Health care: Cost control, or nothing?

We’ve all heard the apocalypse that approaches Obama’s democratic administration. Massachusetts has elected a new senator: Scott Brown. Suddenly all you hear is the word ‘filibuster’.

Exaggeration is not good in politics or journalism. It creates irrationality. Just how quickly this is relevant here, I cannot tell. I am inclined to say it is a serious signal for a traditional democratic state to elect a republican senator. Then again, Obama was never expected to have an easy second year, so does it matter?

It just might, for what is at stake here is health-care reform. Many republicans would love to stop the president dead in his tracks here. That’d be like a bomb going off right in his face, damaging his image on his own soil, more than anywhere else. In other countries this is much less important. Only those who are trying to make up the balance of Obama’s first year, or who are reviewing his general path, present their views in direct relation to his performance.

Much of Obama’s campaigning focused on health-reform, however. He’ll be desperate to get at least something through. He has several options here. At this moment both the House and the Senate have passed a bill. This means that, if one of these accepts the other’s proposal, the essential foundation for reform has been completed. There is only one route that has any potential for success here: The House of Representatives must accept the Senate’s version. The other way around is virtually impossible.

Even seeing the House adopt the Senate’s version, in order to get something implemented, seems unlikely though. Several reasons will take care of that. Most important is that the Senate has not included a government run insurance-scheme. Pelosi once said that “she would not accept anything that didn’t’ include a government-run scheme”. It does provide the option for states to adopt such a scheme, but add to that the unpopularity of the current direction in which things are heading, and it’ll make many representatives very reluctant to accept anything at all at this stage, fearing for their next elections.

Obama could also opt for another route. In order to do so he will have to come up with ideas and plans that cure wounds in the current system. Thinking in financial terms will do much good here: Eradicating rules and policies that waste valuable dollars, but which are nevertheless being overlooked or ignored by many democrats, will please at least some republicans.

“Cost control” will be the magic word. If he manages to cover distance that way, he might be able to reform health-care step by step, instead of drastically, though insufficiently, changing all at once. Most democrats might still be on the president’s side; it would still be a good thing if they kept, or started, looking at some of the republican’s better arguments.