For the past couple of months, I've been reading up magazines and books, asking questions of friends who work in health care, and following the debates as it's gone through both houses of Congress. I hoped the bill would have a public option, because the arguments I heard for it, to offer competition to private insurance companies and to drive down costs, made a lot of sense to me. When the public option was dropped in the Senate, I was disappointed, but wanted to see what alternatives could approximate the same goals of offering alternative choices and drive down costs. Many progressives were angry at the compromises that came out of the Congress because they felt that too many things were given away to private health insurance without enough regulations to reign them in.

Now with Scott Brown's victory in Massachusetts, the plans that the Democrats were working out in Congress seem to be unraveling. I was disappointed when the Senate version dropped the public option, but I thought the National exchange idea had some merit to give more options for insurance for the uninsured. If it was not possible to have a public option to compete with private insurance companies, I was hoping that Democrats would be able to agree to end the exemption of private insurance companies to anti-trust laws, so that the government could go to states where one or two insurance companies have monopolies and work to break up those monopolies. Of the House and the Senate versions, I was actually partial to the Senate version, because it didn't have the restrictions on access to abortion that the Stupak amendment put in the House version.

Yesterday I read in the New York Times that the White House is now pursuing a more pared down health care bill that will only have elements that will attract some Republican votes. I can see the logic of this, as a way of salvaging at least some of good things that had been achieved in months of negotiations of the health care reform bill. I see the logic, but I'm also severely disappointed that it would have to come of this. Both the House versions and the Senate versions of health care reform, even with all their flaws, would have helped give insurance coverage to 30 million to 32 million Americans who are now uninsured. According to yesterday's New York Times article, a pared down bill would cover only 10 million to 12 million people. I'm not sure what happens now to regulations that would force insurance companies to accept people with pre-existing conditions.

What should Democrats do now? Personally I'll probably support Obama's push to save what elements of the health care reform bill can be saved. But if it's possible to save the health care reform bills, I'll go to rallies and email my Senators and Representatives to show my support. Pamela Jean in the progressive activist website Everyday Citizen wrote a blog stating that progressive activists should get more involved in creating a progressive movement that can overcome conservative opposition and pressure politicians for change. I personally think that the push for a more universal health care reform will probably shift from the national level to more state levels. Massachusetts has a health care system that mandates that people have insurance that covers more people from that state. This year Connecticut passed a health insurance system that has a public option. I thought Dennis Kucinich had a good idea when he proposed that states be allowed to have to option of adopting a single payer if they so choose. The January 2010 Z Magazine article by Jane Slaughter "Labor Bargains for Too Little on Health Care Reform and Gets Even Less" notes the movement for health care reform in the state level:

"What's next for the movement? Many groups will turn to winning single payer in their states, whether or not national lawmakers enact a waiver that would make that easier. (Obama's chief of staff Rahm Emanuel was hyperactive in making sure the Kucinich amendment, which would have allowed such waivers, was killed.)

Geri Jenkins, co-president of the California Nurses Association, says, 'Single payer may be something we have to push forward on a state level and prove it works before we roll it out nationally'.

'A major barrier we need to confront is ideological,' says Sandy Eaton, a member of the Massachusetts Nurses Association. 'People are so used to worrying about getting the best benefit you can negotiate... rather than thinking, I have a right to it.'

Savage says, 'quit relying on elections and put your feet on the street.'"

82% of Obama supporters who voted for Brown support the public option, as do 86% of Obama voters who stayed home.

57% of Obama voters who stayed home on Tuesday support the Senate health care bill or think it doesn't go far enough.

And of Obama voters who cast a ballot for Brown, nearly half (49%) support the Senate bill or think it does not go far enough. Just 11% think it goes too far.

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Here are some information I received from Move On on articles on the state of health care reform after Brown's election.

"White House: Let's Let 'Dust Settle' On Health Care," Talking Points Memo, January 21, 2010

"Five myths about the Massachusetts Senate race" by Chris Cillizza Washington Post, January 24, 2010

"Obama Weighs Paring Goals for Health Bill," The New York Times, January 20, 2010

"Democrats begin discussing smaller health care overhaul after losing Massachusetts Senate seat," The Associated Press, January 21, 2010

"Obama, Dems regroup to cut back health plan," The Detroit Free Press, January 21, 2010

"In the aftermath, Dems debate path of party," The Hill, January 20, 2010

Poll conducted by Research 2000 January 19, 2010, commissioned by MoveOn.org, Progressive Change Campaign Committee, and Democracy for America