Though notable, Saturday’s vote by the House of Representatives on
health care reform doesn’t pack the same historic punch as the landmark
creations of Medicare or Social Security. The bill lacks the momentum
to get past the Senate, much less echo through time.

Still, the House bill is important because it moved the process
forward. The Senate now has a strong foundation for its deliberations,
which will likely focus on two points: employer mandates and the public
option.

The first should stay. Influential voices such as Sen. Olympia Snowe do
criticize the mandates, which would compel employers to offer coverage
to workers, as bad for business. However, they would also ensure level
competition in the private sector. Employers should either pay by
offering insurance, or pay a significant penalty for failing to do so —
simple, and without conditions.

If the goal is the lowest possible number of uninsured Americans, this
seems the most straightforward path to it, given the constraints of our
employer-based system.

A public option, however, remains a dangerous idea. If there is one
idea that could cause reform to stall between the House and Senate
(where 60 votes are likely needed), it is the option. On this point,
there must be negotiation.

Democrats cannot allow the pursuit of their perfect plan (the public
option) to stand in the way of more important reforms. The House bill
is packed with sensible, powerful ideas to help more Americans get, and
keep, health insurance coverage.

Near-universal coverage could also provide the leverage necessary to
bend the proverbial cost curve in health care. The current bill does
nothing to specifically address cost reduction; rather, it offers a
framework for controlling ever-increasing medical spending.

As the Massachusetts insurance reforms show, a public option is not
necessary to broaden coverage at an affordable cost. Yet, as the Maine
insurance reforms show, a public option is no miracle drug for the
chronic ailments of spiraling health care and insurance premium
expenses.

If the coming debate in the Senate hinges on the public option, the
possibility exists that all of reform could come crashing down.
Congress must pay attention to the much bigger picture, which is
passing the most complete, innovative package of reforms as politically
possible.

On Sunday, in the vote’s aftermath, there was much touting of its place
in the Pantheon of social reforms. It’s way too soon for that.

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