Tuesday, September 01, 2009
Flip the calendar pages -- as they do in the old movies to show passage of time -- and stop at Nov. 2, 2010. That will be Election Day. How Congress handles health care reform will influence which party gets to party that night.
Democrats should remember that this is the only poll that really counts. The current mood swings on medical reform reflect the public's confusion, exposure to lies and genuine questions about what the final legislation will look like.
By Nov. 2, 2010, the reform, or lack thereof, will be clear to everyone. And the lies about how certain changes would play out will have been rendered toothless. That's why Democrats should forge ahead and do what they must to make coverage universal, contain costs and ensure a high quality of care.
And that's why foes of reform are in a frenzy to stop it now. Their strategy is to intimidate the politicians who are shaping health care legislation. That is done by spooking ordinary Americans, especially those with coverage, who think they have something to lose. People get worked up and start yelling at their elected officials. We've already seen would-be Republican compromisers run for cover and Democrats in swing districts get nervous.
On Nov. 2, 2010, voters will not be asking, "What's in it for me?" They'll already know.
And consider how voters would feel if there is well-designed health reform. The uninsured would be delighted, of course. But that newfound sense of security will have spread to Americans covered through a workplace: A lost job will no longer leave their families vulnerable in a medical crisis.
Older people will see that nothing they care about in Medicare has changed. They might even find themselves enjoying new benefits included in current legislation: a gradual phasing-out of the drug benefit's "doughnut hole" and no co-payments or deductibles for colonoscopies and other preventive-care screenings.
Employers may already observe their health-insurance premiums moderating, thanks to more efficient delivery of care. And their workers might have begun enjoying higher paychecks as the boss passes on those savings.
On Nov. 2, 2010, the big danger for Democrats would not be defending their health care reforms, even if passed without Republican votes. It would be not having passed reform at all.
Republican partisans fondly recall the Democratic bloodbath in the 1994 midterm election, after the Clinton health care proposals went down in flames. Other concerns played into that vote, but the killer for Democrats in the health care piece of it was the failure to reform, rather than what the reform would have done.
Failure is not an option for Democrats. But weakening reform's punch to draw lukewarm Republican support on legislation won't help them much, either. Case in point is the "public option," which special interests with a stake in the dysfunctional status quo want to strangle in the worst way.
The public option is designed to control health care costs -- essential to the profitability of American business and workers' raises. It would compel private insurers to spend more premium dollars on actually delivering health care. (And private competitors would force the public option to keep up on benefits.)
The public option is good policy, and you can count on this: Come Nov. 2, 2010, no one in Iowa or Arkansas is going to care two figs that workers not covered by their employers can choose a government-run health plan.
By then, the blather of summer 2009 will be dusty memories on YouTube. America will have fixed the health care mess or it will have not. That's what the voters will notice -- when their opinions on health care reform will politically matter.
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