House or Senate?

One of the questions for supporters of health care reform right now is where to apply pressure: to the House, or to the Senate?

Both chambers have been blaming each other in the last couple of weeks.  There's a spin war, aimed at liberal opinion shapers, and the impression I'm getting is that the House is winning.  That's not surprising; liberal opinion leaders are naturally more sympathetic to the more liberal House, and while they don't like the Blue Dogs, I don't think too many bloggers actually know very much about their individual stories.  Liberals like Nancy Pelosi and Henry Waxman (and with good reason).  Over on the Senate side, liberals have never been all that thrilled with Harry Reid to begin with, or to other major players such as Max Baucus or Chris Dodd, and liberals know all about the Benator and Holy Joe, and have cast them as villains long ago.  So when the finger pointing starts, liberals are apt to side with the House.

Understandable, but dead wrong.

As I've been arguing, the House appears to be so focused on how the Senate always betrays them that they've missed the ways in which this situation is different: they can just turn the tables on the Senate by passing the Senate bill, and then send over the reconciliation patch.  Remember, the patch is (or at least can be) filled with mainly politically appealing items: repealing the Nelson deal, shifting from Cadillac tax to taxing rich folks, and eliminating lifetime caps.*  Perhaps Republicans would try to block it anyway, but as I've said, that's much better ground for the Democrats to contest than the original complex bill.

And the worst-case scenario for reforms supporters if the Senate bill passes the House is...the Senate bill, which everyone who supports any of the plausible outcomes agrees is better than nothing. 

What the House proposes instead is to wait until the Senate acts on reconciliation, or at least until they get an ironclad guarantee of such action.  The former could take months**, and may never happen; the latter is never going to pass the House's skepticism about the other body.  Instead of trying to figure out a way to get the Senate to assure that House that they'll act, what the House should do if they want reform is to give the Senate incentives to act.  Pass and patch does that if the House passes the Senate bill now.

And liberals shouldn't let the House off the hook.  Nancy Pelosi was widely quoted yesterday:

I've said to my colleagues, go in the door. The door's locked? Go to the gate. The gate's locked? Climb over the fence. It's too high? Pole vault in. That doesn't work? Parachute in. We have to get this done for the American people one way or another.

What health care supporters need to say isn't what Ezra Klein says in response (which is to compare her tough words to various Senators' foot-dragging words) but to say:

Speaker Pelosi, the front door is wide open.  Just get 218 of your friends together, and walk right through.




*Lifetime caps might not survive reconciliation, but I'd think that's a vote that Democrats would be glad to take -- I'm not even sure that Republicans would object to such a feel-good item.

**Jeff Davis has a long piece up at TNR explaining all (some?) of the ways that reconciliation could be slowed, even if all Senate Democrats are on board.  On one issue, it's possible he's overstating things -- as Sarah Binder said in response to my question, it's not clear that the bill would actually have to go through the committee process.  However, everyone agrees that reconciliation is a difficult and complex process.