Even a little means a lot

Hard to argue with Jonathan Cohn's piece on TNR.  He breaks down how the current versions of the bill may only reduce cost marginally over the short term but that in the long-term - by implementing a variety of control measures in moderation to see what works and what doesn't - it can be very beneficial.   Certainly more beneficial than the unsustainable status quo.   

Some of the people complaining about this bill seem to acknowledge the political forces at play. If it's not possible to pass a bill with stronger cost control, they suggest, there should be no bill at all--or, at least, not one that looks like this one. They'd prefer only a very small expansion of coverage, if any, until real cost control has set in.

But here, too, the political logic isn't so simple. Just think about hospitals for a second. Reducing spending on health care is going to require a massive change in the way both public and private insurers pay them.
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You could make the same argument about other interest groups--or what the public, as a whole, would be willing to tolerate. The most aggressive cost control efforts from left and right would start by getting everybody out of their present insurance arrangements. Good luck trying to enact that.

To be absolutely clear about this, I would support health care reform if it did nothing more than expand and strengthen health insurance coverage. I think it's a moral imperative, as much for the sake of the middle class as the poor. But it so happens that the bill moving through Congress will do something more. It will reduce the cost of care--not by a lot and not by as much as possible in theory, but as much as is possible in this political universe. That's far better than the alternative, which is to do nothing.