Paul Krugman asks why are the so-called Centrist Democrats so far outside of the mainstream of most Americans? He is much nicer than I am when hearing about the concern the doubting senators who are more concerned about the health insurance industry than the state of the health care access of Americans. When Democratic Senators worry about the lack of competition if the public option is allowed when within their state one single insurance company has 75% of the market, one might think their Senator is looking out for the wrong constituent.
What will destroy our ability to get the healthcare we need are the Democrats that are standing in the way. What the incrementalists need is a dose of reality and smidgen of courage, because voting for real change (and not just a faux change) based in the best evidence we have today has a great potential of delivering something that really helps Americans. Senators who care about policy must be made aware that the reaction of their constituents to their vote will be based on the effectiveness of the reform. It behooves our Senators to be more aggressive in putting in the right changes rather than being so timid that nothing really changes, because the current system in place is devouring our government and will devour every thing in its path if not fixed. Here's how Dr. Gawande described it on Fresh Air last week:
I think our core understanding here that we just have to keep reminding ourselves is that the road we are on is unsustainable. We have the most expensive health care system in the world, we have a system that is destroying our competitiveness as businesses, it is devouring our government, and its leaving 45 million plus people without coverage. We're bankrupting a million people a year and many of them already have health insurance. The sense that we have a great deal to fear from any change can parallelize us, but if we let it, we will be dooming ourselves as individual people who need to rely on the healthcare system, and we will be dooming ourselves as a country.
Our Democratic Senators must understand that not doing enough is more dangerous than doing too much. And if those fiscal scolds want to hyperventilate about the cost, then they need to be sat down and talked to until they truly understand that the cost for all of us will be much, much worse if we do nothing.
Now is the time for change.