Compromising on Health Care Reform

Steve Benen's take on the value of passing HCR in its weakened form.

As far as I'm concerned, the question is whether the reform framework in the Senate is a step backward or an incremental step forward. Does it make the status quo worse, or does it make improvements with the promise of additional progress? If it's killed now, are reform proponents more or less likely to have success in the years to come?

Given what we think we know about the state of the legislation, I think the effort is clearly a step  forward. It's not the bill I'd write if I were dictator, but it advances the cause of reform, and create
is a foundation that can be built on in the future. If this bill were to fail, I suspect it would be decades before anyone even tried to improve the broken status quo. In the meantime, the effects on those suffering under the current system would get worse.

 As we've talked about recently, progressives have faced this situation before. When Medicaid passed, it did very little for low-income adults. When Medicare passed, it all but ignored people with disabilities. When Social Security passed, the benefits were negligible, and the program excluded agricultural workers, domestic workers, the self-employed, railroad employees, government employees, clergy, and those who worked for non-profits. The original Social Security bill offered no benefits for dependents or survivors, and included no cost-of-living increases.

These are, of course, some of the bedrock domestic policies of the 20th century, and some of the towering achievements of progressive lawmaking. But when they passed, they were wholly inadequate. There were likely liberal champions of the day who perceived the New Deal, the Great Society, FDR, LBJ, and their congressional Democratic majorities as disappointing and incompetent sell-outs who failed to take advantage of the opportunity before them.

But the programs passed, and once they were in place, they improved, expanded, and became integral to the American experience. It took years and perseverance, but progress happened after the initial programs became law.