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.

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With the Senate poised to debate health care, we face a torrent of words. They will be important words. America desperately needs health care reform, no matter how set against it are sections of the political establishment. “The richest country on earth still unable to provide basic health care cover for one-seventh of its population” cannot and should not be allowed to stand. But nor should the illusion that health care reform will make America healthy. We need health care reform so that every sick American gets the treatment she or she so vitally needs; but we need far more than that. We need to put aside our tendency to require our key institutions to solve problems which we decline to solve ourselves. We ask our schools to solve problems of segregation and poverty whose origins lie deep in the way we choose to live our lives as adults.  We are now asking our hospitals and doctors to solve problems of illness that are similarly socially rooted.

By David Coates

As health care reform legislation moves to the Senate floor for debate later this month, the stakes are high for President Obama and the nation. Health care reform is Obama’s Waterloo. He has to win this one. A loss on the health care front would lead to losses on future key legislation as well. If Obama loses health care, he will lose immigration.

In order to pass health care reform, the two sides must consider the following key points.

“The Perfect Must Not Drive Out the Good” – While the current legislation is far from perfect, it does pave the way for important changes in the U.S. health care system that could ease the anxiety level among Americans. We want to get to the point where health care is not something Americans worry about. Even though there is a widespread belief that we have the finest health care system in the world, we also have a higher level of anxiety than any other country about the cost and availability of the heath care that makes us so proud.

“Weakness on the Cost Side Must Not Prevent Reform on Access” – Much of the opposition to reform is focused on the costs involved, but there is a critical need to broaden access to health care in the U.S. now. The current reforms would only be Round 1, with Round 2 to follow as the cost implications play themselves out. Paradoxically, the public option, which Republicans oppose, is the very provision that would drive down costs by providing competition for private insurance companies.

“Health Care Reform Would Stimulate the Economy” – The U.S. health care system accounts for 1/6 of the economy and employs 14 million people. New players on the demand side would provide an economic stimulus, whereas the status quo will lead to escalating costs and stagnation.

Informed discussion on these and other issues is the key to overcoming the current divide.

Health care is arguably the most important political issue touching the daily lives of each of us, yet deep ideological differences scar the political landscape. The final settlement will be a compromise satisfying neither extreme, but definitely privileging access over costs with proposals designed to widen and deepen access to health care.

David Coates is a political science professor at Wake Forest University and a frequent speaker on health care reform. For interviews with him, contact Carol Cirulli Lanham at 972-818-0895.