Healthcare’s Penultimate Hurdle

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Ezra Klein calls it “winning ugly,” but a win’s a win: early this morning the Senate voted 60-39 to pass its healthcare reform plan, only the second time in American history that a healthcare bill of this magnitude has even reached the Senate floor. Next stop: a House-Senate conference committee after the winter recess and then one final vote for all the marbles, probably in late January.

So why do I not feel more elated? Part of the reason is that in the modern era of the institutional filibuster, 60 votes is a paper-thin margin and there’s still a chance that someone could come back from recess bloodied and beaten up and looking for a pretext to change their vote. The conference report might give them an excuse, and that would mean healthcare reform dies again.

But I think that’s unlikely. The bigger reason, of course, is that healthcare has splintered the liberal movement so badly. There’s a far-left wing so obsessed with the demise of the public option that it’s working overtime to team up with reactionaries to destroy the bill and — maybe — Obama’s presidency along with it. The more moderate left supports the bill, but hardly enthusiastically. For us, it’s a “starter house,” or “the best we could get.” That’s not exactly a rallying cry. And independents are just confused and exhausted by months of political sniping, intra-left bickering, and the relentless flood of Beck/Palin/Drudge demagoguery.

So it doesn’t feel much like a victory yet. But it should. I’m 51 years old and this bill is, without question, the biggest progressive advance in my adult life. You have to go back to the great environmental acts of the early 70s to get close, and to the civil rights/Medicare era to beat it. That’s four decades, the last three of which have constituted an almost unbroken record of conservative ascendency. And now that ascendancy is just days away from being — finally, decisively — broken. Warts and all, we’re on the cusp of passing a bill that provides all of this:

  • Insurers have to take all comers.  They can’t turn you down for a preexisting condition or cut you off after you get sick.
  • Community rating.  Within a few broad classes, everyone gets charged the same amount for insurance.
  • Individual mandate.  (Remember how we all argued that this was a progressive feature back when John Edwards and Hillary Clinton were championing it during the primaries?)
  • A significant expansion of Medicaid.
  • Subsidies for low and middle income workers that keeps premium costs under 10% of income.
  • Limits on ER charges to low-income uninsured emergency patients.
  • Caps on out-of-pocket expenses.
  • A broad range of cost-containment measures.
  • A dedicated revenue stream to support all this.

A trillion dollars in benefit for low and middle income workers. 95% of Americans insured. Medical bankruptcies on the verge of disappearing. And for the first time ever, an acknowledgement that decent healthcare ought to be universal in the United States. This is historic. This is a cause for celebration, not recriminations. As recently as 2005, I wasn’t sure I’d ever see this day, and now, a mere three years later, it’s here. I can still hardly believe it.

UPDATE: Some good thoughts in a similar vein here from Jon Chait.

WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

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That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

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And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

If you can, please support the reporting you get from Mother Jones—that exists to make a difference, not a profit—with a donation of any amount today. We need more donations than normal to come in from this specific blurb to help close our funding gap before it gets any bigger.

payment methods

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