Both Sides Now

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Now we know that Brown's margin is solid, it behooves us to respect and admire the daring insurgent campaign Brown ran, and to think through what this could mean in Washington. The next few days will be volatile. So let me try to show why I think Obama's reform is imperfect but still necessary by responding to  a thoughtful post from Megan. Am I misreading the populist passion? Am I not seeing a genuine attempt to reform conservatism? Is the opposition to the attempt to reform health insurance merely a function of nihilism, as in my reader's vent:

Unabashed nihilism. But what leaves me shaking with anger damn near every day since President Obama's inauguration is the pure smugness and nonchalance of their nihilism?

Although I understand the feeling behind the email, it is a little sweeping in its dismissal. I ran it as a vent, not a policy analysis. But I still think it's more on the mark than Megan is. Her diagnosis of the protest vote in Massachusetts and the poor poll numbers for health insurance reform is simple: that the voters believe that it's "a bad idea."

In the abstract, if I were devising my ideal health reform plan, it would indeed be hugely different. Probably more like Megan's. But here's the difference: I think the lack of insurance for 40 million people is a real issue that we have a moral duty to deal with - now. I've been deeply affected by the nightmare stories readers have sent in of the current horrors. I also think that healthcare costs under the current system are crippling and require some sort of response by, yes, government - now. And I believe there is only one adult in Washington proposing an actual solution to these problems.

Here's Megan's description of her opponents:

They look at people without insurance, and they want to help them.  I'd like to help them too.  They believe, as I do not, that the government will be able to muster the political will to control costs. They believe, as I do not, centralized government planning will improve the health care system rather than being hijacked by special interests within it. They believe, as I do not, that there is so much fat and waste in the pharma and medical technology industries that they can considerably reduce reimbursements without reducing useful innovation and thereby condemning those who might have been saved to an early death.

I have yet to see a single proposal from the right that would in any way address the problem of the uninsured in America. McCain sure didn't and the GOP offers nothing. Cost control? Again, the current bill is the first one even to start to address this issue and Megan wants to kill it. What else would do that in any practical way in the current climate? I agree that one of the costs of reining in the healthcare industry will probably be less research, fewer new drugs, less innovation. But I cannot see a way in which the recent amazing breakthroughs will continue to occur without bankrupting the private and public sectors. And I say this as someone who has a constantly evolving retro-virus in my body trying to kill me.

The Senate bill is more moderate than the Clintons'; it has enraged the left; it won't insure everyone; it won't automatically control costs. But it's a start. It takes the problem seriously. In the real world, if this fails, there will be no reform until the country is bankrupted. The GOP has no interest in offering an alternative, just as they have no plans to cut the deficit - only plans to increase it. If this bill goes down, no Democrat will touch the issue for another decade.

I live in the real world, where these issues have to be dealt with, where a president was elected by a landslide on this very platform, and where the opposition was based not on Megan's thoughtful, if, in my view, utopian libertarianism but on populist rage, stoked by inflammatory claims of government take-over and communism, fed by every discontent in an economy wrecked by the Republicans.

I supported Obama to support reform in a difficult climate against enormous vested interests. I am not going to stop supporting his efforts now. And I am not going to dignify the vicious campaign against him and anything he does with the respect it has not yet deserved.