Saturday, 19 December 2009

It's Now or Never

One further thought for the many people of good will out there who care about health care reform but wanted something better:

I'm not saying this bill is perfect. I do think it is good - very good even, and will leave many millions of people much better off than before. But sure, there are things in it that I would change if I were starting from a clean sheet of paper.

But we all have to understand the choice that we are making here. Our choice is not between this good but not perfect bill or another, better bill that we could pass in a year's time. It's between this or the status quo.

Remember that there isn't a single Republican in the Senate, and there is just one in the House, who is willing to vote for even this version of health care reform, let alone the stronger one that we progressives would like.

Now remember that there were nearly 40 DEMOCRATS in the house who voted against this current House bill, and there were 3 Democrats (plus Joe) who had a lot of issues voting for it. These people are not going to suddenly change their mind because progressives want something stronger. They don't LIKE PROGRESSIVES. They WANT to defeat progressives. In many cases, the best thing that they can do for their own electoral chances in their states is to be seen to anger us fighting lefties. And because health care reform doesn't exist yet, there's no constituency in their state this is benefiting from it and wants it protected. Social science proves that people are far more loathe to lose something they have than they are eager to get something better. When it comes to the conservatives in both parties who are blocking us here, we have no power over them.

Plus, we are likely to be a smaller caucus after the 2010 elections, especially if Democrats fail to achieve their single biggest domestic priority. Failing to achieve health care reform makes us look (and act!) like losers. Losers do not win the good will of voters.

But with the modified health care reform passed, a couple of things work in favor of improving and expanding it.
  1. The world will not end. All the Republican scare mongering about death panels and socialism will start to look even more crazy as people look around and see none of this happening. Meanwhile:
  2. A consituency is created for the Health Exchanges. People who are on it will want to protect and keep it. And the number who are on it will go up in time.
  3. Insurance industry regulation will kick in right away and will make small but relieving changes to the deals people can get from their insurers.
  4. All of this, plus the political bonus that comes from achieving what no other Democratic Congress or President has ever been able to accomplish before should helpt mitigate losses in the 2010 election.
Now, I know that Democracy for America is circulating a petition that shows only 33% of the public support the current bill. But I'm neither surprised by that nor worried about it. As Ezra says,
The final days of a bill are, almost by definition, the hardest. Critics have had time to mobilize. Industry has had time to lobby. Supporters have endured one painful compromise after another. Enthusiasm ebbs at the exact moment opposition peaks.

And as those who would like to see the bill fail organize, those who would like to see the bill succeed nitpick. Joe Lieberman refused to allow Medicare buy-in. Ben Nelson worries over the abortion language. Susan Collins wants to ensure access to catastrophic plans. Progressives are concerned that insurers will game the individual mandate. Name your interest group or constituency and they will name the provision, or set of provisions, that worries them. The goals of covering the uninsured and bending the cost curve remain popular, but the means are, well, more controversial.
A bill will pass. Millions will be better off. Those who oppose the bill from the left (a large number) will realise that their cause is better off now than it was before. Those who oppose it from the right will have to find a way to live with it. Either way, by the midterms people will be judging the law, not the bill - and those aspects of it that aren't working can be fixed incrementally rather than as a once and for all take it or leave it deal.


KathyF said...

I wonder, did those on the left who oppose this bill also oppose the children's health bill? After all, it could certainly have been better--it could have, and should have, covered adults as well.

I'm relieved we're getting a bill signed, and that personally, we don't have to wonder how our daughter will be insured after she graduates from college in another year. This way she'll be able to go to grad school and continue on our insurance...yay!

Thanks for all your clear-headed blogging, Karin. I normally would have jumped into this with both feet--well, hands--but I've been distracted these last few weeks. So thanks for being a voice of sanity round these parts!

Obama London said...

Thanks very much for the kind words, Kathy.

I'm really glad for your daughter. I'm glad for a lot of folks out there who deserve better than they are getting now.

I'm sad to see that so many of the folks who voted for this change don't see how much their efforts have achieved here. Nothing even close to the current bill would have been possible a few years ago - and we made that happen.

Happy holidays!

Taylor_Democrat said...

I am grateful that the Senate may be able to get to a vote on this legislation so that we can move to the next stage-merging the two bills.

Those of us who are not satisfied with the current bill can now work to improve it through the negotiations with the House.

I hope "those on the left who are satisfied with the Senate bill" will still work as hard as they can to make the bill better during conference.

We may in the end get something we can call health care reform, but it will be far short of what is really required to bring universal health care to the United States.

I am in total agreement that this is the one and only opportunity we will have to get something done on health care reform, it is just a shame that we did not use it to fundamentally change the system.

This legislation does make improvements to the existing private, for-profit health insurance system, but it now locks us into that flawed system for ever after.

Yes we have patched a few holes in the hull and we have managed to bring a lot more people on to the ship, but the ship is still slowly sinking. I was hoping that we could eventually get EVERYONE off the sinking ship and onto a new ship all together.

I know now that this is not possible and you will have to forgive me if I am not jumping for joy.

Taylor Kunkle