As usual, some of the best commentary on health reform comes from my friends Ezra Klein and Karen Tumulty, who--like yours truly--think the Senate's inability to come up with politically satisfying revenue sources is a pretty big deal.
Ezra diagnoses the problem as soft support for health reform generally. And that, he suggests, is hardly surprising:
Health-care reform isn't simply suffering because the public is overly opposed to some of its revenue raisers. It's suffering because the public is insufficiently supportive of its core.
...it's not obvious what health-care reform will do for the average American. I could give you a long answer about delivery system reforms and so forth because it's my job to know these things. But it would have to be a long answer. The basic structure of health-care reform has been specifically built to avoid changing people's existing arrangements. The hope was that Americans would be convinced that their health-care coverage wouldn't change for the worse. But that's also made it hard to explain why it will get better.One of the president's health-care reform principles is that everyone must be able to keep what he or she currently has. But that means we're not really going to change, or improve, what they have. And that means they're not getting much in the way that's new. Higher taxes aren't buying them obvious benefits. Instead, they seem to be paying the health-care bills of poorer Americans.
To be sure, the administration has tried to tout one big benefit their plan can offer the middle class: Lower costs. But voters seem dubious. Ironically, the Clinton Admnistration ran into this same problem back in 1993 and 1994. That's why, as Stan Greenberg recently explained in this space, Clinton hit the "security" theme so hard. Voters did buy that argument. And it was something the plan clearly would have provided, had it passed.
Karen, meanwhile, ends her piece with a smart question for Democrats: "Is it riskier to push for health reform--or to be seen as having stopped it?" Again, I couldn't agree more. Voting to raise money is never easy. Whether you're raising taxes or reducing spending, you're taking money out of people's pockets. But you can't pass health care reform without raising money somehow. And that's going to mean taking a tough vote or two.
Update: Matt Yglesias makes a good case for President Obama's original revenue proposal: limiting itemized tax deductions for high-income Americans. Better still, he provides a Beatles video to go with his item. And I never miss an opportunity to embed the Fab Four. So here you are:
--Jonathan Cohn