Health Care Deal in the Senate?

A lot of outlets are reporting a deal along the following lines:  Medicare buy-in for those 55 or over, some sort of non-profit quasi-public option overseen by the Office of Personnel Management, and a trigger for the public option that is arguably very unlikely to ever kick in.  With Ben Nelson's abortion amendment voted down, and Nelson saying he won't vote for a bill without very similar language, a workable compromise on a public option substitute is necessary to get the 60 votes they need.

But Lieberman just sent out the following press release:

"I am encouraged by the progress toward a consensus on proposals to send to the Congressional Budget Office to review.  I believe that it is important to pass legislation that expands access to the millions who do not have coverage, improves quality and lowers costs while not impeding our economic recovery or increasing the debt. 

"My opposition to a government-run insurance option, including any option with a trigger, has been clear for months and remains my position today.  
 
"Regarding the 'Medicare buy-in' proposal that is being discussed, we must remain vigilant about protecting and extending the solvency of the program, which is now in a perilous financial condition.  

"It is my understanding that at this point there is no legislative language so I look forward to analyzing the details of the plan and reviewing analysis from the Congressional Budget Office and the Office of the Actuary in the Centers for Medicare and Medicaid."

To me, that reads like nothing with a public option trigger is going to pass.  But perhaps I am not understanding the exotic subtleties of Congress-speak.

The meat of this proposal is obviously the Medicare expansion.  Like the now-discarded "co-op" idea, the non-profits suffer from one obvious flaw:  someone else has to decide to put capital into starting them up.  Starting an insurance company is not something you do with a $500,000 grant from the Ford Foundation, especially not on a national scale.  And it's not clear why you would want to--there's no profit opportunity, and I suspect that the onerous regulation is going to make it look relatively unattractive to philanthropists who would have to concentrate a really significant chunk of their charitable giving on making one of these things work.

Is this enough to make a deal?  It still looks to me like either Lieberman or the public option nuts have to blink.  And for all their obsession with an increasingly watered down proposal, my money's on the public option afficionadoes.  At the end of the day, they want these deals more than I think Lieberman does.

This article available online at:

http://www.theatlantic.com/business/archive/2009/12/health-care-deal-in-the-senate/31514/