Democratic Senate Majority Leader Harry Reid announced last night that he is ready to bring a health care reform bill to the Senate floor for debate as early as Saturday (November 21). This can only mean that Reid thinks he has the 60 votes needed to block a Republican filibuster against introducing the bill.
While we do not yet know the horse-trading needed to get all 60 members of the Democratic caucus to support the bill, it's probably safe to say that Progressives will be disappointed. There is still talk among some Progressives of withdrawing support for the bill entirely; so far does the bill depart from their vision of what true progressive health reform should be.
While the bill may not contain everything, or even much of what we would like, I believe it deserves our support. As the Happy Warrior, Hubert Humphrey himself said, "If you can't get a whole loaf, take half a loaf."
Just don't give us crumbs. We can always go back later for improvements, for more of the loaf. But if the bill fails, it may take another 15 years before we can go back to the table at all.
That brings up a subject that deserves more discussion than it has gotten so far: what will happen if health care reform fails in the Senate (or, later, in the full Congress)?
Advocates for health care reform point out how inefficient, costly, and unfair the current system is, and point to those problems as reasons enough to effect change.
Opponents fixate on the cost of reform, on hot-button labels like socialism, and on outright lies (death panels, government takeover, etc.) They seem to hope that if health care fails, the status quo will somehow be restored, their money will not be spent on somebody else's care, and everything will get back to normal.
They may not especially like that "normal" -- with 46 million Americans uninsured, 45,000 deaths a year, twice-inflation premium increases, denial of coverages, and more -- but it's a normal they know and understand.
There is a big surprise in store for those people, and it will not be a surprise they like: Whatever else happens, the status quo is not coming back.
If health reform fails, within five years, I believe we will all look back on the last decade in health care as "the good old days."
And Democrats will get the lion's share of the blame in 2010 and 2012 for failing to pass health care reform legislation in 2009.
If health reform fails, I think we will see dramatic increases in health insurance premiums starting in 2010. "Health insurances prices were going to go up anyway," opponents will say. "Prices always go up. We expected that."
Not like this. Here's why. The health insurance lobby has spent hundreds of millions of dollars trying to defeat health care reform. If they succeed, they will want to get their money back fast. And they will get it back -- from you.
That's not all. All this talk about reform has increased the systematic risk of being in the health insurance business. And that is risk for which companies demand to be paid. After all, most health insurance companies are not in the health care business; they are in the insurance business. They get paid to produce healthy balance sheets, not healthy people.
Premiums will zoom out of control for still another reason: insurance companies will raise prices because they can; because our Congress members let them. If the measures that would control industry revenues and profits -- including a robust public option -- are defeated, then there will be no competitive control, and little statutory control, on insurance company revenues and profits for the foreseeable future.