The Realities Of Passing Health Care & The Risks Of Not
Time and time again during this grand debate, I’ve said that compromise was not only appropriate, but absolutely necessary if we wanted anything passed. Yes, this legislation is flawed. But all important legislation is. Eventually, we’ll build on it and create something that works for every single American, but for now we’ve got a good start.
Still, what did we hear from the left throughout this process? “You’re not doing enough! This isn’t reform! Give us a public option or give us nothing! Obama is breaking promises!”
Perhaps they forgot this during the Bush years, but politics is the art of the possible and a public option wasn’t possible with this Senate. Neither was not having a mandate. Sorry folks. Thems the breaks. And it’s not like the Dems will have a better chance to pass this because it’s likely that Dems will lose their 60 votes next year.
Thankfully, liberals like Ezra Klein get it…
Passing legislation, it turns out, is a long and ugly process. God, is it ugly. The compromises, both with powerful special interests and decisive senators. The trimming of ambitions and the budget gimmicks and the worship of Congressional Budget Office scores. By the end, you’re passing a compromise of a deal of a negotiation of a concession.
But bad a system as it might be, it’s the only one we’ve got. At least for now, this is what victory looks like. The slow, grinding, ineluctable advance of legislation that is quite similar, albeit not identical, to what you began with. It’s not pretty, and it doesn’t necessarily feel like winning is supposed to feel. But this bill will do most of the things supporters hoped it would do: cover about 95 percent of all legal residents, regulate insurers, set up competitive exchanges, pretty much end risk selection, institute a universal structure that we can improve and enhance as the years go on, and vastly reduce both medical and financial risk for families.
It’s been a long time since the legislative system did anything this big, and people have forgotten how awful the victories are. But these are the victories, and if they feel bad to many, they will do good for more. As that comes clearer and clearer, this bill will come to feel more and more like the historic advance it actually is.
And from the right, well, there was basically a consensus early on that defeating the health care bill was more important than being involved in the process. I thought that was foolish, and still do. Sure, they’ll pick up some seats next year, but they weren’t involved in the most important legislation they’ll ever vote on. And all because they wanted to pick up some seats? Not smart.
Let’s see what they voted against:
- Removing lifetime caps on how much care you can get.
- No more denying people insurance based on pre-existing conditions, which has the net effect of making health care a right, not a privilege.
- Insurance companies can’t charge higher premiums based on gender or medical history.
- Subsidization of private health insurance for Americans who make up to 400% of the poverty level.
- Medicaid will be extended to those who make 133% of the poverty level.
- Health insurance exchanges (co-ops) will be established in all 50 states that give people and businesses the opportunity to pool together and force down premiums.
- Antitrust exemptions for health insurance companies are now gone. That means the monopolies that exist all across the country will eventually go away.
That’s a hell of list to oppose. Think that won’t hurt Republicans down the road? I can’t help but think it’ll seriously hamstring them, especially after 2014 when a lot of the reforms kick in.
So, those are some of the realities and the risks. And, at least to me, Americans got one hell of a gift this holiday season with this legislation.
Here’s the question: What do you think?
(Photo: Getty via Daylife)
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[...] This post was mentioned on Twitter by Justin Gardner, healthy. healthy said: The Realities Of Passing Health Care & The Risks Of Not – Justin …: Time and time again during this grand debate,… http://bit.ly/6X1k8s [...]
So has it occurred to you, Justin Gardner, that NO bill might be better than this bill?? Are you for passing ANY bill, just so a bill is passed? What is the goal here? Many of us are willing to compromise; you paint the left opposition as monolithic. We want a bill that improves the quality of health care and doesn’t hand the insurance companies a gift, and we don’t think this bill does that.
Yes, I’ve considered what you’re talking about and, given that we haven’t been able to pass anything for the past 30 years, I find that point of view incredibly shortsighted.
Also, this isn’t just any bill. The bullet points I listed above represent massive changes.
However, you want to scrap the bill, right? Okay, so when is your version of compromise going to pass? Because I’m assuming it includes a public option or medicare buy in. How exactly do you propose convincing moderate Dems, who’ve already rejected those ideas, to support it? Especially going into an election year where it’s very likely that Dems will lose their 60 seat majority. Do you really think it’s likely they’ll pass something that’s even more liberal during a time when they’ll need to be campaigning?
As far as the quality of care, that’s not something the government can explicitly do. All they can do is provide greater access to it. However, I’d argue that the fact that tens of millions will now actually have access to health care and thousands of new clinics will be opened up across the country does improve the overall quality that people will receive…especially when we’re comparing it to none at all. And I disagree that the insurance companies are being handed a gift. They have to make massive changes and their special status as being exempt from antitrust laws is now gone. Why don’t liberals appreciate how huge that is?
To close, it might not be fair for me to lump everybody in the left who opposes this legislation together, but the net effect of all of your opinions are the same…no health care bill and none of the reforms I mention above. To me, that’s crazy.
In response to another comment. See in context »How’s this for a compromise? Do what Howard Dean suggested as his first comment, before he got so much flack he withdrew it:
Go to reconciliation and pass Medicare for all. A bit less than ideal, but still better than this.
