How to reconcile health care with reality

Democrats must use extreme measures if reform is to succeed from here

The Senate procedure known as reconciliation is strangely named considering how it can be used: to force a simple majority vote on controversial budgetary legislation. ItâÄôs less a way to make friends than it is a way to blow a raspberry at the dissenting opinion.
And thatâÄôs exactly what Democrats have got to do to move ahead with health care reform: give obstructionists on both sides of the aisle the raspberry and use reconciliation to make a better bill. Though itâÄôs not a silver bullet by any stretch of the imagination, reconciliation can still include the crucial addition of a cost-controlling âÄòpublic optionâÄô and, in doing so, it can increase the Senate billâÄôs appeal to the more liberal House Democrats. Although President Obama maintains that he is âÄúpersonally committedâÄù to adding a public option in the future, he unfortunately isnâÄôt willing to fight for one now. Using the reconciliation procedure will draw heated criticism from Republicans who, through their unwillingness to compromise, have essentially forced the move. Then again, what action on health care wouldnâÄôt draw heated criticism from Republicans? The only substantial political risk of reconciliation might be public backlash against a strategy that might easily be spun as bully tactics. Even then, Congress needs to check their rock-bottom approval ratings and realize that at this point, nothing could be less popular than continued waffling, infighting, and inaction. ThatâÄôs why health care reform is generating so much public ire. That, and the fact that the SenateâÄôs bill is so compromised and watered down that it barely appeals to anyone anymore, let alone those Democratic constituents who, a year ago, saw the public option as a conservative compromise on a single-payer system. Looking ahead to elections âÄî which, sadly, is exactly what this vote boils down to for many members of Congress âÄî reconciliation is a last opportunity to craft a stronger, more popular reform that includes a public option. Now, thatâÄôs something to run a campaign on. When all is said and done, any health care reform will be better than none; the most important issues are simply getting more people covered and controlling costs at every level. But if Congress can feasibly do better, they should. If only Democrats can dig deep and find a little sense of resolve, compromise, and solidarity, theyâÄôve got the chance to pass reform that voters will be grateful for. Michael Pursell welcomes comments at [email protected]