Pass Health Care Reform
December 17, 2009 by Nik, under Blog.
Since Joe Lieberman killed the public option, many liberals, from Howard Dean to Keith Olbermann to Markos Moulitsas, have called on Democrats to shelve health care reform. They argue that without a public option reform is worthless, and Democrats should wait to pass “real” reform at a later date.
Such a view, while understandable, is immensely shortsighted. Even without a public option, health care reform would do tremendous good and is still worth passing.
First, the bills before Congress still contain consumer protections and subsidies which would help tens of millions of Americans. They would ban insurance companies from engaging in a host of abusive practices, including recession and discrimination based on pre-existing conditions. They would also provide subsidies to those making under 400% of the poverty level ($88,200 for a family of four), which would dramatically expand coverage.
The Congressional Budget Office predicts that the net result would be coverage for 31 million Americans, a huge improvement from the status quo. This would reduce the 45,000 deaths per year which occur due to holes in our insurance system, as well as the bankruptcies and financial troubles caused by the status quo.
Just as importantly, it would establish the principle that government is responsible for ensuring the health of its citizens. Whereas health is now a private affair, post-reform government would have a legitimate role to play. Put simply, in both practical and symbolic terms, health care reform would be the most important piece of social legislation since the Great Society. To quote Nate Silver,
how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?
Second, even if health care reform is inadequate, it can be improved later. As it gains a constituency and political muscle, it can be expanded in the future.
This is more than a remote possibility; in fact, it is exactly what happened with Social Security. As enacted, it was a small, limited program for older Americans. However, later changes increased benefits, broadened eligibility, included disability, created SSI, and automated cost of living increases. Whereas only 222,000 Americans received benefits in 1940, 44 million receive them now.
The same can happen with health care reform. As long as it establishes a foothold, it can develop a constituency. Then, incremental changes can strengthen existing components and add new ones.
Finally, if health care reform fails, we are unlikely to get another chance in the near future. Politically speaking, as the incumbent party in a midterm election, Democrats are likely to lose seats in 2010. Historically, too, failure at health care reform has meant decades of dithering.
For example, after Clinton’s attempt, our country waited sixteen years before anyone even tried again. Conventional wisdom held that health reform was politically toxic, and its electoral toll too high. If reform were to fail, it would send the same message that obstacles are insurmountable. Health care would again become a “third rail”, and, as it did after Clinton, it would slip into the background for another generation.
The costs of waiting are simply too high. Tens of thousands of people are dying now, and it would be decades before we got another chance.
Health care reform is still worth passing: it would insure 30 million Americans, it can be expanded later, and failure will only beget more failure in the future.
Progressives have been fighting to pass health reform since Truman. For the first time in half a century, we have a genuine chance. We would be fools to toss it aside.
—–
Also consider: failure would depress our base, embolden Republicans, and sink the rest of President Obama’s agenda. He’s staked his presidency on health care, and abandoning it would jettison financial reform, immigration overhaul, and energy legislation for years.
Comment by Cal Berkeley Democrats » Krugman: Pass the Bill.
[...] Krugman has a column which makes the same points I did, only more eloquently. I strongly recommend you read it: The result would be a huge increase in the [...]