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Globe Editorial

Doomsayers take note: Voters still deserve reform

January 26, 2010

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HERE’S ONE lesson President Obama and congressional leaders need to remember after Scott Brown’s Senate victory last week: One state’s vote, by a 52-47 majority, doesn’t erase a 29-state presidential victory and a 59-vote Senate margin. If Democrats use the Massachusetts election to abandon health reform, they won’t be following the people’s mandate - they’ll be defying it. And voters will rightly take revenge at the ballot box.

Over the last week, some leading Democrats, including Massachusetts representatives Barney Frank and Bill Delahunt, have been disparaging the chances of passing health reform. To some extent, they’re merely playing messenger. They don’t believe their colleagues will vote for it. And now that Brown’s election has deprived the Democrats of the 60th vote they need to stop a Republican filibuster in the Senate, the one way to make health care a reality for all Americans is for House members to swallow their misgivings and approve the Senate bill.

But wouldn’t this require the suddenly wobbly House Democrats to defy the will of the 52 percent of Massachusetts voters who chose Brown? Not really.

According to a post-election survey of voters here, among Brown supporters who said health reform was a big factor in their choice, the chief gripe was not with the bill’s specifics but with the wheeling and dealing and lack of bipartisanship in that process. They have a point, but the backroom agreements, which are common with complex issues, were particularly extreme in this case because of the GOP’s promise to stage a filibuster. Without that threat, backers of the bill would not have had to horsetrade for the votes of fence-sitters like Senator Ben Nelson of Nebraska.

One concession to bipartisanship that Democrats should have made is a commitment to medical malpractice reform - a good idea on its merits. Democrats should now get together with Republicans and design a separate bill to change a dysfunctional tort system that causes too much defensive medicine. In much the same way, after the House approves the Senate bill and sends it to Obama for his signature, Senate and House supporters of reform should agree to improvements in the Senate bill, such as increasing subsidies for the premiums of the working poor, that can be achieved with just a 51-vote Senate majority through budget reconciliation.

Nothing in the post-election survey by the Washington Post, the Kaiser Family Foundation, and the Harvard School of Public Health indicates that Brown supporters opposed a provision in the reform bill that prohibits insurance companies from denying policies to people with preexisting conditions. Nor were voters protesting the bill’s ban on annual or lifetime claims limits, the small-print clauses that often bankrupt even insured families who happen to need costly medical treatments. The voters surveyed also did not say they were against extending coverage to more than 30 million Americans who lack it, or the bill’s many pilot programs for ways to curb skyrocketing medical costs.

These are the posts, beams, and rafters of the bill. Because health care makes up more than 16 percent of the economy, achieving these changes requires a dizzying array of other provisions and results in, yes, a 2,000-page door-stop. Voters in Massachusetts and elsewhere have grown understandably impatient with all the quibbling about public options, taxes on Cadillac policies, and employer mandates. To counter this, reform’s supporters, especially Obama, but also doomsayers such as Frank and Delahunt, must take every chance to remind the public of the many popular changes that would emerge from the bill.

Congress should not walk away now from a reform that achieves a goal of presidents since Theodore Roosevelt - that Americans have a right not to fear denial of care or financial ruin because they lack what citizens of all other industrialized countries have: health insurance.

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