The Road to Reform
Thursday, December 17 2009
I haven’t posted about health care reform in a while – partly because I’ve been distracted, partly because I’ve been waiting to see how things shake out in the Senate. Now that I am not so distracted, I discover things have been not so good.
For starters, the Senate bill never had a strong public option. Then they dropped even what they had, in favor of a weaker compromise. Then it dropped the compromise substitute for the public option – apparently, due to the influence of Sen. Joe Lieberman (I-FU). (When I was a younger man, and Lieberman was running for Vice President, the two of us shook hands on a runway in Orlando; nowadays, my skin crawls whenever I think about that day.) If health reform fails, Joe Lieberman will bear much of the blame.
Which isn’t to say that all hope is lost. The House bill is still good, and the Senate bill still has some incredibly valuable language. Even if the Senate text was all that became law, it would still be better than the current system – which shows you how bad things are, if even milquetoast legislation is a substantial improvement. For more on this theme, Ezra Klein has had a few compelling posts about what the Senate bill might accomplish – this one, for example. It’s also worth considering Nate Silver’s 20 Questions for liberals who are clamoring to kill the bill, and Jon Cohn’s response to the same activists.
Obviously, I’m not advocating killing the bill. But at the same time, I’m not spending a lot of my energy advocating for the bill. I say it’s acceptable, but it’s also tremendously disappointing. The public option was important – it was already a compromise from single payer or similar government-intensive reform; Jacob Hacker has a helpful post about what we’ve lost there. Moreover, I am mostly convinced at this point that the Obama administration never intended to deliver comprehensive health care reform, and what they do plan to deliver is a giant new pool of money for insurance companies – in which case, Joe Lieberman is not so much arch villain, as eager henchman in this story.
Assuming the Senate bill makes it through without further amputations, the bottom line for sick people is that it should be a good deal easier to obtain and keep health insurance. It might still be relatively expensive, but folks with lower incomes will get subsidies to help them buy that insurance. The insurance companies can’t eject you arbitrarily, or refuse to pay claims for pre-existing conditions, but they can impose an annual or lifetime limit on your care. There may be some changes that help to improve the quality of health care, but no obvious means by which to contain costs.
That said, we are now at the point where only the most die-hard ideologues can object to this bill. If you’ve been on the fence – perhaps you were suspicious of a “government take-over”- the ball is now yours: this bill changes a lot of things, but it is nowhere near a government take-over of health care. So if you haven’t yet called your Senators to voice your support for reform, now is your chance. Those of us who favored more comprehensive reform have already made our voices heard; it’s your turn. Read a little, think a little, and then call or email.
We’re pretty close to the end of this road, and though it didn’t lead where I wanted it to, we can at least make sure it doesn’t lead us back to where we started.
