How cynical do you have to be to understand the politics of healthcare reform?

Jacob Hacker purports to be puzzled about why Blue Dogs (centrist Democrats in Congress) are resisting health care reform that would provide significant benefits to voters and small businesses in their typically rural and small town districts.

Yet the Blue Dogs have mostly ignored the huge benefits of a new public plan for their districts. They have also largely ignored the disproportionate benefits promised by new federal subsidies for low- and medium-income workers. Right now, large swaths of farmers, ranchers and self-employed workers can barely afford a policy in the individual market or are uninsured. They will benefit greatly from the premium assistance in the House legislation promised for workers whose earnings are up to 400 percent of the poverty line, from additional subsidies for small businesses to cover their workers, and from a new national purchasing pool, or "exchange," giving those employers access to low-cost group health insurance that's now out of reach.

Paul Krugman wonders if the Blue Dogs are just being corporate tools of drug and insurance interests that lately have been pouring cash into Blue Dog re-election coffers. But then he says he's not quite that cynical.

Mark Thoma stops short of saying the Blue Dogs are selling out their voters, but he links to Brad DeLong who says he has all the cynicism Paul and Mark lack:

The Blue Dogs have been bought and paid for. They do not want a fiscally-responsible bill. They want to please their masters from the health insurance industry by trying their best to keep there from being a bill at all.

Update on Thursday, July 30, 2009 at 08:47AM by Skeptic

Further evidence that it’s impossible to be too cynical is in this NYT story today about huge federal campaign contributions received from McAllen, Texas doctors and hospitals and specifically who seems to have been influenced. McAllen was featured in a June article in The New Yorker as a community where per capita healthcare spending is twice that in El Paso and places of renowned quality like the Mayo Clinic although there are no measurable benefits in outcomes or in disease loads, demographics, or anything else that would justify such a spending discrepancy. President Obama has repeatedly cited this in speeches and meetings as an example of how health care costs are breaking the backs of Americans.  

The Democratic Senatorial Campaign Committee collected nearly $500,000 at a reception here on March 30, mostly from physicians and others affiliated with Doctors Hospital at Renaissance, financial disclosure records show.

. . . .

Another event at Mr. Cantu’s home, in September 2007, brought in at least $800,000 for the committee’s House counterpart, the Democratic Congressional Campaign Committee, according to disclosure reports. The House speaker, Nancy Pelosi, was in attendance and cut a ribbon at the hospital’s new women’s center while in town.

. . . .

Although Congressional negotiations over health care legislation are continuing, Doctors Hospital seems to be getting much of what it wants. Thus far, physician-owned hospitals have been insulated from some of the most onerous potential restrictions in the health care legislation moving through Congress.

Representative Pete Stark, a California Democrat who wants to clamp down on physician-owned hospitals, said their formidable lobbying had helped eliminate his proposal to limit physician ownership to 40 percent at any hospital.

“Particularly led by these guys in Texas, these guys who have been raising tons of money for contributions,” Mr. Stark said in an interview. “I am sure that some of my colleagues have been willing to hear them out.”