I took a moment, yesterday, to chat with Ezra Klein about where we were--and where he was--on this whole health care thing. Most of you know that in regards to reform, I've basically outsourced my blog to the dude. I figured I'd complete the process by picking up the phone and picking his brain. Much like mixed metaphors, the results are in.
Can you paint the stakes in detail? What will be the cost of not passing this bill?
I'm going to put the choice very simply-- If you pass the bill things get quite a bit better. If you don't pass the bill things just continue to get worse. We all spend our time saying that this is not a perfect bill. That this is not our first choice. That If I were king I'd create a single-payer utopia. That's because we're intellectually honest. But that's been a mistake. It's obscured the fact that this bill is a tremendous improvement in the situation.
The basics of it remain the same. The people who really get helped are the people who end up without a large employer giving them insurance. For those people, this bill is a hedge against extremely bad luck. It's a hedge against the worse part of the system--You lose your job because you have breast cancer and now no one will insure you. You have out of pocket medical bills that go up to 90 thousand. On an average day, none of that happens to us. But there comes a day that is not the average day, and that's when everything goes wrong. This bill says we won't allow it to go too wrong.
Beneath that there is the basic subsidy scheme. In 2019 you're spending 200 billion a year in subsidies on poor people. When was the last time you've heard about government helping low income folks like that? It just doesn't happen anymore.
Two weeks ago, and maybe even a week ago, you were very optimistic that whatever happened in Massachusetts, health care reform would pass...
I did not account for some things. What i looked at was the underlying reality--the bill had passed both the house and senate. There was a pretty clear compromise between the two. You had a race against an almost historically bad candidate, and that would change one vote in the Senate. But yeah, I thought the House might not love the Senate bill but they'd recognize that it's better than nothing, and then they could make a fairly small number of changes through reconciliation.
The other thing I thought, and maybe this is core to my misunderstanding, was that Democrats understood how important this was, morally and politically. Whether it's been signed into law or not, it's been voted on. To not sign this bill is to take all the political pain of health care reform and get nothing for it. Second, to let this go now when they were so close of doing something historic for people who so desperately need help...Look, I can understand why Jon Kyl, who doesn't think this is a good bill, won't vote for this bill. We disagree, but I understand his position. I don't understand the position of an Anthony Wiener or name your blue dog Democrat. They are the ones who now say we'll abandon this because I'm tired. Or because I'm scared for my seat. But they're also the ones who know how many people the bill will help. Who agree on the basic premises of the legislation. And if you agree on that -- if you agree that the bill will save many, many thousands of lives and save people's homes and prevent chronic pain and infirmity and all the rest -- then rejecting it is another level of moral decision entirely.
Calling that irresponsible, I think, is too soft. I didn't think they'd go there.
So with that in mind, what's your perspective on "Democrats" in general, on the party as a whole?
Before we get into this, some people like to dismiss it as an angry or
panicked reaction. But my health care
insurance is not in doubt here. My pulse is slow and steady. We
obviously all agree there's some
point at which the base should not support the Democratic party anymore.
launched a war in Yemen, for instance, or tried to abolish Medicare.
You can argue about whether this
rises to that level. But we need to be clear that this is not a
situation where Democrats can't pass health-care reform, or can't break
a filibuster. Democrats are
choosing not to pass health care reform. If they make that choice, and
the base wants to have any hope of legislative progress in the future,
have to then make yourself clear about the ramifications of this sort
Awhile back I linked to your comment that the purpose of a majority isn't to simply sustain itself, but to actually use the power it has and, eventually, lose that majority.
I was talking with a friend recently, and was asking how many lives saved would make it worth losing a reelection. I'd like people to be clear about that. We don't like talking about outcomes because it's uncomfortable. But if you know you'll revert back to the mean, and that we will not have one party dominance--and we will not and should not--if that's true, then you have to think of rare majorities, like the one Democrats have now, as moments to make concrete improvement in the lives of people.