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.