Do Voters Have to Like Healthcare Reform?

Atrios writes:

I know I’m a broken record on this subject, but I do think it’s the thing most lacking from the insider conversations on HCR. Not that I really know, because I’m not an insider, but occasionally I get a wee sense of what’s actually occupying staffers in various places. “Voters liking this thing” seems to be at best an afterthought.

It’s sorta weird, really, because on most subjects it’s the first thing they think of, both about the policy itself and the myriad imaginary attack ads that can be run based on the policy. If voters don’t like this thing, it’ll likely be repealed before most of it even takes effect, either because Republicans take over or because frightened members of a Dem controlled Congress do so.

First of all, I think it should be said that the idea that a healthcare reform bill would be reformed is pretty fantasical. For one thing, Republicans would have to regain control of the White House, Senate, and House at once again. For another, they’d have to overcome the filibuster. And given that red state Democrats are the most likely to lose their seats in the near term, the Democratic Senators most friendly to repeal likely won’t be around to vote for it.

But beyond that, this idea that Democrats should be worried that the healthcare bill they pass will be unpopular and shouldn’t vote for anything that might cost them votes just seems bizarre to me, in large part because I simply can’t imagine a healthcare bill that’s popular with the marginal voter in the short term. The simple fact is that any healthcare bill worth passing is going to help the disadvantaged, whether it’s sick people or poor people, and passing legislation to help disadvantaged people simply isn’t good for short term popularity in this country. Among other things, banning discrimination against pre-existing conditions will probably increase the costs of premiums, as insurance companies are forced to cover people who are more costly to cover. Whether that’s popular depends on how willing the average person is to pay a higher premium price in exchange for not screwing over sick people. Perhaps Atrios has a more charitable view of Americans than I do, but from what I can see, one can never go wrong betting that Americans are perfectly happy giving a short stick to the poor or otherwise disadvantaged if it saves them a buck. With that in mind, progressives ought to be more concerned with how much a healthcare reform bill helps the people who need help than how many seats it might cost Democrats in 2010, or 2012, or 2014, because until we get a major change in the median view on social welfare spending that primarily benefits poor people in this country, passing any truly progressive legislation is going to require a willingness to incur short term political loss.