Health Insurance Bill or Not?

No less a flaming liberal than Paul Krugman has endorsed the healthcare reform act twice. Today he called it a major achievement. He then went on to warn about the fundamental dysfunction we are witnessing in the Senate. As he says, what should have been a straight-forward vote became a nail-biter because of a handful of Senators.

Forgive me folks, but I'm inclined to agree with him.

We were NEVER going to get anything like our heart's desire, some form of single-payer system, in the current political climate. This legislation is a whole lot less than I would have liked. It will be a huge give-away to the insurance industry. This bill was always going to be a piece of crap after going through the Congressional sausage mill. The only question was, how much of a piece of crap?

For the first time ever, the insurance industry will be regulated. It will lose its exemption from anti-trust laws. The insurance industry will be forbidden to discriminate against people because of pre-existing medical conditions. It will be forbidden to drop people when they become sick. Those are huge changes that will benefit millions of people. While the industry will always be looking for new ways to screw us over, the influx of huge numbers of newly covered people should drive down premiums substantially. Compared to a single payer system, these reforms are very modest and conservative. But let's remember that even these reforms were unthinkable for decades. They were out of the question as recently as a year ago.

There is always the risk that a Republican Congress will trash the whole thing. That's a risk with any legislation. There is also the possibility that this is a first step toward finally joining the civilized world on the issue of healthcare.

I believe that a little bit of something is always better than a whole lot of nothing. Those who take "all or nothing" positions on issues almost always get the second option unless they are backed up by an army.

UPDATE:
Princeton University Prof Paul Starr is on Brian Lehrer's show right now explaining the bill. He points out that the insurance industry is not at all happy about the bill. He explains that it will indeed be a huge transformation in health insurance that will add as many as 30 million people to the rolls of the insured. The Wall Street Journal editorial page this morning is very much opposed to the bill. I will link to the podcast as soon as it is posted.

And here is that broadcast.

FURTHER UPDATE:

Here is more of what Paul Krugman has to say:

Many progressives are deeply dismayed about the shortcomings of the Senate bill. And they should hold onto that feeling! History suggests that this reform will get much better over time — but only if people keep demanding improvements.

But I think my reaction to the bill’s apparently imminent passage is being shaped, in part, by memories of how it was, not long ago. Five years ago, after the 2004 election, I was devoting most of my efforts to an attempt to stop Social Security privatization. And it seemed likely to be yet another losing battle: all the wise heads, all the makers of conventional wisdom, were sure that Bush was going to get what he wanted, and that people like me were just boorish obstructionists unwilling to embrace change.
But Social Security survived. And here we are now with a reform that, for all its faults, is the biggest expansion of the social safety net since Medicare. That, in my book, counts as a big victory.