Quote of the Day: Andrew Sullivan on Obama and health-care reform

By Michael J.W. Stickings

From The Times:

I remain convinced Obama will win this fight. Not totally; not without political cost; but win it he shall. And the strategy is really very simple. The most popular elements of the bill will be kept in and the most contentious left out.

The fundamental issue of costs will be deferred. A bill that prevents insurance companies from denying coverage to people with pre-existing illnesses; that creates healthcare exchanges, where people can buy their own insurance policy subsidised by the government; that brings agreed price reductions by the drug companies in return for all these new, previously uninsured clients: this will pass and be popular. How could it not? The option of a government-run insurance plan to compete with private ones will be either dispensed with or held in reserve. If, after a few years, health costs keep soaring and the private companies have not mended their free-spending ways, it could be brought back.

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So, tactically, Obama is on the defensive. Strategically? Again, he is stronger than he now appears. When the health insurance bill is passed and elderly Americans are not rounded up into concentration camps and granny isn't subjected to euthanasia, and when many uninsured people gain a peace of mind they have never felt before, and people become able to change job without fearing loss of insurance, the Republican scare tactics may come to seem absurd.

Well, the Republican lies are absurd, we know that already, but they likely will "come to seem absurd" to more and more people as time goes on. Overall, while I continue to stress that a public option ought to be an essential element of any reform package (and while Josh Marshall may be right, even through hyperbole, that a bill with "no public option or competition with the insurers" would be "pretty much a catastrophe for the Democrats in political terms"), I think that Sullivan's prediction makes a lot of sense. Even if we don't get quite what we want, namely, a robust public option, there is still the possibility that a compromise package (with the "most popular elements"), if passed, would be the thin end of the wedge leading to additional reform down the road.

This, I suppose, is my fall-back position, and I think it's one we need to prepare ourselves for. Obama still ought to push for a robust public option, as he may in his speech this week (and may behind close doors, attempting to pull Democrats together), and I still think Democrats ought to consider going it fully alone on reform (or with one or two Republicans), even with less than 60 votes in the Senate, but some reform may be better than no reform if the reform that is actually passed addresses some of the most pressing problems of the current system -- such as the huge numbers of uninsured and inadequately insured -- in a serious and meaningful way.

Okay, I sound like I'm backing down. I'm not. The fight for reform needs to continue. But there is nonetheless the possibility that Obama retains "a strategic cunning," in Sullivan's words, that will actually lead to more substantial change over the long haul.