Conservatives May Create The Horrors They Warned About In Health Care Reform

One lesson of watching the battle to pass health care reform is that compromises must be made. I don’t agree with everything in the bill and many on the left do not feel it goes far enough. Steven Benen addressed the issue accepting a bill which does too little as a step in the right direction. He referred back to an article form Paul Begala which showed how limited Social Security was when originally passed when FDR was president:

No self-respecting liberal today would support Franklin Roosevelt’s original Social Security Act. It excluded agricultural workers — a huge part of the economy in 1935, and one in which Latinos have traditionally worked. It excluded domestic workers, which included countless African Americans and immigrants. It did not cover the self-employed, or state and local government employees, or railroad employees, or federal employees or employees of nonprofits. It didn’t even cover the clergy. FDR’s Social Security Act did not have benefits for dependents or survivors. It did not have a cost-of-living increase. If you became disabled and couldn’t work, you got nothing from Social Security.

If that version of Social Security were introduced today, progressives like me would call it cramped, parsimonious, mean-spirited and even racist. Perhaps it was all those things. But it was also a start. And for 74 years we have built on that start. We added more people to the winner’s circle: farmworkers and domestic workers and government workers. We extended benefits to the children of working men and women who died. We granted benefits to the disabled. We mandated annual cost-of-living adjustments. And today Social Security is the bedrock of our progressive vision of the common good.

Health care may follow that same trajectory. It would be a bitter disappointment if health reform did not include a public option. A public plan that keeps the insurance companies honest is, I believe, the right policy and the right politics. I believe subsidies should extend to as many Americans as need help and that the hard-earned health benefits of middle-class Americans should not be taxed. I believe insurer abuses like the preexisting-condition rule should be outlawed. The question is not whether I or other progressives will support a health-reform bill that includes everything we want but, rather, whether we will support a bill that doesn’t.

It is totally understandable to accept a bill which doesn’t do enough in the hopes that it will be expanded in the future. Ask any conservative and they will tell you that the inevitable result of a new government program is to see it grow.

The more serious problem is when there are portions of the bill which are not desired. In some cases this is understandable as we know compromise will be necessary. Health care is just too complicated to produce a bill which everyone will agree with. It is necessary to accept some items I do not want in order to achieve the much needed reform. What is not acceptable is to use health care as a back door way to restrict abortion rights.

Conservatives claim that health care reform will result in the government coming in between the patient and their doctor. As the American Medical Association found, the bill originally did not include “any new authority that would overpower the relationship between patients and their physicians.”  Suddenly in the rush to achieve a narrow majority it turns out the conservatives are right. A final compromise on the bill does intrude upon medical decision making by restricting abortion rights. After all their bogus scare stories about horrors coming from health care reform we suddenly do have the prospect of a real horror–the return of coat hanger abortions.

Hopefully Pelosi knows what she is doing in accepting this intolerable compromise to gain passage on the bill. Rep. Debbie Wasserman Schultz, the Democratic chief deputy House whip, does predict that the Stupak amendment will be stripped from the final bill. If not, this could doom health care reform as at least forty-one House Democrats have now pledged to vote against the bill if the restrictions on abortion rights are not removed. For now it appears that Obama does not like the Stupak amendment but would not be willing to sacrifice the bill over this.

While we do not know how this will play out, I’m sure that many conservatives love the prospect that it might come down to a choice between reforming health care or preserving abortion rights. It totally escapes them that this tactic results in in bringing about what they claim to fear: government interfering with medical decisions and bringing about substandard forms of medical care.

Health Care Reform and Harry Potter

Posts on health care reform have gotten into a lot of wonky subjects such as the insurance exchange, a variety of plans lumped together under the label “public option,” and details of how the system currently works from the inside. Now that the House bill has passed it seems like a good time to point out his trivia in evaluating the bill.

There have been a lot of comments that the bill is long, which I certainly will not argue with after trying to wade through multiple proposed House and Senate bills in addition to the current one. Length is hardly the key factor in evaluating a bill, but there is an interesting take on this at Computational Legal Studies. They argue that “simple page count vastly overstates the actual length of bill” and turned to word count instead. They counted 363,086 words (including titles, tables of contents, etc.) and further narrowed this to 192,531 words which impact substantive law. This falls in the neighborhood of a Harry Potter novel:

Number of substantive words in H.R. 3962: 192,531 words
Harry Potter and the Order of the Phoenix – 257,000 words
Harry Potter and the Goblet of Fire – 190,000 words
Harry Potter and the Deathly Hallows – 198,000 words

How much of the bill will need to be cut for the movie version?

This was also compared to the full US Code:

Size of the United States Code: 42+ Million Words
Relative Size of H.R. 3962: H.R. 3962 is less than 1/2 of one percent of the size of the United States Code

I’m not sure that this is a meaningful argument to minimize the impact of its size. It seems that 1/2 of one percent might be pretty substantial for a single bill. To evaluate this it would help to know how many laws are included in the full United States code and what their typical size is. Regardless, it is not surprising that a bill which handles something as complex as health care coverage would be on the long side.