Nice post.

(1) If budget reconciliation leads to reduced deficit and reduced federal power, reconcile away. Uh, oh! I notice I didn't bother to ask whether or not this was a GOP or Democrat idea. But that's probably because I don't much care.

(2) Question: can the "3 legs" be addressed in separate legislations, sans crap? E.G., why can't "bipartisan support" for the pre-existing conditions laws be harnessed into passing a law focused on that point?

[NOTE: I actually know that the answer to that question is, "because that would be sensible and therefore above the pay grade of the federal government" so don't bother providing that answer. I am just trying to think outside the beltway for a moment here.]

(3) banning health insurance denial of pre-existing conditions mandates more law on universal heathcare? Really? I think that might be a false what-chum-you-call-it. I refute that assertion.

(4) Only by striving for mandatory universal health care coverage will the government (like "no child left behind") fail.

This is not the nation of universal success. It is the nation of universal opportunity. That's a crucial difference. Provide all citizens a rational opportunity to have health insurance. Let's start there.

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"There's a reason we don't quote Hitler when we discuss highway spending. It just puts too much noise into your signal." Joel, 2010

In all this talk about using "reconciliation" to pass ObamaCare — still no sure bet — I'm struck by a couple of things. One, the fact that various polls show overwhelming opposition among the American people for passing ObamaCare. A CNN poll finds that only 25 percent believe Democrats in Congress should pass what it has come up with, 48 percent say it's time to start all over again, and another 25 percent say it's time to cut bait entirely and move on to other issues. (That's probably the worst of the polls at the moment from Obama's perspective, but others show similar sentiment among the public.) Yet Obama said at the end of his 7-hour summit that he's gonna give it a few weeks, then urge the Dems to find a way to pass a bill CNN's poll says just 25 percent of Americans want to see made law. Just one word: Wow.

Anyway, I'm reminded about Bush's first year in office upon reelection. I was covering the White House at the time, and remember his first post-election press conference in the Eisenhower Excutive Office Building in January 2005. Bush declared his re-election, like it does for all presidents, gave him political capital. "And I intend to spend it," he said, by moving forward with his campaign pledge to enact Social Security reform. I don't remember how the polls reflected his plans to partially privatize Social Security for younger workers, while keeping the status quo in place for the retired and those close to retirement. But it could not have been worse than ObamaCare is polling now in some quarters — though it may have matched it and I'd wager it was probably polling at least a little better.

So I've wondered this week what the political and media class would have been saying back then if Bush used his much smaller Congressional majority in 2004 to jam Social Security reform through via reconciliation. Using that parliamentary maneuver — distorting it, really — to get his way would have elicited the same kinds of howls from Democrats that we're hearing now from Republicans. But I don't recall it even being contemplated by the then-in-power GOP. Not a whiff — even from a president who was just as certain his Social Security reform ideas were as necessary to ensure America's long-term fiscal health as Obama is of his health care plan.

So perhaps Republicans in this case have a strong point when they insist reconciliation should not be used to muscle through sweeping changes to social programs. They didn't try it when they had a chance under very similar circumstances. And even if one wants to look at that dynamic cynically, one could say the GOP failed to pull the reconciliation trigger not out of principle, but out of a sheer survival instinct. Such a move would have been politically risky, if not political suicide, because of the outrage over how the Republicans were openly defying public opinion.

So despite Obama's implication that he will push for the use of reconciliation to pass such an unpopular bill, I have my doubts his fellow Democrats will be accommodating. While Obama famously declared that he'd rather be "an effective" one-term president than an average two-termer, I have a feeling most Congressional Democrats — who face voters in an alarmingly short eight months — would rather they keep getting re-elected than do the president's bidding.

There is zero upside to walking the plank Obama has set before them. Better to simply make the best of a bad situation and try to convince voters that ObamaCare would have been really awesome if Republicans didn't muck it up by ... well ... helping to defeat a bill they hated anyway. I can't wait to see how that turns out.

Oh, and a quick side note about this comment:

On the other hand, the Republican's complete refusal to participate in the process leaves the Democrats without many alternatives.

It's more accurate to say that the Democrats didn't allow Republican participation in the committee process — when it matters. Besides, I thought I heard from the summit yesterday that there were a few Republican ideas in the bill. From the president's own lips. So which is it? Kinda hard to argue both points.

I've said it before and I'll say it again: Obama and the Democrats have blown the greatest set of favorable political conditions in at least half a century. Just one year ago — one year! — Republican politicians were saying that Obama had a mandate, and it was time to get on board with some of his ideas. Offer some suggestions of their own, certainly. But they thought voters would dig the dagger in deeper in 2010 if they didn't show a willingness to cooperate with this enormously popular new president.

Congressional Democrats reacted by walking through the political battlefield and shooting the wounded. Obama reacted by saying "I won," and embarking on an agenda well to the left of what he expressed during the campaign — or at least way to the left of what the press and voters were convinced he campaigned on. Every new president, and a heartened Congressional majority, acts as if they have a mandate larger than the one they actually have. It's only natural. But most presidents are smart enough to eventually walk back and reassess when they realize their error. Not Obama, and not this Congress.

I've been watching and covering politics for a long time. I've never seen anything like this self-inflicted political disaster.

Okay, just for fun, I'll give a couple of libertarian responses:

• First and foremost, providing (or ensuring access to) healthcare is in no way the business of the federal government. Throw the whole stool on the fire.
• A variation on the first point: If there's anything the federal government proves every single day, it's that they are the worst level of government for solving these kinds of problems. Hand the stool back to the states and let them give it a shot. Chances are, one or two will find a system that works reasonably well. In addition, any failures will occur on a smaller scale than they would if the "experimenting" is done at the national level.
• The problems of our current healthcare system are, in large part, the result of too MUCH government meddling. For example, the state-by-state insurance monopolies reduce competition in such a way that natural market forces that would drive down healthcare and insurance costs are unable to operate. Introducing additional mandates at a national level will only make this worse. Any reform of health care should start with eliminating barriers to competition.
• Read this article from The Atlantic. It makes the case that a critical problem with our health insurance system is that it disconnects the consumer of services (the patient) from the buyer of services (the insurance company) which keeps market forces from bringing down the cost of services. All three legs of the stool will exacerbate this problem, driving costs further up.

So what should the federal government do instead, if anything?

• Make all medical expenses tax-deductible.
• Expand the flexibility of medical flexible spending accounts (FSAs) by allowing dollars to roll over, making it easy for small businesses and self-employed to set up FSAs, making the accounts portable between employers, etc.
• Kill the lawyers: Lower the costs of medical malpractice insurance (and, by extension, the cost of care) by reforming tort law to lower punitive awards and reduce frivolous lawsuits.
• If there's anything to which interstate commerce clause does legitimately apply, it's breaking up the state-by-state insurance monopolies. Competition drives down costs.

Okay, let me have it.