Is Health Care Reform Still Progressive?
Eleven months ago, in the midst of a Category 5 economic hurricane, President Barack Obama, Congress and progressive leaders embarked on an improbable quest to pass comprehensive health insurance. The goal was to provide coverage to tens of millions of Americans, health care stability to the middle class, cut costs to business and individuals, and, don’t forget, reduce the federal deficit without raising taxes on average Americans.[IMGCAP(1)] On Thursday, the United States Senate will vote on a bill that, miraculously, does just that. The House has already acted. And yet, on blog posts, op-ed pages and in Congress, many progressives seem absolutely miserable. Why?It stems from the demise of the public insurance option and the feeling among many progressives that with its omission, Congress traded away core progressive principles to get a health care deal. The debate over the public option was, indeed, very public and very intense. No doubt, the decision to drop it from the Senate bill was to get to the magic 60 number on votes. But the final horse-trading over the public option should not obscure the fact that this bill is a breathtaking accomplishment that is anchored by, and advances, three vital progressive values.Taking care of the vulnerable. Reform will erase the moral stain that comes from leaving tens of millions without health insurance. The bill will extend coverage to more than 30 million Americans, roughly 90 percent of the uninsured citizen population. It dramatically expands Medicaid to cover millions of low-income adults. It gives billions of dollars in subsidies to low- and middle-income families so they can purchase insurance that they can afford. No longer will a run of bad economic luck, a loss of a job, a divorce or a death in the family mean the loss of coverage.Protecting the middle class. Health reform will provide stability, security and peace of mind to the middle class through sweeping and unprecedented regulation of the insurance industry. No longer will a pre-existing condition be the basis for denial of coverage or a premium increase. A catastrophic illness will no longer mean a catastrophic bill because of a benefit cap on costs. A car accident, a lump on a breast, a child with cystic fibrosis may cause personal and emotional anguish, but not financial ruin or the loss of economic freedom. Starting a business will no longer mean scrambling for overpriced and underwhelming health care. Working at a small company will no longer mean paying much more for the same product than those who work for big companies.Making the health care system sustainable. For 75 years, progressives have fought to cover those without insurance, but over the years our health care system has become so broken and expensive that it is ultimately unsustainable. Health reform will wring waste out of the health care delivery system and take strides toward replacing the broking fee-for-service system with one that pays for quality and outcomes, not just volume. It will end the travesty whereby America spends more on health care per person than any other industrialized country yet has little to show for it. It will reduce the shocking geographic and racial disparities in the health of our people. It will substantially reduce runaway health care inflation that threatens our economy, chokes down wages and sends jobs overseas. On top of all this, we shouldn’t forget that these reforms will be achieved without raising middle-class taxes or adding to the federal debt. What could be more progressive?Public opinion polls are beginning to show a dangerous slide in support for health reform, and we are perilously close to a tipping point at which we won’t be able to win back hearts and minds to the cause of meaningful reform. No achievement of this size and impact will be perfect, but the longer progressives spend on attacking what’s not in the package, the less attention will be paid to what it actually contains. And that would be a shame, because the impact of what is in front of us would be as sweeping and beneficial on American society as the passage of Social Security in 1936 and Medicare in 1965.Almost one year after the start of this impossible march, it is time for the entire progressive movement to not only support this legislation but to celebrate it as one of the great achievements of our time.Jim Kessler is vice president, Anne Kim is economic program director and Jon Cowan is president of Third Way.