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Posted by on Sep 7, 2009 in Economy, Health, Politics, Society | 5 comments

Is Half a Loaf Better Than None?

That is essentially the question Josh Marshall asks about health care reform. And the answer is, when it comes to health care reform, half a loaf may well be worse than none:

In light of Max Baucus’ now circulating health care bill, Josh Marshall asks if he is “the only one who thinks that if the Dems pass a bill with mandates and subsidies for poor and moderate income people to purchase it but no public option or competition with the insurers, that it will be pretty much a catastrophe for the Democrats in political terms?”

As it so happens, he is not the only person who thinks this will be a catastrophe for the Democrats. As he notes, this kind of half-reform leaves Democrats in the worst possible position; it forces poor and moderate income people to purchase still-expensive insurance without providing adequate subsidies or substantively regulating the insurance market. A plan this timid would rightly be perceived by most Americans as burdensome and inefficient, and voters will respond accordingly in next year’s elections.

As I’ve said many – many – times, congressional Democrats need to realize that their electoral fortunes are tied directly to passing good legislation.  Not only will voters like and respect the party that passes effective health care reform, but Republicans will be completely discredited when health care reform passes and a year from now the United States hasn’t slipped into a commie/socialist/fascist totalitarian dictatorship. Rick Perlstein describes programs like Social Security and Medicare as efforts that created more Democrats, and if the party leadership really is interested in building a durable, long-term majority, it needs to remember that successful legislation leads to successful parties, and vice versa.

Ironically, the inability shown by the please-Republicans-at-all-costs faction in the White House to take this long-term view mirrors the seeming inability of many Republicans to see beyond the immediate costs of a robust public option:

The talking heads and the right wing still don’t admit that we all pay for lousy health care in the end. We pay hugely in lost wages, in lost lives, and in absurd last minute emergency care for trivial, manageable, chronic illnesses. We pay at the end, but as always we could save money and improve lives by agreeing to pay up front and at the start. It is essentially the same debate we have about Public Education vs Imprisonment. People who get a good public education and have good job prospects seldom end up in Prison. A year of Prison costs much more than a year at Harvard. And yet we can’t, as a society, bring ourselves to pay the money up front to improve lives–that would be socialism, or charity, or something. We are only willing, and that grudingly, to pay to punish people. The fact that the money is fungible and all comes from the same source, the taxpayer’s pocket, seems lost on our public discourse.

TMV’s very own, very valued commenter, Ron Beasley, thinks we are better off with no bill than with a bad bill:

The health care crisis in this country is going to have to get even worse and it will before legislators are forced to reform it.  [Matt] Taibbi concludes that it will take a revolution and we are to blame for it not occurring this time around.

Then again, some of the blame has to go to all of us. It’s more than a little conspicuous that the same electorate that poured its heart out last year for the Hallmark-card story line of the Obama campaign has not been seen much in this health care debate. The handful of legislators — the Weiners, Kuciniches, Wydens and Sanderses — who are fighting for something real should be doing so with armies at their back. Instead, all the noise is being made on the other side. Not so stupid after all — they, at least, understand that politics is a fight that does not end with the wearing of a T-shirt in November.

So we would be better off with no health care bill at all now.  The train wreck will only get worse and at some point the legislators will be forced to act.