With the public option now out of the healthcare bill, is it still worth passing? Regular readers will be unsurprised that I think the answer is pretty firmly yes—and that liberals who now want to pick up their toys and hand reform its sixth defeat in the past century need to wake up and smell the decaf. Politics sucks. It always has. But the bill in front of us—messy, incomplete, and replete with bribes to every interest group imaginable—is still well worth passing.Six defeats. Think about that. More from Kevin:
When big legislative efforts go down in flames, they almost never spring back onto the calendar anytime soon — and that's especially true when big healthcare bills fail. It didn't happen in 1936, it didn't happen in 1949, it didn't happen in 1974, and it didn't happen in 1995. What makes anyone think it will happen in 2010?Drum also makes the point that if healthcare reform dies this year, it dies for a good long time, and Republicans know it. And even though it's not the bill we wanted, it's a good start. Via Ezra Klein:
"This is a good bill," Sen. Sherrod Brown said on Countdown last night. "Not a great bill, but a good bill." That's about right. But the other piece to remember is that more than it's a good bill, it's a good start. With $900 billion in subsidies already in place, it's easier to add another hundred billion later, if we need it, than it would be to pass $1 trillion in subsidies in 2011. With the exchanges built and private insurers unable to hold down costs, it's easier to argue for adding a strong public option to the market than it was before we'd tried regulation and a new competitive structure. With 95 percent of the country covered, it's easier to go the final 5 percent. And with a health-care reform bill actually passed, it's easier to convince legislators that passing such bills is possible.Here's some other things we'll be getting:
Drum is right. This is still a huge achievement, one that will benefit tens of millions of people in very concrete ways and will do it without expanding our long-term deficit. And he also points out "this is more than Bill Clinton ever did, more than Teddy Kennedy did, more than LBJ did, more than Truman did, and more than FDR did."
Insurers have to take all comers. They can't turn you down for a preexisting condition or cut you off after you get sick. Community rating. Within a few broad classes, everyone gets charged the same amount for insurance. Individual mandate. I know a lot of liberals hate this, but how is it different from a tax? And its purpose is sound: it keeps the insurance pool broad and insurance rates down. A significant expansion of Medicaid. Subsidies for low and middle income workers that keeps premium costs under 10% of income. Limits on ER charges to low-income uninsured emergency patients. Caps on out-of-pocket expenses. A broad range of cost-containment measures. A dedicated revenue stream to support all this.
Don't throw in the towel now.