Friday, December 18, 2009

How I’m dealing with my depression about health care reform

This is not the way I expected it to turn out. No public option, no Medicare buy –in for people 55-64. But I don’t want to kill the bill.

I spend too much time reading liberal/ progressive blogs and am dismayed by how many on the left are making the argument that it’s better to scuttle this bill.

Many thanks to Nate Silver who kept me from falling into this defeatist way of thinking! One of my Facebook friends alerted me to
His 20 Questions for Bill Killers

Silver convinced me that passing this bill is so much better than starting over. Among his most compelling points:

8. How many years is it likely to be before Democrats again have (i) at least as many non-Blue Dog seats in the Congress as they do now, and (ii) a President in the White House who would not veto an ambitious health care bill?

11. Would base voters be less likely to turn out in 2010 if no health care plan is passed at all, rather than a reasonable plan without a public option?

[An aside: Nate Silver got me through the 2008 general election. Whenever I stated to panic, I went to and Nate’s solid, fact-based analysis calmed me down. Silver demonstrated that electoral arithmetic was clearly in Obama’s favor and that helped me get beyond the headline of the day.]

Silver’s arguments helped and a little bit of history helps. Major social reform has always been piecemeal. In order to get the votes to pass social security, FDR made a devil’s bargain with Southern Democrats to exclude domestic workers and share croppers, effectively excluding the majority of African-Americans.

In many ways the New Deal was racist, but it established the principle that the elderly were entitled to financial support. In the 1950’s the laws were amended to ensure that the principle applied to all workers. (Those who had been excluded from social security or their descendants should have been compensated.)

Medicare was similarly a work in progress, with prescription drug coverage not included. Medicare established the principle that the elderly were entitled to health care, but it took forty years for prescription drug coverage to be included, and even then, the prescription drug coverage passed during the Bush administration was deeply flawed. We are still working on fixing that one.

Killing the bill will kill reform for the foreseeable future and kill more of our fellow citizens who are dying for lack of health care.

And from Bill Clinton:
“Take it from someone who knows: these chances don't come around every day. Allowing this effort to fall short now would be a colossal blunder -- both politically for our party and, far more important, for the physical, fiscal, and economic health of our country."

Maybe Obama and the Democrats could have fought harder, fought smarter but the archaic senate rules have stacked the deck against change. It’s time to get rid of the filibuster and the 60 vote threshold required.

So I’m reconciled (sort of) to passing this flawed bill as a first step and trying to talk myself into a "don’t mourn, organize!” mind set.

I’m going to work like crazy to make sure the people who came out for Obama in 2008 come out in 2010 to give the president the votes he needs to fix this bill. Too bad Lieberman doesn’t come up for re-election until 2012.

Karen Bojar


  1. Yes! Exactly!

    If there's something you want in this bill, fight for it! Fighting against the abominable no-abortion-coverage provision is a great first step. So is fighting for an expansion of Medicaid to cover more families near the poverty line. Maybe the Olympia Snowe public-option trigger needs to be reinserted as an absolute parachute, in case the national nonprofits don't do what they're supposed to (although I think they will, and better than the watered-down state plans).

    Sometimes I worry that so many people are checking out of this debate because caring about something other than one version or another of a public plan requires actually knowing something about the less-dramatic but ultimately-gigantic details of this reform. It requires paying attention.

    Too many of us bought into the right-wing frame that it was all about the public option, and whether you were fer' it or agin' it. That was always a losing proposition, so long as the moderate Democrats/Republicans were going to hold the line, designed to distract everyone from the substantive show.

    Progressives are also still mad about Afghanistan. They've bought in to this idea that Republicans are organized, Democrats inefficient, and they're throwing that into the street.

    I don't think that our politicians or their staffs are disorganized. I think that we, the hoi polloi, are fickle in how much attention/commitment we're willing to offer. I think we have fantasies about political purity, where you should vote against every imperfect policy in favor of an ideal even if it's unattainable. Better to lose everything than to have dirty hands. A curious ideal for a party that claims to be reality-based, that claimed they were tired of unpragmatic idealists who did what they thought was right and left the results with the Lord.


  2. A really good point about fantasies about political purity!

    Tim, I hope some day you go back to political blogging. Do you post on Nate Silver’s site?