Or . . . another option: what would happen if we let them (we know who they are) rant on until they look really silly, and the people realize they are obstructionists. Don’t you think they would eventually give up? Just how long can a filibuster last? Let’s find out. Right now they are in control even though we have the majority. And if they get away with it, their way of doing business will paralyze this president for the rest of his term and set a precedent for future administrations. Do we want to render congress so weak that it can only function on the most mediocre level? We have bigger issues than healthcare, important as it is, to deal with, namely the preservation of the human race. Is congress up for the strong measures required to face the ‘inconvenient truth’? Not if we don’t take a stand now.
First off, that’s not compromise. But it does explain more about your state of mind.
But let’s break this down…your solution is forcing the opposition and moderate Dems to possibly filibuster the bill? If that’s the case, it would have to be split into two parts to be passed through reconciliation. It’s unclear if doing it that way is even feasible from a procedural standpoint. From what I’ve read the answer leans towards no.
Also, you’re right about there being other issues (health care is the biggest in my book), but do you really think that having a knock down, drag out intra party fight is the way to get that other stuff passed? Come on now…
Sorry riolama, but you seem to be the type of Dem who doesn’t understand what’s possible in the current political climate. The Dems did stand up and the changes I listed above is evidence of that.
In response to another comment. See in context »Arguing ad hominum is uninteresting. . . “you seem to be the type of Dem who doesn’t understand . . . ” adds no light to the discussion, so I’m done here.
Listen, there are people who understand what it takes to get things done and there are those who won’t budge. Saying that you fall into the latter camp doesn’t mean the point isn’t valid or inappropriate.
Also, look at my last paragraph in my first comment. I said essentially the same thing there too. You’re offering up “compromises” that aren’t really compromises.
Meanwhile, you don’t even acknowledge all of the points I list as achievements of the current legislation.
I’m just glad that the part isn’t run the way you’re describing because we would alienate moderates and independents and make politics even more divisive. How would that help after the last 8 years? We need the exact opposite right now and that’s what we’re getting with Obama and the current leadership.
“‘You’re not doing enough! This isn’t reform! Give us a public option or give us nothing! Obama is breaking promises!’”
I don’t get it. It seems pretty obvious to me that anything good this legislation might contain owes its existence to big pushes from the liberals that you mock. When single-payer was removed before negotiations began (even as a bargaining chip, and you are writing about compromise, right?), then the public option (a cornerstone of Obama’s campaign) was allowed to die an unceremonious death, it was pretty clear that our theoretical representatives were feeling zero pressure from the left. Then people got vocal, and at least reminded some in government that they weren’t going to be apologists for a Democratic Party that wasn’t doing its job. And what we ended it with was a lousy bill, albeit one that does contain some of the good things you pointed out. But instead of ostracizing those who spoke out, why don’t you say something more like, say, “thanks”?
kramer,
First and foremost, the reason single payer wasn’t on the table was because it was so unrealistic that Hillary and Obama didn’t even mention it during the campaign. Again, we’re talking about political realities here.
Next, the public option was put up there, but it was just ONE piece of the legislation. Just one. Obama campaigned on reforming the health care system and getting more people the care they need. This legislation does both of those things. Liberals act as if the mechanisms are the most important thing. That’s why I’m so frustrated…because look at all of the reforms I listed. How do you all not understand how huge this is?
Also, liberals ignore the fact that not for profit co-ops will be created in all 50 states to compete with the insurance entities in each state. The insurance entities that can no longer have monopolies. This is great news. Because it means you get “public” options in every single state that recognize the needs of each state, not one monolithic federal entity that would easily be the subject of scorn from the right. And you know who asked Baucus to come up with this idea? The White House. Because they saw the writing on the wall and decided that the most realistic way was via a state by state exchange.
So no, people speaking out didn’t force anything. And people saying “kill the bill” on the eve of the passage of the most significant health care reforms in the past 40 years aren’t forcing anybody to do anything either…except make us write posts like this telling everybody else to ignore you.
In response to another comment. See in context »“First and foremost, the reason single payer wasn’t on the table was because it was so unrealistic that Hillary and Obama didn’t even mention it during the campaign.”
I already answered your objection before you voiced it, so I’ll just paste in what I already wrote: “…even as a bargaining chip, and you are writing about compromise, right?”
Whether it’s a possibility or not (and Obama is on record – and video – speaking in favor of it before he ran), it’s a bargaining chip, as I said.
This is what I find frustrating in the mainstream corporate Dem/TNR position: it’s intellectually dishonest. This bill might well be worthwhile after all, but the “center left” commentators keep leaving inconvenient facts out of their arguments, and that makes you guys suspect. You can’t rightly argue in favor of beginning negotiations from a weak position; if you do, your argument is fatally flawed from the outset. If you admitted the big fumbles at the beginning of these proceedings, I’d feel a lot more comfortable with your conclusions; as it is, I feel like I’m being condescended to by people who are intentionally misrepresenting the facts, or who just don’t get it.
In response to another comment. See in context »