Healthcare fallback plan

In the software world, the best strategy is to ship early and often. Get something out there that solves a real problem, then fill in the missing pieces and continue to improve it. Iterate. In politics, though, we often only have one chance in years or decades to get it right.

The healthcare bill passed the Senate and is on its way to becoming real, even if it’s a shadow of what it could have been. We should be thankful that we got anything — the changes do matter — but at the same time I can’t help thinking it was a missed opportunity.

Who’s to blame? I wish Democrats had fought harder; I wish they’d framed the debate correctly from the start. I still like George Lakoff’s focus on calling the public option the American Plan, but I also like John Neffinger’s point that maybe the real mistake was in not starting with a single-payer plan so that the public option would look like a moderate compromise. It feels like many Democrats were resigned to failure early on.

In an unrelated tweet a few weeks ago, from comic artist Kazu Kibuishi: “If you have a fallback, you will fall back.” My failures reflect that too. To shoot for greatness you have to put everything you’ve got into your first effort.

I keep coming back to something Hillary Clinton said in a debate with Obama early in the Democratic primaries of 2008. It struck me as so true at the time that I wrote it down:

If you do not have a plan that starts out attempting to achieve universal healthcare, you will be nibbled to death.

And that’s what happened.