Be Excited!

Michael Tomasky has a nice piece on what I've come to call "the dull reality of change":

So now, liberals have to fight hard for something they're not terribly excited about. A health bill will likely have a very weak public option or it won't have one at all. But liberals will have to battle for that bill as if it's life and death (which in fact it will be for thousands of Americans), because its defeat would constitute a historic victory for the birthers and the gun-toters and the Hitler analogists. In the coming weeks, building toward a possible congressional vote in November, progressives will have to get out in force to show middle America that there's support for reform as well as opposition, even though they may find the final bill disappointing. This is what movements do – they do the hard, slow work of winning political battles and changing public opinion over time. It isn't fun. It isn't something Will.i.am is going to make a clever and moving video about, and it offers precious few moments for YouTube. It takes years, which is a bummer, in a political culture that measures success and failure by the hour. The end of euphoria should lead not to disillusionment, but to seriousness of purpose.

I'd go a step further than Tomasky: The upside of health-care reform is not that it's a defeat for the reactionaries. Rather, the upside of health-care reform is health-care reform. Four years ago, when the public option didn't exist as a popular policy concept, liberals would have been thrilled with the legislation we're seeing today. It's better than anything the major Democrats proposed in the primary, much less anything that passed four committees in Congress.

I keep recommending this Families USA brief (pdf, but worth it!) outlining the 10 most important elements of health-care reform. The public option is one of them, to be sure, and I think there's a substantial chance it will be present in the final legislation. But what about the expansion of Medicaid to 133 percent of the poverty line? That's a solid 20 million poor Americans who don't have coverage now, and will soon. What about the out-of-pocket caps, so no one goes medically bankrupt ever again? Or the assurance that no insurer can ever discriminate based on a preexisting condition? Or the subsidies for working Americans who can't quite afford coverage? Or the requirements that insurers spend more money on medical care and less money on premiums? Or the guarantee that the gruesome practice of rescission will finally end?

Obviously, there are a hundred ways that reform is going to fall short of not only perfection, but sufficiency. And the political compromises required to pass anything will dispiriting and inane. But it's worth keeping in mind that this bill is going to help a lot of people. Tens of millions. Hundreds of millions over the course of a few decades. It will mean that some of the very worst things that can happen to someone -- medical bankruptcy, or a cancer that strikes when someone is uninsured -- will, by and large, simply stop happening. That's worth being excited about.

Photo credit: Alex Wong -- Pool Photo.