The Senate voted this morning and got a healthcare bill out of their chamber. Now key people from the House, the Senate, and the White House are going to meet to hash out the differences. And I am hoping - for substantive policy reasons, contrary to rumors that any progressive opposing the Senate bill is either an idiot or acting in bad faith - that we end up closer to the House version, because the Senate version of the bill does not address the single biggest issue with healthcare in this country, nor does it put us on a path to do so.
Until we get our hands around the problem of paying twice as much as the rest of the world for healthcare that doesn't keep us as healthy as people who pay half as much, we're not actually fixing the real problem with healthcare. We are merely putting bandaids on bullet wounds and pretending like that's all we need to do.
So indulge me in a metaphor, if you will. Imagine you have a leak in your roof. If you fix it now, it's going to cost you $500. If you don't fix it, the water getting into your attic will eventually breed mold, which will cost many thousands of dollars to mitigate - if it hasn't already gotten to the point where your house is unsalvageable.
So what do you do? Do you spend the $500 to fix the leak, or wait and pay the thousands of dollars later?
If you plan on living there for the rest of your life, you will fix the roof now. But what if you know you are going to move next year? Do you hope that the prospective buyer doesn't notice the leak? That by the time the mold sets in, it isn't your problem anymore?
The tenets of capitalism suggest you should defer - you have, after all, deniability. "A leak? Thanks for catching that! It could have ruined the whole house!"
That's exactly the behavior the insurance companies engage in. This kind of distortion of incentives is at the heart of the problem with our healthcare system. They don't do the relatively inexpensive things that would keep Americans healthy, because they figure they won't be the ones footing the bill later when people need really expensive care.
And the current Senate bill isn't going to fix it.
The healthcare battle is the first time we've tried to deploy the inside-outside Progressive Block strategy. It will certainly not be the last opportunity we have. So in addition to thinking about the impact of our actions on the battle we're currently engaged in, it's worth thinking about their impact on future battles.
The choices we make in the coming weeks will determine whether we come out of this stronger or weaker than we were when we came into it.
So here's my basic question: what do we need to do in the endgame of the healthcare battle to ensure that progressives - including the CPC in the House, the progressive Senators, and all of us progressives outside of Congress - are stronger for the next battle because of the way this one played out?
The House progressives have been saying that no health insurance reform bill can pass the House unless it includes a public option.
House Speaker Nancy Pelosi has said that no health insurance reform bill can pass the House unless it includes a public option.
Today, The Hill posted an article saying that 23 Democratic Members of the House have said they're planning to vote against the bill, and Mike Ross (Blue Dog lead on healthcare) has said he'll vote against anything that includes a public option.
I keep having the same argument, in which someone says, "The progressives won't really kill healthcare reform, right? Even if they don't get a public option - right?"
And I unfailingly respond, "Actually, they will. And they should."
A no-public-option bill would mandate that every American buy health insurance while ensuring skyrocketing premiums. What sane politician would vote for a bill like that?
The public option is essential to the success of the reforms - not merely for political reasons, but for fundamental policy reasons.
Simply put, if you want other reforms like elimination of pre-existing condition exclusions, you need a public option because:
* Reforms such as eliminating pre-existing condition exclusions only work if you have an individual mandate. * If you have an individual mandate, rates will skyrocket unless you have a public option to provide competition (or rate controls, which aren't even on the table).
So what opponents of the public option are proposing is that we pass a bill that will spike the cost of health insurance at the same time we require everyone by law to buy it.
Given that as the alternative, we are in fact better off with no reform.
Let's pull apart the logic I described a little more to understand it better.
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So indulge me in a metaphor, if you will. Imagine you have a leak in your roof. If you fix it now, it's going to cost you $500. If you don't fix it, the water getting into your attic will eventually breed mold, which will cost many thousands of dollars to mitigate - if it hasn't already gotten to the point where your house is unsalvageable.
