First let's make sure we're clear on what we're talking about.
If the House was going to have a vote on passing the Senate Bill as-is, without modification and with only a "promise" that the Senate might one day make fixes via a second bill - then I would vote NO on that.
Purist right? Well, let's see...
I would vote no because, after having devoted quite literally hundreds of hours to reading legislation, participating in inter-agency conferences calls with policy experts dissecting the provisions, reading CBO reports, and listening to and reading what feels like a million different analysts, pundits and commentators, I believe that this bill does not meet my criteria for passage.
What is that criteria, you ask? It's a very simple one, and one that I think serves very well as a heuristic. A bill should be passed if and only if:
- It has sufficient benefits for poor and working class families
- It has no critical defects that would harm poor and working class families.
- The benefits for poor and working class families sufficiently outweigh any remaining non-critical defects
- Further effort on this issue would be more harmful than helpful.
In my opinion - and yes, this is all opinion having done my best to be as informed as I possibly can - the Senate Bill, has critical defects that would harm poor and working class families. And the benefits for poor and working class families do not sufficiently outweigh the defects. Put another way, I believe the bill would hurt ordinary Americans in the long run more than it helps some Americans in the short run.
What a damn purist am I. But wait!
The House is talking about using some cleaver procedural tactics to pass a "reconciliation" like bill first, full of fixes to the Senate Bill. From what I've read (but I'm confused about the specific procedures for the process) they would pass this in such a way where it would have to be implemented as law with the full health bill.
The specifics of the fixes are still partially under wraps, however Congressman Weiner suggested that some fixes would include closing the donut hole, increasing premium subsidies, tightening restrictions on annual limits, and decreasing out of pocket caps.
IF this happened - if the House really does pass fixes first and does so in such a way that the overall health reform package is unbreakable tied to those fixes such that they are guaranteed to become law, then I believe that I would vote
YES on the bill if I were in Congress.
What? That doesn't sound like a strident all or nothing person.
- I'm such an ideological purist that I've already compromised on single payer, which is what the American people deserve.
- I'm such an ideological purist that I've already compromised on the public option, which is what we critically need if health reform is going to have any serious hope of bringing costs down.
- I'm such an ideological purist that I've already compromised on out of pocket costs, even though the caps are so high that the combination of out of pocket, premiums and deductible could still bankrupt both poor and middle class families.
- I'm such an ideological purist that I've already compromised on delaying many of the key provisions of health reform for years and years.
Apparently "ideological purist" has been re-defined to mean "one who bends over backwards to compromise, stopping just short of breaking in two."
If the Speaker calls a vote on a series of fixes that address some of the critical problems in the Senate Bill, and does so in such a way that it guarantees such fixes will become law as part of any HCR signed - depending on the nature of those fixes, I would
support it. But if the Speaker puts up that Senate Bill as-is for a vote with nothing but a promise that the Senate will fix it sometime "down the road" - I simply can not in good conscience support that. I would break me in two.
Your friendly "ideological purist,"
PH
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