Thursday, November 12, 2009

A process, not a product

Remember back in the dark days of the Bush presidency, when most progressives would have given anything to make a public health-care regime happen? Yeah, now that we're there, the tune has changed. With an initial bill -- not even near final bill status -- to read, people are hitting the brakes. People I admire (the indefatigable Deb Butler, and Martha Coakley) are finding this or that provision that is disagreeable in the bill, and declaring that the whole thing should be shot down. Perhaps we'll do better next time we try, which would probably be around 2027 or so...

Go ahead and knife the current effort if you want, but if this bill is killed don't expect anyone to try again for a while. Obama has expended gigantic amounts of political capital on this and needs to build some up. Rahm Emmanuel, Nancy Pelosi, and Chuck Schumer are some of the sharpest vote-counters since LBJ. The ombre of Ted Kennedy still hangs over Congress. In the wake of a failed attempt at reform, there'll be many more Republicans in Congress come 2011. Right now is the moment -- if we don't take it, it will not return probably for a generation.

Health care reform is a process, not a product. Canada passed its current health care regime into law in 1984, and they still tinker with it almost weekly. The CBC has mountains of reports of health care improvements, studies, and reports. Canada's system is a work in progress, and so would our system be. Don't doubt that in two years, before the health care system is actually implemented, that Stupak would be lasered out of the system by a smart bill weaving through a pro-choice Congress. Don't be surprised that in four years defects will appear in the system that will need shoring up.

It's a work in progress, if we get there. But first we need something to work on, and that "something" is this bill. Because righteous indignation ain't gonna take care of your cancer when you can't afford a doctor; this bill will.


James Patrick Conway said...

Like I said in ten years people won't remember the Stupak amendment, but they will remember that passing health care was the defining moment of President Obama's term, or killing it was the moment he appeared vulnerable. We cannot afford to lose this. The short term thinking on the pro-choice side of the progressive movement is really destructive, not just to the overall cause of health care for all Americans but even to their own cause. Do they really want to be known as the progressive pariah's that killed health care for all?

Daniel Habtemariam said...

In the wake of a failed attempt at reform, there'll be many more Republicans in Congress come 2011. Right now is the moment -- if we don't take it, it will not return probably for a generation.

This is the most terrifying part of your post and the part that dissenters tend to undervalue (or misunderstand entirely). Social Security, Medicare, even things like the abolition movement and Civil Rights are in their current forms after many, many iterations of horribly deformed and insufficient legislation. But they all started by getting a foot in the door with a single landmark bill that liberal-progressives found didn't do nearly enough and conservatives thought did grossly too much. And little by little, public support shifted left as dire consequences from the conservatives warned about failed to materialize.

To play devil's advocate, however, I think the dissenters have a point if, for example, you look at the stimulus/Recovery Act. The left caved in even after knowing it wasn't big enough, the right said it wouldn't work, and what we got was a bill that cost quite a bit of political capital and yet has been almost universally panned in the mainstream press - it really was too much of a compromise to mean anything to the lay public. The dissenters on the left perhaps would've been right to oppose it on the same grounds that many single-payer proponents oppose the current bills in Congress -- it's too much of a compromise to be effective, it'll end up being a political liability, and thus perhaps no bill is better than this bill.

Just a thought.

Daniel Habtemariam