When Compromise Is Necessary, And Sufficient

As the Senate winds up (winds down?) its work on health reform, any legislation that it might pass will be the result of a number of compromises; or as some critics would have it, a series of cave-ins and capitulations that have led to submission, succumbing and surrender.

We all know that Sens. Joe Lieberman (Conn.) and Ben Nelson (Neb.) have been successful in amending the legislation to their own particular needs. Unless you have just returned from a trip to Mars, you know that the public option is dead, a Medicare opt-in for those ages 55-64 is dead, a prohibition against annual medical limits may be dead, etc, etc.

And here’s Brian Williams from NBC Nightly News on a possible liberal revolt: “Even friends of the President, those most loyal to him, fear that the healthcare reform bill he wanted so badly has been pecked to death, and picked apart, watered down, and in the end, will be something nobody really wants.”

Really? I have been writing about health care for more than 25 years, and the health reform bill currently in the Senate represents, as Paul Krugman of the New York Times recently wrote, “the biggest expansion of the social safety net since Medicare, greatly improving the lives of millions. Getting this bill would be much, much better than watching health care reform fail.”

And here is Mr. Krugman on the perils of refusing to compromise: “Not to put too fine a point on it, America would be in much better shape today if Democrats had cut a deal on health care with Richard Nixon, or if Bill Clinton had cut a deal with moderate Republicans back when they still existed.”

The Senate is one or two Senators and one or two days away from agreeing to the following:

• covering 33 million more Americans,


• prohibiting preexisting conditions,


• limiting insurers’ profits,


• providing substantial tax breaks to small employers to help them provide health insurance,


• providing financial aid to other individuals without access to employer-provided insurance,


• establishing standards of health care coverage for all qualified plans


• providing long term care options to all Americans.

Republicans understand, possibly better than do the Democrats, that the opportunity for health reform will not come again for decades, and the unanimous Republican opposition to health reform has played well against increasingly fractured Democratic concerns.

What is before the Senate is real change in health care in the United States, and it’s now or (maybe) never.