What Democrats need to do about health-care reform

By Michael J.W. Stickings

I don't have much to add to J. Kingston Pierce's excellent post, "Pass health-care reform NOW!" -- but I will add this:

Paul Krugman is right:

Health care reform -- which is crucial for millions of Americans -- hangs in the balance. Progressives are desperately in need of leadership; more specifically, House Democrats need to be told to pass the Senate bill, which isn't what they wanted but is vastly better than nothing.

It isn't perfect, but it's better, much better, than nothing. The problem, as Krugman notes, is the "gaping hole in White House leadership."

President Obama is still talking up bipartisanship. Has he learned nothing, from his first year in office, and from yesterday's election in Massachusetts? No, no, he knows what's going on. But why does he insist on caving in to Republican demands? I understand that he isn't exactly the progressive saviour many of his more delusional supporters thought he would be, but surely he can fight back, surely he can stand up to Republican opposition and obstructionism.

But why isn't he?

Ezra Klein: "My preference is that House Democrats pass the Senate bill and then run their fixes through the reconciliation process." Or "Democrats could scrap the legislation and start over in the reconciliation process."

That alternative option is intriguing but risky. I think it's best to get it done as soon as possible, and that means going with the flawed Senate bill and then improving it later.

Jon Cohn has penned a "Dear Nervous and Frustrated House Democrat" letter:

You're depressed: Brown inherits the seat that once belonged to Ted Kennedy, who had made health care reform a lifelong crusade.

You're angry, either for taking politically difficult votes or compromising your ideals in order to move the process along.

And, let's face it, you’re scared. If a Democrat can lose in Massachusetts, any Democrat can lose anywhere. That includes you.

Now you have a choice.

The temptation will be to drop health care, change the subject, and hope for the best. After all, the voters clearly don't like what they're hearing and seeing out of Washington. And health care is all they've been hearing and seeing for the last few months. The polls suggest more people oppose the plan than support it. And the right wing is having a field day with it.

But is it the product the voters don't like -- or the process? Truth be told, most people don't even understand the basics of what this bill would do.

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Remember, Republicans will blame you for this bill anyway. Unless you're among the few Democrats who opposed it on the first go-round, you've already voted for health care reform. And you can bet the Republicans will let voters know that come November. You’ll be the representative who voted for that awful liberal boondoggle that, thankfully, the Senate blocked at the final stages of deliberation. Or maybe you want to explain to constituents why you were for health care reform before you were against it.

On the other hand, if you find a way to pass legislation, then you have something to show for your efforts -- an accomplishment you can tout, legitimately, as making people's lives better.

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[Y]ou can pass health care reform very quickly if you want. All you have to do is vote for the Senate bill, as written. Yes, I'm aware of its flaws. But it's also far better than nothing. (Heck, if you're a centrist, you may think the Senate bill is even better than the original House one.)

Once the main bill is passed, you can always revisit it -- perhaps right away, by passing a "patch" through the reconciliation process. If you're clever -- and you are -- you'll extract some sort of promise from the president and Senate leadership to make sure the patch gets enacted.

There you go. (Make sure to read the whole thing. It's really well done.)

Reconciliation should be on the table, but Brown's election, giving the Republicans 41 seats in the Senate, still a decisive minority, shouldn't change anything.

Admittedly, it will be quite difficult for Pelosi to keep her caucus together in the House, with some Democrats already saying they won't vote for the Senate bill, but why not try? After all, both the House and Senate have already passed reform legislation, and a serious effort to persuade more progressive House Democrats of the necessity of passing the Senate bill as is (as opposed to getting nothing done at all) could work. There is fear, understandably so, and that fear, along with panic, seems to be driving Democrats in different directions, and driving them crazy, threatening to tear them apart, but perhaps they'll end up coming to grips with the reality of the current political situation and what is in their own best interests.

But this means not just Pelosi and her lieutenants twisting arms, it means Obama taking an active role in getting this done. That means White House leadership. And that means filling up that gaping hole.

Cohn again: "[I]f health care reform is to be salvaged -- and, I'll be honest, I'm not terribly optimistic right now -- it will take something more. It's going to take the president showing the resolve and leadership that got him elected."

I want to believe, I really do, but I just can't, not with what I've seen from him so far.

With his leadership or not -- and we may learn something at the upcoming State of the Union -- there is still an opening for Democrats to pass historic health-care reform and to open the door for improvements down the road. Brown's election didn't change that.

Now it's time to get it done.