There has been much pissing and moaning from some quarters that even though the Lieberman-appeasing polished turd of a Senate health care reform bill is deeply flawed, liberals and progressives should not try to kill the bill because: first, it does a lot of good; and second, once we get this piece of crap enshrined into federal law, we can always improve it later. For now I'm going to rebut the second point, and then perhaps later I'll attack the first.
To be clear: the incremental improvement argument is demonstrably wrong. If it weren't, we wouldn't be arguing the point because we'd already have a public option.
In a 1945 address to Congress, President Harry S. Truman proposed the creation of an optional national health insurance program that would be open to all citizens. Americans who chose to participate in the program would pay monthly premiums, and in exchange, when you got sick, or if you were injured, the government would pay all medical expenses, plus a cash benefit to make up for lost wages.(http://www.trumanlibrary.org/...)
It was not until 1965 that a form of Truman's proposal was signed into law by LBJ in the form of Medicare. But rather than being a national health insurance plan open to all Americans, the only people eligible were the elderly. Medicaid, only for the poor, followed one year later.
So you see, we've already taken the "even though the bill is only half a loaf we should take it and then improve it slowly over time" incremental approach with Truman's original proposal - which was essentially what today we're calling the public option. It's sixty-four years later and we're still no closer to the original proposal today than when the half-measure was signed into law forty-plus years ago. Medicare is still only for the elderly, and Medicaid is still only open to the poor. So if incrementalism has not, in forty years, expanded either program enough to count as the public option Truman originally proposed, why should we for one second delude ourselves into thinking that anything that Lieberman and his bad-faith dealing ilk will deign to let come to a vote in the Senate is going to be anything WORTH improving?
So, if you want to continue to argue that it's possible to improve on half a loaf, I'd say I've shown that it doesn't work because we haven't managed to do it so far. But, if we're going to try the incremental approach, shouldn't we work on incrementally improving the two half-a-loafs we already have - Medicare and Medicaid - (which BTW, since they are budget items, could be 'incrementally improved' through simple-majority reconciliation) rather than begging Lieberman to give us yet another half-a-loaf he's pinching especially for us?
Let's work together to kill the Lieberman-appeasing bill. There's no reason NOT TO.