The State of Health Care Reform

Josh Marshall has posted an e-mail by a Democratic Hill staffer that's well worth a read. The standout paragraph is probably this one about the Democrats:

The worst is that I can't help but feel like the main emotion people in the caucus are feeling is relief at this turn of events. Now they have a ready excuse for not getting anything done. While I always thought we had the better ideas but the weaker messaging, it feels like somewhere along the line Members internalized a belief that we actually have weaker ideas. They're afraid to actually implement them and face the judgement of the voters. That's the scariest dynamic and what makes me think this will all come crashing down around us in November.

This doesn't surprise me - many politicians are establishmentarian, and really don't want to do anything - but it is pretty discouraging.

The Balloon Juice crew have been pressing hard on for everyone to call their House representative immediately to urge them to agree on the Senate bill. If the whole thing passes, then the reconciliation process could be used to pass amendments to make it better. There are still pitfalls, but that looks like the best route at the moment.

There are plenty of lousy aspects to the current bills. Watching all the political ineptitude of the Democrats, the corruption of the Blue Dogs, and the screw-you-all-and-my-constituents-too attitude of almost the entire GOP, has been maddening. Most of the Beltway commentary has been inane as usual, made more frustrating by the high stakes of health care reform.

I keep coming back to a Krugman column from 12/18/09, "Pass the Bill":

Bear in mind also the lessons of history: social insurance programs tend to start out highly imperfect and incomplete, but get better and more comprehensive as the years go by. Thus Social Security originally had huge gaps in coverage — and a majority of African-Americans, in particular, fell through those gaps. But it was improved over time, and it’s now the bedrock of retirement stability for the vast majority of Americans.

Look, I understand the anger here: supporting this weakened bill feels like giving in to blackmail — because it is. Or to use an even more accurate metaphor suggested by Ezra Klein of The Washington Post, we’re paying a ransom to hostage-takers. Some of us, including a majority of senators, really, really want to cover the uninsured; but to make that happen we need the votes of a handful of senators who see failure of reform as an acceptable outcome, and demand a steep price for their support.

The question, then, is whether to pay the ransom by giving in to the demands of those senators, accepting a flawed bill, or hang tough and let the hostage — that is, health reform — die.

Again, history suggests the answer. 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.

Even passing the Lieberman/Blue Dog/GOP savaged bill will be tougher now. But "tough" always seems to come with giving a damn, doesn't it?