THE ART OF THE POSSIBLE
May 25, 2009
In politics, as in life, there is the ideal, and then there is what is possible. Those of us who are idealists are seldom satisfied with getting anything less than—well, the ideal. As a result we often have to settle for far less than that, which is most often nothing at all. It is easy to be pure if you don’t expect much other than feeling good about yourself.
We are now at a pivotal point for American social policy; 126 years after Kaiser Wilhelm introduced universal medical coverage in Germany, we are on the brink of becoming the last industrialized nation to adopt a policy of health care coverage for its citizens. Whatever your concept of “ideal health care coverage” may be, from “single payer” to no government coverage at all, the odds are great that what we get won’t match your expectations. But the odds are certain that we will get something that is much better than what we have now, and that brings me to Montana’s Senator Max Baucus, and his role as the putative architect of America’s coming system of health care coverage for all. It’s not exactly “Nixon goes to China,” but it’s sort of similar.
The allusion to Nixon refers to the fact that at that time only a Republican President could have pulled off opening the door to international relations with “Red” China without political repercussions. Similarly, only a Democrat trusted by America’s medical and health insurance providers can deliver the kind of health care policy that the American people want, and one that the health care sector may not like, but can live with.
Some Democrats have chided Baucus because they feel he is much too close to the insurance industry; but the most precious coin in all of politics is a relationship based on trust, and Baucus has placed himself in exactly the right position to get the job done. Whatever Nixon was, he was above all else a practical politician who understood full well that “politics is the art of the possible.” So, too, does Baucus.
Much of the Democratic concern about Baucus’ coming health care proposal is that it will not be a “single payer”—for which read government—plan. While the insurance industry is feeling the heat from public discontent with our current health care coverage system, they are not feeling so much heat that they would capitulate to a single payer program. If a single payer program were to be advanced it’s a safe bet that it would be opposed by all Republican senators and therefore would take all 60 Democratic senators to prevent a filibuster that would doom the project. It does not take a political genius to figure out that one or two of those Democrats could be taught to have misgivings about their political future if they voted for something that one of the biggest lobbying forces in America didn’t want, and that would end the battle right there.
And by the way, if the main concern for a single-payer program is to lower health care costs, there is, as a fellow in Thompson Falls pointed out to me a few days ago, another way to do it. A significant cost factor for medical providers is coping with the legion of different insurance claims forms they have to process. Every insurer has a different way of getting and processing claim information, and medical practitioners have to have a staff that is familiar with all of them. Not surprisingly, that cost is passed on to the patient one way or another. A mandatory standard claim form for all insurers could solve that problem without having to go to a single payer plan.
The possible is possible, the ideal is not, and Baucus, as one of the most powerful and savvy people in Washington knows that. We may not get our version of what is ideal, but we will get something one heck of a lot better than what we have now.
Thirty or so years ago Senators from the Rocky Mountain West, and in particular, Montana, were the guiding forces for our nation. Montanans can be proud of that time in our history, and we can be equally proud to have Montana, because of Senator Max Baucus, back in the leadership saddle again.
Montana Viewpoint© is carried by 20 Montana weekly newspapers, including those in Helena and Billings, with a combined circulation of over 60,000.
Jim Elliott is a former state senator from Trout Creek. He served in the Montana House 1989 to 1996 and the Montana Senate from 2001 to 2008. Elliott has distributed his opinion column statewide since 1992. There is no charge for publication.