[Posted by Karl]
Late on Thursday, the WaPo’s Ezra Klein found out that Obamacare is running into more problems than he thought. Here’s the summary:
Earlier today, Sen. Kent Conrad, the North Dakota Democrat who chairs the Senate Budget Committee, introduced a “potential compromise” on the public plan: A system of federally-chartered co-ops that could offer a non-profit alternative to the for-profit insurance industry. In this telling, the co-ops preserve the central feature of the public plan — they’re a competitor to the traditional insurance industry — but are free from the baggage of government control.
I spoke to the Senator this evening about the co-op model, and he said a few things that surprised me. First, his search for an alternative was on behalf of the G-11 — the key Senate powerbrokers on health care. Second, it proceeded from the premise that the public plan doesn’t have the votes. All Republicans are opposed and, according to Conrad, “at least three Democrats.” And third, he thinks reconciliation is basically out as a viable option for comprehensive health reform. (Emphases added.)
Klein certainly should have known that trying to railroad Obamacare through as part of the budget reconciliation process would be problematic in the Senate. Indeed, I blogged his explanation of why this was so back in March.
For that matter, Klein’s own reporting on efforts to weaken or delay any public plan also should have warned him that the patient was suffering from internal bleeding. Since then, there have been only more stories about centrist Senators, Blue Dogs in the House and the AMA distancing themselves from any “strong” public plan.
So, what to make of Sen. Conrad’s latest trial balloon? Here is his spin:
The co-op structure came to mind because it seems to fulfill at least some of the desires of both sides. In terms of those who want a public option because they hope to have a competitive delivery model able to take on the private insurance companies, a co-op model has attraction.
And for those against a public option because they fear government control, the co-op structure has some appeal because its not government control. It’s membership control, and membership ownership.
Also the co-op model has proven very effective across many different models. Ocean Spray in the cranberry business, and Land of Lakes in the dairy business, and Puget Sound in the health care business.
What Conrad does not say is that Ocean Spray settled a lawsuit a few years ago which alleged that the co-op engaged in anti-competitive practices and abused its dominant position to drive rivals out of business. Conrad also did not mention that the Health Care Purchasers Association on Puget Sound pretty much had the field to itself after Washington state passed a disastrous (and now mostly-repealed) Clinton-style healthcare takeover. Thus, it does not seem as though Conrad’s co-ops are much more about competition than the “strong” public plan. The good news is how quickly the Democrats are already having to find new ways to try to fool the public.