President McCain And The Democratic Congress

In Tampa tomorrow, Sen. John McCain will formally unveil his national health care reform plan. So -- specifics are TBA. The politics, unfortunately, for McCain, are more easily limned. I've not spoken to a single Republican who believes that a President McCain would operate in a political environment that is conducive to Republican policies; Democrats are likely to retain (or expand) their majorities in both the House and the Senate. As outlined so far, McCain's health care proposals don't seem terribly novel. He's more concerned with cost and less concerned with the uninsured; he has expressed sympathy for those who don't have health insurance, and he'll need to find a way to connect his affect to real policy. He's proposed to means-test Medicare, which will be a non-starter even for many Republicans. Same with expanded health savings accounts and association health care plans, which will be DOA in a Democratic Congress. Other ideas, like allowing drugs to be imported from Canada, enjoy wide support. The philosophical hinge of his plan seems to be accountability. Doctors and hospitals that perform well will be rewarded; those that don't, won't be. (Leave No Patient Behind?)

The upside for a President McCain is that the Democratic Congress will face enormous pressure from below to Do Something About Health Care. So McCain, at this point, has little incentive to offer an olive branch; why negotiate now and start from a point of weakness?