The New Health Dialogue

In the long run, to misquote John Maynard Keynes, bipartisanship can be good for health policy.

In the short run, we've got the Senate Finance Committee to deal with.

The Hill (among other newspapers today) has some interesting, insights into GOP dynamics in an Alexander Bolton article headlined: "Grassley promised not to sell out his party."

Sen. Chuck Grassley, the senior Republican on the Finance Committee, has assured his GOP colleagues that he will not sell them out and strike a private deal with Democrats on health care reform, according to Republican senators.

Grassley, (R-IA) who is known for having a close relationship with Finance Committee Chairman Max Baucus (D-MT) and has been negotiating behind closed doors with Democrats for weeks, made the promise to the entire Senate Republican Conference at a meeting late on Wednesday, according to several senators who attended.

Sen. Mike Enzi (WY), the senior Republican on the Senate Health, Education, Labor and Pensions (HELP) Committee, who has also participated in the negotiations, made a similar commitment. But Grassley's words had the most impact, easing the anxieties of conservatives who feared the unpredictable Iowa senator would give Democrats the crucial bipartisan support needed to pass a $1 trillion health care package of Democratic priorities.

Grassley, Enzi and Sen. Olympia Snowe (R-ME) are still meeting with Senate Finance Committee Max Baucus and a few other Democrats. They've been putting in long hours for a long time -- even though many of their GOP colleagues would be happy to see them quit. Senate Democratic leaders are going to have to weigh the willingness of these three Republicans to keep slogging through this -- and the odds of a timely success. In the Senate, bipartisanship still has many advantages, now and in the future. But the end result has to be a bill -- a good solid comprehensive health care bill.

Even if those three still keep working with the best of intentions, it's impossible not to hear the loud and clear rhetoric from Republican party leaders and strategists that the way to kill health reform is to slow it down. They say it in their speeches, and in their strategy memos. It's not a secret.

Like it or not, we do have more time now -- the month of August. The extra time may even turn out to be wise, a chance to work out kinks in the bills and explain it to the public. Numerous polls have shown the public is nervous about the changes -- but also still quite sympathetic to the overall aims of reform. A New York Times/CBS poll also found that voters see the President Obama Democrats as trying to reach out and be bipartisan on health reform, but they do not see Republican reciprocity. (In the text of the poll we read, it was page 12 of 23 on the NYT home page).

It's disingenuous to say this is a rush job. The Senate Finance Committee spent much of 2008 -- even before they knew who the next president would be -- getting ready for health reform, holding hearings, meeting experts, arranging a bipartisan summit, producing a White Paper. And the key players, including Grassley, Enzi and Snowe, have been working on health care for years -- in some cases decades. Grassley himself, as the Washington Post noted, had earlier backed Baucus's timetable.

They know, just like the rest of us, what the failure to act means, for constituents losing their jobs and their health coverage, for families going broke or losing their homes when insurance doesn't cover the bills when someone gets sick. They know how our current system (and in the absence of reform our future trajectory) hurts small businesses trying to cover workers, and harms big businesses struggling to compete in a global market where other countries spend less but get more. So in the long run, we need health reform. And in the short-term too.