I appreciate the push-back coming from the left on the gutting of the healthcare reform bill. It's a shame that the bill has been gradually stripped of elements that could constrain costs and increase competition due to the disgraceful conduct of certain members of both political parties. I don't have a great deal of sympathy for the idea that we should accept a bill full of table scraps as reform. But if the good outweighs the bad, passage of a seriously flawed bill is better than doing nothing. Howard Dean, the new public face of "the present bill is crap" movement, has made that point.
Michael Tomasky lists provisions that he believes will be in the final bill and asks why anybody on the left would oppose a bill that includes those provisions. If those provisions are all that are in the bill, he's right - the political left should embrace it as a starting point for reform. But add in poison pills, such as a mandate to buy overpriced, inferior insurance,1 or various elements that can be exploited by employers to increase the cost of insurance beyond what their "less fit" employees are able to pay, and the calculus shifts. It's unreasonable to attack people for not seeing the benefits of a bill that has not been finalized, and with each passing day is stripped of provisions that would benefit significant numbers of Americans.
A word for those on the left who supported Hillary Clinton in the presidential campaign and have stated or implied since that time that she would be a better President, and use healthcare reform as an example, remind me again... which of the remaining reforms were passed into law during President Clinton's push for reform? That's right - none of them. Really, get off the idea that the President has magic powers that can make Senators with secure seats (that is, virtually all of them) fall in line.
For those who howl, "You should have used reconciliation" every time something negative happens in the legislative process, think about it. There are provisions in the current proposed legislation that could not be passed through reconciliation, even assuming the Senate had been willing to pursue that path - and it wasn't. So again, if there's enough good in this bill that it's worth passing, stop whining about how reconciliation would have been better, and start pressing for a follow-up bill that fixes this legislation's most serious problems (to the extent possible) by reconciliation. It's not as if we pass a bill and then the Earth stands still.
I'm with Paul Krugman in relation to the attacks on those who would favor passage of a flawed but helpful bill as being "just like the 'liberal hawks' who supported the Iraq war". Even if we assume that there were no good reasons to support a war in Iraq (and I for one thought the probable downside outweighed the possible upside), there's no meaningful parallel. It's a dubious tactic - poisoning the well. If you want to argue that people are wrong, fine, but if you can't do better than that - if you can't logically substantiate your analogy - what do you think you're accomplishing?
On the other hand, I disagree with Krugman that just because the passage of any healthcare reform seemed like an impossible dream after Bush's reelection, we should just the current bill by comparison to nothing. It's a profound disappointment that the Democratic Party, particularly a handful of shameless self-aggrandizers and opportunists in the Senate, have not worked hard to make this the best possible bill instead of being so self-absorbed, so dim-witted, and/or so in the pockets of industry that serious concessions had to be made from the outset and we continue to shed helpful provisions from an what has gradually become at best a mediocre bill. Robert Reich has a more accurate assessment, that "We are slouching toward health-care reform that's better than nothing but far worse than we had imagined it would be".
Frankly, the behavior of the Republican Party, from top to bottom, has been disgraceful. The party of "no" - no ideas, no cooperation, no cost savings... A handful of Republican Senators could, right now, come across the aisle with a set of serious cost-savings measures and, as long as they were willing to accept the majority of the terms of the present bill, could squeeze the obstructionists like Lieberman and Nelson out of the picture. Instead they obstruct and obfuscate, and openly hope that the bill fails because they anticipate that its failure will bring them political advantage. Screw the people. "The uninsured don't vote for us anyway".
To get a sense of the significance of even what's left of the reform bill, take a look at some Republican commentary on the subject. First, after pretending to be thoughtful, David Brooks gives his inevitable "thumbs down" - like the liberal critics of the bill, he doesn't need to see a final version of the legislation to know that he opposes it.
If you pass a health care bill without systemic incentives reform, you set up a political vortex in which the few good parts of the bill will get stripped out and the expensive and wasteful parts will be entrenched.So what do you think he and his party offer up as an alternative? One joke after another? The Republican Party presently offers little more than a head count: forty Senators, at least thirty-seven of whom (and arguably all of whom) are stuck in their "terrible twos".
But at least Brooks has enough self-respect not to pull this trick, Matthew Dowd begging us not to throw the Republican Party into the briar patch. Aw, shucks, it's always wonderful to have a Republican operative tell the Democratic Party, "Don't let your lying eyes or Michael Steele's lying words deceive you - if you pass healthcare reform, you'll only hurt yourselves." Wow. The only way that sort of caution might be more credible is if it were penned by Karl Rove or Bill Kristol. I mean, that would be convincing.
Come up with a health-care bill that draws real bipartisan support.Remind me again, Dowd, what brilliant initiatives the Republican enfants terribles in the Senate have brought to negotiations for bipartisan reform? I mean, even if they didn't recognize the joke earlier, that zinger would push it over the top for pretty much everyone, no?
1. I recognize the importance of a mandate to reform, but the quality of insurance available to the public must be at least adequate for that to be a fair requirement - there's potential that people will be forced to choose between paying a penalty or overpaying for garbage.