Health Care Reform In Jepardy

Once again health care reform is in jeopardy of failing. This time it is the election of Scott Brown to the US Senate that has put more than a years work in real peril. Mr. Brown won the special election in Massachusetts to fill the Senate seat of the late Edward Kennedy. The election was held on Tuesday January 19th. How can one man derail what a majority of Congress has voted for? As part of his platform for election, Republican Scott Brown promised to be the 41st vote for fillibuster, which would prevent the Senate from holding a final vote on the jount House/Senate version of the health care bill.

So, What happens now? There are several possible outcomes as follows.

First off, the House could vote to accept the Senate version as is. If the House votes for a 'same as Senate' bill, there would be no need for another Senate vote and the bill would immediately go to the President for signiture. This outcome is unlikely because a great many liberals in the House strongly dislike what they consider a 'watered down' Senate bill.

Another option is for the House to leverage its new found power to gain improvements in the health care bill. Up until now it was the Senate that held the cards in this debate, with a few moderate to conservative democratic senators holding the bill hostage to their demands. In the opinion of many liberals this led to a weakening of the bill but there seemed to be no other way to pass the bill. Now however, both the Presient and the Senate need House liberals to vote for the Senate version in order to save the bill. The House can refuse to pass the Senate version unless they get promises that there will be a reconcilliation later on in the year. Reconcilliation is a legislative process that allows legislation to be moved through the budget process, the benefit of doing this is that budget bills cannot be fillibustered and require only a majority to pass. The purpose of the reconcilliation would be to add House demands that would strengthen the health reforrm bill. If the Senate promises to improve the bill through reconcilliation, then the House would vote for the Senate version of Health Reform as is and improve it later in the year through the budget process. Early indications are that the House is indeed attempting to move in this direction.

Another option already mentioned by President Obama is to pass small pieces of the bill, the parts that are less controversial and have wider support such as an end to the practice of discrimination based on pre-existing conditions. This less ambitious road to insurrance reform would seem to hand Republicans a huge victory and would fail to meet many of Obama's stated goals. Are Obama's statements supporting this route calcullated to spur democrats to reach an accomodation that would save health care reform?

The last option is that the whole thing falls apart and nothing is done. This is a very real possibility considering the history of health reform efforts in this country. Considering the effort and political damage that this debate has already caused, it is very likely that failure now could mean decades more time, and tens of millions more uninsurred before it is attempted again.

So, is health reform dead? Not yet, there are opportunities that could lead to a very strrong bill if leadership and fearlessness are exhibited by our congressional prepresentatives. If on the other hand, self preservation and fear are the guiding lights on Capital Hill, there will be a weak version of insurrance reform that leaves millions on their own, or even worse, nothing will change. The time is now, people are suffering in the greatest and wealthiest nation in the world and its all due to selfishness, fear, and lack of care for our fellow countrymen. The goodness and kindness of people shines like a beacon in times of disaster, such as in Haiti, we need this to be so all the time. We need health care reform now, it won't be perfect, it will very likely need fixes along the way, and we may all have to endure some rationing of one kind of another but we need this. Make no mistake, rationing is already here, people who are uninsurred have been rationed based on the amount of money they have, this is neither moral or just. If rationing must take place, which in most cases is true for any finite resource, then it sure occur with thought on a moral and just basis.