Senate Majority Leader Harry Reid's bill, which would pay doctors an additional $247 billion over ten years through Medicare, was voted down today. The "doc fix" proposal was widely seen as a move to build doctor support for broader health care reform. Its defeat is seen as a blow to Reid and fellow Democrats who have struggled for nearly a year to secure doctors' endorsement, which would lend them high-profile credibility, but their full-throated support remains elusive.

Earlier this month, a White House press conference with 150 doctors, meant to illustrate their support, became an embarrassment when it was revealed that officials had handed out white lab coats to improve the visuals. Today's vote marks another defeat. Does this forebode the failure of broader reform measures, such as the public option, or is it just a bump in the road for Democrats?

  • The 'Bribe' Was Terrible Idea  The Atlantic's Andrew Sullivan praises Republicans and the 12 Democrats who voted the "bribe" down. "Good for the Republicans and those Democrats who balked at an unfunded $247 billion bribe to doctors to keep taking Medicare patients. The key word here is unfunded. It's fiscally, well, Bush-like, to add this to the debt without offering any way to pay for it. Yes, the GOP is principle-free: their fiscal conservatism only applies when the Democrats are in charge. But it's nonetheless the right thing to do."
  • A Good Thing For Dems?  Washington Post health care blogger Ezra Klein notes that 27 Republicans, including the bill's co-sponsor, initially supported the bill but turned against it to embarrass Reid. "This is arguably the best possible outcome for the Democrats: They don't have to pass a bill that increases the deficit, but they get with the docs credit for trying, and the American Medical Association is furious at the Republicans," he writes. "Democrats got off easy on this one."
  • The Doc Fix Will Still Happen  The Wall Street Journal's Jacob Goldstein thinks the $247 billion ten-year plan will simply be passed year-by-year. "Congress will likely do what it almost always does: Pass another short-term fix that blocks the pay cuts for the immediate future but leaves in place plans for future cuts. As Harry Reid said today: 'Right now, we’re going to a one-year fix,'" Goldstein writes. "Maybe they’ll have an easier time figuring out how to pay for a one-year patch."
  • Don't Listen to 'Failure' Narrative  The Guardian's Michael Tomasky doesn't buy that this will matter. "So it was a defeat for Reid. On NPRthis morning the report went basically, Reid couldn't hold his caucus together in what may serve as a test-vote for broader reform," he writes. "Will any of this matter when the big reform bill careens toward final passage in November (or December, as some are now saying)? Probably not a whit one way or the other. But as I said up top, it's an interesting example of how insta-interpretations aren't necessarily the true ones."