I’ll answer your question. As many liberals see it, myself included, the small incremental changes that you laud in the Senate bill are not changes at all. Lacking a public option, the Senate bill still keeps the power of healthcare delivery entirely in the hands of private insurance companies. And lets be clear – insurnace companies are in business to first make profits for their shareholders and second deliver healthcare to policy holders. While the insurance companies have been required to expand their coverage pool by a a small but still significant number of people, because they are private companies, they will still argue that in doing so they need to maintain their profit margins, which can only be done by cutting services or raising rates.

Neither is acceptable to liberals, because we view healthcare as a necessary service, not a discretionary good. Thus, any plan that doesn’t include things making the delivery of that service affordable and universal doesn’t meet our test of good legislation, nor does it show any real change from the present system as we see it.

I would also add, from inside the federal bureaucracy, that small incremental change doesn’t generally happen – the bureaucracy waits it to death. Big change – as intellectually challenging as it may be for some Conservatives – is the only way the goal posts will move.

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