The New Health Dialogue

With Vice President Joe Biden presiding, the Senate passed the health bill this morning. We are finally nearing the end of our long and winding road to comprehensive reform. There is much to celebrate: we have committed to making decent health insurance and quality care accessible and affordable for (almost) all Americans. That commitment -- an ancient obligation of any just community -- is vitally important, and hard to repeal, which is why some opponents fight so hard against it.  Political commitments to fellow human beings’ well-being are hard to retract.

We should also celebrate the commitment to making our health system better and sustainable, i.e., to reducing cost growth while improving quality of care over time. Neither the Senate bill nor the House bill is perfect in this regard. But both take huge steps forward and have been unfairly maligned by people who do not read, do not understand, or choose to ignore key provisions, and by those whose self-interests are served by the status quo.

We weren’t surprised to see The New York Times endorse health reform -- not any more than we were to see The Wall Street Journal attack it. But we weren't quite sure where The Washington Post, which has understood the case for reform but been nervous about the cost , would come out. It endorsed reform. Twice in one week. Once on Sunday and once again on Tuesday, thanks to the weekend snowpocalypse which buried DC's weekend papers.

The Post considers a stable financial future for Americans to be a priority, and they believe health reform is a step forward in controlling health care costs. Health reform is going to cost money, but the bill is paid for and it will improve the lives of millions of Americans by providing them with necessary coverage. So even though we’re in a tough place financially as a nation, the benefits of reform outweigh the risk.

Talking about the polling on health reform is like reviewing a Demi Moore film. Sure it's sort of fun to watch, but at the end of the day what's the point?

Depending on where you stand, you can find a poll to back up your position and a spin to dispute your opponent's.

If you’re the chairman of the Republican National Committee, for example, then recent polls showing declining presidential approval ratings and increasing opposition to reform are cause for rejoice. In just a few months you’ll be decking the halls of Congress with pink slips for Members who voted for “aye” on passage.

If you’re the White House Chief of Staff, such talk is on par with sugar plum fairies. The polls are an aberration, like the August town halls. The only way to avoid a day after Christmas fire sale in Congress on par with the midterms of 1994 is to pass reform. Besides, not all the polls are bad.

Handicapping political horse races is more difficult than betting on Ivy League Basketball (Our advice? Don’t bet against Cornell…), but there are two things to consider when looking at how health reform will impact the 2010 midterm elections.

A comity sandwich to go please. Right before, and again right after, the Senate voted early Tuesday on a party line 60-39 vote to advance the Democratic health reform bill -- Majority Leader Harry Reid (D-NV) asked everyone to play nice. At one point he channeled Rodney King (he quoted him by name) asking "Can't we please get along." Everyone in the Senate (including, perhaps particularly, the poor staff) is exhausted and tense. They have been working day and night and weekends for weeks. "Tensions have been high," said Reid with his usual flair for the understatement. He asked everyone on both sides to be "thoughtful and considerate" as "we try to figure out a way to leave here in a peaceful" manner. The one thing everyone should be able to agree on, he said, is that it's time to get home.