Ezra argues that we should grab half a loaf while we can:
There are many themes in the sad and frustrating history of health-care reform. But one of the central ones is that there were many points when Democrats could have accepted a compromise and did not. Richard Nixon, for instance, proposed a plan that could have passed Congress but that liberals thought comically inadequate. It was more comprehensive than anything we will get this year. George H.W. Bush also offered a pretty good proposal but got no support among Democrats.
Opportunities at health-care reform do not happen frequently. The average between major attempts is 19.5 years. That’s 19.5 years in which the uninsured stay uninsured and their ranks grow. Where a situation that is already bad gets a lot worse. This year, Barack Obama is popular, and there are 60 Democrats in the Senate and huge majorities in the House. There is no reason to believe that Democrats will be in a stronger position anytime soon. It is not like when a weakened Nixon, or a fading Bush, offered a compromise.
If reformers cannot pass a strong health-care reform bill now, there is no reason to believe they will be able to do it later. The question is whether the knowledge that the system will not let you solve this problem should prevent you from doing what you can to improve it. Put more sharply, the question should be whether this bill is better or worse than another 19.5 years of the deteriorating status quo.
Most of the liberals I talk to are deeply frustrated with how compromised the health care being discussed in Congress is. The House bill is far from the most lefty bill imaginable — but it’s probably a lot more left than whatever bill the Senate ends up passing, and therefore more left than whatever compromise bill between the House and Senate will eventually be hammered out in committee.
Given the history, I think it may make more sense to get something in place, and then work to improve it over the next 20 years. Single-payer, even if it’s a good idea for the U.S., isn’t something that has any shot of getting through Congress. Elections matter, and progressives and liberals — a much smaller group than “Democrats” — simply don’t have enough elected representatives to get our preferred policy passed, and might not even if our Democracy was better designed. (As it is, the way the Senate in particular is designed leads to extremely undemocratic results.)
Matt Tabbi sees the health care debate as proof of how bad our government is:
It won’t get done, because that’s not the way our government works. Our government doesn’t exist to protect voters from interests, it exists to protect interests from voters. The situation we have here is an angry and desperate population that at long last has voted in a majority that it believes should be able to pass a health care bill. It expects something to be done. The task of the lawmakers on the Hill, at least as they see things, is to create the appearance of having done something. And that’s what they’re doing. Personally, I think they’re doing a lousy job even of that. I lauded Roddick for playing out the string with heart, and giving a good show. But these Democrats aren’t even pretending to give a shit, not really. I mean, they’re not even willing to give up their vacations.
This whole business, it was a litmus test for whether or not we even have a functioning government. Here we had a political majority in congress and a popular president armed with oodles of political capital and backed by the overwhelming sentiment of perhaps 150 million Americans, and this government could not bring itself to offend ten thousand insurance men in order to pass a bill that addresses an urgent emergency. What’s left? Third-party politics?
Ezra (sorry to quote him so much, but he really is a good blogger on health care) agrees, but points out that if congress fails to address the long-care problems but does get 40 million currently uninsured Americans insured, that’s still an accomplishment.
Anyhow, please use this thread is for discussing health care, and in particular the health care legislation that seems like it might plausibly pass Congress this year.