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Health reform: Are we there yet?

Nancy Pelosi is known around San Francisco — and in a few other spots — as one tough politician. She likes being Speaker of the House, and she doesn’t much like losing. So this week’s do-or-die health reform bill is going to get all the muscle she can manage. It is, Pelosi has declared, “a moral and political imperative.”

Okay, it’s not what we hoped, it’s too complicated and too fraught, it’s going to be full of little gifties given to get votes. If we don’t get something America will be stuck with a non-functional system and millions will remain without health care at all. So I for one am on Pelosi’s side.

The plan is for the House to pass the Senate version and send it to Obama for his signature and enactment. Certain fixes the House is demanding for passage of the more conservative Senate bill will be included in a separate, special measure that will go to the Senate for an up-or-down vote that avoids a filibuster.

But once the House passes the base legislation and Obama signs it, the measure becomes law regardless of what the Senate does.

Democrats do not yet have the votes in hand and Pelosi will not call a vote until they do. Liberal lawmakers have deep reservations about the Senate bill, and fights over abortion and immigration have yet to be resolved. But Pelosi has set the legislative train in motion, even as Republicans have publicly begun to express doubt that they can stop it.

Pelosi laid down the law to wavering Democrats who are threatening to bolt. “It’s not about abortion, it’s not about immigration,” she said. “The only reason, therefore, to oppose the bill is that you do not support health care reform.”

A lot of people don’t support health care reform. The Republicans, the insurance industry, the anti-abortion folks and the anti-immigration folks and more than a few people who feel pretty much okay with what they’ve got and frankly don’t care a lot about what others don’t have.

But health care reform is a moral imperative.

Pelosi: Dems will have votes to OK health care.

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