The Death Of Health Care Reform, Cont.

Fast and furious, the journalists in this town continue to move toward the conclusion that major health care reform is dead, dead, dead for the year. Mike Allen and Jim VandeHei call it "in real jeopardy." A draft of the new Senate Finance Committee legislation obtained by Ezra Klein cuts back premium subsidies significantly and does not include a "public option." House liberals are shopping a candybag full of potential tax hikes, including one on artificially sweetened drinks. I can't predict the future, but I approach this from a slightly different angle. We've reached, certainly, a point of clarity in the health care debate. We know, fairly precisely, what the political boundaries are -- the room within which a bill must be written to reach the magic number of votes in both chambers. Several very important and eternally difficult challenges remain, including the size and composition of the employer mandate, the "revenue enhancers" needed to pay for approximately $400 billion worth of additional spending, and the precise rules under which insurance companies are going to have to live by. If and when we look back to this debate from the hindsight of a bill that does pass, I think what we'll find faulty is the idea that Democrats thought they could sell health care reform without sacrifice. That magical notion simply has no bearing on reality. Health reform was -- is -- always going to be an expensive, complex endeavor requiring political capital expenditures and greenback expenditures.