Some voices on the Left are unhappy with the health care reform bill the Senate will vote on this week. They are upset about the lack of a public option. They are mad that Sen. Joe Lieberman abandoned a position he has long held in favor of a Medicare buy-in and, by doing so, got that provision tossed from the legislation. And, some contend that only a single-payer system like that in Canada would truly fix health care. They are wrong and should support the bill.
To be clear, the bill would have been stronger if it had either a public option or a Medicare buy-in. And, a single-payer system is preferable to the hodge-podge we have in many ways, starting with the fact that the legislation that set up Canada’s system was eight pages long and could be readily understood by everyone, legislator and citizen alike. The problem is that none of these provisions can win sixty votes in the U.S. Senate.
Most of those on the Left who are bemoaning the outcome are a bit wet behind the ears. They do not recall that the Voting Rights Act of 1965 was preceded by the Civil Rights Act of 1964 and that both were preceded by the 1957 Civil Rights Act. This latter measure was weak, weak to the point that some denounced it as merely a political ploy to provide cover for liberal Democrats, but it paved the way. Similarly, Medicare did not start as the nearly comprehensive health care program it is today, originally only covering hospital visits and expanding over time.
Once the current bill is enacted, Americans, all Americans, will view health care more as a right and less as a perk of employment. It will become an entitlement. It will be unassailable the way Social Security is unassailable. If, when the full reform is implemented it turns out that the subsidies are insufficient and that people now forced to buy insurance find it cost prohibitive, the political debate will focus on increasing the subsidies or lowering the costs, not on denying the right to coverage. If other states come to object to the special treatment of Nebraska’s Medicaid costs, a measure included to win over Sen. Nelson, the pressure will be on the federal government to increase its share of costs for the other states, not on denying Nebraska its special treatment.
This is not only a matter of not permitting the perfect to be the enemy of the good, although it is also that. This reform is good on the merits. It improves the current health care system. The Secretary of Health and Human Services should send a letter to all Americans the day after the bill is signed outlining some of the measures that most impact on citizens, such as the provision to end the denial of coverage for pre-existing conditions. This measure does not actually affect that many people but it has come to represent for all Americans the abusive power of the insurance companies that put profits before people. While the ban on such denial of coverage only applies to children immediately, it will apply to all citizens when the pan is fully implemented, and all citizens will have the opportunity to enroll in a catastrophic care plan immediately. The letter from HHS should state this and provide a toll-free number to call if citizens encounter continued stone walling by insurance companies. I need scarcely add that sending such a letter will help convince people that the reform effort is a good thing. That can’t hurt in the midterm elections.
The abortion issue is different, and I have yet to find anyone who has been able to demonstrate how the Senate language differs from the House language. The provision in the Senate bill that individuals who buy a plan that includes abortion must write a separate check every month for that coverage sure seems like a rider to me, and it was just such riders that the House bill envisioned but did not mandate. The House language is more clear but it seems to me that the Senate bill achieves the same effect.
So, liberals have to stop whining and get on board. Passing health care reform is not only a big achievement, it is an historic achievement. It is also a first step.