Monday, November 29, 2010

Musing on Political Centrism

Kathleen Parker, writing in the Washington Post, wonders if a centrist political movement could succeed in the U.S. As a progressive, I would welcome the chance to work with centrists to get the country back on track with sensible public policies.

That having been said, I want to work first and foremost to create sensible public policies. Parker claims that many moderate Democrats were "purged" in state and local elections. That may well be. But let's consider the cases of Sens. Blanche Lincoln and Joe Lieberman. Both are moderate Democrats in the Senate. During the health reform debate, both eventually voted with the Democrats. However, Sen. Lincoln opposed the public option, despite earlier appearing to endorse it on her website. Sen Lieberman opposed the public option as well. When Sen. Reid, the majority leader, proposed replacing that with a Medicare buy in for people aged 55 and older, Lieberman essentially threw a fit and demanded that the Medicare buy in be removed. When campaigning as a Vice Presidential candidate with Al Gore in 2004, Lieberman endorsed a Medicare buy in.

Both a public insurance plan and a Medicare buy in could have reduced national health expenditures significantly and the deficit, assuming they were designed properly. Most of the long run deficit is driven by health care costs covered by the Federal government. These options would reduce compensation to doctors, hospitals and pharmaceutical companies. Insurance companies would have to adapt, and they would see very significant competition with a public plan. But there's no intrinsic reason why providers, insurers, and healthcare companies couldn't adapt.

The public plan and Medicare buy in were arguably sensible public policies, or at least they had sensible goals, Lieberman and Lincoln opposed them. That opposition appeared to be protecting business interests over the public interest. And for what? They never articulated a clear reason behind their opposition. The logical conclusion is that their opposition was solely for political reasons. They could have said, a public plan's lower payment rates could lead to problems with people being able to see doctors. Lower payment rates could constrain medical innovation. They could have counter proposed: let's raise the excise tax on high cost health insurance plans instead. If you do that, you'll get my vote. That would arguably have been good public policy as well. But they chose to vote based on politics, not good policy.

Lincoln was defeated in Arkansas' Senate race. Lieberman is not up for re election, but I understand that he will probably have difficulty winning re election in Connecticut in 2012. Perhaps they will complain that they were "purged". But these two may have deserved it.

I have disagreements with the policies endorsed by some on the left, and in particular I disagree with those on the left who are intrinsically suspicious of business. However, most of the left's excesses are aimed at protecting vulnerable populations. Most of the right's excesses are clearly aimed at promoting the interests of the powerful, often at odds with the interests of the general public. It is clear to me which set of excess is the most pernicious.

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