IT WAS MARCH of 2006, and the long legislative standoff over expanded health care coverage in Massachusetts had finally been resolved. Peter Meade, who as a politically connected Blue Cross Blue Shield of Massachusetts executive had been heavily involved in brokering the deal, called Senator Ted Kennedy to fill him in.
“I said, ‘It’s not the bill I would have written,’ ’’ recounted Meade.
“That’s the wrong standard,’’ replied Kennedy, who had been pushing behind the scenes to break the Beacon Hill logjam. “The standard is, what bill can you get out, what bill can you pass?’’
Meade, who today is president and CEO of the Edward M. Kennedy Institute, thinks Kennedy would have approached the US Senate’s health care bill the same way.
“He would be strongly urging everybody to vote for this bill - and saying to the people who weren’t satisfied with it, ‘OK, let’s pass this and then figure out how to make it better,’ ’’ Meade said.
Vicki Kennedy says her husband predicted that as the final vote on health care got closer, the fight would get tougher. Fragile coalitions would fracture. Every vote would be needed. Compromise would be required.
So would Kennedy support the Senate bill?
“I hate to put words in his mouth, but I have to say, in my heart of hearts, absolutely, because so many provisions of this bill are in the bill that he put forward,’’ Mrs. Kennedy told me. “With so much at stake, he would go for half a loaf and then look to improve it to a whole loaf, if not in conference committee, then next year.’’
That’s the kind of pragmatic mentality those who favor near-universal health care reform now need to adopt. The Senate bill is the best chance in years for that cause - but it’s already under attack.
Conservatives, predictably, are decrying the legislation as an unaffordable boondoggle being rushed and rammed through that chamber.
But it’s not just the right that’s up in arms. Former Democratic National Committee Chairman Howard Dean has declared that no plan without a public option can constitute meaningful reform. Several women’s rights groups say its abortion-funding restrictions are unacceptable. Unions are apoplectic about the tax on so-called Cadillac health care plans.
Some of those arguments are easy to dismiss. A hasty partisan power play? Actually, it’s hard to think of any recent legislation where the majority party has tried harder to enlist the support of the minority. Witness the long search for common ground led by Senate Finance Committee Chairman Max Baucus. That Baucus ultimately wasn’t successful says much more about the rigidity of the GOP than it does about Democrats’ attitude toward compromise.
As for the cost argument, the Senate bill has been vetted by the Congressional Budget Office, which says it would reduce the cumulative federal budget deficit over the next decade, and probably in the decade thereafter as well.
The notion that you can’t have landmark reform without a public option is also misplaced. The Senate bill will mean affordable coverage for 30 million people who now lack insurance. By prohibiting insurance companies from denying coverage based on pre-existing conditions and by otherwise toughening insurance industry regulations, it will help protect countless people from medical and economic calamity.
No, the complex legislation isn’t perfect. It will need years of fine-tuning. Cost containment efforts, including slowing Medicare increases, will require determination and discipline.
But here’s the question for those who support near universal health care coverage but are dubious about this bill. When will the next best chance come along?
Not in 2010, an election year. And if Democrats lose seats in the mid-terms, not for the rest of President Obama’s first term, either. In short, believing that a better bill can somehow rise from the ashes of this one is putting hope over bitter experience.
Ted Kennedy would have realized that the Senate bill is about the best that can be done given current political realities. He would have voted for it - and then started working to fix its flaws.
If congressional Democrats are ever to realize their dream of dramatically expanding health coverage, they need to do the same.
Scot Lehigh can be reached at lehigh@globe.com. 
