Dave Weigel, one of my blog favorites, titles his post on left-wing health care defectors thus: "Kucinich to Vote with Republicans on Health Care." It's not just Kucinich, either--Eric Massa, Democrat of New York, is joining him, as they both did before. Technically, they are voting with the Republicans on this issue, but for opposite objectives, and only one of these groups is acting rationally. Hint: it's not the GOP.
In fact, the Republicans' cynicism will catch up with them if they are indeed successful in killing off Obama's health care plan. It seems clear to me that Republican opposition to Obama is more about personality and identity than about policy, and while there are certainly things in the HCR bill that Republicans wouldn't like, the end game it sets up is one they should. I'm absolutely positive that there are only two plausible paths for health care in America to follow: it can either go the way of managed competition (a la Wyden-Bennett), or it can go the way of single-payer in everything but name. There might be some pushback on the latter option, but I definitely think it will be on the table in the future. While the term "single-payer" is extremely unpopular term, the actual concept appears to poll considerably better when the term isn't applied, and I suspect that terminology will matter less if the amount of uninsured doubles over the next decade. I don't really know how the employer-based insurance system will finally unravel, but it has been unraveling for some time now, and it will continue to do so. Health care costs will continue to rise, companies will drop their insurance plans, and many of those people will struggle to afford anything on the individual market as it is now. The end result will invariably be a huge uptick in the amount of the uninsured, lots more deaths, and a demand for real action far more radical than anything in the current bill. And when this happens, Democrats will be able to say, "I told you so," blame Republicans for spreading lies and keeping them from fixing the problem before, and the public will put the Democrats in charge to fix things. And the history of America is such that these sorts of problems are almost always ameliorated by direct government assistance.
Out of all the obstacles to passing real health care reform, perhaps the biggest one has been that there isn't enough of a public will to get it done. We can talk for some time about whether it was the White House's only intermittently compelling message or the GOP's supreme cynicism that dropped support for the measure, whether it was poor process management from Democratic leaders or the hyperpartisan GOP that bears the blame for making the public become more sour about the process, or whether it was all of this plus a bunch of bad luck and random flukes, like Martha Coakley's utter patheticness. But I think the real reason is that not enough people really feel the need for reform yet. After all, the groups that stand to benefit the most from health care reform--young people, minorities, and the poor--still heavily support reform. They don't need to be sold on it, and they understand the stakes. Unfortunately, they don't make for a majority of the public at this point. If the next decade turns out to be the decade when our health care system (for lack of a better term) finally collapses, and middle-class people start losing their health insurance, the situation will change rapidly.
What HCR does is put us on the path toward Wyden-Bennett. If the bill passes, within a decade or two the status quo will be indistinguishable from Wyden-Bennett. The left realizes this acutely and has decided to oppose this version of reform because they assume--correctly, in my opinion--that they'll be situated to do something more radical in the future if HCR fails. I think that this sort of thinking is deeply wrongheaded and hypocritical for people who no doubt trade on the tragedy caused by the current system as a basis for reform and then reject reform if it doesn't meet their ideological notions, but they are ideologues, which has more to do with it I suppose. But at least they're seeing the situation clearly. Republicans are not taking yes for an answer solely out of political and personality-based reasons (they don't want to give Obama a win), while they bash a "government takeover" of health care that simply doesn't exist. Of course, their short-sighted tactics are going to make that much-hated government takeover inevitable, and the people being celebrated by the right today for their ability to derail HCR will likely not be remembered as heroes in the long term. I'm not altogether convinced that HCR is dead, in large part because the Democratic leadership hasn't given up on it yet, but if it does it's going to be far worse for the right in the long run.
