Is the Senate health-care reform bill still worth passing?"Insurance companies win," Markos Moulitsas tweeted last night. "Time to kill this monstrosity coming out of the Senate."
This was, for progressives, a frustrating vote. But the flip side of it being morally unconscionable for Joe Lieberman to put the bill at risk over something as small as Medicare buy-in for 3-or-so million people is that the absence of Medicare buy-in -- and of the weak public plan -- is not reason enough to oppose the bill, either.
The core of this legislation is as it always was: $900 billion, give or take, so people who can't afford health-care insurance suddenly can. Insurance regulations paired with the individual mandate, so insurers can't discriminate against the sick and the healthy can't make insurance unaffordable by hanging back until the moment they need medical care. The construction of health insurance exchanges so the people currently left out of the employer-based market are better served, and the many who will join them as the employer system continues to erode will have somewhere to go.
That's all policy. And as I spent yesterday arguing, it has a tendency to overshadow the lives in the balance. You can choose your estimate. The Institute of Medicine's methodology says 22,000 people died in 2006 because they didn't have health-care coverage. A recent Harvard study found the number nearer to 45,000. Since we talk about the costs of health-care reform over a 10-year period, may as well talk about the lives saved that way, too. And we're looking, easily, at more than a hundred thousand lives, to say nothing of the people who will be spared bankruptcy, chronic pain, unnecessary impairment, unnecessary caretaking, bereavement, loss of wages, painful surgeries, and so on.
A lot of progressives woke up this morning feeling like they lost. They didn't. The public option and its compromised iterations were a battle that came to seem like a war. But they weren't the war. The bill itself was. When liberals talked about the dream of universal health-care insurance 10, 20 and 30 years ago, they talked about the plight of the uninsured, not the necessity of a limited public option in competition with private insurers.
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On its own terms, the bill is the most important social policy achievement since the Great Society.(more)
http://voices.washingtonpost.com/ezra-klein/2009/12/is_the_senate_health-care_refo.html 
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