So I see that Health Care Reform finally got its cloture vote, which from what I've read means that it can now be debated and voted on on the Senate floor, and passed with a simple majority. Sure, it's not over then, as it has to be reconciled with the House version, which is probably more in line with what Progressives were hoping for when this whole mess started, and there'll be some tricky procedural bullshit thanks to the Republicans, who would rather that tens of millions of Americans go without health care (not just insurance, but actual care), tens of millions more go broke trying to pay for health care, and tens of thousands die early every year because they have no health care than for President Obama and those damned pesky Democrats to score a legislative victory, because, let's face it, they're just vicious and spiteful like that, and don't much cotton to losing, even when they richly deserve to, which they did after the last decade or so.
And while I've been paying only marginal attention to the blogosphere lately, because, well, I have a life, I'd've had to've been hiding under a rock to miss the howls of outrage from the Left over the various big sellouts and compromises necessary to get us to this point. After all, Progressives really want Single Payer, which wasn't even on the table. But the Pubic Option looked good, until it was a deal-breaker and had to be scrapped. Then there was the Trigger, which was fine with Snowe and Lieberman et al until it looked like the Dems might actually go for it, then it became a deal-breaker. Then the Medicare Buy-in for those 55 and over, which was Joe Lieberman's idea, until he heard that Russ Feingold liked it, and then suddenly he was totally against it and it had to be dropped to get to cloture.
Big shout-out to the voters of Connecticut, by the way, for sending Joe Lieberman back to the Senate. Thanks, guys. That was awesome.
So what we end up with is, charitably put, a mixed bag. Devotees of conventional wisdom will say that something must be right with it, because the radical wings on both sides of the spectrum are livid with outrage. On the one side, the Teabagger Wing on the Right side of the aisle thinks that government is staging a takeover of their lives and their health care, and that soon government bureaucrats will be getting together over lattes and arugula to decide which old folks are worth saving and which ones are gonna get put on an ice floe and set adrift. They cry 'Socialism!' and 'Keep your government hands off my Medicare!' Unaware, apparently, that Medicare, which everybody who has it loves and is one of the single most successful government programs of all time, is, in fact, a single payer system that works pretty good.
On the Left, the Progressive Wing, who in a truly amazing feat of collective hallucination and projection apparently thought Barack Obama was secretly one of them and would reveal his true colors once safely in office, feel shafted because the Health Care Bill they're getting is not the Health Care Bill that they dreamed about. As if the whole edifice could be torn down and rebuilt according to rational first principles. And hey, don't get me wrong, I would love that, because what we got now is the worst of all possible worlds, which is reflected in the fact that we spend twice what any other developed nation does on Health Care (it's something like 16% of the whole economy), but still get consistently worse outcomes than any other (higher infant mortality rates, lower life expectancy: you name it, we're worse at it). They feel particularly sold out when they hear that Rahm Emmanuel told Harry Reid "Everything is on the table. Get the bill."
The worst thing is, like everyone on the far end of either side of the spectrum, they're increasingly likely to stay home in 2010 in a fit of pique, like spoiled children holding their breath, and they'll lose what ground they've gained electorally, while the Teabaggers will pick up a seat or ten in the House, and it'll be that much harder to pass Progressive legislation.
I understand the frustration. Believe me, I'm not all that thrilled with the Health Care Reform bill as it now stands. It's beyond imperfect, and it might in the short run turn out to be a giveaway to the insurance companies, who really don't need any more money, whatever their CEOs and shareholders might think. After all, an individual mandate, with or without subsidies, without a Public Option to drive costs down thanks to the Federal Government's access to economies of scale and lack of a profit motive, could shake out to be an absolute windfall for insurance companies.
But let's step back from the trees for a second, and take a look at the forest.
First off, we were never going to get it right the first time. That's not how America works. America's great innovation, there at the start, was the realization that people only very rarely agree with each other over how they ought to live or how government ought to work, and so the best we could do is to set up a framework for hashing it out without resorting to killing each other. And while each side might see the other as traitorous, or dumb as a box of rocks, everybody gets a chance to have their say, and leverage their numbers, and then what gets hashed out gets tested in the crucible of the real world. I absolutely believe that what we'll get will shortly be revealed to be inadequate, and the necessary improvements will become obvious with time. No, it's not the best possible outcome, but I have a certain faith in America that it seems others lack, because Americans are, at their core, pragmatists. We want shit to work, and so when it doesn't, we fix it.
For those disappointed that the legislation is not Progressive enough, well, I feel your pain. I myself tend to have pretty Progressive policy goals, though I come at them from a more pragmatic point of view. I think certain aspects of public life ought to be outside the realm of profit, because they're too important to leave to capitalists to manage.
But for those who deride the Democrats for having the White House, a majority in the House of Representatives, and a 60-vote majority in the Senate, and still not being able to ram through the totality of the Progressive Agenda in Obama's first year in office, well, all I can say is that thsoe folks don't have a very clear understanding of who's a Democrat and how this works. Democrats have a bigger tent than Republicans, which means a broader range of views, some of which, quite frankly, are way more conservative than the base. Remember, that 60-vote majority in the Senate essentially gives veto power to people like Ben Nelson and Joe Lieberman (who seems to be taking his revenge on the Progressives who denied him the Democratic nomination), because the Republicans have been whittled down to the hard-core and pretty much threaten to filibuster just about everything the Senate tries to do, so for anything beyond passing say, the Defense budget, all 60 Senators who caucus with the Democrats have to be united. As you might expect, this is no mean feat.
But the main thing I think Progressives have lost sight of, now that they've gotten all huffy and started in on the whole circular firing squad thing (which is never attractive), is that now, for the first time ever in our nation's history, we have acknowledged that quality health care is a right, something everybody should have as a result of their citizenship. That was the thing the insurance companies didn't want to happen. That was the thing the Republicans were marching in lockstep against. Yeah, the current version sucks, but you know what? The first draft of Social Security wasn't all that awesome either, nor the first draft of Medicare either. There were all sorts of exceptions, and all sorts of true believers who said their elected representatives sold them out. But nobody has ever seriously tried to walk those programs back, and over the years the gaps have been plugged, and improvements made, and these days no American can really even conceive of a world without them.
So take heart, Progressives. No, you didn't get everything you wanted this Christmas (who did, really?). But what you got is something that will never be taken away, that will improve with age and become a natural part of the American political landscape, a foundation upon which can be built a healthier and more just society. Something had to be done. The tide had to be turned. The present arrangement was unsustainable and, more importantly, morally wrong from an outcomes point of view. And, imperfect though it may be, the first step has been taken, and it's in the right direction.
And for those opposed (at least those not in the pockets of the insurance companies, who I could give fuck-all about), take a deep breath and have a little faith in America. Like Winston Churchill said, she can always be counted on to do the right thing, after every other possibility has been exhausted.
The things you fear will not come to pass. Life will get better as a result of this legislation.