same author.
Health Reform: The Fateful Moment
By Theodore R. Marmor, Jonathan Oberlander
"...What kind of legislation can we realistically expect to be enacted in 2009? House Democrats have a good chance, as noted above, of winning passage for the Tri-Committee Bill. With Al Franken finally in the Senate, Democrats have a filibuster-proof majority that could pass health reform without any Republican votes (though that assumes all conservative Democrats would back a reform that does not have bipartisan support). As mentioned, the Senate could also use reconciliation rules, which require only a simple majority, to pass health care legislation. However, some Democratic senators are reluctant to invoke reconciliation rules for both political and technical reasons. Max Baucus, for his part, has insisted upon enacting reform on a bipartisan basis. Furthermore, the reconciliation process risks producing legislative "Swiss cheese," since the Senate parliamentarian has the authority to exclude any provision he regards as irrelevant.<16>
If both houses of Congress pass health reform legislation, a conference committee will struggle with reconciling divergent bills and conflicting political coalitions. The political dilemma is that abandoning a strong public plan—in order to win votes from centrist Democrats and moderate Republicans in the Senate—will alienate liberal Democrats in the House, who threaten to withhold support if such a plan is not included.
President Obama's involvement in this political endgame will be crucial. The most important unanswered question in health reform is how much influence the President will exert on the conference committee. Will Obama successfully pressure Senate conferees to accept a more liberal reform—including a robust public plan—than they prefer? Or will he accept a more conservative bill in order to take credit for a political victory?<17>
Whatever health reform legislation emerges this fall (if any), we can plausibly predict that it will substantially reduce the number of uninsured Americans. That in itself would be a major achievement, though it will surely fall short of universal coverage. Moreover, unless it provides system-wide limits on health care spending, any legislation that emerges from Congress will not reliably control the costs of medical care. These two issues are closely linked. Failure to control costs would jeopardize the very gains in health insurance coverage that reform promises."
—July 16, 2009
http://www.nybooks.com/articles/22931