Freedom is slavery, health is insurance: the metabenefits of a bad bill

(To my "regular" "readers": I am writing this blog post in response to multiple brous-haha around the interwebs into which I may have dipped more than just my little tippy-toe on the matter of health care.  It was written at the suggestion of ex cob logger Ian Welsh as a substitute for taking my frustrations out on his impudent commentariat. Don't expect this blog to stop going Billmon after this any time soon, especially since the Noo Typepad now suXX0rz.  Next time you see me blog, it will be on Wordpress or something non-annoying that does not make my browser cry bitter Javascript tears.  But at least thunderpants will be happy that I've satisfied his demand.)

I thought I'd write a long song-and-dance about my opinion on the US health care reform effort, but then I realized that not only would it be highly susceptible to the worst sort of nitpickulation, it would also be better summarized as a table.  Well, at this point in time, there are two legislative options: no bill, or a bad bill.  Here's my assessment of the relative likelihood of good, bad, and ugly outcomes of both options:

	Long-term outcome likelihood
	Good	Bad	Ugly
No bill	Nonexistent	Reasonable	High
Bad bill	Very Low	Reasonable	High

So, as you can see, I've done the math and I think it's better to pass a bad bill rather than no bill. A bad bill has a chance of defeating at least one pernicious meme: that no Congress or administration can alter US health care delivery systems, which are wholly broken. 

I will not get into Nate Silverian attempts at defending anything about the bill as it stands.  It's a terrible bill.  It is completely bone-headed not to simply expropriate the "health" "insurance" "industry" wholesale and immediately institute a Canuckistani single-payer system.  Anything that doesn't lead to this outcome is a lie.  However, if I had a dollar for all the political lies and terrible ideas we have to tolerate, I'd be Warren Buffett.  Am I Warren Buffett?

Nevertheless, the bill should pass.  The only condition under which I would take this statement back is if there is any chance that there are legislators who are willing to scuttle this turkey who also have the wherewithal to bring about a better bill---one that eventually eliminates the desurance industry.  Since this has a hellball's chance in snow, it's better for all the other people who think that they'd rather have no bill to fix that problem---that they have no effective progressive representation in Congress, or that they have no leverage either way---than engage in perverse quests to leave the effort with nothing.

Comments

[Paul Lukasiak]

your conclusion is based on the assumption that nothing good can come out of not passing a bill at this point. I dispute that assumption.
_
if we pass nothing, we maintain the option of trying again in the near future. The public demand for change will still exist, and the biggest impediment to effective change will be the 'optics' -- Democrats will have to somehow convince the electorate that it was GOP obstructionism that defeated the bill, and make a 2010 midterms a referendum on health care reform, laying out a clear, detailed, and unequivocal platform for health care reform that they promise to pass in 2011.
_
But if this bill passes, all the steam goes out of the demand for health care reform -- especially since the provisions of the bill don't really go into effect until 2013 -- Dems and Obama will wind up campaigning on their "success" with the GOP able to campaign against what is a truly horrible bill. The best outcome of a "bad" bill is the status quo for at least 5-6 years, the most likely outcome is that the GOP is empowered to strip the most crucial parts of the bill from it prior to 2013 (the subsidies) leaving a complete mess that benefits no one but the health insurers and big Pharma.

[Mandos]

If the bill fails, the Beltway CW will be that the Obama health reform effort has been "Clintoned", and it will be touted as the second Democratic health reform failure there is. In 2010, the Republicans will use this clown show as evidence for the incompetence of Democrats to handle the issue. If they win, you will see tort reform on the agenda in 2011. The Democrats will not campaign on blaming the Republicans for the failure of the effort, as that would be absurd, as the Republicans do not have the votes to block anything at this point.

The Democrats will not campaign on health reform at all in 2010, if no bill is passed now. It will have become poison. You are dreaming in technicolor if you think that defeating a bad bill will somehow punish the Democrats into behaving in a way you like. Progressives will be blamed and cast out.

And if the bill fails but the Democrats are still able to hold onto Congress in 2010, you can bet that they won't have it on the agenda in 2010. You will have to wait at least until 2013 or 2014 for the issue to return in any sense. At that point, the agenda will be attempting to return to the 2009 status quo from whatever further degeneration has occurred by 2013.

Passing a bill makes it seem as though it were possible to pass a bill, where once it was thought impossible.

[Helena]

Once the news of the individual mandates sinks into the public's mind, the Dems will pay at the ballot box, which is what Rahm Emanuel and the WH is trying to avoid by throwing away the public option, the Medicare buy in, and all the contortions made in order to get any bill passed, no matter how bad. How fatally flawed is the thinking here.

[Helena]

Actually, I hope the bill does pass for one reason. The consequences to the public stemming from it may at last mobilize an angry citizenry to raze the entire structure and form a new one.

[ifthethunderdontgetya™³²®©]

POSTS!!!11one!
~

[Mandos]

Yeah, see, I knew you'd be excited.

[Rob]

You're right. Health is insurance. But we have to extra cautious too.
Rob@Insurance Agent Forum