HuffPo (Cesca) - Offers Rage Plus *Gasp* A Bit Of Constructive Thought Re Health Reform

While I clearly empathize with the dominant sense of rage spreading throughout the progressive movement right now, we've always taken pride in our ability to grasp the objective reality of both policy and politics. And the objective reality of this conundrum is that if health care reform dies here, it won't be back anytime soon.

I don't need to tell you that we've been outflanked on health care reform and so the whole affair has been tainted with the foul stink of compromise and bad faith, with someone as universally despised as Joe Lieberman absconding off with the smoking gun -- grinning from ear-to-ear across that jowly pie plate of his. That's what it feels like right now, and suggesting that it's an unpleasant sensation is vastly understating the rage.

Yet I can't help but to believe that killing reform will only heap an even larger failure on top of losing the public option, the Medicare buy-in and so forth. Only this time, it won't be a failure limited to an ideological or political routing. The failure of health care reform will invariably mean at least another decade (if not two decades) of a desperate health care system in crisis. Another decade or two of medical bankruptcies and deaths due to a lack of insurance -- exponential premium hikes and rescissions. You know the list.

If I stop being pissed off long enough to take a good look at what remains in both the Senate and House bills, there aren't necessarily fool-proof solutions to these problems, but there are regulations, subsidies and reforms that will ameliorate a significant chunk of the present crisis. For example, the Senate bill will reduce the cost of insurance for a family of four earning $54,000 from around $19,000 per year to around $9,000 per year.

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At what point, and how many years from now will there be another center-left president with a Democratic quasi-supermajority in Congress? Certainly not after next year's midterms. But imagine the perfect storm happening again down the road. History has proved that health care reform is always weaker after a failed effort. So we start there. Then where to? The centrist Finance Committee? More watering down of the legislation? It's 2009 all over again, only weaker. Suffice to say, I can't imagine anything resembling Medicare for All being passed without an intervening health care reform bill.

America has always been governed by incrementalism, and health care reform is no exception. Health care reform was always going to be a work in progress -- we're just going to have to work a little harder to make up for a lack of a public option and the Medicare expansion.

Maybe our anger would be better channeled into fixing the bill than killing it. Amendments can be attached to budget bills and war spending supplementals. If you recall, the Wellstone amendment, forcing insurance companies to cover mental health, was passed in the stimulus bill last February. And there's no reason why the Democrats couldn't bring up the public option and Medicare buy-in as its own reconciliation bill. But SHH! Don't tell Joe Lieberman.