Thursday, December 17, 2009

Welcome to the Big Leagues
No, this isn't another baseball post; it's addressed to the Democrats and liberal activists hoping that the health care bill dies in the Senate. To put it succinctly, they're frakkin' nuts.

This isn't to offer a blanket defense of the measure. Frankly, there's a lot wrong with it--at least in the sense that it could be much, much better. My personal gripe list? I'd have loved to keep the Medicare buy-in for Americans ages 55 to 64, I think the individual mandate to buy insurance could be designed better (I like this idea, which suggests letting people opt out of the mandate but blocks them from opting back in afterwards for five years), and I would have included some degree of malpractice reform--which isn't the panacea the bad-faith Republicans present it as, but would help at the margin and isn't in because the Dems are shills for the trial lawyers. I also would have liked some more forceful reforms to push the system toward rewarding outcomes rather than interventions of any type whether effective or not--though it's possible that the cost controls measures that are included eventually will yield that result.

Maybe there's more; I don't present myself as a health care policy expert. But the guys whom I do regard as experts, people like Ezra Klein (here and here, and really throughout his excellent blog over the last few weeks, which I'll be adding to the permanent links around here) and Jonathan Cohn (here and here), are foursquare behind this measure. So are Nate Silver (here and here, among other places), Paul Starr and Mark Schmitt, as astute among liberal-leaning big picture political thinkers as you'll find anywhere.

They support the measure--again, while being fully attuned to its faults--for a myriad of reasons that I think are worth reading and considering in detail (which is my polite way of saying that I'm not gonna do that here). But boiled down, the two "for" arguments are that this measure still does much more good than harm, and that the track record of major social welfare reforms is that they get better, not worse, over time. Social Security and Medicare weren't what they are today when they were first passed; subsequent Congresses responded to public concerns over the flaws of those measures and improved them. So too will health coverage, which all but becomes an entitlement, be improved over time. We're getting a foot in the door, a nose in the tent, or whatever body part into an opening you choose to contemplate.

Really, though, it's even more fundamental than that. The Democrats--the progressive movement in America, arguably even the totality of people in this country who retain some faith in government's ability to take on and positively address major structural problems--need to win this one, and the win here is passing something. Enacting a bill that one can plausibly call "health coverage reform" would represent the biggest success for progressives in more than a generation. I know the polls are bad; as of yesterday, even the miserable status quo polls preferably to the measure.

But the Democrats need to ignore that data--which, as I noted a few days back, the polls really just show that the public is in a foul mood. They're in a foul mood because the economy still sucks for anyone who wasn't loaded three years ago and/or isn't well educated, and they're fed up with Washington because, in their eyes, this debate is taking friggin' forever. That it's the Republicans, who simply want to deny the White House a win without any regard for the policy consequences, who are holding things up, doesn't register.

Emotions are running high in this debate. Nobody loves the measure. But when those passions fade, what we're going to have--if this passes--is a major step forward for disadvantaged Americans, and a framework for a much better health care system in years to come. I wish all those on the left who are fired up to kill this bill would instead take the smart tactical approach and turn their energies toward figuring out how they'll improve it once the foundation is laid. They need to accept the reality that this is what it means to govern: you fight as hard as you can, take what you can get, celebrate the wins and mourn the losses, and then immediately turn to making it better.


The Navigator said...

Well said. I think there's every chance that the Dems will never see a political benefit from passing this - the benefits are so amorphous, and future-shifted, and limited in scope, that there may not be any significant chunk of voters who actually reward the Dems for passing this. And in the meantime a generalized, inchoate, economy-driven anti-incumbent and anti-government sentiment may result in some Dems losing their seats over this. But for all that, it's the right thing to do, and it's to the everlasting credit of its backers that they're fighting for this.

David said...

Sounds like Nelson is on board, which gets us pretty close to all systems go.

If it passes, I wonder how the FDL/MoveOn/Kos types will react. Maybe it'll smack a little sense into them. To me, their opposition feels painfully similar to my self-righteous and incredibly dumb Nader support from a decade back...

The Navigator said...

It is important to have a passionate left to pull the debate leftward. It might even be really good to have some pissed-off lefties rejecting the bill right now so it looks like a reasonable centrist compromise. G-d knows Lieberman is more likely to stay on board if he thinks Anthony Weiner and the Lamont voters are upset about the bill, and maybe it makes David Broder more likely to back it too. The trick is that the left can't actually bring the bill down or the whole purpose is defeated.