Monday, March 1, 2010

What E.J. said ....

E.J. Dionne (WaPost): Living with partisanship

The word "partisanship" is typically accompanied by the word "mindless." That's not simply insulting to partisans; it's also untrue.

If we learn nothing else in 2010, can we please finally acknowledge that our partisan divisions are about authentic principles that lead to very different approaches to governing?

Last week's health-care summit was a day-long seminar that should make it impossible for anyone to pretend otherwise -- and Republicans on the Sunday talk shows said yet again that they had no intention of making it any easier for President Obama to pass his health-reform plan. But before we get to that, let's examine the Senate debate over whether to extend unemployment insurance coverage. The matter is rather urgent for jobless workers because 1.1 million of them are scheduled to lose their benefits this month, and 2.7 million are slated to lose them by April.

Sen. Jim Bunning (R-Ky.) has put a hold on the extension bill, but one of the key reasons the measure is blocked is the effort of Sen. Jon Kyl (R-Ariz.) to use it as a way of forcing a cut in the estate tax. Kyl is essentially leveraging the unemployed to get a deal on estate tax relief that would cost $138 billion over the next decade, according to estimates by the Center on Budget and Policy Priorities. The estate tax has already been cut sharply, so the reduction Kyl is pushing along with Sen. Blanche Lincoln (D-Ark.) would affect the estates of fewer than three out of every 1,000 deceased, according to the Tax Policy Center.

The proposal helps estates worth more than $7 million in the case of couples. I guess struggling millionaires deserve the same empathy we feel for those without a job.

And notice this: Especially in the Senate, what passes for "bipartisanship" too often involves a Democrat such as Lincoln allying with a Republican on behalf of the wealthiest interests in the country. And we're supposed to cheer this?

At the health summit, the most revealing exchange was between the president and Sen. John Barrasso, a Wyoming Republican who is also a physician. Barrasso's central concern is that the health-care system doesn't operate enough like every other market. He seemed troubled less by the many Americans who lack health insurance than by those who abuse the insurance they already have.

Addressing Obama, Barrasso suggested that we might be better off if people were insured only for catastrophic care. "Mr. President, when you say [people] with catastrophic plans, they don't go for care until later, I say sometimes the people with catastrophic plans are the people that are [the] best consumers of health care in . . . the way they use their health-care dollars."

"A lot of people" with insurance, he added, "come in and say, 'My knee hurts, maybe I should get an MRI,' they say. And then they say, 'Will my insurance cover it?' That's the first question. And if I say 'yes,' then they say, 'okay, let's do it.' If I say 'no,' then they say, 'Well, what will it . . . cost?' And 'What's it [going to] cost?' ought to be the first question. And that's why sometimes people with . . . catastrophic health plans ask the best questions, shop around, are the best consumers of health care."

Obama played the old TV character Columbo, who thrived on posing seemingly naive questions: "I just am curious. Would you be satisfied if every member of Congress just had catastrophic care? Do you think we'd be better health-care purchasers?"

Barrasso answered in the affirmative, though he didn't propose that senators dump their present coverage. Obama came right back: "Would you feel the same way if you were making $40,000 . . . because that's the reality for a lot of folks. . . . They don't fly into [the] Mayo [Clinic] and suddenly decide they're going to spend a couple million dollars on the absolute, best health care. They're folks who are left out."

Obama concluded: "We can debate whether or not we can afford to help them, but we shouldn't pretend somehow that they don't need help."

As neatly as anything I have seen, this exchange captured the philosophical and emotional difference between the two parties. Democrats on the whole believe in using government to correct the inequities and inefficiencies the market creates, while Republicans on the whole think market outcomes are almost always better than anything government can produce.

That's not cheap partisanship. It's a fundamental divide. The paradox is that our understanding of politics would be more realistic if we were less cynical and came to see the battle for what it really is.

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