I spent a long time trying to formulate the title for this diary. Candidates were "Cutting Off Your Nose To Spite Your Face" and "As Politics and Policy, Killing The Bill Is Stupid" or "Look How High Joe Lieberman Is Making You Jump".
Ultimately I went with what I really felt about this whole ordeal, though. Yesterday, I was disgusted to read Daily Kos, and honestly was a little embarrassed to be a progressive if being progressive meant acting the way I saw.
Yesterday made me feel like the adults were in charge anymore. It felt like facts, and reasoning, and realism went right out the window, and the new goal became trying to satisfy some masochistic urge to scrap the whole project because progressivism had sand kicked in its eye by Joe Lieberman.
Most of this post is catharsis for me, as I try to lay out the myriad reasons why HCR is still an absolutely necessary bill to pass. Today was a setback, but I am sickened at how many people think the loss of a watered-down public option is grounds for flipping over the whole chess board right as the last moves are being played.
If there's one thing I try to avoid in politics, it's raw, unreasonable emotion. If there's one thing that I've picked up in politics, it's that the person who is angriest and yelling the loudest probably is the least likely to be talking about an issue in a constructive way. I considered this to be true as the Tea Party protesters screamed about...well, everything, and I considered that to be true as a few people really, honestly, truly tried to push the idea that not passing health care reform is a good idea.
There is a little bit of the same anger that I try to avoid in this post, but I hope it will be mitigated somewhat with some attempts at objective reasoning.
So let's discuss facts:
- LOSING THE PUBLIC OPTION DOESN'T CHANGE THE BILL THAT MUCH - This small piece of the overall HCR bill ultimately became the crux of the entire health care debate for progressives. That makes sense - ultimately, the public option represented a not-for-profit force (the government) providing some balance in an arena dominated by companies who literally made more money when they gave less health insurance to healthy people. The public option tied together many important parts of progressive ideology, from anti-corporatist sentiments, to the benevolent role that government can play in people's lives, to notions of fairness and positive freedom.
But aside from being an important symbol of pure progressivism in the overall bill, the public option as it was buried today wasn't going to change health care in this country.
Sure, if the public option was allowed to be just like any other insurance company, backed by the size of the federal government and negotiating the lowest possible rates, we would likely end up with a much cheaper single payer alternative for most people in this country. But there weren't the votes for that kind of system in a 60-vote Senate. So the public option got watered down to what came out of the Finance Committee - limited in availability and scope, not allowed to negotiate even at Medicare rates (Nate Silver says much the same in this post)
So what really was the battle here? Was it a fight to get a neutered public option on to the market that was likely going to act as a dumping ground for sick people that couldn't afford private premiums? Or was it a fight to feel like liberals were getting SOMETHING out of the bill that they would have preferred to be single payer anyway?
I'm not trying to even argue that the latter is an illegitimate rationale - I WANTED to see the public option in the bill, even knowing its limitations.
But if we're being realistic, the public option in its current form wasn't going to change the insurance market. Anyone shouting to "kill the bill" because of the loss of this provision should be absolutely required to indicate how the neutered public option on the table was going to ameliorate the myriad harms they're now citing because the bills not there (including the "evils" of the individual mandate).
- THE HEALTH CARE BILL IS STILL A TREMENDOUS PIECE OF LEGISLATION FOR LIBERALS - Nate makes a similar point in his recommended diary right now, and mcjoan had a strong front-page article listing the HCR bill's effects this weekend.
Take a look at that list. Subsidies to buy health insurance for up to 400% of poverty level? A legally mandated minimum level of coverage? Financial and/or legal penalties for any company with more than 50 employees that doesn't provide health insurance to its workers? Expansion of Medicare and Medicaid? Massive new changes in the ways that insurers do business, including outlawing rescission, extending the age at which kids can be on their parents' health insurance, and the end of banning people based on preexisting conditions?
Be honest - before this whole debate started, if someone told you that the Democratic Party would succeed in passing a bill that offered all of those provisions, would you honestly vote no? What part of progressive ideology would inform that decision? Again, is this a debate about what the bill IS, or now is it an argument about it ISN'T? Are you arguing because of what the bill DOES, or are you going to disagree with it because of all the things it DOESN'T DO?
Put another way - are you angry that this is an inherently BAD bill, or simply that it's not the bill you wanted?
