Senate Democrats are already lowering expectations for the final health care bill, insisting that there will more efforts at reform to come.
In a conference call with reporters on Friday, Sen. Sheldon Whitehouse (D-R.I.) and Debbie Stabenow (D-Mich.) both stressed that they will continue to try to tinker with changes to the health care insurance and delivery system and the pharmaceutical industry, even after legislation passes.
"This is fairly clearly the beginning and not the end of health care reform," said Whitehouse. "There is going to be an awful lot of oversight of the big programs, which is necessary. We have got to change the delivery system so it provides better health care to Americans with less... And the ongoing nature of this continuing effort to make the American health care system one we can be really proud of is one that will allow plenty of time for people to continue to advocate for their views. It is not as if, if you don't get your voice heard in this particular episode, or if you don't win the program or position that you wanted in this particular episode, you have to walk away for ever. This is going to be continuing."
Whitehouse is right in a narrow sense. Additional health care related legislation will be considered once -- or if -- the current round of massive reform becomes law. But his remarks seem aimed at diffusing anger (largely from the progressive community) over the concessions granted during the current process of reform. Both senators, for instance, said they are personally discouraged by the deal cut by the Obama White House to limit the government's ability to negotiate prescription drug prices in exchange for help from Big Pharma in passing reform. But Stabenow, for one, suggested that she was willing to swallow that disappointment in hopes of future action.
"All of us in the caucus are united to make sure that, even if there are things that we need to come back and work on later -- such as has been done with every other major reform that has ever passed -- we can't let anything get in the way of the larger goal," said the Michigan Democrat. "I'm hopeful we can do more on the prescription drug front. But if we can't I'm sure Sheldon and I will be back again."
Whitehouse and Stabenow didn't spend the entire call, hosted by the group Families USA, attempting to mitigate potential dissatisfaction. They also emphasized that various components of the reform effort are hugely important steps forward. And, in particular, they lauded the last-minute decision by leadership to expand Medicare coverage to those as young as 55.
"For a lot of Americans it will be viewed as more reliable, certain and secure," said Whitehouse. "It has lower administrative costs so you are by definition getting more medical payment per dollar you put in. And ultimately the subsidy that the bill provides for low-income folks can travel with them into this Medicare program... I think people are pretty optimistic that this will be a very credible alternative for those in the age group."
"For a lot of people in that age group the coming of age to qualify for Medicare is [like] finally entering safe harbor after years of stormy seas," he concluded. "And for people to be able to make that turn earlier, even as a relatively comparable price point, would still be a big plus."