With health care, don't let the perfect be the enemy

Early in the morning on December 24, the U.S. Senate passed its version of a health care reform bill. The next step is conference committee, where the Senate and House versions -- quite different each another -- will be reconciled and merged.

The Senate version contains a lot of compromises -- so many that some progressives feel the Senate should have let the bill die and then started again from scratch next year. But a new Senate bill would require the same 60 votes to break a filibuster, and those 60 votes would surely require similar compromises, since the cast of characters would be the same. To wait until after the 2010 elections would be to continue losing people every day who die from lack of health insurance. That would not be acceptable.

While the Senate bill is surely far from perfect (I would have liked a public option, and I don't like the health insurance mandate), it will at least fix a few of the major issues facing sick Americans today: As I understand it, the Senate bill would force insurance companies to cover preexisting conditions, and it would prevent them from dropping your coverage when you get sick and start costing them money. It would reduce the number of uninsured Americans by 31 million by 2019. In addition, the bill is fiscally responsible, and would allegedly reduce the deficit over time. Those are good steps in the right direction. And, as Bill Clinton said recently, "America can't afford to let the perfect be the enemy of the good."

In a recent New York Times column, Nobel laureate Paul Krugman endorsed the bill despite its imperfections, looking instead to its long-term promise. He pointed out that "social insurance programs tend to start out highly imperfect and incomplete, but get better and more comprehensive as the years go by. Thus Social Security originally had huge gaps in coverage -- and a majority of African-Americans, in particular, fell through those gaps. But it was improved over time, and it's now the bedrock of retirement stability for the vast majority of Americans."

Another person I admire, Minnesota Senator Al Franken, has spoken out in favor of the Senate bill. Franken is a progressive, and I think he recognizes that passing this thing is better than doing nothing out of disappointment for not getting everything.

Even self-described democratic socialist Senator Bernie Sanders, a progressive hero if there ever was one, voted for this Senate bill, because he believes that it's better than nothing and will help a lot of people overall.

Perhaps most importantly, Vicki Kennedy, widow of the late Senator Ted Kennedy, wrote in a Washington Post op-ed that her late husband would have wanted this bill to pass. And you can't accuse Ted Kennedy of not being a progressive.

So maybe the more radical progressives who condemn the Senate bill should take a step back and look at the big picture. A step in the right direction is better than no step at all. And, as Krugman noted, it would provide a foundation on which to build additional public health benefits in the future. This solid (or at least semi-solid) foundation is certainly better than trying to build something entirely different on a wobbly foundation that doesn't have the support it needs in both houses of Congress.

Do it for the 45,000 people who die in the U.S. each year due to lack of health insurance.

And do it for Ted Kennedy. May he rest in peace.