In a new column for the FT I argue that healthcare reform along the lines now envisaged will be much better than none at all.
In the end, I think, everything depends on the weight one attaches to achieving security of coverage as quickly as possible. In my view, this is the overriding consideration. Abandoning the effort now might postpone that goal for another decade or more. The country should regard this as unacceptable. Once the reform is law, though, the real work begins. Getting a grip on costs will be even more urgent than it is already - especially when you recall the broader fiscal calamity that awaits the country during the next decade.
The honest case for reform along the lines of the Senate bill is not that it fixes US healthcare; still less that, as the White House blithely maintains, it alleviates the country's fiscal distress. The truth is, it will create more problems than it solves. But the one big thing it gets right - the assurance of affordable health insurance for all Americans - is of surpassing importance.
Enacting this reform is not the end of the healthcare argument, but the beginning. If it does pass, it may well be looked back on as a mistake once its financial implications sink in. Yet the principle of universal coverage will have been accepted, and with luck there will be no going back. The price will be high, but is worth it.