Health reform now

Pass health reform now.

Progressives' response to the health reform debate will affect negotiations now—and even more, what happens for the next several years. With that in mind, we should call for Congressional negotiators to improve the bill as much as they can, and then pass whatever results.

In expressing his completely justified frustration with the legislative product of the Senate's internal debates on health care, James on Friday linked to the New York Times' Bob Herbert's critical analysis of one of the bill's provisions. Herbert rips the Senate's bill for its reliance on a health insurance excise tax.

As Herbert points out, if the bill's effective level on insurance values to be taxed stays the same over time, it could eventually produce a harmful tax level impacting middle-class households. That's so if the provision's flaws are not fixed either now, or at some point in the future.

I've also gone back and forth on the health reform legislation staggering its way through Congress. I fully support House negotiators in fixing whatever can be fixed in the Senate's version--although I'm cognizant too that on some points, including the abortion provisions and the principle of mandating that minimum percentages of premiums go to the costs of providing care, the Senate version is better.

To the extent that Herbert is helping set the plate for House negotiators to leverage higher ceilings on the health insurance excise tax kick-in level, then more power to him.

However, on the implicit conclusion that the bill as a whole should be deep-sixed if that provision can't be fixed immediately, he's wrong.

Eugene Robinson in the Washington Post succinctly lays out why here:

In sum, the inevitable result of the House/Senate negotiations on health reform will be an ugly patchwork with a jewel at its heart: that every American, regardless of income or age, is entitled to affordable access to decent health care.

For all its real and serious flaws, the bill will make substantial progress toward implementing that principle almost immediately. It will also provide real work and real opportunity to make ongoing improvements over a period of years or a decade. It's a start that helps tens of millions of people within the next four years.

The ugly flaws within the bill will immediately and for years to come be the proper target of legislative amendments and improvements. Some can take place in budget bills and riders to other must-pass legislation. There will be real opportunities to pass those amendments and improvements.

Unfortunately, there is going to be no other real opportunity any time soon to pass an overall reform attempt. Certainly not in the next three years, or the next seven for that matter. If this bill fails now, the entire topic of health insurance reform will be politically radioactive for a very long time.

Kill the bill now, and we've lost the opportunity to start, for another generation. Obama understands that, and so do the Senators and Representatives who we know believe in health care for all. Not the Liebermans and the Nelsons--a pox on their houses--but the Harkins, Shumers, Pelosis, Franks.

We need to take the flawed start that still constitutes a historic achievement, and help for millions of people, and keep fighting for better. That's what progress is all about.


Pass then fix?

Your arguments have been persuasive to me and I have come around to your way of thinking, grudgingly. The scenario you outline is exactly what will happen.

That said, I'd be shocked to see any significant improvements in the plan, as it appears Senator Reid will be handing the keys to the kingdom to Ben-the-Whore Nelson behind closed doors to get his precious vote. The New Republic has the story.

I have a question on this:

The ugly flaws within the bill will immediately and for years to come be the proper target of legislative amendments and improvements. Some can take place in budget bills and riders to other must-pass legislation. There will be real opportunities to pass those amendments and improvements.

Let's say that there is a change in the "balance of power" in congress in the years to come with republicans becoming in control once again (heaven forbid !). Could there then be legislative amendments put in and riders to other bills and so forth that would effectively negate most of the health care bill once passed?

If so, it is just one more reason for all of us to double-down our efforts to make sure that doesn't happen. I admit to being a bit fuzzy on how things work so if it is a stupid question, ignore me :).

Not at all a stupid question

If the GOPs take either chamber this fall, we will be dealing with a host of horrific proposals across a wide spectrum of issues. In that scenario, any chance of significant improvements to the health insurance system are next to nil for the following two years. However, I think we can look for Obama to veto significant retreats on health care.

If GOPs were to take both Congress and the presidency in 2012, we would probably lose most of everything we're worked for and gotten since '06, across the issue board. In this issue area, too much of the health reform structure will not have been firmly established yet and therefore remain relatively easy to undo. That's the doomsday scenario.

So long as we can hold on to either the presidency or Congress through 2014, there's a good chance that wholesale revocation of the new health insurance rights will become politically unthinkable for enough Republicans to lock them in for good.

As usual, the only real opportunity for continued progress on an important issue like this is to hold both Congress and the presidency, and then fight for every inch gained. However, with a major new change like this, with new public rights and institutions established, once progress is made it becomes especially difficult to undo it.

Dan Besse

agree with Dan

I've gone back and forth myself, but have come to the same conclusion.

Plus, there are some really good things in these bills:

Sen. Sanders (Mensch-VT) Obtains More Funding For Health Centers

While the headlines have been centered around Joe Lieberman and Ben Nelson, and what we have to trade to get health reform past the egos in the Senate, Bernie Sanders has been quietly representing the voters.

I'll reserve my thoughts until the final version....

But I do have some concerns, especially on the senate version. First, unlike the House version, it doesn't get monies from the plus $500k group, but it does get money from those of us who fought for labor contracts to hold onto company health insurance plans. And it will be in the form of a tax, just like the Bush gang, which succeeded in passing the financial burdens onto the middle class, while alleviating their own responsibilities. Secondly, it succeeds in giving another 25 million subscribers to the insurance industry without any regulation, on a mandatory basis. (I think that might be struck down in a court challenge) Thirdly, the companies still have the ability to monopolize the state markets, since the anti-trust clause was dropped. And I could probably find more negatives on a scale that makes me say, "the heck with that". My other thought is that the justification would be that it wouldn't be revisted again, is just not so. If it doesn't pass, the same problems will exist, only more so, and will have to be re-formulated, or we go bust. But, I'm hoping this can be corrected, and have something we can live with.