Healthcare reform might be controversial right now, but if Obama gets a bill onto his desk and signs it, it will become a huge triumph almost overnight. Support for both the bill and for Obama will rise steadily, and Democrats of all kinds will reap the benefit of being seen as tough enough and savvy enough to get it passed. This is the fundamental reason that I'm optimistic about healthcare reform.Popular approval may have a "donut hole": there may be bumps in perception, even over years, in a rocky implementation. And assuming that the final product is weaker in several particulars than it should be, a key question is whether it creates a scaffold that can be built on : fair requirements for minimum coverage in health plans, controls against insurer cherry-picking to protect the exchanges, MedPAC or some near equivalent to keep the ball moving on cost control initiatives. But assuming the final legislation is not wired for failure -- like, say, the Texas Insurance Purchasing Alliance of the mid-nineties -- then Drum's "future perfect" should be on target.
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