If I had a functional voice, I would have laughed out loud at the conservatives this morning on This Week with George Stephanopolous. George Will and "Dishonest Jon" Kyl were both suggesting that it would be a bad idea, politically, for Senate Democrats to pass their health care bill because the latest polls show that it's unpopular (although just barely).
A couple of weeks ago, of course, and for the last many months that this issue has been debated, these same people were counseling that the polls meant nothing--because until the latest round of polling, health care reform has been extremely popular with the majority of the American people. The reasons that it's not today are simple--conservatives have never liked it, to a great extent because their spokespeople and pundits in the media have lied to them about what's in it. Democrats and independents continued to support it (and, I expect, still support the House version) because it includes a public option, which is the key to genuine competition and cost-cutting. Even after the public option went away but was replaced by a Medicare buy-in, the support remained. Only when both those elements went away did support collapse on the center and left.
So what's left is a bill that few people can love, except for the Senators voting for it and the insurance company execs who will profit from it. It's a bill that enshrines in the protection of law the idea that only private companies can provide health insurance, and everyone has to buy their products. Although there's some stricter regulation, in the long run the 31 million more customers (and government subsidies) the insurance industry picks up more than outweigh the inconvenience of having to, say, actually provide the health insurance they offer.
The right wing's hypocrisy is also amply illustrated by their insistence that the bill contain some sort of restriction on abortion. The fact is that abortion is a legal medical procedure, and any legislation making it more difficult is, in absolute terms, "the government coming between doctor and patient."
Still, while it's a long way from perfect, the Senate bill seems to contain some good things among the bad, and although in some respects it pains me to do so, I think I have to support its passage (I'd like to think it'll be improved in conference with the House, which produced a much better bill, but I think the problem remains the same--an improved bill won't pass through the recalcitrant conservative Dems, and the Lieber Man, in the Senate).
But it's a framework upon which much can be built. If it fails, then we'll go another generation with the certainty that health care reform is politically impossible. If it fails, then the Democrats will take their (rightful) lumps as being unable to govern, even with 60 votes in the Senate. And it won't come back up for a very long time, during which countless millions more will die and declare bankruptcy and otherwise have their lives ruined by a health care system that's by far the most expensive in the world.
With this framework in place, though, a kind of warning shot will have been fired over the bow of the insurance companies. We're willing to work with you, it says--but you have to understand that you'll be regulated. If you continue to play fast and loose with the lives of your customers, that regulation will be tightened, as it has been, say, with tobacco companies. We'll be fiddling with the mechanics, trying to make it right, rather than starting from scratch. If insurance companies still fail to come through, a public option added to this new framework will seem less radical.
It's still a long way to single payer from here. But it's moving in the right direction. I'd hate to see that movement shot down now. If this passes and becomes popular with the people, then further reform becomes that much easier.
UPDATE: It also occurs to me that, while there might be some short-term political fallout for passing this flawed bill on a strict party-line vote, what it really illustrates is that to actually govern, a majority needs to have more than 60 votes. If the Senate had 65 or 66 Democrats, then the conservative handful couldn't have blocked real reform. With 60, each Democrat has too much individual power, so a Nelson or a Lieberman can prevent progress. Throwing some Dems out of office will only bring back absolute gridlock--what we need to do is throw some obstructionist Republicans out and elect enough Dems to marginalize the votes of the few who vote like Republicans.