Why We Are Hopeful and Hopeless About Health Care Reform

Barack Obama backing off (or maybe not?) the public option is either the death of health care reform or yet another of this month's distractions from what is actually still a very viable bill. We lay out both cases, below.

Why You Should Be Cautiously Optimistic About Health Care Reform

Because the "public option" is actually maybe more important symbolically than actually. Government subsidies, expansion of Medicare and Medicaid, and strict regulation of insurance companies would achieve most of the same goals, and gradual expansion of Medicare and Medicaid are just as much stalking horses for single-payer as a public option would be.

Additionally, the Town Hall debacles and bubbling revolt of the citizenry are largely smoke and mirrors. August is a news vacuum, and health care opponents provided a story to get us through the slowest month for political journalists. Most members of Congress will not change their votes based on what crazy people shouted at them in town halls.

Now. Politically, when everyone gets back to work, all the momentum is still in favor of something passing. As Ezra Klein describes the process here, things actually look pretty good. Something decent will pass the House, something will most likely pass the Senate, and then, in the conference committee, liberal Representatives and hopefully liberal Senators will hammer out a compromise. This compromise will also pass the House, and while there may be a lot of grandstanding in the Senate, the odds are still against a filibuster.

Why You Should Have Given Up Hope Already

What the hell are these "co-ops"? They don't exist. They are non-existent. No one can explain what they are or what they will do except that they will not be run by The Government and so they will not Kill Grandma.

Meanwhile the Democrat charged with getting something, anything out of the Senate Finance Committee is committed to keeping his girlfriend Chuck Grassley involved in the negotiations despite the fact that Grassley openly acknowledged that he would not actually vote for a bill that he himself crafted.

The longer the misinformation campaign drags on and the more Obama appears to repeat and internalize criticisms against liberal health care reform, the more public polls slowly turn against any reform at all.

It seems reasonable to believe that whatever passes will be so limited in scope and yet so much of a political headache that, once again, actual universal coverage of Americans will be kicked down the road for yet another generation.

And someone will probably actually shoot up a town hall by the time this fucking month ends.

In Conclusion

It depends on whether you will be dispirited by seemingly lackluster reforms or heartened by some small step toward joining the rest of the developed world.