Jack & Jill Politics

It’s not a full-throated endorsement of the current Senate bill, but it is another voice in favor of taking what we can and working to make it better, which seems infinitely more reasonable and productive than scrapping everything and vaguely “starting over,” whatever that is supposed to mean.

Jacob Hacker is not “bought and paid for” by the insurance industry. He’s probably been the strongest, and most influential voice promoting the idea of a public option, so I urge everyone to read every sentence of the full article carefully. In the meantime, here’s an excerpt.

The public option was always a means to an end: real competition for insurers, an alternative for consumers to existing private plans that does not deny needed care or shift risks onto the vulnerable, the ability to provide affordable coverage over time. I thought it was the best means within our political grasp. It lay just beyond that grasp. Yet its demise–in this round–does not diminish the immediate necessity of those larger aims. And even without the public option, the bill that Congress passes and the President signs could move us substantially toward those goals.

As weak as it is in numerous areas, the Senate bill contains three vital reforms. First, it creates a new framework, the “exchange,” through which people who lack secure workplace coverage can obtain the same kind of group health insurance that workers in large companies take for granted. Second, it makes available hundreds of billions in federal help to allow people to buy coverage through the exchanges and through an expanded Medicaid program. Third, it places new regulations on private insurers that, if properly enforced, will reduce insurers’ ability to discriminate against the sick and to undermine the health security of Americans.

These are signal achievements, and they all would have been politically unthinkable just a few years ago.

Update: hattip to lamh32 who actually posted this in the Open Threads. Sorry I missed it!