What to Watch in the Health Care Debate

Amidst all the crazy health care negotiations, one thing to keep your eye on is this: Will the Senate Finance Committee come to dominate the process. Multiple congressional committees are working on health care, all with their own ideas. But the Senate Finance Committee is probably the most important to watch because its chairman, Max Baucus, the Montana Democrat, has vowed to produce a bipartisan bill. Other bills incorporate Republican amendments but that's not quite the same thing. Anyway, I bring all this up today because Baucus announced this afternoon that they have a bill that keeps the cost under $1 trillion and is all paid for--mostly through Medicare cuts. It eschews the so-called public option that Democrats and the administration consider so essential to reducing costs and getting insurance to the uninsured.

Intellectually, the public option still makes a lot of sense as a bludgeon to the insurance comapnies. But the Finance Committee version still feels like the one that'll emerge victorious from this Darwinian struggle. It's going to annoy a lot of Democrats but they could wind up signing on to it anyway.

In any event, it's worth thinking of health care not as a one shot deal but as an ongoing process. Medicare is still being modified 40 years later. The idea that we'd get to universal care in one year--even if it's one big year--was always a little unrealistic.

This process will go on for awhile, into the fall. But the Finance Committee version still feels like the one to watch. And the question is not whether we get full health reform this year but if we get some of it or none at all.

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Matthew Cooper is a managing editor (White House) for National Journal.

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