Pass The Bill

Nobel laureate Paul Krugman writes in today’s New York Times:

A message to progressives: By all means, hang Senator Joe Lieberman in effigy. Declare that you’re disappointed in and/or disgusted with President Obama. Demand a change in Senate rules that, combined with the Republican strategy of total obstructionism, are in the process of making America ungovernable.

But meanwhile, pass the health care bill.

Yes, the filibuster-imposed need to get votes from “centrist” senators has led to a bill that falls a long way short of ideal. Worse, some of those senators seem motivated largely by a desire to protect the interests of insurance companies — with the possible exception of Mr. Lieberman, who seems motivated by sheer spite.

But let’s all take a deep breath, and consider just how much good this bill would do, if passed — and how much better it would be than anything that seemed possible just a few years ago. With all its flaws, the Senate health bill would be the biggest expansion of the social safety net since Medicare, greatly improving the lives of millions. Getting this bill would be much, much better than watching health care reform fail.

At its core, the bill would do two things. First, it would prohibit discrimination by insurance companies on the basis of medical condition or history: Americans could no longer be denied health insurance because of a pre-existing condition, or have their insurance canceled when they get sick. Second, the bill would provide substantial financial aid to those who don’t get insurance through their employers, as well as tax breaks for small employers that do provide insurance.

All of this would be paid for in large part with the first serious effort ever to rein in rising health care costs.

The result would be a huge increase in the availability and affordability of health insurance, with more than 30 million Americans gaining coverage, and premiums for lower-income and lower-middle-income Americans falling dramatically. That’s an immense change from where we were just a few years ago: remember, not long ago the Bush administration and its allies in Congress successfully blocked even a modest expansion of health care for children.


Whereas flawed social insurance programs have tended to get better over time, the story of health reform suggests that rejecting an imperfect deal in the hope of eventually getting something better is a recipe for getting nothing at all. Not to put too fine a point on it, America would be in much better shape today if Democrats had cut a deal on health care with Richard Nixon, or if Bill Clinton had cut a deal with moderate Republicans back when they still existed

[Emphasis mine]

I understand that this bill has been extraordinarily watered down. But I’m still of the mind that 50% of a loaf is better than no loaf at all, and that doing something to help those in need–even if it isn’t as much as we’d like to do, or could do otherwise–is better than doing nothing.

My question to progressives who say we should kill the bill and try again later is, when is later? When are we going to have a chance like this? We have a Democratic President, 60 Democratic Senators and a massive Democratic majority in the House; when in the near future will we be better-positioned to pass anything more substantial?

As Krugman points out, the history of health care reform has been chock full of failures followed by long periods of nothing. 15 years passed between when Clinton’s health care reform failed and when we could take up that cause again. And, to be honest, there are millions of Americans out there who can’t afford to wait another 15 years for reform.

I wanted a public option. I wanted a Medicare buy-in. I wanted more policies that would have expanded coverage and lowered costs. But, unfortunately, that’s just not in the cards right now.  And it’s likely that, as time goes on, our majority is going to shrink, not grow; over time, we’re going to become less and less able to pass anything at all, even the halfway compromise we’re looking at now.

Health care can always be improved piecemeal in the future. We can always pass small improvements here and there that will garner less attention, be less controversial and therefore be more likely to pass. But I’m of the mind that, as long as we have the chance to do something we should do something; doing nothing is just not an option.