This health care thing is pretty personal isn't it? There are tens of millions of different ways it's personal for the uninsured, the underinsured, those with pre-existing conditions, those afraid of losing their job or afraid to change jobs, the self-employed, small business owners, and small business employees. Then there are the boundless egos of our representatives and the personal insults all of us have been subject to as the goalposts were moved again and again and again.
There's alot of talk about what the Damn Senate Bill does do that it shouldn't or doesn't do that it should. There are a few things it does that are a really big deal:
universal health insurance coverage
subsidies for those who can't afford it
exchanges for individuals and small businesses to buy insurance
I know that as written, the Damn Senate Bill's subsidies are too stingy, it punishes those labor union members who gave up some salary for high-end insurance, and it has the ridiculous Cornhusker Kickback. These things can be fixed in reconciliation this year and beyond. But look back at those things the bill does do. Those are very good things, and very personal things for those of us on the fringes of our health care system.
This community knows more about health care than most, and we are probably pretty hardened in our opinions. However, since I have already e-mailed and/or called my Congressman, 2 Senators, Speaker Pelosi, and President Obama, I am left advocating within this community in the desperate hope that my thoughts will somehow resonate and make a difference. I sum it up as 3 reasons to pass the Damn Senate Bill.
1. The Damn Senate Bill is the only path to universal health care.
It's a source of profound embarrassment for progressives that we live in the only industrialized country in the world without universal health care. The Democratic Party has been fighting for universal health care since Harry Truman. It is a moral tragedy that 45,000 people die every year because they have no health insurance. Only the Damn Senate Bill can provide structures essential to universal coverage: a ban on exclusions and exchanges for purchasing insurance. No further bills, no matter how "popular", will pass through the Senate through regular order. Republicans just don't care - they are deeply invested in keeping Democrats from enacting ANY health care reform.
2. Reconciliation alone is not likely to bring any results at all
The politics of a reconciliation-only strategy do not work. Although it only takes 50 votes + Biden to pass a reconciliation bill, it's still not easy. It would have to go through 3 House committees and 2 Senate committees. One of those Senate committees is the Budget Committee chaired by Kent Conrad. Conrad said he is open to reconciliation to modify the Senate bill as long as he approves of the modifications. Do you really think Kent Conrad, champion of the entitlement reform commission is going to welcome reconciliation from scratch and become a progressive champion expanding Medicare and Medicaid? Sorry, it's not going to happen.
3. We won't get another chance.
Filibuster or not, Democrats have big majorities in both the House and the Senate. It will not work to ask the voters to give bigger majorities to a party that fails to govern. Democrats won't rush to the polls to endorse their party's failure, and you can bet everyone else won't either. Explaining the filibuster to the electorate is not only impossible, it's making excuses. The people want results. The Democrats will never ever have credibility on health care again if both chambers pass universal health care but it doesn't become law.
This is why we have to pass it now.
It is completely understandable that progressives and Democrats in Congress trust nobody after the goal posts have been moved so many times. It's been floated that the House only pass the Damn Senate Bill after the reconciliation bill fixing it has been passed by the House and Senate. Universal health care would thus be held hostage by progressives. Hostage? Progressives threatening to kill universal health care is like PETA threatening to kill a kitten if it doesn't get its way. It would be horrific to follow through on the threat and discrediting not to.
It's better to take the pressure off by quickly passing the bill. The air would rush out of the teabaggers' balloons and the reconciliation process would be about making the bill better instead of trying to kill it. There's no better motivation to fix a bill than to actually make it law.
Paul Krugman puts it succintly:
A message to House Democrats: This is your moment of truth. You can do the right thing and pass the Senate health care bill. Or you can look for an easy way out, make excuses and fail the test of history.
Ezra Klein captured very well the deep moral peril the Democrats face:
Letting this process die is, of course, the worst of all worlds. Democrats have 59 votes in the Senate and almost 260 votes in the House. They brought their bill to the one-yard line before Scott Brown forced a fumble. Proving yourself unable to govern in that scenario is proving yourself unable to govern. Moreover, it would be staggeringly cruel to the people that this bill is meant to help, and who need this bill's help. Covering 30 million and protecting countless millions more is not just a talking point. It's the reason for this whole enterprise. To abandon those people because Brown won in Massachusetts is simply indecent, and would prove the Democratic Party worse than ineffective. It would prove the party unconcerned.
This isn't about what all of us think this bill should be. It's not about Joe Lieberman or Ben Nelson or Kent Conrad or Bart Stupak. It's about what the bill actually does for people and how it can be made better now and in the future. The Damn Senate Bill is still a huge win for progressives. It moves the goalposts forward to a whole other field. It will be very difficult to repeal the law and its subsidies that let tens of millions get health insurance once it is enacted. Just pass it. Please.