Monday, December 21, 2009

US Senate Passes First Step of Health Care Reform 60-40

It's difficult to call this "health care" reform when it's really "health insurance" reform, but whatever you want to call it, there is no denying that this was a historic event that puts us closer to ultimately changing the face of health care in this country.
After a long day of acid, partisan debate, Senate Democrats held ranks early Monday in a dead-of-night procedural vote that proved they had locked in the decisive margin needed to pass a far-reaching overhaul of the nation’s health care system.

The roll was called shortly after 1 a.m., with Washington still snowbound after a weekend blizzard, and the Senate voted on party lines to cut off a Republican filibuster of a package of changes to the health care bill by the majority leader, Harry Reid of Nevada.

The vote was 60 to 40 — a tally that is expected to be repeated four times as further procedural hurdles are cleared in the days ahead, and then once more in a dramatic, if predictable, finale tentatively scheduled for 7 p.m. on Christmas Eve.

Both parties hailed the vote as seismic.

The Senate bill is horribly flawed (follow link for some details), as anyone following this debate already knows. This is far from a done deal though, as eyes now turn to the House.

The Senate bill, once completed, must be reconciled with the bill adopted by the House last month, and there are substantial differences between the two. The House measure, for instance, includes a government-run health insurance plan, or public option, that was dropped from the Senate bill.

The House speaker, Nancy Pelosi, has said the House would not just accept the Senate bill. And some Senate Democrats have warned that they could turn against the bill if changes made during negotiations with the House are not to their liking.

If they do, its failure will be on them, and the general dysfunction of a Senate that has to clear the hurdles placed in its path by "Party of No". Krugman explains how the threat of filibuster from the Republicans since the Dems took power in 2006 has soared, making compromise, and maybe even governing itself, virtually impossible.

But our current situation is unprecedented: America is caught between severe problems that must be addressed and a minority party determined to block action on every front. Doing nothing is not an option — not unless you want the nation to sit motionless, with an effectively paralyzed government, waiting for financial, environmental and fiscal crises to strike.

It's Michigan, writ large. And the end result of this obstruction was that the Nelsons and the Liebermans of the Senate received "extraordinary power to shape the bill". That's a shame. But for now, let's take what we can get.

If the bill is passed, it will make health insurance available to millions of people who can’t get it now either because of preexisting conditions, or because they just don’t make enough: community rating and the subsidies — remember, we’re talking about almost $900 billion in aid — will make a huge difference. Yes, there will be some people forced to buy insurance by the individual mandate; everything I’ve seen says that the number of people for whom this will be a real hardship will be far less than the shouting suggests.

We can come back to this. Progressives can push for bigger subsidies; stronger exchanges; a reinstated public option; stronger cost controls. Some of these things can be done through reconciliation. Having this bill in place will make it easier, not harder, to do these things than having passed nothing.

I’m not happy — this is too flawed a bill for joy — but I am relieved ( or will be once I’m sure that Joe Lieberman isn’t going to pull a double-cross). You can’t always get what you want. But if you try sometimes you might find you get what you need.

But will we get what we need? Unknown. If the end result proves unworkable and unaffordable to Americans, it will collapse or be repealed - and all this will go for naught anyway.

Miles to go yet. Let's hope that some changes can be made with the House, and certain Senators will put aside their selfish egos and work for progress for the American people.