What’s the Matter with Harry?
- 10.22.2009 - 8:17 AMMajority Leader Harry Reid shot himself in the foot yesterday and unnerved his party. The subject was a discrete vote on doctors’ Medicare payments:
A dozen Democrats (plus independent Joe Lieberman) voted against Majority Leader Harry Reid’s gambit, which would have superseded automatic cuts in Medicare payments to doctors scheduled for 21% next year and higher after that. Democrats had included this fix as part of “comprehensive” reform but that pushed costs too high, while President Obama is insisting on a bill that doesn’t increase the deficit on paper.
So the AMA is miffed, given that their payments aren’t “fixed” and Democrats are left wondering if their leader knows what he is doing. As Yuval Levin points out, this suggests:
The biggest problem is the danger of losing the confidence of his Democratic senators. Passing health care reform remains an extremely difficult challenge: there are two Senate bills, with very significant substantive differences between them, which need to be combined, voted on, then merged with an even more different House bill, and voted on again. Each of these votes would require the support of just about every (if not indeed every single) Senate Democrat, and each would be a very tough vote for one or another group in their caucus.
It may just be that there isn’t any legislative skill there to pull off the “serial needle-threading” needed to get this through, if the “this” is going to be one massive health-care reform bill. And as of yet the White House hasn’t demonstrated any inclination to roll up its sleeves and try to broker a deal.
Maybe all the pieces will magically fall into place and the stars will align to produce a viable bill by the end of the year. But how likely is it that a messy legislative process run by not-very-competent leadership struggling to produce a bill that the public opposes will “succeed”? Not as likely as one would have thought nine months ago.
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