David Coates is a political science professor at Wake Forest University and author of the new book, “Answering Back: Liberal Responses to Conservative Arguments.”  Here he shares his perspective on the healthcare reform efforts. If you are a journalist who would like to interview Coates, email Carol Cirulli Lanham at carol@sternersedeno.com or call 972-818-0895.

By David Coates

This is crunch time for health care reform. The Democrats cannot afford another stalled attempt at reform. Nor can they afford another long, dragged out process of negotiation.

It is now or never for major health care reform.

The reform will not be perfect. The President does not have the Congressional numbers for perfect.

But he does have the numbers to shift the goal posts decisively in a progressive direction.

Shifting goal posts is good. If he can get us to a new system, taking us back to the old one will be politically impossible.

 The new system is significantly better that what we have now: ensuring:

  •  No pre-existing conditions
  • A health care exchange for the uninsured
  • Federal funds to help the uninsured buy basic coverage

 What is missing will need to be added later:

  •  A genuine public option and/or tight limits on what insurance companies can charge
  • Real cost reductions, linked to changes in the whole fee-for-service system
  • Even a single-payer system if insurance companies continue to misbehave

 This is the start of major health care reform, not the end. Better start with something than with nothing.

 The strategy is credible – pass the Senate bill in the House, and reform the joint bill by use of reconciliation

 But success, even on modest change, is still not guaranteed. Watch those blue-dog democrats!  Watch the Stupak amendment crowd.

 Let’s hope liberals in the House don’t let the perfect drive out the good. Snatching defeat from the jaws of victory is not sensible politics, this close to the mid-terms.