Health Care Plan? What Health Care Plan?

It is a measure of the disarray in which the president finds his top legislative priority that he had to ask the country in a Rose Garden appearance on Monday not to “bet against us” on health care reform. Well, if that’s the best the president can do, then one might suspect that his health care plan is in trouble. Deep trouble.

But that, as lawyers like to say, assumes “facts not in evidence.” Truth be told there is no “plan.” At least not any plan on which even the Democrats can all agree upon. Yuval Levin, observing the president’s appearance and declaration that “the plan” would not add to the deficit, wrote:

What in the world is the president talking about? Where is the committee in the House or Senate that has offered up a bill that will not add to the deficit? What bill would that be? Even in their own terms, with all the gimmicks they’ve been able to come up with, the plans the Democrats have proposed so far are all enormously expensive, and no one has yet proposed a way to pay for them. So what is the “it” the president has in mind exactly?

The White House is leaving the details up to Congress. Despite the president’s accusation that “special interests” are to blame for the slow progress on health care, the reality is that Democrats cannot agree among themselves on the specifics — or even the general outlines — of a bill. We are told a bill will be out today, but alas it isn’t really the “finished product,”  Speaker Nancy Pelosi concedes. ( Translation: they need to get something, anything out there.)

Last Friday House Blue Dog Democrats revolted and prevented release of any plan. Over the weekend Democrats suggested the president wasn’t going to get his bill by the August recess.

It is not hard to see why they are stuck in neutral.

The president, Pelosi, and the liberal leadership in the Senate insist on the “public option.” But not a single Republican has embraced a government insurance plan that would almost surely push private insurers out of business. And Democrats including Tom Daschle (who was to lead Obama’s health care effort until felled by tax problems) and Senate Budget Committee Chairman Kent Conrad have come out against the idea.

Then there is the funding problem. Rep. Charlie Rangel wants to soak the rich with a so-called surtax. That is a clever way of saying the liberal Democrats would like to hike marginal tax rates to levels not seen since the 1970s and sock it to the thousands of small businesses which are taxed under individual tax rates. But that idea makes plenty of Democrats including Senate Majority Whip Dick Durbin nervous. Republicans rejected the idea out of hand:

Representative Eric Cantor, the second-ranking Republican in the House, told the Fox News Sunday program Rangel’s bill included an “incredible half a trillion dollar tax on folks making over $200,000 a year.”

“Half of those people are the ones making the decision as to whether to hire Americans or not,” he said, asking why the government would make it more difficult for them to hire people now out of work due to the recession.

We also saw the proposal to tax employer-provided benefits. That didn’t sit well with Democrats’  Big Labor patrons, many of whom have members who receive generous health care benefits. And this gambit would represent, of course, a stunning reversal of Obama’s campaign position, which was loudly proclaimed in numerous TV ads excoriating his opponent for suggesting this very idea. (Actually John McCain wanted to provide a tax credit in lieu of employer benefits, a position far more generous than what Democrats were considering.)

But aside from the knotty legislative issues, there looms a larger political problem for the president and Congress. Simply put, the economy isn’t any better and they lack credibility to take on a huge government-run redesign of 300 million Americans’ health care.  Is the gang which got the stimulus wrong the same crowd to whom we want to entrust our family health care? “Misreading” the number of jobs they could “save or create” is one thing, but getting  health care redesign for the entire country wrong could be, pardon the expression, a fatal error.

Indeed, the administration’s fiscal train wreck and stimulus failure have made health care reform tougher. The funding dilemma is made infinitely more difficult by the widening budget deficit. Meanwhile the soaring unemployment figures suggest now might be the time to focus on job-creation, not a whole new set of taxes, mandates and regulations. Really, is now the time to spend another trillion dollars and whack taxpayers?

So the president continues to issue platitudinous statements and insist Congress “get it done.” He is threatening to delay the August recess. But of course, Congress, not the White House, decides when lawmakers go on vacation. And the president, absent any specific plan of his own, is in a poor position to insist Congress come to a legislative conclusion. After all, why doesn’t he tell us what he wants health care to look like?

Then there is the public. At least according to one poll, the voters (perhaps increasingly worried about their jobs) are no longer clamoring for the government to redesign and possibly take over their health care. Honestly, who can blame them? If the choice is the current system or a bevy of new taxes and nationalized health care, perhaps the status quo isn’t so bad after all.

But for the president and the Democrats this is do-or-die time. Their base will never forgive them if they don’t achieve nationalized health care now. And the prospect of facing the voters in 2010 with double-digit unemployment and no significant legislative accomplishment is enough to send shivers up the spines of even the most confident Democrats. After all, if the Democrats can’t deliver either an economic recovery or health care reform, it might be time for “change.”