by Patrick Appel
Matt Steinglass explains to Conor Friedersdorf why you can't pass health care reform in small chunks:
[T]he reason one often can’t pass individual planks of the reform in isolation is that taken individually, each plank generates perverse consequences that will lead to strong opposition from a particular constituency.
Exactly. If you sliced the House bill into pieces and passed each piece individually only the politically popular bits would get through. The cuts to medicare advantage would never make it on their own, but you can't fund the bill without them. Simple, small bills sound nice, but there are a lot of sections in complicated bills that would make the status quo worse if enacted in isolation. I've my concerns about the health care bill, but its page-count is not one of them. Conor also addressed his grandmother's fear of sweeping, disruptive reforms, but many of the conservative solutions to the health care mess, some of which I'd be willing to try were they politically feasible, would be equally disruptive, if not more so. Take the Wyden-Bennett bill, which has largely been labeled the bipartisan health care bill. Here is Ramesh Ponnuru on the politics of the bill:
Is there any reason to expect the public to be more enthusiastic about a plan that gets rid of the tax break for employer-provided coverage altogether? The disruption of existing arrangements has, as I noted earlier today, been the most important political disadvantage of Obamacare. It's a bigger one for Wyden-Bennett. As for its vaunted low costs, they are achieved by more than doubling the percentage of Americans in HMOs. That should sell well.
Eliminating the tax exclusion for health insurance would quickly and a bit too obviously chase employers out of the health care businessa result much to be desired but one that could turn the town hall crazies into a lynch mob.
And here's Alex Knapp arguing in favor of the bill:
[A]s for the proposals on the table, I think that Wyden-Bennett is a superior plan for reform than the current House bill, though I don’t think that Wynden-Bennett is politically feasible. This is largely because the Republicans in Congress have dug in their heels so deep that they’ve made themselves not players anymore. You’ll notice that the big debate is not between Republicans and Democrats, but rather between liberal Democrats and conservative Democrats. I think that if Wyden-Bennett got some more, serious support from the GOP, it would stand a better chance. As it stands now, though, I don’t think that’s the case, so we’re stuck with the House bill which, as bad as it is, is still better than the status quo.
Conor, like any good conservative, doesn't like the idea of sweeping changes, a viewpoint I have sympathy for and often share. But a lengthier bill does not necessarily mean it is more radical. Wyden-Bennett is 168 pages long. The House bill is 1017 pages. The 1935 Social Security bill was 64 pages. Their size doesn't tell you much about their nature.