As everyone knows, the US Senate is currently in the midst of negotiations, mostly among the 60 members of the Democratic caucus, aimed at producing a consensus health insurance reform bill that can pass the Senate. Without being privy to any inside information, I can only speculate as to what is really going on behind closed doors in these negotiations. But I did find interesting this week’s reports that the Democratic Senators had apparently reached a compromise agreement that would have jettisoned the so-called “public option” but included a provision to allow people over 55 to buy into Medicare. This latest new idea now seems dead, but the bill may be back on track, and the majority of Senators remain hopeful for its passage.
So again, without knowing what any of the parties involved were actually thinking, I have to wonder what is going on here. The Medicare buy-in proposal seemed like a clever idea because no matter how much various opponents of reform complain about government-sponsored health insurance, nobody is very much opposed to the government-sponsored program we already have, namely Medicare. There may not be a single member of Congress who would vote to repeal that program. Therefore the idea of expanding Medicare rather than creating a new government program, was–not suprisingly–popular among a whole range of members of Congress. (perhaps too popular with liberals, as some have speculated.) On the other hand, the idea of expanding Medicare was rejected a long time ago as too threatening to the status quo of private employer-based health insurance. So what purpose was served by re-introducing this concept into the negotiations?
Sometimes in the midst of a stalled negotiation, it is useful to get the parties away from the issue they are stuck on and take them down a whole new track. For example, when parties reach an impasse on the amount of the settlement payment, I have tried sidestepping the impasse by asking whether something other than payment of money might be of benefit to the plaintiff, say the possibility of future business in a commercial case, or the provision of in-kind services, or finding another position for an employee whose employment was terminated. Sometimes the introduction of such ideas will get the parties thinking about how to solve the problem in a more creative way. More importantly perhaps, throwing out new ideas gets the parties working together to explore whether those ideas will work. Even if they decide that the alternative method of settlement is not feasible, they may still make important progress. That progress comes from the experience of collectively trying to solve a problem, and can even come from the mutual rejection of a new alternative. (Mutual rejection of an idea can be viewed positively: it means the parties finally agree on something!) Rejection of an alternative forces the parties back to the original way of settling the dispute, and may provide them with greater incentive to break the impasse that prevented the original form of resolution.
As I said, I have no idea what is actually going on in the Senate other than what I read in the papers. But I do know that failure to achieve an alternative approach does not necessarily doom the possibility of resolving this complicated, multi-party dispute, and may even help advance resolution.