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The Underpants Gnomes Theory of Reform

Dem lawmakers seem to bet on the following: 1. Reject the only bill that can be enacted any time soon. 2. ????? 3. Universal coverage!

blog post from Paul Krugman on potential for a better bill:

The Underpants Gnomes Theory Of Reform

Watching some liberal members of the House explain why they won't do what's necessary, and pass the Senate bill, I was wondering what they imagine will happen. Then the answer came to me: it's the  Underpants Gnomes business plan. In its original form this was:

1. Collect underpants. 
2. ????? 
3. Profit!

The current version is:

1. Reject the only bill that can be enacted any time soon. 
2. ????? 
3. Universal coverage!


On the future of the issue it raises an interesting point. I think it was Ezra Klein who pointed out health care reform attempts come along I believe every 17.5 years (although maybe at the rate of things falling apart, the next chance will be sooner). But however long the time period, is the degree of how terrible the situation is regarding health care reform (number of uninsured, among other yardsticks) inversely proportional to the chance that progressives will get a better bill next time? Meaning, if you hold out and wait for things to get worse, are your chances for a better bill improved? Will a grassroots swell among the citizenry emerge in favor of single-payer, for example? Or will there be an even worse bill next time?

And how long will it actually take? On the one hand, as Chris  argued here, we would have achieved a public option or Medicare buy-in had a few Senators not lied. So it is only a matter of ridding ourselves of a few bad apples to achieve an acceptable bill to those in the House currently refusing to support it. But you also need a supportive President and similar or better congressional majorities, and how long that takes, given that a shellacking appears likely this November, is anyone's guess. Alignment of all those stars is difficult.

Given all that, it seems to me the central point here is that the crystal ball is hazy, and you never know how long it will take to get the political dynamics all aligned again to take another shot. I can't find the comment link, but one of the strongest arguments I've seen in favor of passing the bill was by Mark Matson (who can correct me if I'm not paraphasing correctly) which is that if the bill became law in the future, no one would want to go back to the health care situation this country had in 2009. Given that the political future is hazy on when we'll get another shot, that seems worth keeping in mind as members of Congress consider whether it's worth banking on another shot in the future.



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