single-payer are entirely different than you would find in blended public/public system. The legislative compromises you make from single payer to something else are what exactly? There isn't a way to get from A to B and not enough support to pass single payer. So you end up with a cacophony of voice like you did when Bill Clinton tried this in the 90s.

By making the public option the left position it puts every supporter of serious reform in the same boat fighting together. That's smart, not dumb. The House is rowing together on this one and it's the House version that is going to be jammed down the Senate's throat in reconciliation. I'll be overjoyed when that happens because A) I'll be able to sign up for public health care and B) I won't have to read 3 posts a day about Max Baucus on my interwebs.

If it's true that the senate rules will permit a path for this reform bill which requires only a simple majority, then I say screw bi-partisanship and give the majority of the voters the option they want, a public system which will compete directly with the insurance oligarchy. Isn't that what competition and free enterprise are all about ?