How to Save Health Care Reform From Joe Lieberman

It's been pretty clear that the members of the Democratic leadership in the Senate are a bunch of amoral cowards who are not only afraid to play hardball, but unwilling to at least pretend to play hardball. As the predictable consequence of this weakness, Sen. Reid has let the health care reform debate become an opportunity for "centrist" Democrats to use logically inconsistent assertions about reform (which often go unchallenged) as a pretext to block the Senate from making progress. Joe Lieberman, who Jonathan Chait says "pose[s] the greatest threat to health care reform", has provided the clearest example of this hypocrisy yet in his incoherent flip-flopping on the public option compromise which would allow Americans to buy into Medicare.

Democrats in the Senate still seem to think there's some virtue in being polite to their colleagues who would uphold a status quo that kills tens of thousands of Americans every year, but this needs to end. While I doubt the leadership in the "upper house" would ever deign to lower themselves to hurting Joe Lieberman's feelings in order to save lives, here's what I would do if I were in charge :

1) Joe Lieberman is persona non grata - From this point forward, it should just be assumed that the Democratic caucus has 59 members. I wouldn't suggest taking punitive measures against him (yet), lest the leadership come off as spiteful and alienate some of the votes still in play. Rather, Democrats should just ignore Lieberman completely. Stop inviting him to caucus meetings, don't pay attention to the things he says, and actively engage on-the-fence Senators like Nelson, Collins, and Snowe while making no secret of the fact that the Senate leadership is no longer interested in giving a troll like Lieberman the attention he craves. If asked about Lieberman, Dems should be diplomatic, but treat him as if he were Sen. Graham or McCain. If Joe bashes any aspect of the reform effort, amiably write it off saying something like "Of course Joe would say that. Sen. Lieberman is a good friend, but he's made it clear over the past few months that his vote isn't in play." If Joementum isn't going to negotiate in good faith, stop negotiating.

2) Put reconciliation back on the table - I understand budget reconciliation is a convoluted process which the Democratic leadership is weary of employing, but they underestimate its value as a threat to moderate Senators who are willing to cut a deal. Harry Reid should split the Senate bill into its budget and non-budget related components (per standard reconciliation procedure), include the House version of the public option, and submit the bills to the CBO for scoring. Even if Reid never intends to move forward on reconciliation, a pending CBO score for a reconciliation-ready robust public option should hang like the sword of Damocles over the heads of every centrist Senator. If you don't cut a deal, we'll have a more liberal bill waiting to be passed.

3) The public option is still dead - It's been obvious since the summer that the public option wouldn't make it out of the Senate, so the Democratic leadership needs to work overtime to find a good alternative, even if it means taking a hit from the base. Unfortunately, it looks like allowing people to buy into Medicare is a non-starter, but ditching the public option entirely in exchange for ditching annual/lifetime coverage limits, implementing a hard 95% medical loss ratio, ending the monopoly exemption for insurers, and including Ron Wyden's ideas for opening up the health care exchange (singular, not plural) to every American would accomplish just as much if not more than the already-watered down public options would. The key is to keep focused on the purpose of the bill and not the specifics. If a public option can be traded out for a compromise that will encourage stiff competition and actually control costs, be willing to make a deal.

4) Bring back the "constitutional option" - Once again, like reconciliation, I doubt Harry Reid would ever have the balls to pull something like this off, but it's still worth employing as a tactic to get moderate Senators talking. The Democratic leadership should start trying to get whip counts together to see if they can scrounge up 51 votes for the nuclear option. Moreover, they need to make a serious effort to put the legitimacy of the filibuster in the spotlight. Every Democrat should be prepared to decry the filibuster as a parliamentary trick that has no constitutional basis and start peppering their speech with go-to phrases like "up or down vote", "framer's original intent", and "simple majority" as a way of drawing attention to the fact that Republicans are using a procedural loophole to subvert small-D democracy. If Democrats can get the message across, they can assure the public there's no shame in using a loophole to kill another loophole.

As they say, politics ain't a beanbag, but for too long Democrats in the Senate have chosen the path of least resistance and let the American people be a punching bag in the process. This isn't a game. Harry Reid and the rest of his cohorts need to put down their copies of "Robert's Rules of Order" and pick up Machiavelli's rules for kicking some ass (aka The Prince). They need to stop being congenial and realize that if reform doesn't happen in the next few weeks, it's unlikely to happen for another generation or more. The fate of hundreds of thousands of lives rests on their shoulders.

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