The debate over new healthcare legislation now shifts to the Senate, at a time when the majority of Americans are not convinced that a new law would benefit either the national healthcare system or their own personal healthcare situations in the long term. The overall advice from the average American to his or her member of Congress at this point tilts negative, although about a third of Americans initially say they have no opinion on the legislation.
My own response would be: let's see what happens next.
If you see this as a process, then what matters is whether cost-controls can be subsequently generated through new research, comparative studies, bundling and the like. Once you get everyone in a system, you can start tinkering and adjusting. The current plan could lead to a stronger public option in due course, or a more libertarian approach that builds on the new health insurance exchanges. It could lead to serious cuts in Medicare - or a decision to maintain health as such a big and expensive part of American economy. It could lead to a cut in the employer subsidy ... or to a single payer over time. We don't know. The question is: does this attempt to include everyone, to remove obvious injustices, and to craft a structure for the future make sense right now?
I think it's a decent start. And I think it was clearly Obama's campaign pledge, and is much more moderate than many seem to believe. I also believe that its failure would cripple Americans' confidence in their Congress to address any profound problem. And that would be a death-blow to constructive government and civil politics for a very long time to come.