- THE INDIVIDUAL MANDATE WILL NOT BRING ABOUT ARMAGEDDON - Ezra Klein has talked more about this policy point than I have the ability to link to succinctly, so let's start with some of the basics about the individual mandate that he's laid out in the past few months (including here)
a. Bringing more people into the market further dilutes risk - More people paying for insurance means more money in the insurance pool. Since most of these people are likely to be younger, healthier people that don't present major health risks, less of this money is going to be siphoned off to pay for their services and can be used to pay for the care needed by sicker people. The result is lower premiums for those in the market as the cost of coverage is spread among more (and healthier) people
b. The individual mandate is NOT going to bankrupt poor people - As someone mentioned in another diary, there are several reasons why a person can opt out of the individual mandate, including inability to pay because of high premiums or low income. Those who qualify can receive subsidies to greatly help the cost of paying premiums. The result is a system where the poorest people are not only spared any kind of punishment for being poor, but are actually given the most aid in paying their premiums.
c. The individual mandate already exists - no Armageddon yet - As Klein points out, the individual mandate has been implemented fairly smoothly in Massachusetts, where 98.3% of people filed information about their health care and almost 96% of filers had health insurance the entire year. Not only did the mandate increase the number of people covered, but this again represents a tremendous dilution of risk that would otherwise be shared by a much less healthy population.
Also, one minor point that's always bugged me when people gripe about the individual mandate: At least in my state, car insurance is required for vehicle owners, with absolutely no subsidy provided for the poor (so much as I know). Minimum liability insurance on my vehicle costs me almost 10% of my annual income even after discounts (I'm young and a student, so this isn't representative of the entire population), yet I hear nary a peep about the "government oppression" inherent in this system.
- WORKING AGAINST THIS BILL IS AN ABSOLUTELY DISGUSTING DISPLAY OF POLITICAL IGNORANCE - Nate already made this point earlier today, but I'm going to reiterate it:
YOU NEEDED SIXTY VOTES TO PASS A PUBLIC OPTION. THERE WERE NEVER SIXTY VOTES IN THE SENATE.
Ah yes, the oh-so-loathed "art of the possible". There were never 60 votes for the public option, and that isn't the fault of Harry Reid, Barack Obama, Daily Kos, or anyone on God's green earth besides the handful of Democrats and Joe Lieberman who a long, long time ago said that they wouldn't support a public option. More and more senators supported the legislation as it got weaker and weaker, but ultimately the line in the sand was drawn by Joe Lieberman, Ben Nelson and two or three other "centrists".
There is absolutely no reason why people shouldn't be unloading on those individuals. I even believe that the attempt to put political pressure on Lieberman via his wife's position in a prominent health care-related charity isn't outside the pale, given that it's a rare tangible way to express anger to a guy who considers himself safe from public ire for another three years.
But Jay Rockefeller isn't the reason that Joe Lieberman is a dick. Neither is Tom Harkin. Neither are any of the progressives who worked so hard to find a public option "compromise". When the negotiations on this fell through, it wasn't that progressives in the Senate just "gave up" - it's that the people they were trying to negotiate with said no to EVERY SINGLE DEAL. That's not a workable solution.
What do you get when passing a bill requires 60 Senators? You end up getting legislation that has to make 50 liberals, 9 moderates and Joe Lieberman happy. That means passing a bill that is watered down to get the people at the margins who aren't comfortable with a strong bill.
You can stomp your feet and scream all you want about how Joe Lieberman is a giant dick, but ultimately the bill had to make him happy to make cloture. If you don't like the result, let me ask you this:
What would be the alternative bill that would get all 60 Senators on board? How would it be better? I don't think there is an answer to that question.
The main point of this line of argument is this:
Killing this bill only hurts Democrats.
Killing this bill takes legislation that's perhaps 80% progressive in its philosophy, that has policy aims more ambitious than anything we've seen in a generation, and kills them.
Killing this bill guarantees electoral failure for the Democrats - and not just for the moderates of the world, but for good progressives who worked hard to produce a good bill in the face of necessary moderates that wouldn't budge.
Killing this bill takes health care reform off the table for at least another 15-20 years.
Killing this bill preserves the status quo for another generation.
And for what? To send Joe Lieberman a message? To punish the majority of Democrats for working in a 60-vote Senate? Because even the good parts of the bill "probably will just be worked around anyway"? Because you're angry that you live in a country where the politics is to the right of what it would need to be to accomplish solid progressive goals?
I'm sorry, I can't be on board with that. I can't be on board with killing this bill because doing that would be terrible politics that would kill a lot of good policy.
But I also can't be supportive of a movement that considers a piece of legislation that's only 80% progressive to be "unacceptable" or "failure". I can't support people that watch 7 "moderates" effectively kill stronger reform, only to blame everyone else in the party for "not trying hard enough".
If you want to hate Joe Lieberman and Ben Nelson for setting a political price for their wholly necessary support, be my guest - they deserve your ire and whatever political consequences come with it.
But if you want to torch genuinely progressive legislation and abandon the rest of the party in the process, you can count me out. If being a "real progressive" means that we can spit in the eye of real, true progress because it's not perfect and perfection was taken by a craven jerk, then I don't know if I want to be a part of that movement anymore.
I understand that I wasn't as conciliatory as I might have liked, and that might stir up some anger itself. I'm OK with that, though, so much as any criticism is based on the facts laid out here and not on personal stuff. Ultimately I'm going to be OK even if it is personal, however.