Universal health insurance won't happen unless Obama can light a fire under the Senate Finance Committee this week. Within the next two weeks, the committee must report out a bill that contains a public option and a credible source of money (either limiting deductions of the wealthy to 28 percent or capping tax-free employer-provided healthcare, or some of both). Obama then has to get both the Senate and the House (which reports out a bill today) to approve their respective bills before Aug. 7, when Congress heads home for recess.
Why is timing so important? Because the healthcare clock is ticking, and doesn't have many weeks left. Universal healthcare is so complicated -- touching on so much of the economy, stepping on the toes of so many vested interests -- that to allow the bills to languish past recess risks the entire goal. Speed is essential. Recall that after Bill Clinton was elected, universal health insurance looked inevitable; a year later, it was doomed. As Lyndon Johnson warned his staff after the 1964 landslide, "Every day while I'm in office, I'm gonna lose votes."
Republicans don't want any bill. Blue Dog Democrats are afraid of the costs of any bill. The AMA, private insurers and pharmaceutical companies would be delighted if universal healthcare died. If bills aren't passed in the House and Senate before Aug. 7, the fights in both chambers over the public option and money will carry over into the fall, where they'll become more intense and more prolonged. Obama won't have a bill on his desk before the end of the year. That's a death sentence for healthcare reform. The gravitational pull of the midterm elections of 2010 will frighten off Blue Dogs and delight Republicans.