Krugman Gets Nostalgic

Paul Krugman has a good column today railing against secret holds -- a procedure that enables a small number of Senators to temporarily (and anonymously) block a motion from reaching the floor.

No one really seems to be too fond of holds . . . until they're in the minority:

What gives individual senators this kind of power? Much of the Senate’s business relies on unanimous consent: it’s difficult to get anything done unless everyone agrees on procedure. And a tradition has grown up under which senators, in return for not gumming up everything, get the right to block nominees they don’t like.

Krugman's point is well-taken. But, of course, he couldn't resist throwing in some partisan hackery:

Readers may recall that in 1995 Mr. Gingrich, then speaker of the House, cut off the federal government’s funding and forced a temporary government shutdown. It was ugly and extreme, but at least Mr. Gingrich had specific demands: he wanted Bill Clinton to agree to sharp cuts in Medicare.

Today, by contrast, the Republican leaders refuse to offer any specific proposals. They inveigh against the deficit — and last month their senators voted in lockstep against any increase in the federal debt limit, a move that would have precipitated another government shutdown if Democrats hadn’t had 60 votes. But they also denounce anything that might actually reduce the deficit, including, ironically, any effort to spend Medicare funds more wisely.

This seems a little unfair. The key feature of the Republican alternative health care proposal is tort reform, and the CBO examined this aspect of the Republican proposal in detail:

[I]mplementing a typical package of tort reform proposals nationwide would reduce total U.S. health care spending by about 0.5 percent (about $11 billion in 2009). That figure is the sum of a direct reduction in spending of 0.2 percent from lower medical liability premiums and an additional indirect reduction of 0.3 percent from slightly less utilization of health care services. (Those estimates take into account the fact that because many states have already implemented some of the changes in the package, a significant fraction of the potential cost savings has already been realized.)

Enacting a typical set of proposals would reduce federal budget deficits by roughly $54 billion over the next 10 years, according to estimates by CBO and the staff of the Joint Committee of Taxation. That figure includes savings of roughly $41 billion from Medicare, Medicaid, the Children’s Health Insurance Program, and the Federal Employees Health Benefits program, as well as an increase in tax revenues of roughly $13 billion from a reduction in private health care costs that would lead to higher taxable wages. [My emphasis]

These aren't huge savings, but if Democrats were really interested in bipartisan compromise, why did they exclude any meaningful tort reform provisions from the final version of their bill? There doesn't seem to be any good reason for this. A clear majority of American support caps on medical malpractice lawsuits, and these caps would reduce the deficit and curb health care inflation.

Refusing to incorporate the Republicans' central idea into the health care bill -- even when that idea is popular and sensible -- seems just as petty as anything the Republicans have done.

Update: Ruth Marcus has a wonderful op-ed on this subject:

[A] summit aspiring to be more than show would require Obama to deliver his promised break from politics as usual. A cardinal rule of political negotiation is never to give something for nothing. But what if the president were to offer Republicans an inducement -- say tort reform? He has pointed to defensive medicine as one contributor to rising health costs. If "that's a real issue," as Obama told doctors last June, why not add it to the existing Democratic plans?

I can see them in the White House now, snickering. Would this kind of preemptive strike entice Republicans to cooperate? Not en masse, but enough such flexibility might pick off a few. It would show a Democratic Party willing to stand up to its own special interests for the public good, and a Republican Party -- assuming it balks -- unwilling to compromise.

If you're going to serve chicken soup, Mr. President, you might as well ladle some meat into the bowl.

Ezra Klein scoffs:

Indeed, one of the notable elements of this process is that at no time has a Republican or a group of Republicans released a specific list of policies that Democrats could add to the bill to ensure their vote. Concessions might be good for PR purposes -- unilateral bipartisanship and all that -- but that's all they seem able to do in this process.

This makes almost no sense. Maybe Democrats could, uh, look at the Republican alternative health care proposal to get some sense of the specific policies that they endorse? Or maybe they could listen to what Mitch McConnell said on Meet the Press. It's pretty clear what the Republicans want: tort reform and interstate competition.

There is no question that most Republicans are being deliberately defiant. And it's probably true that many Republican senators will not vote for a health care reform bill, even if clear concessions are made. But the majority doesn't need many Republicans. They need one or two.

Making sensible concessions could easily sway some more moderate Republicans.