Friday, July 11, 2008

A Very Important Little Known Fact about Universal Health Care

There's a crucial little known fact that Paul Krugman and everyone else for universal healthcare needs to know:

The bill for it can be structured so it's not filibusterable.

So it only needs 50 votes (with a Democratic vice president to break the tie).

It's therefore far more realistic to achieve than people think, and we don't have to compromise and not have a true universal health care plan as Obama has done at least so far (although he's said things to leave himself wiggle room to propose a true universal healthcare plan after being elected.)

New Republic Senior Editor Jonathan Chait describes this in his 2007 book, "The Big Con: The True Story of How Washington Got Hoodwinked and Hijacked by Crackpot Economics" On page 204:

Perhaps the most incredible thing about the [1993 Clinton] health care debacle
is that the Democrats could have avoided the filibuster that ultimately killed
the reform if not for the stubborn insistence of one senator – a liberal
Democrat, at that. Passage would have been all but guaranteed if the senate had
included health care as part of a "reconciliation bill". This is a senate term
for an annual piece of legislation dealing with the budget. A reconciliation
bill, unlike any other, cannot be filibustered and therefore can pass with a
simple 51-vote majority. Given that the Democrats controlled 57 senate seats,
the numbers would have allowed for easy passage even with a half dozen

Yet the Democrats did not do this because West Virginia's
Robert Byrd adamantly refused. Byrd was an old fashioned New Deal Democrat who
supported reform but cared more about the traditions of the Senate than anything
else. He was given to interminable speeches quoting Cicero and other orators of
antiquity, and his sense of importance exceeded even Moynihan's. Byrd objected
on the grounds that reconciliation bills could be subjected to a twenty-hour
debate limit, and he felt the issue too important to be so circumscribed. He
would not budge in the face of pleas from Clinton and his fellow senators, and
his ability to tie the senate in knots if so inclined deterred the Clinton
administration from crossing him. In the end, Dole spearheaded a filibuster that
killed the potential reform.

See also, the Washington Post article from March 14th, 1993, "Shortcut for Health Care Plan Blocked".

As I've written before, enacting universal health care would create such enormous political capital, it would be well worth making any enemies in the Senate. And once it was enacted, like old age Social Security and Medicaid, people would clearly see how much better off they were with it than before, and the Republicans would (probably) never be able to get rid of it. It would be political death, another third rail of American Politics. So there's no need for a hopefully new Democratic administration to be scared to go for a true universal health care plan. I hope everyone in a new Democratic administration understand this.

Important Addition:
After looking into this further, Jonathan Chait, normally a good source, may be misleading here or incorrect. Senator Robert Byrd wrote a senate rule which was passed in the 1980s which allowed objections to be raised for reconciliation bills when "extraneous" material is included; ostensibly, "extraneous" means no budgetary impact, but how exactly a law will be interpreted is often unclear; it depends on past cases (precedents), legal principles, some established over centuries, and other things, so it is often difficult for a laymen to predict how the law will be applied in a specific instance, and it requires a legal expert, perhaps even a legal expert who specializes in that specific area, and is very good.

I've done a good deal of reading on filibusters, but this is a fine and difficult legal point, and to really get a clear idea of whether a universal health care plan would be able to avoid filibuster, or whether perhaps some parts of it would, while others would require 60 votes, requires an expert specializing in this area of the law.