Towards a more perfect health-care reform bill

By Michael J.W. Stickings

It's been a long day, it was a terrible Steelers loss in Kansas City, I had a bit too much sake with dinner, and I just haven't been in the mood to blog.

Still, at this late hour, let me quote Sen. Jeanne Shaheen (D-NH), from Sunday's State of the Union on CNN:

Listen, in the end, this is going to be a compromise. It's not going to be a perfect bill, but it's going to be a very important starting point.

I keep going back and forth on this, as I have for a long time now. Compromise is inevitable. Democrats can't pass health-care reform on their own. Or, rather, they can, if you include Joe Lieberman (which you shouldn't), it's just that they're divided. Or, rather, they're not, not really A huge majority of Democrats in both the House and Senate support reform with at least a fairly robust public option. It's just that in the Senate they need 60 votes to override a Republican filibuster and a few of them aren't on board. Which means that, when it comes right down to it, a small group of Democratic centrists hold the key to reform -- notably Ben Nelson, Mary Landrieu, and Blanche Lincoln. And, unless Harry Reid wants to use reconciliation to bring reform to a vote on the floor, the only way to bring them on board, and the pass reform, is to appease them. And it seems that the only way to appease them will be to water down, or kill, the public option.

Here's the thing, personally speaking: I prefer more reform (a bill with a robust public option) to less reform (a bill with no public option), but I also prefer some reform (including a compromise bill with no public option) to no reform at all (or to Republican-style reform, which would amount to an entrenching of the status quo).

So, the question is, how much compromise am I -- are we -- willing to put up with? How much is too much? How far is too far?

"We are open because we want to pass the bill," said Sen. Dick Durbin (D-IL). Okay, but how open? What are you willing to accept?

Ultimately, I suppose -- and I say this reluctantly -- Shaheen is right. Better an imperfect bill that would be, as I have been putting it, the thin end of the wedge leading to further reform down the road, than no bill. And that means, perhaps, no public option, or perhaps a trigger, or something else to appaese the centrists. In the end, it will still be an historic effort, a breakthrough, genuine reform for the better.

But no, not yet. If it comes to that, we may very well have to accept a compromise that we otherwise oppose. In the meantime, it's essential to keep fighting for more rather than less reform.

It's not too late, after all, for Congress to do what's right.