18 December 2009

Pass the Health Care Bill

Paul Krugman, the New York Times columnist and 2008 winner of the Nobel Prize in Economics, wants congress to pass the health care bill.

Key passages of today's column:
A message to progressives: By all means, hang Senator Joe Lieberman in effigy. Declare that you’re disappointed in and/or disgusted with President Obama. Demand a change in Senate rules that, combined with the Republican strategy of total obstructionism, are in the process of making America ungovernable.

But meanwhile, pass the health care bill.

...let’s all take a deep breath, and consider just how much good this bill would do, if passed — and how much better it would be than anything that seemed possible just a few years ago. With all its flaws, the Senate health bill would be the biggest expansion of the social safety net since Medicare, greatly improving the lives of millions. Getting this bill would be much, much better than watching health care reform fail.

At its core, the bill would do two things: First...Americans could no longer be denied health insurance because of a pre-existing condition, or have their insurance canceled when they get sick Second, the bill would provide substantial financial aid to those who don’t get insurance through their employers, as well as tax breaks for small employers that do provide insurance.

All of this would be paid for in large part with the first serious effort ever to rein in rising health care costs.

The result would be a huge increase in the availability and affordability of health insurance, with more than 30 million Americans gaining coverage, and premiums for lower-income and lower-middle-income Americans falling dramatically. That’s an immense change

Bear in mind also the lessons of history: social insurance programs tend to start out highly imperfect and incomplete, but get better and more comprehensive as the years go by. Thus Social Security originally had huge gaps in coverage — and a majority of African-Americans, in particular, fell through those gaps. But it was improved over time, and it’s now the bedrock of retirement stability for the vast majority of Americans.

Whereas flawed social insurance programs have tended to get better over time, the story of health reform suggests that rejecting an imperfect deal in the hope of eventually getting something better is a recipe for getting nothing at all. Not to put too fine a point on it, America would be in much better shape today if Democrats had cut a deal on health care with Richard Nixon, or if Bill Clinton had cut a deal with moderate Republicans back when they still existed.
Krugman then goes on to suggest that the Senate needs to change its ways:
Beyond that, we need to take on the way the Senate works. The filibuster, and the need for 60 votes to end debate, aren’t in the Constitution. They’re a Senate tradition, and that same tradition said that the threat of filibusters should be used sparingly. Well, Republicans have already trashed the second part of the tradition: look at a list of cloture motions over time, and you’ll see that since the G.O.P. lost control of Congress it has pursued obstructionism on a literally unprecedented scale. So it’s time to revise the rules.
With rules as they stand, the Democratic majority can't govern. Of course, they have only themselves to blame for making the rules that way. But, with the hapless Harry Reid leading them, the only way the Democrats stand a chance next November is if they change the Senate rules so they can actually GOVERN between now and Election Day next year.

I am not suggesting they do away with the filibuster. But they really ought to make it so that it's really hard to call one. As I have suggested before, the way to do that is to go back to the old days solid Senate leaders like Alben Barkely and Lyndon Johnson. If a senator calls a filibuster, then that senator (and only that senator) must stand on the senate floor and discuss the issue at hand non-stop until either one of two things happen: 1. the chamber cobbles together 60
votes to stop the filibuster; 2. The senator stops speaking.

As it stands right now, the current rule essentially requires every bill to pass with a 60-vote majority. That's a super-majority rule, and that, in my view, is unconstitutional.

UPDATE: A TPM reader writes Josh Marshall:
If I feel abandoned, it's not by Obama and the Democratic party, it's by those on the left advocating to kill the bill.

I am unemployed and have a pre-existing condition that requires daily medicines, quarterly doctors visits and an annual test. I am on COBRA, which runs out mid-2010, when I will have to find new health insurance. I will need to purchase some kind of health insurance, assuming I can find provider who will insure me.

I don't pretend to understand all the intricacies of the health care reform bill, but I do read a lot. From what I can glean, if the bill passed, I would be able to find health insurance because I could not to be turned down due to my pre-exisiting condition. And based on my income at the moment, my premuims would be subsidized.
My hunch is that once (if) this bill passes, more people will be pleased with it than you think.

But as I said earlier today, those on the left who are advocating that congress jettison the current proposals and start from scratch aren't really thinking. Dump the current legislation and it will be another generation - if not longer - before we see this tried again.