Back to the health care bill

Congress will be returning from its Christmas recess shortly and pundits are predicting a protracted battle to reconcile the House and Senate versions of Health Care reform. I think this is unlikely. It seems much more likely to me that the real hard part is now over. Here for the record are a few predictions...

1. The final bill will (not surprisingly) more closely resemble the Senate bill than the House. This is because the Senate has no wiggle room in its vote count. With unanimous Republican opposition the Democrats can not afford to loose a single vote. The House will have to swallow hard and accept most of the Senate bill as written. Which means...

2. There will be no public option or anything resembling one or anything that could trigger one.

3. Most of the Senate's plans for financing this monstrosity will survive intact.

4. The House language on abortion (it is much more restrictive than the Senate's) is likely to win for the same reason the public option will loose. The House has a significant number of staunchly pro-life Democrats who are unlikely to vote for the Senate's fudged language. They are large enough in numbers that they could in combination with Republicans kill the bill if they don't get their way. Liberals will swallow hard and pass it anyway.

5. Some of the more controversial provisions are likely to be stripped out of the bill. I would be more than slightly surprised if Nebraska's exemption from Medicaid costs survives the conference committee.

6. This is going to happen sooner rather than later. Pundits are predicting a protracted battle. But Democrats are exhausted. They are (pardon the pun) sick of health care. They also see this (correctly) as a rallying point for the GOP's base. There is no upside and a great deal of downside to dragging this out. If the whole health care thing has dragged on much longer than expected I believe it is about to end much more rapidly than many think likely. There is a better than even chance that this will be passed and signed before the President's State of the Union speech. Democrats want to move on to more politically advantageous issues like spending insane amounts of money (that we don't have) in an effort to create jobs.

There is one other reason why Democrats are going to pass this quickly. Once it's been passed it will be all but impossible to undo. They realize that what they are about to do is create a "right" to health care for every US citizen. Politically this will not be reversible. Congress can tinker with the system (and you can bet they will) but the underlying premise will be carved in stone. This is the main reason the GOP has been fighting tooth and nail to kill the bill. They grasp that once it's passed they will never be able to return to the status quo ante. And Democrats believe that as the memory of exactly how this thing got done starts to fade; Americans will focus on the promise of (near) universal health coverage. And of course the Democrats also know that this is the camel's nose under the proverbial tent flap. More than a few of the very disappointed liberals are going to vote for this pig because they see it as the first and most difficult step towards a single payer system of national government run health insurance.