So, are you satisfied now?

Updated Seriously. Are you? Are you satisfied with the health care bill that passed the House? After all the compromises, after all the "asses of Blue Dogs are to be kissed, those of progressives are to be stomped" concessions, after stripping out authorities for state-level single-payer plans and adding in abortion bans, after changing "Medicare plus 5%" to "negotiate one provider at a time," after creating a flimsy, weak, unattractive "public option" consciously designed to be no better than private insurance and which will cost more than private insurance, after creating an individual mandate but omitting any rate caps and removing the prospect of serious competition, after creating a system of what amounts to multibillion dollar taxpayer handouts to the insurance industry, after getting zero concessions from the right or the insurance companies that they weren't prepared to give even before the debate began, are you really satisfied?

Well, no, of course you're not "satisfied" and I know you're not. But here's what I was really asking: Do you think this bill was good enough to pass? Do you think the health care system it creates, the one of the actual facts on the ground, not the lofty rhetoric, is worthy of active support? Would you have voted for it?

I say it was not, it is not, and I would not have.

There was a period of time a few weeks ago when I could have been swayed by the "better than nothing" argument, not so much by the argument itself as by the political impact of a defeat and how it could (would) be spun as a declaration that "the people do not want reform" rather than as "this is not reform enough." That was before the House leadership caved and allowed a floor vote on Rep. Stupid's amendment knowing it would pass and before Tailgunner Joe Lyingman announced his intention to block the Senate version and got no reaction from the party leadership.

It became obvious beyond obviousness at that point that the concern was no longer, if it ever had been, enacting actual health care reform. It was passing a bill. Whatever concessions to politics and platitudes, to conservative endruns and Connecticut egomania, had to be made to get a bill passed were going to be made so long as at the end of the day the Democrats could say "we did health care reform" - even if they hadn't.

To those who say "It's a first step, one that can be built on," I say you can't build a solid house on a foundation of "stubble and straw." Medicare was supposed to be a first step. Medicaid was supposed to be a first step. Yet here we are, nearly 45 years later, still talking about "building" on "first steps." Why are we to imagine this time is different?

Have Medicare and Medicaid been improved over the years? Yes, they have - but the point is, they are still Medicare and Medicaid. They have not been built into anything more, anything different. And neither will this, no matter the final form upon passage. Oh, it will be tinkered with, adjusted, over time but it will never become something more if only because - again, just like Medicare and Medicaid - the energy will go to defending the system against being dismantled in the face of unending complaints about deficits and unremitting claims of impending bankruptcy.

At the end of the day, I can see only one progressive in the list of those who voted no, one name of someone who stuck to their guns and to the earlier pledge made by House progressives to reject the bill if it did not contain a strong public option. That one representative was Dennis Kucinich. I am not a constituent but I called his office anyway to say that there are those of us out here who understood why he did it, who recognized that the bill was just not good enough to deserve passage and that in the long run it may well do more to harm the hopes of real reform than to advance them.

We will never have universal health care. Damn it to hell, we are a disgrace before the world.

Footnote: The New York Times had an interesting chart about the 39 Democrats (including Kucinich) who voted "no." The accompanying text makes all the usual noises about how "vulnerable" many of them are, but the chart demonstrates that to be bullshit. For example, it mentions that

[a]n overwhelming majority of the Democratic lawmakers who opposed the bill — 31 of the 39 — represent districts that were won by Senator John McCain

in 2008. But of those 31, 23 won by double digits in 2008 and three more were unopposed - despite being in a district McCain carried. And they're supposed to be running scared in an off-year election? Of the 39 "nay"s, 30 won by double digits or were unopposed. They're supposed to be scared? For 17 of those who had an opponent, the margin was more than 20 points; for nine, the margin was over 30 points; for five of them it was over 40 points.

Of all 39, I could see only eight who could claim serious electoral concerns: They are first-termers, each of who won by no more than 5 points.

Other than that, I just don't buy the "running scared" or "vulnerable" crap. These people aren't "vulnerable." Other than Kucinich (If there's another name in there I should credit with similar gumption, let me know.), they are either prisoners of the insurance industry, reactionary jackasses, or both.

Footnote to the Footnote: The Times also had a good overview of the differences among the various bills; the link is right here.

Updated to note that among the vulnerable was Eric Massa, a single-payer supporter who voted against the bill, he said, because "at the highest level, this bill will enshrine in law the monopolistic powers of the private health insurance industry, period. ... I believe the private health insurance industry is part of the problem."