Jonathan Rauch has a piece up in the National Journal in which he, reluctantly, endorses the current Senate Health Care Reform Bill. Clive Crook and Andrew Sullivan both concur, but it’s Rauch who makes the best argument, and he makes it from the Deficit and Cost perspective:

Although long-term budget projections are squishy, the Congressional Budget Office’s are the best we have to go on. Notably, CBO scored the Senate bill as deficit-neutral (actually, it would slightly reduce the deficit) over the reform’s second decade after enactment, which is well beyond the window of cost-shifting and timing gimmicks. We could do worse, and possibly will do worse next time around.

And what about bending the cost curve? Health care inflation devours wages, burdens employers, and could eventually bankrupt the government. A reform that fails to grapple with the cost problem, the critics say, is not worth having. I agree.

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Most economists believe that two pervasive market distortions fuel health cost inflation. The first is Medicare’s fee-for-service payment system, which pays providers based on the number of procedures they perform, rewarding inefficiency. The second is the tax deductibility of employer-provided health insurance, which subsidizes high-cost policies, hides the costs of those policies from employees, and denies employees the opportunity to shop around.

Both distortions inhibit market discipline, and both originate with bad government policy. If socialized medicine is state payment for most health care, then the country is there already: When the value of the employer tax subsidy is included, the government (federal and state) pays for almost 60 percent of all U.S. health care, according to Paul Van de Water, an analyst with the Center on Budget and Policy Priorities. Dealing with Medicare and the employer tax deduction is therefore crucial to cost control.

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As for the employer tax break, the Senate bill docks it. Not a ton. Only high-premium policies covering a minority of workers would be taxed. But even the limited tax is very important, for several reasons.

Crucially, the threshold for taxation would not rise as fast as health inflation. Translation: Gradually more and more employer-provided policies would be taxed. The change would be incremental, even glacial — but slow seems to be the only pace with which Americans are comfortable.

Moreover, after reform is enacted, the taboo on taxing employer-provided health benefits will be shattered once and for all. From then on the question will be how much to tax, not whether. A door that had been welded shut will have been pried open. The country will be able to have a new kind of discussion, one in which the tying of health insurance to employment — which is insane, when you think about it — is no longer sacrosanct.

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Taken together, these measures could set in motion a virtuous cycle. As health costs rise, more employer-provided health plans become taxable, giving employers an incentive to find cheaper plans. As employer-provided plans grow less generous, more employees have an incentive to take a tax credit and shop around, and, as premiums rise, more qualify to do so. Little by little, insurance coverage shifts toward an individual-based, consumer-driven market. And the faster health insurance costs rise, the faster the transition happens. The disease triggers its own antibodies.

Again, no guarantees. The transition would be very gradual, and political blowback could easily disrupt it. But the point is that the reform contains a pathway to sanity. No one can say that about the status quo.

This is much better way of making the argument I was attempting to make here.

If the GOP were serious in their Health Care Reform critique, socialism!, they would propose how to slowly END Medicare. But that’s not their position; no Scott Brown, Michael Steel, and Jim deMint have all made defending Medicare, of any cuts, a central tent pole of their argument. I suppose that this is to be expected from the people whom passed Medicare Part D, which as it happens cost MORE than the bill currently before Congress. Yet, Medicare Part D was passed without a funding mechanism, blowing a ‘doughnut’ hole in the deficit.

So our option is pass this bill, or stay with the status quo.

If we pass this bill there is a decent, better than even, chance that Health Care costs can be contained, and those costs will be funded, without a huge and growing deficit. (Yes, taxes will be higher) If we do not, we will ASSURDELY have an exploding deficit, and Health Care related costs will continue to retard the growth of the economy, until most likely, a posse of Bond Traders from China and the Middle East shout ‘No Joy’ and all those economic calamities that the GOP is warning about, dollar collapse, stagnation, inflation, unemployment, ect., come into full fruition.

Pass. The. Damn. Bill.