Unusual Paintings Of Obama Naked With Unicorns

Wow.

Health Care Bracketology

At this point I'm having a lot of trouble understanding how the various players in the health care negotiations regard the deals they're making -- for example, the Gang of Six deal in Senate Finance, and the Waxman-Blue Dog deal in House Energy and Commerce that was subsequently renegotiated with progressives.

All these agreements are subject to multiple stages of future modification and renegotiation. People are just trying to get bills out of the last committees right now, and they'll have to be blended with bills from other committees of their chambers before they pass the House and Senate. And then there'll be amendments on the floor. And then, after things pass both chambers, there'll be conference committee the House and Senate bills are reconciled. That's when Obama plans to make his big play and push the legislation in the direction he wants. There's a huge question of whom the negotiators in conference will be. The bill that emerges from conference will end up being the final product.

So if you're a Progressive renegotiating deals with the Blue Dogs, or Mike Enzi making a deal with Max Baucus, what do you expect to come of it? Do you have any confidence that anything you've agreed to will be in the final product? Are you just hoping to push the final bill a smidgen in the direction you prefer? To politically position yourself in some way or other? To make yourself seem like more of a significant legislative player who can't be left out of future reindeer games? I'm sure it's some mix of this stuff, but I have very little sense what the proportions are.

Wacky Institutional Reform Day: Super-Size The House!

Yglesias ticks off a number of procedural reforms that would make political life in America better. I would add to this the idea that we really ought to look at making the House of Representatives much larger than it currently is. Representatives in the large body of most nations' legislative body tend to represent between 75,000 and 200,000 constituents. The US, there's one Congressman for every 700,000 constituents. Getting down to the international norm would require tripling the size of the House.

It should be noted that massively increasing the size of the House would have other interesting consequences. A district with 200,000 members would have a off-year primary electorate of about 15,000 to 20,000 voters. This is a small enough number that it's plausible for a candidate to meet, in person, everyone who's going to vote for them. Medium sized cities would have so many members that campaigns would be waged strictly by direct mail, or we would move to multi-member districts. Having more members would lead to more factions, which might make cross-partisan coalitions more common. Even if we don't go all the way to a 1,300 member House, there's no reason for body to have fewer members that British Parliament, considering Great Britain has a population one-fifth the size of the States'.

If You Build A Good Public Plan, They Will Come

Ezra:

A strong public plan on a weak exchange will fail because it won't attain sufficient market share. It's as simple as that.

Ezra's been saying this for a while, but it seems way too Big Bang Theory of Legislation. If you have a strong public plan that cuts costs, but it's on a limited exchange, the next thing that's going to happen is that there's going to be massive political pressure to expand the exchange. Demonstrate to Ford and GE that their health care costs will in fact be lower by operating a cheap public plan in front of their eyes, and they'll knock some Cigna heads in to get access to it in a subsequent session of Congress. When the rest of corporate America takes on the big insurers, the results will be awesome. If there's some reason this doesn't work, I'd be interested in hearing what it is.

Trouble

Item One, from today:

Waxman, Blue Dogs Strike A Deal: ... Roll Call reported ... "the deal would cut more than $100 billion from the Democratic health bill, increase exemptions for small businesses and prevent the public insurance option from basing reimbursements on Medicare rates".

Item Two, from Monday:

House Progressive Take Hard Line on Public Option: ... eight members of the caucus wrote to Speaker Pelosi on behalf of the entire CPC, to draw a line on any efforts to further weaken the public option ... "the public option must not be based on any trigger and must be available immediately. Further, the public plan must be on a level playing field and receive the same subsidies as private plans in the Health Exchange. And, it must be connected to the Medicare infrastructure, including the provider and payment system".

Not sure how this is going to go down.

Update: Well, this actually sounds pretty reassuring. In the short term, there's still a big difference between "use Medicare negotiated rates", or even Medicare rates plus some markup, and "let the HHS negotiate rates". But in the long run the two would converge.