Also at the meeting this morning, Alan Enthoven was criticizing the Democratic proposals for addressing access without offering cost containment. Won't work, he said. And maybe that's right. But Enthoven is allied with the Committee for Economic Development, a business umbrella group. They want -- nay, need -- cost controls. And you know what? They're going to have to work for them. From where I sit, the Democratic proposals currently offer the correct theory of constituency involvement: You front-load the goodies and make the various interest groups work for, and thus grow invested in, the tougher provisions. If business wants hard cost controls, they can pledge their support and put their muscle behind the final product. But what their abandonment of the 1994 plan taught politicians was that you don't start with what you think business wants. You start with what voters want, and let the stakeholders negotiate for their priorities. At the end of the day, if health reform doesn't pass, the next president can work on preschool, or some other popular issue. But business will still be stuck with the spiraling costs of a broken system. If they want relief, they need to assure success. After 1994, no politician will preemptively put their neck out for them.
