Not Worth It?

December 15, 2009 7:17 a.m.

There’s a rising chorus of progressive Democrats saying: with the bill so denuded and watered down it’s better to scrap the whole thing and try for real reform at a later date. In other words, no bill is better than the bill on offer now. But there’s a different pattern that I’ve seen over the past months.

I know a lot of people who’ve followed health care reform issues for years from the progressive side. And from what I can tell very few of these people feel this way. That’s not to say they aren’t very disappointed that various key policies likely won’t be included. Half a steak is always a big let down when you thought you might get the whole steak. But there seems to be a clear correlation between people who have followed health care policy closely for years (and know it inside and out) and those who think that even the scaled down reform bill is very worth passing. I wouldn’t say that I have a stronger grasp of the policy implications than most of the folks in the “Burn It Down” camp. But most of the arguments I hear from them some down to sloganeering with a weak grasp of the mechanics of the bill.

The one thing that’s not as clear to me is whether the health care policy experts have a clear read on the politics. In other words, how do mandates play politically absent stronger cost control? That’s a good question that I don’t necessarily expect the policy wonks to have a good read on. On the other hand, I’m confident that scraping the process now would likely be catastrophic for the Democrats.

But on the substance, that pattern has been the most revealing and important to me in terms of making sense of the pros and cons of the bill.

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