In an op-ed several months ago, I advised my fellow progressive Democrats to support health care reform even if it fails to include some of their cherished goals.
Now I'm begging.
I understand and share the frustrations of progressives. They compromised before the debate even began, giving up on Medicare for all and settling for its weak cousin, a public option. The progressive wing of the Democratic Party has been everything that the reactionary wing of the Republican Party has not: open-minded, pragmatic and respectful of the views of others. The Republicans' obstinacy has been rewarded by the voters, who sent Scott Brown to the Senate as the candidate of change who promised to defend the status quo on health care. So why do I urge further flexibility? Because failure is not an option and surrender is not a strategy.
I am convinced that Democrats lost the Congress in 1994 because we failed to pass health care. And yet today many Democrats are worried that they will lose the Congress if they pass health care. They are wrong. Here's why:
You're going to get the attack anyway, you may as well get the accomplishment. I don't mean to be rude, but if health care is the kiss of death, you've already been kissed. Now, I don't think it is -- not in the slightest. If passing health care would ensure Republican takeover of Congress, wouldn't those Rovian Republicans cut loose one or two senators to help it pass?
The Senate bill is progressive. No, it's not as progressive as the House bill -- but that's the wrong question. The right question is whether the Senate health care bill is better than the status quo. And that ain't even close.
The Senate bill prohibits insurance companies from denying coverage for pre-existing conditions, stops insurers from dropping health insurance coverage when someone gets sick, eliminates gender discrimination, requires coverage of preventive care, and levels the playing field for the little guy and gal through new health insurance exchanges. It includes the largest expansion of Medicaid since it was created under LBJ, fully funds the Children's Health Insurance Program through 2016, protects seniors who have fallen through the so-called "Donut Hole", and finally -- finally -- covers 31 million Americans who today lack health insurance.
After passing the Senate bill Democrats should use the budget reconciliation process -- in which the majority still rules -- to make improvements like a fairer system of taxing (assessing the rich instead of the middle class), and a better system of subsidies. I am convinced those improvements will never be made without first passing the basic architecture -- and the Senate bill is the only viable blueprint.
The winners get to write the history. Winston Churchill said, "History will be kind to me because I intend to write it." The truth is the winners in Massachusetts are miswriting the history. Health care is a uniquely complicated issue in Massachusetts because the state already has near-universal coverage (which Scott Brown voted for). Thus, many voters who would otherwise support a candidate in favor of health care reform worried that a new national program might cost them more for health security they already had in Massachusetts. As Brown said in a debate, "We have insurance here in Massachusetts. I'm not going to be subsidizing what other states have failed to do." That's a far cry from outright rejection of health reform. In fact, if there's a lesson to be learned from Massachusetts, it is that once enacted, comprehensive reform quickly becomes broadly popular and politically impregnable. A poll co-sponsored by the Washington Post, the Kaiser Family Foundation and Harvard University showed that 68 percent of Massachusetts voters support their state's health care reform -- including a majority of those who voted for Scott Brown.
This is our last, best shot. Up to 40,000 Americans die each year because they lack health insurance. 40,000: a 9/11-size death toll every thirteen days. After our failure in 1994 it took 16 years before another president and Congress were bold enough to take on the challenge. If we fail now it won't be just 16 years -- or even 36. If we fail now, I doubt anyone old enough to read this column will live long enough to see universal health insurance.
If Democrats fail to deliver on a basic campaign promise, it will only heighten voters' anger and deepen their cynicism. But health reform that actually protects consumers and controls costs will soon join Medicare -- and the Massachusetts reform -- as unassailable accomplishments.
The writer, a Democratic strategist and political analyst, was a political consultant to President Bill Clinton during the 1993-94 health-reform effort and later served as counselor to the president. He is an affiliated professor of public policy at Georgetown University. He has advised the Service Employees International Union, which supports President Obama's health-reform efforts. The views expressed here are his own.