So much for true health care reform.

The Democrats in the U.S. Senate are congratulating one another for a job well done because they managed to pass something they can call health care reform. And, in many ways, it is certainly that.

But it is a far cry from what the President said he wanted when he ran for office, and even from what the more liberal wing of the Democratic party said we needed in order to make health care reform real and not a shallow victory.

Many economists, Congressional budget analysts and , of course, members of Congress, had spent months telling us all that real health reform would require the creation of the so-called public option. Indeed, the House version of health care reform still has that as a provision and it must now be worked out with the just passed Senate version which does not! It will vanish.

Anxious to demonstrate that they can actually accomplish something, the Senate Democrats ( no Republicans went along with this one)  did vote in favor of health care reform but stripped anything remotely resembling a public option from the measure, even a proposal to allow some under retirement age to buy into Medicare.

They caved to the lobbyists from the insurance industry, they caved to the GOP and, most important, they caved to the more center and right wing of their own party. Needless to say, President Obama did not exactly take a strong stand on a public option to help it along. To the contrary, he sent signals early on–first through underlings, then directly from his own mouth, that he would be willing to throw the public option overboard just so that he can claim some sort of victory. 

Once the House and Senate fully engage in an effort to forge a single piece of legislation from their two, separate bills, it is considered a done deal that the public option provision in the House measure will be chucked in order to make Senators happy.

Yes, there is no doubt that the legislation that will emerge from this will make health insurance in this country more on par with what is offered in just about every other civilized Western (and even non-Western) nation; it’s just that it could have been so much more meaningful.

All that can be done now to salvage the situation is to use these victories as a foundation for future alterations that may, someday, actually bring the American health care payment system firmly into the 21st century.

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