If President Obama's health care reform plan were a patient, it would be in the emergency room, its condition downgraded to critical. The prognosis may not quite be terminal, but long-term survival looks iffy.
Six months into a new administration and Washington D.C. reality has sneaked in rather quickly -- and on three fronts.
1) House conservative Democrats had already voiced their concerns a week ago on the direction of health care. This week, one key Democrat lawmaker went from expressing reservations to out and out rebellion. And considering that Obama narrowly won Indiana last year, Rep. Baron Hill's opposition is particularly troubling: It endangers not merely the policy itself -- but the president's electoral chances in a key swing state.
2) A splash of cold-water from the director of the Congressional Budget Office won't help. Douglas Elmendorf blew a hole through the president's main reason for the health care overhaul -- that it will save money. Au contraire, says Mr. Elmendorf: "The coverage proposals in this legislation would expand federal spending on health care to a significant degree and in our analysis so far we don't see other provisions in this legislation reducing federal health spending by a corresponding degree."
The Democrats' response to Elmendorf's analysis contained an interesting irony:
[Connecticut Sen. Christopher] Dodd complained that CBO refuses to assume that government savings will occur from an increased focus on wellness and preventive health care.
“The only thing CBO does is tell you how much taxpayer money has to be invested to achieve those results,” Dodd said.
“We believe we have crafted legislation that does bend that curve, bring health care costs down and make it affordable for all Americans,” he said. “I appreciate their work, but frankly we’re on the right track, we have a solid bill and one that’s affordable.”
The irony in Dodd's words are that they are the mirror image of Republican complaints on CBO's analysis of the impact of tax cuts. The GOP argued for decades that the CBO should adopt a so-called "dynamic scoring" model that would allow for the impact of tax cuts in stimulating economic growth. By doing that, Republicans argue, the CBO could see how much revenue would be brought in -- and thus the tax cuts wouldn't have such a negative impact on the deficit.
Democrats now argue that the CBO isn't taking into account the possibility that "wellness" growth will bring in as-yet-unrecognized savings which will keep annual deficits from rising.
3) A dissing of the president from one of solons of the Senate: The key committee chairman that all health-care observers are keeping an eye on is the head of the Senate Finance Committee, Max Baucus. A Montana centrist who's been known to vote with Republicans in the past -- much to the distress of activists on the left -- Baucus is essential in getting through the funding component of health care. Well, it's not so good for the effort when he mouths off that, the president, "is not helping us" structure workable legislation. Baucus apologized later. Nice thing about those quotes, senator: The dis gets the headlines. The apology? Nada!
The heading-into-the-weekend prognosis? Dr. Obama's patient's not getting out of the intensive care unit anytime soon.