Living with the possible

Politics is the art of the possible. That’s a cliché, of course, but no less true for it. And the health-insurance-reform legislation that will emerge from Congress early in the new year is the best that is possible, at least for now.

Lest that sound like settling for half a loaf, consider what the Senate bill, which is likely to prevail over the House measure in conference, will do, according to the Center for American Progress:

• Extend health-insurance coverage to 31 million Americans.

• Make the largest single expansion of Medicaid since its inception.

• Make it illegal for insurance companies to drop or deny coverage because you are sick.

• Lower premiums for families by an estimated 8.4 percent.

• Invest in disease prevention and wellness through a Prevention and Public Health Fund.

• Prohibit subprime policies that deny coverage when illness strikes.

• Help businesses afford coverage by enabling them to purchase insurance through state-based exchanges.

• Improve Medicare by eliminating the special subsidy to private insurers participating in Medicare Advantage and extending the life of the Medicare trust fund for nine years. It also closes the so-called “doughnut hole” in Medicare’s Part D prescription-drug plan.

• Reduce the federal deficit by up to $409 billion over 10 years, according to the Congressional Budget Office.

The wheeling and dealing needed to get the 60 votes required for passage in the Senate was unpleasant to watch, but politics are rarely a pretty sight.

There’s a lot of resistance to the bill, from the tea-party extremists on the right who insist it’s socialism (or worse) to the progressives on the left who won’t be satisfied with anything less than a single-payer system.

For all its weaknesses, however, the bill that will soon emerge, be passed and signed by President Obama will be a historic accomplishment. It will give tens of millions of Americans real help and everyone else greater security. Most important, it will confirm that in the United States health care is a right, not a privilege meant only for those who can afford it.