Ezra Klein’s live chat with readers today included this interesting exchange:
Washington, D.C.: I found it interesting that the subsidies, which is the bulk of the $900 billion, didn’t receive a whole lot of attention and detail last night from Dems and Republicans. Is the general agreement on both sides about the subsidies?
Ezra Klein: I’m continually surprised by this too. I don’t know if there’s agreement on it — no House Republicans are likely to vote for this bill — so much as neither side really sees a margin in shouting about it. A lot of Republicans attack the cost of the bill, which is an indirect attack on the subsidies, but they’re not interested in assailing the general concept of health care for poor people.
As Trudy Lieberman notes today, among the people not discussing the details of the subsidies last night was the president. But the general, and ongoing, absence of subsidy levels and similar topics from the discussion—in the press, and in the most high-profile remarks of politicians—shows just how strange this debate has become.
The question of how much revenue the government should collect—and what tools it should use to do so—to provide an agreed-upon service is the essence of workaday politics. At the outset, it was at the center of the health care story, too. Think all the way back to July, when a proposal for a surtax on rich people briefly dominated the news cycle.
In the intervening two months, though, the debate has been about other things entirely. That’s partly because, as Klein says, the partisans in Congress don’t see “a margin in shouting about it.” But it’s also because their bases have been pushing other concerns: “death panels” and the like on one side, the “public option” on the other. There’s a Grand Canyon-sized chasm between the news merits of those two issues, but the omnipresence of both has brushed other important issues aside. It’s also demonstrated how hard consensus has been to come by: what’s the point in arguing about the cost of something, if you can’t agree on whether you want it?
But when a health care reform bill finally gets passed—and it looks, at the moment, as though one will—boring, banal budgetary decisions will make enormous differences in people’s lives. Will subsidies extend to families who earn 300 percent of the poverty level, or 400 percent? How will they be structured, and how generous will they be? How steep will the penalties be for not obtaining coverage? How should the other costs be borne—and how can they be designed so they are not passed on to individuals?
These are some of the questions that are driving back-room negotiations on Capital Hill; the way they are answered will determine what health care reform amounts to. Covering them would be a public service. It would also, if done the right way,* attract readers. As CJR’s town halls have shown, there are a lot of people out there who do want to know more about the specifics of health care, and are frustrated that nobody is explaining it to them clearly.
In other words, politicians might not see a margin in this sort of discussion. But journalists should.
*For an example, see here.