Why I have mixed, but on balance positive, feelings about the passage of the Health Care Bill.

[Donald Ian Rankin]

I think there are three important things to say about this bill; two in its favour and one against.

For:

1) It is a non-trivial step in the right direction.
2) It will benefit the left and the Democrats significantly in November.

Against:

3) It will make a subsequent, larger step in the same direction in the future less likely.



1: In and of itself, this bill is clearly a good thing: it will make it easier for poorer Americans to afford healthcare. I haven't studied it in detail, but as far as I can see, it's pretty much strictly and improvement on what came before it. So, viewed in isolation, I'd be 100% in favour of it.

2: Failing to pass a big, high-profile bill with the words "Health Care Reform" in the title before the 2010 elections, while controlling all three branches of government, would have been catastrophic for the Democrats. Passing a bill which appears to be a moderately good thing is an added bonus. Whatever your views on the consequences of this bill for health care, it's undoubtedyl a good thing for Iraq, Afghanistan, control of the SCOTUS and hence preserving Roe vs Wade, the Middle East peace process, the environment, and the host of other issues where the Republicans are far worse than the Democrats.

3: On the other hand, I suspect that America only has the stomach for one big battle over health care reform every decade or two. This bill goes a *lot* less far than I'd have liked - ideally, I'd have liked to see the establishment of something along the lines of the NHS we have here in Britain - and I suspect it will sap some of the momentum for a future campaign to establish such a thing, or at least to arrange for the state to finance free-at-point-of-use healthcare.




So, not everything I'd hoped for but, on balance, a damn good thing. Or, if you prefer it the other way round, on balance a good thing, but far short of everything I'd hoped for.

[liberalpragmatist]

1. Actually an NHS-like system may be likelier than people realize

The Community Health Center expansion is potentially huge. And it could eventually lead to a large, national network of federally-administered clinics that directly provide care.

I'll add to that, yes, big, titanic health care battles are probably only come along once every decade or two. But now that the basic structure is in place, you could continually expand and modify the programs, just as Medicaid, Medicare and Social Security were modified. For the most part, those programs were modified quietly, as part of other processes or appropriations bills, not as large, isolated battles.

[Bullet1987]

5. I hope so.

Maybe that's why the Right is losing it.

[kestrel91316]

2. Careful. They're gonna show up to pee in your Wheaties any second now.

:popcorn:

The oh-so-concerned faction, that is.......

[Donald Ian Rankin]

3. As I said, I share at least some of their concern.

While I don't agree with those who are unhappy with the passage of this bill because they were hoping for something better, I can entirely understand their position - I just think it's based on an overoptimistic interpretation of what is currently possible given the state of American politics. I certainly don't think it's fair to brand them "concern trolls", though.

I think the best response to them is not to call them names, but to ask them "how?" - where would the votes for a better bill have come from. I haven't yet heard a convincing answer to that.

[kestrel91316]

4. They don't have an answer. The votes simply weren't there.

I want something better, too. But I guess I'm just an evil pragmatist like Obama. I see half a loaf as better than none, particularly when it comes to insuring children with PEC's.

Too bad there's no guarantee this law everyone is crowing about will actually pass and get signed. The Senate will debate the reconciliation to death, add amendments, and then back to the House it goes. Failure is still a possibility.