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Today In Ridiculous ACA Counterfactuals


Tom Harkin has pretty much joined the Rahm/Schumer/Frank bandwagon:

“We had the power to do it in a way that would have simplified healthcare, made it more efficient and made it less costly and we didn’t do it,” Harkin told The Hill. “So I look back and say we should have either done it the correct way or not done anything at all.”

On the general argument that Democrats should have just given up on health care reform until it was possible to get the unicorn and the magic pony, I continue to believe that this position is not merely wrong but grotesquely immoral. It’s one thing to think this in 1974. But at this late date, it should be obvious that Republican control of any legislative veto point makes any health care reform impossible, and there’s also no reason to believe that health care reform failing will magically lead to more progressive reform the next time Democrats get rare full control with a Senate supermajority.

Harkin’s arguments about what was possible at the time are no more convincing:

“We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate,” he said.

He believes Congress should have enacted “single-payer right from the get go or at least put a public option would have simplified a lot.”

“We had the votes to do that and we blew it,” he said.

I’m dismayed to see Harkin use one of the favorite rhetorical strategies of left opponents of passing the ACA — namely, conflating single payer and the House version of the public option as if they were comparable. Single payer would indeed be better and simpler than the ACA, but the idea that Democrats “had the votes” for it in either house is insane, and Harkin can’t possibly believe it.

With the public option the possibility of obtaining the necessary votes is not nearly as risible, but the first problem with this shell game is that the House public option 1)was small potatoes and 2)certainly wouldn’t have made the ACA less complex. I support the public option all things being equal, but as structured in the House bill the public option would not have been available to everyone, would very likely have had higher premiums, and most likely would have ended up as a group of the least healthy people on the exchanges. It was worth trying, but it did not fundamentally change the structure of the ACA.

And even so, I still don’t see how there were 60 votes for it. Harkin, as always in cases like this, doesn’t explain how the votes could have been obtained. The most obvious problem is Lieberman, who repudiated policies he had previously favored to spite liberals, but there were a number of opponents of the public option and Harkin doesn’t explain exactly what leverage Obama or Reid had over them. Indeed, Harkin’s argument in total becomes very nearly self-refuting. If he was willing to walk away from health care and have nothing pass, you don’t think Nelson and Lieberman and Linclon etc. etc. were willing to?

I have nothing against Monday morning quarterbacking in principle, but these arguments about how the leadership that succeeded where Clinton, LBJ and Truman failed actually screwed things up have a very high burden of proof, and this burden cannot be met with bare assertions, hand-waving, and wishful thinking. Alas, that’s all they ever have.

…Mayhew is excellent on this.

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