Friends and sources who know Capitol Hill better than I do tell me that Senator Lindsey Graham is smart, responsible, and reasonable--in other words, the sort of Republican with whom Democrats could work on health care. Among other things, they note, Graham recently signed on as a co-sponsor of the Wyden-Bennett health reform bill--which, whatever its flaws, would give all Americans insurance in a fiscally responsible way.
I'd like to believe these friends and sources are right. But Graham's performance on ABC's "This Week" yesterday makes me think they're wrong. Consider this passage:
GRAHAM: Well, it's just not Republicans, George. The reason you're not going to have a government run health care pass the Senate is because it would be devastating for this country. The last thing in the world I think Democrats and Republicans are going to do at the end of the day is create a government run health care system where you've got a bureaucrat standing in between the patient and the doctor. We've tried this model--people have tried this model in other countries. The first thing that happens--you have to wait for your care. And in socialized health care models, people have to wait longer to get care and the government begins to cut back on what's available because of the cost explosion.
The CBO estimates were a death blow to a government run health care plan. The finance committee has abandoned that. We do need to deal with inflation in health care, private and public inflation, but we're not going to go down to the government owning health care road in America and I think that's the story of this week. There's been a bipartisan rejection of that.
STEPHANOPOULOS: Well, you call it a death blow. Let me just press that point. Are you saying now that Republicans just as we saw in the stimulus where I think only three Republicans voted for the president's stimulus package--if there's a government run health insurance plan, are Republicans going to vote on that against this package?
GRAHAM: I don't think it's just going to be Republicans. You've got Senator Conrad talking about a co-op. You've got other Democrats running away from the government-run health care where the bureaucrat stands between the doctor and the patient. I think this idea is unnerving to the members of the Senate and will be to the public when they understand what it means, that you'll wait longer to get treated and you'll get health care the government decides for you, not that of your doctor. So yes, I think this idea needs to go away and replace it with something maybe like Kent Conrad's proposal.
As usual, and probably not by accident, it's a bit difficult to figure out which idea Graham is attacking.
Graham starts by talking about a "government-run system." But under all of the plans now under consideraiton in Congress--even the recently released House plan, which seems to be the most liberal--the only sense in which the government would be "running" the whole "system" is that it will be regulating public and private insurance, subsdizing coverage for those who can't afford it on their own, and pushing the providers of care toward better quality and efficiency. If Graham truly objects to that, then he needs to withdraw his sponsorship of the Wyden-Bennett bill, since Wyden-Bennett would do all of these things.
Stephanopoulos--to his credit--quickly narrows the conversation to Graham's true objection: Giving people the option of enrolling in a public insurance plan, like Medicare, rather than private insurance. Graham's staunch opposition to this is a matter of public record, and a view nearly all of his GOP colleagues share.
But in making his argument, Graham is still dupliticous. Citing recent Congressional Budget Office estimates--specifically, an estimate that the Senate Finance bill would require $1.6 trillion in outlays and the Senate HELP bill would reuqire $1 trillion, but only to cover part of the uninsured--Graham says a government-run plan is not feasible.
Um, what? The public insurance option was not part of either plan that the CBO scored. And as every expert will tell you, a public plan lowers costs, by more aggresively bargaining down prices and introducing payment reforms designed to reward efficiency. It's precisely because a public plan can do these things that much of the health care industry--along with conservatives like Graham--oppose it.
And that's fine. There are some perfectly legitimate (if, in my view, ultimately unpersuasive) arguments for why creation a public plan option would ultimately be counter-productive. But to suggest we need to ditch the public plan because it would drive up costs, as Graham did on Sunday, is just dishonest.
Update: More from Paul Krugman and Bill Scher.
--Jonathan Cohn