Monday, March 22, 2010

The Amazing Technicolor Healthcare Reform (Plus Students!)

It's not the healthcare bill, to be signed into law tomorrow by Pres. Obama, that the progressive in me wanted. But the pragmatist in me is pretty happy with the basic provisions (pending reconciliation [reconciliation bill text is here]).

I think, though, that this has to be an ongoing dialogue. I don't mean that we ought to listen to idiots like Nunes or Bachmann. That's not dialogue and they're not interested in one anyway. And I don't mean the silly puffery by some Republicans about repealing the law next year. Frum has the answer to that one.
No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?
I mean simply that the new law provides a shifting framework for rethinking healthcare in the US. It resolves some standing issues of efficiency and fairness but doesn't reform the basic structure. Maybe that basic structure has to change as well, maybe not. Either way, policy changes come incrementally in the US and this necessitates attentiveness to policy. Tinkering around the edges can sometimes start to work its way towards the center. This goes for proponents and opponents.

The student loan initiative bundled into the healthcare bill is also a big win. It's a solid move in the right direction towards figuring out how to get a good college education without everyone going into massive, unpayable debt to each other. Like jobs, like healthcare, like the banking sector, like immigration reform, like the national debt, and like the various pressing foreign policy fronts, the cost of college education is a festering problem that the current administration has also tackled directly.

Here's Obama speaking to House Democrats on Saturday (cited by Krugman):
Every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made ... And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine.
And I don't think Krugman is exaggerating:
This is, of course, a political victory for President Obama, and a triumph for Nancy Pelosi, the House speaker. But it is also a victory for America’s soul. In the end, a vicious, unprincipled fear offensive failed to block reform. This time, fear struck out.
This is a win on substance, form, and the representation of both.


Cheryl Rofer said...

The student loan reform will take free money from bankers and give it to students.

Quite a win.

troutsky said...

The great tragedy of our times is peoples low expectations.Too little too late is considered a victory when people are inured to outright reversals.

Anonymous said...

My guess is that the Republicans will pull a 1994 style sweep. They may even pick up as many as 10 Senate seats. Once they control appropriations, they can break the implementation process and render a bunch of it unworkable.

The problem with the bill as passed is that it is a massive Medicare cut. The Democrats had to repeal their catastrophic plan back in the 1980s due to seniors going ballistic. Seniors are going to go ballistic when these Medicare cuts come into play.

Obama himself said that you can't do something like health care with 50%+1. You can't govern that way. It's a shame.

BTW, the student loan program is not going to give money back to students. The spread between what the US borrows and the lending rate will be used to pay some of the costs of health care. From what I understand, that's about $90B per year.