Health Care: Make the Deal!

President Obama has signaled to the leaders of Congress that they should do what it takes to close the deal with moderate Senators on health care reform. Already this has meant throwing the public option overboard. A group of ten senators – five liberals and five moderates – crafted a compromise last week that ditched the public option but gave liberals some satisfaction by permitting a buy-in to Medicare for those over 55 who can’t get coverage elsewhere. The buy-in, too, appears to be on the chopping block now.

The President is right to push for a deal. The public option always has enjoyed more comment and concern than it deserved, a useful tool to drive down costs but not really a meaningful step towards a single-payer plan. The Medicare buy-in, on the other hand, is really a good idea. Democrats should let is go to pass the current bill, and then immediately begin campaigning on “Medicare for All.” Call it a reform of the reform. Make it a central part of their campaign for next year’s midterms. But, don’t let it get in the way of a deal now.

What Democrats can’t lose sight of is that they agree 100 % with about 90% of the bill. There are insurance reforms that constituents will surely like, such as ending the practice of denying coverage for pre-existing conditions. There are new ways for people to find affordable coverage. Most of all, there is the essential change in the social contract: The minute President Obama signs the bill, American citizens will now that health care is not a privilege for some but a right for all. Yes, yes, many of the provisions do not kick in right away. But the earth will have moved nonetheless and health care will increasingly look like Social Security, a part of the social safety net that not even the staunchest conservative can dare touch.

Of course, there is as yet no compromise on federal funding for abortion. Here the issue is one of principle: No one is waiting for the Congressional Budget Office to “score” the Stupak amendment. It is a shame that these other concessions to moderates make it less likely the Senate will adopt Stupak. Federal funding for abortion really will hurt the Democrats in the long run as key swing voters conclude that all that talk about finding common ground was nothing but talk.

Everything else should be negotiated, deals should be made, and the House and Senate leaders should do what it takes to pass a bill. No Congress has gotten this far before. Seven presidents have tried to pass universal health care, and none have succeeded. If President Obama signs a health care bill, no one will remember the ugly negotiations it took to get us a bill. They will know that history has been made. And, the Democrats in Congress need to make some history or they are looking at a dismal showing in next year’s midterm elections.