Why Progressives Should Embrace Reform

The biggest problem for healthcare reform advocates has been that there was no actual plan, as the whole thing was in flux and anything could change.  So we had nothing to defend.  Meanwhile, opponents could cite anything they wanted, from a vague passage being debated to something they invented in their fevered imaginations, and insist that this was a deal breaker that should stop the discussion immediately.

And so reform was easy to attack and impossible to defend.  But, that's just the nature of the beast, and no, it wouldn't have helped if Obama had brought down a plan from Mount Sinai and attempted to do whatever it is progressives think Bush did to strong-arm things when he was in office.  Because Bush spent all his political capital pushing popular bills through Congress, like war and taxcuts, while his unpopular privatization scheme completely derailed his presidency.  As it turns out, getting things done in Congress is difficult.

But now that we've got a good idea what we're getting and Obama's got something to sell, it really looks like we're going to get it.  I'm not sure how many comebacks Obama gets before people realize that he's really quite good at this sort of thing, but it's obvious the man has a bit more magic than his critics give him credit for and I can't figure out why anyone ever doubts him. 

Why Progressives Hate It

And yet, there are still reform holdouts on the liberal side.  And I've had the hardest time figuring out why, because they so rarely will explain why they're holding out.  They'd typically complain about the shittiness of the bill because it lacked a public option, and rarely articulated their specific complaints beyond the generic "It's a Republican bill that subsidizes bastard insurers," as if that was some self-evident point that settled everything.

And I finally found an opponent willing to lay it all out.  A Washington Monthly commenter named Tlaloc has been hasselling us reform supporters, insisting that we're all lying douchebags when we say that reform will end rescission, control premiums, end annual/lifetime caps, and prevent insurers from denying coverage for pre-existing conditions.  But he'd never explain why, though he imagined he did, because he'd complain about the lack of a public option.

Well, I finally got him to explain himself, in a comment you can read here.  But you needn't bother, as it's a long way of saying: These new regulations are worthless because there's no enforcement mechanism, and therefore, insurers will continue to do what they've always been doing, no matter what the regulations say.  Meanwhile, we'll all be forced to get insurance, so they'll get rich while we all get sicker.  So without a public option, this is worse than before.

And that's an awesome paraphrase and the guy could do no better than to quote that the next time he wants to complain about reform, as it's far superior to the "You're all lying douchebags" comments he usually hurls at us.  Because, for all of his complaining about how there are no new rules, his real complaint was that there was no way to enforce the new rules, so they didn't really count.  But...that's because he didn't understand one of the biggest pieces of the reform: Insurance Exchanges.

Insurance Exchanges

You see, insurance exchanges will change everything.  Because if the insurers break these rules, they don't get to sell in the exchange.  And people will only buy insurance that's sold in the exchanges, because it will always be better than anything they'd get outside of an exchange. 

After all, any insurer with a plan superior to what's in the exchange would surely want to be in the exchange, so nobody would be dumb enough to purchase a plan outside the exchange.  It's a self-fulfilling prophcy.  In other words, the entire face of insurance is changing, and people still don't seem to realize it.  But insurers realize it.  They don't want a regulated exchange.  They want the wild west.  But the wild west is over, if we get this reform. 

And so, yeah, sure, a public option would have been nice.  But...the free-for-all is over, and indivduals and small businsess are no longer at their mercy.  Not only will this be better for them than it is now, it'll be superior to what large businesses use now.  Yes, we're still working with the jerks who got us here, but we're no longer at their mercy.  And that's a huge difference that everyone should support.