Ezra Klein sums up why liberals should love this bill, even with its deficiencies
He also explains why conservatives naturally hate it. It will, over time, lead to more government as the notion of universal coverage becomes expected by Americans.
Ezra Klein has made a name for himself during this health care debate. He’s one of the most sensible writers out there, and he’s great with the details and the big picture.
Here’s the latest big picture argument as to why liberals should move the bill forward.
I still believe health care will look more similar than different when the day is done. A good bill will pass, if not a sufficient one. A sum of money will be appropriated, and a basic infrastructure constructed that will be, in the long-run, understood as a tremendous, even unlikely, political victory. The next steps will be easier, because $80 billion is easier to find than $900 billion, and because the argument over whether America has a universal health-care system and whether government provides some of the funding and scaffolding will be over. The money will be there. The scaffolding, too. The universal structure, built around the mandate and the exchanges and the subsidies, will be firmly in place.
At this point, an odd dynamic has developed, in which most all of the right, and some on the left, believe they’d be better served by the defeat of this bill. It is unlikely that they are both correct. But the right has had substantially more experience than the left opposing government initiatives before they can take root and grow into popular entitlements.
Look at the development of Medicare and Social Security, of Medicaid and S-CHIP, the Swedish and Canadian health-care systems, public education. Social Security was designed to exclude African Americans. Medicare didn’t cover prescription drugs. Medicaid was mainly for pregnant women and their young children. Canada’s system was limited to a single province. There was no University of California at Los Angeles.
It’s difficult to conclude that these things slip backward rather than marching forward. The $900 billion for people who need help, the regulations on insurers and the exchanges that will force them to compete, the structure that will make health care nearly universal and the trends that suggest more people — and more politically powerful people — will be entering the new system as employer-based health care erodes — it all makes this look even more like the sort of program that will take root and be made better, as opposed to the sort of common opportunity people should feel comfortable rejecting. It doesn’t feel like that now. But then, it rarely does.
Every liberal should read this. There’s a reason the Republicans are abusing every stall tactic they can muster in the Senate to delay this bill. They want to kill it all costs. It will lead to everything they despise, and everything liberals want. The details now really don’t matter. Once this is set in motion, they’ll never be able to turn back the clock.
In that context, it’s stunning to hear people like Howard Dean and Keith Olbermann play into the GOP’s hands by arguing that the bill should be scrapped. In one sense, as Kos pointed out, it’s healthy to have a real debate on the left. But Dean and Olbermann have taken it too far, risking everything.
Posted in: Democrats, Health Care, Liberals, Policy, Politics
Tags: Ezra Klein, Howard Dean, Keith Olbermann, progressives
Sir Winston Churchill commenting on the American character once remarked that: “You can always count on Americans to do the right thing—after they’ve tried everything else.” Well, it seems with reforming healthcare, we, Americans, are still in our experimental stage. The health insurance industry; others who benefit from the system as it exists; Republicans for reasons ranging from the cynical pursuit of political power, shilling for the insurance industry, genuine conservative philosophy, and a deep hatred of the other, who they place under the rubric of liberal; and too many Democrats, who either share the Republicans’ conservatism, the so-called Blue Dog Democrats, or who also shill for the insurance companies, have combined to defeat the President and his allies in their efforts to give us the healthcare reform that we need. Given the forces arrayed against him, it is amazing that the President and his allies got as far as they did.
But it is not an utter defeat. Yes, there is much to regret and be bitter about. Instead of covering virtually every American, removing the burden of healthcare from our businesses large and small, and doing it while spending no more than 9% of our GDP on healthcare, as is true for our single-payer cohort of modern industrialized nations– instead of the 14% that we currently spend to insure no more than a liberal estimate of 75% of Americans–the bill, as presently contemplated, will cover too small a number of additional Americans who have no or inadequate healthcare coverage, do too little to control costs, especially costs that do nothing to do with delivering healthcare, will leave undisturbed the burden of healthcare that is throttling throttling American businesses, and apparently will force all Americans to become customers of our profligate healthcare industry, resulting in an a stunning boon for that industry.
So what, if anything, is there to take from this defeat. Well, not much more than that a significant, though inadequate, number of Americans will get coverage who weren’t covered, that there will be some laws which should help contain costs, and, perhaps, for it remains to be seen what a final bill will mandate, that there will be a universal rules which will promote competition and prohibit the healthcare industry’s most egregious practices. And probably one other thing: That it may be the beginning of the healthcare reform that we need.
I am not as sanguine as Messrs. Orlando and Klein that the proposed legislation is such a beginning. The powers that arrayed to defeat healthcare reform that I recited, supra, are supremely powerful and are determined to prevent any erosion of their power and of the wealth that they earn from the present system of healthcare. But Mr. Klein’s views that the contemplated bill establishes the infrastructure for future beneficial reform and that benefits from even such a modest and inadequate reform will create a momentum of popular opinion for further constructive reform have merit, yet they may not have enough merit, as we await the final bill from Congress. However, one thing is clear. Our current healthcare system is failing and is unsustainable. And as the great Harvard economist Hebert Stein once remarked: “Unsustainable trends won’t be sustained.” So our healthcare system is inexorably on the road to change, even the opponents of reform know that. Whether it will be reform that better provides for all Americans’ health in a manner no worst than exists in most other advanced nations, while removing the burden of healthcare from our businesses, and limiting the costs of healthcare to 9% of our GDP, or whether we will delay reform until our healthcare systems collapses is an open question.
Yet, I believe, as Sir Winston did, that America will eventually do the right thing and reform its system of healthcare, though we seem determined to wait til the eleventh hour to do so.