Thursday, October 29, 2009

Will we be Health Care Reform's unwitting assassins?

(I'm going to tempt fate by doing some speculating about what will happen once Obama signs the HCR bill into law. May the gods forgive me.)

While there are still details to be worked out, the final form of Health Care Reform has come into focus. The public option is almost certainly going to be an opt-out, trigger-free, negotiated rates system that will be available realistically only to those who aren't already covered. We can wail and moan about this, but all of that is pretty much wasted breath at this point.

There will be floor amendments (all of which will fail). There will be reconciliation (which will could possible have some additional teeth grinding compromises). We should continue to fight for further reform in the final package (lightning can still strike). But what we will get in the end is no longer much of a mystery.

What we cannot do is let our disappointment stand in the way of defending the final bill. That is precisely what the opponents of HCR want.

The propaganda war that is coming will make the last few months seem like a small skirmish. You and I both know that the opponents of HCR (and the PO in particular) are already cranking up their machines to try and paint the worst picture possible of the enactment and execution of this bill. We cannot let them succeed, even if means defending what we consider to be a poor bill.

For example, we all know that the PO is only going to be available to a limited number of people. A lot of people outside the debate don't know this, but they will become aware of it soon enough when they ask their Human Resources rep what they need to do to switch.

When they find out that they can't, there is going to be a lot of outrage. And when the limited PO does not produce any great savings in insurance costs (as even its proponents expect), the propaganda machine will point at this and say, "See! We told you it wouldn't work!"

The worst thing we could do at that point is agree. We must not give their position weight. If they manage to convince the public that the public option is bad, it will die and will set back our efforts by another couple of decades.

We must be prepared to argue that the PO's weaknesses are entirely because it was hobbled from the beginning (suggested image: a horse leaving the gates with three of its legs chained to iron balls). We must be prepared to use the inevitable complaints about limited access to push for Wyden's proposal (or one like it) to open the exchanges to ALL Americans.

We must not let our bitterness over the limited nature of this reform get in the way of using it as the foundation for more profound reform down the road. We must not let our anger become our opponents greatest weapon.

Once Obama signs this bill, the fights of the last few months are over. The fights to come are waiting for us. Will we be ready for them?


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