Last night's vote in the Senate sent its watered-down version of health care reform on to the next step in the sausage-making process. And while reform advocates seemed to cheer the end result last night -- at least from my decidedly imperfect vantage, which was monitoring the vote via Twitter while standing on line for a cab at Union Station -- here on the morning after, plenty of divisions remain between those who want to propel this imperfect bill forward and those who want it scrapped.
Over at Firedoglake, Jane Hamsher doesn't see the Senate bill as either effective or the beginning of something effective: "The Senate bill isn't a 'starter home', it's a sink hole." Hamsher goes on to list the "Top 10 Reasons to Kill Senate Health Care Bill".
1. Forces you to pay up to 8% of your income to private insurance corporations -- whether you want to or not.
2. If you refuse to buy the insurance, you'll have to pay penalties of up to 2% of your annual income to the IRS.
3. Many will be forced to buy poor-quality insurance they can't afford to use, with $11,900 in annual out-of-pocket expenses over and above their annual premiums.
4. Massive restriction on a woman's right to choose, designed to trigger a challenge to Roe v. Wade in the Supreme Court.
5. Paid for by taxes on the middle class insurance plan you have right now through your employer, causing them to cut back benefits and increase co-pays.
6. Many of the taxes to pay for the bill start now, but most Americans won't see any benefits -- like an end to discrimination against those with preexisting conditions -- until 2014 when the program begins.
7. Allows insurance companies to charge people who are older 300% more than others.
8. Grants monopolies to drug companies that will keep generic versions of expensive biotech drugs from ever coming to market.
9. No re-importation of prescription drugs, which would save consumers $100 billion over 10 years.
10. The cost of medical care will continue to rise, and insurance premiums for a family of four will rise an average of $1,000 a year -- meaning in 10 years, your family's insurance premium will be $10,000 more annually than it is right now.
The Washington Post's Ezra Klein doesn't see it that way, and counters by saying that while the bill "that looks likely to clear the Senate this week is not very close to the health-care bill most liberals want... it is very close to the health-care bill that Barack Obama promised."
...there are, to be sure, some differences. The public option did not survive the Senate. The individual mandate, which Obama campaigned against, was added after key members of Congress and the administration realized that the plan wouldn't function in its absence. Drug reimportation was defeated, and a vague effort to have government pick up some catastrophic costs was never really mentioned.
But the basic structure of the proposal is remarkably similar. Here's how it was described in the campaign's white paper:
The Obama-Biden plan provides new affordable health insurance options by: (1) guaranteeing eligibility for all health insurance plans; (2) creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance; (3) providing new tax credits to families who can't afford health insurance and to small businesses with a new Small Business Health Tax Credit; (4) requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan; (5) requiring all children have health care coverage; (5) expanding eligibility for the Medicaid and SCHIP programs; and (6) allowing flexibility for state health reform plans.
This is about where the debate is right now, with some willing to settle and other angry that the administration -- by not attempting to do more politicking in advance of last night's vote -- gave up too much. As I wrote last week, my main problems with the bill are that while it may comport to the campaign's white paper, it falls far short of the promises made on the campaign trail. That's why I suspect that the one thing the passage of a reconciled health care reform bill will not achieve is to end the need for substantial health care reform.