Bad Health Care Bill Is Better Than None

The hard road to a more perfect democracy

The health care bill that hopefully will pass in the Senate on Christmas Eve isn't final. The finalized legislation will be negotiated between House and Senate conferees early next year. But it seems safe at this point to make a few observations about what the Health Care Reform struggle 2009-2010 will do or has done.

• It has helped clarify just how dysfunctional Congress is (see Ruth Marcus' "The next decade from hell?" Washington Post, Dec. 23 here or Richard Cohen's "An imperfect ray of hope," Washington Post, Dec. 22 here).

• It exposed some members of the Senate, like Ben Nelson (D-Neb.) or Joe Lieberman (I-Conn.) as particularly repellant (see Michael Gerson's "For sale: One senator (D-Neb.). No principles, low price." Washington Post, Dec. 23 here or Eugene Robinson's "Health-care hardball," Washington Post,Dec. 18 here).

• It created opportunity for Republican members of the Senate to raise the bar for hypocrisy. Mitch McConnell, the Senate Minority leader and his caucus did everything they could to keep health care reform in any form from passing, including forcing Democrats to get 92 year-old Sen. Byrd (D-W Va.) to haul himself and his wheelchair to the Senate for roll call votes three times in the last week. They relentlessly criticized every compromise Senate Majority Leader Harry Reid (D-Nev.) brokered in an effort to get something passed. Hearing Sen. Lindsay Graham (D-SC) on NPR denounce the admittedly repugnant deal with Ben Nelson, as though Graham was a disappointed advocate for a better bill, seemed somewhat like we had all fallen down a large rabbit hole. Other Republicans seemed to be wishing for fate in the form of, say, a sudden illness that would prevent Democrats from rounding up 60 votes. It boggles the mind that Republicans have seemingly decided their obstructionist behavior and petty cruelties improve their chances of success in the 2010 mid-term elections.

• It will result in a bill that will dismay virtually every Democratic voter (see Harold Meyerson's "For unions, a messy bargain," Washington Post, Dec. 23, here), but it is a start; that fact will prove to be more important than many disappointed advocates are likely to believe (see Eugene Robinson's "Carpe health reform," Washington Post, Dec. 22, here or Henry J. Aaron's "Health-reform legislation would accomplish more than critics admit," Washington Post, Dec. 18, here).

• It confirmed that there is a senator for the rest of us. Bernie Sanders, the Independent from Vermont worked diligently to make a bad bill as promising as possible (see Katrina Vanden Heuvel's post on The Nation's website, Dec. 22, here).

It seems to be a general perception that if the US electorate were as sophisticated as the Western European demos, we would have a democracy that provided national healthcare, assumed international leadership on global warming and invaded fewer foreign countries, but that's probably not a helpful comparison. We should measure our democracy by the effort we put in to improving it, by the quality of our encounters with political opponents, and by the accumulated progress we make. As Eugene Robinson pointed out in "Carpe health reform," the US may continue for some time to come to use wealth and work as a means to ration health care, but with President Obama's signing of the health care reform bill early next year, we will, for the first time, "enshrine the principle that all Americans deserve access to medical care regardless of their ability to pay." We should celebrate that achievement while we are also working on the peace dividend, affordable housing, quality public education. and clean air and water.