Just want to put in my two cents because this is an issue on which we've all really worked hard. So much of our efforts to elect more and better Democrats have been with an eye toward our goals for health care reform. That's why so many have been feeling desperate as we've watched piece after piece compromised and then further compromised and then compromised again. I've felt as frustrated as anyone.
Our community is nothing if not politically progressive and, whether we agree of disagree on various tactics, we are all on the same team, wanting the same things; in this case, true health care and insurance reform that makes quality care affordable and available to everyone. We want such care to be a right rather than a luxury that only the wealthy and the fortunate can afford.
In the large picture, I consider this bill an important step forward. Is it everything I would want? No. But it makes no sense to turn up our noses because that's not the way progress occurs.
Consider the Emancipation Proclamation. It "freed" only those slaves living in territories not under federal control. Progressives considered Lincoln a total and complete sell out, a faker, a weak, pathetic excuse of a leader. But that same proclamation was an important first step. It was issued in January, 1863. By the end of 1865, the 13th Amendment abolishing the very institution of slavery had been signed into law.
Now don't get me wrong; I despise Lieberman and Nelson as much as the next guy. I just don't see how it punishes them to give them exactly what they want most, which is to see nothing change.
For generations, progressives have been trying to achieve the goals set forth above for health care reform. Many times, we've rejected compromise, thinking we could get more by holding out. That's not how progress is made. Only at times of great crisis does one witness earth-shattering change. Such large changes have often lead to unforeseen consequence. Consider, for instance, some of the excesses of the Great Society programs signed into law after Kennedy's assassination and the urban renewal projects that were intended to remedy the demographic impacts of the post-war period on major city centers.
This bill, when signed into law, will provide some really good elements of reform. For example, tremendous subsidies to allow many more to purchase insurance. Others will be eligible for Medicaid. The overwhelming share of that cost will be born by the insurance companies themselves. It will prevent those insurance companies from canceling policies when people get sick, end the denying and rating of coverage for pre-existing conditions, eliminate annual and lifetime policy limits, and set up numerous pilot programs to attempt various ways to contain costs while improving coverage. Don't dismiss pilot programs. Although OMB allocated no cost-savings to them, similar projects were extremely effective in earlier progressive struggles. We simply cannot know in advance which will work and which will prove less effective.
Under current law, many people who have worked hard all their lives become victims of medical bankruptcy after their policy limits are exceeded or coverage is denied. Others can never obtain coverage to begin with. This bill goes a long way toward addressing these issues.
If we reject this effort, countless people will continue to die for lack of insurance coverage. To allow that to happen when an imperfect but important bill stands before us would be wrong.
Would I have liked to see a public option? Absolutely! A Medical buy-in option? Yes. In fact, the best reform in my opinion would look a lot like a Medicare system open to all (which is very similar to what our Canadian neighbors enjoy. But we're not there yet.
As I've said, in my opinion the best reform is incremental. Though you and I would both liked to have seen a strong public option as part of a first step forward, let's not allow our quest for the best result be the enemy of the good. Such words have been used so often as we've been disappointed again and again, they tend to ring hallow now. But when one stands back and looks at the larger picture of what has been accomplished, things look better. After all, this is not the end. In fact, it is the dawn of a new beginning.
Let's say yes to this profound first step, let's celebrate this truly historic achievement -- and then get to work to achieve more.