Both on substance and politics, better to pass it than not. It does not do the important work of sowing the seeds of the insurance industry's destruction, leaving the skimmers in place, and only takes baby steps towards moving them to the regulated public utility model. It also doesn't get rid of their anti-trust exemption, leaving the effective monopolies in place. This leaves us open to continued abuses by the industry and fails to do the most important cost-cutting measure, cutting out the paper pushers who serve no useful purpose in the economy. But there is good in the bill, too, and one has to be a bit Hopey that over time demands by the public will make the bad and unpopular stuff less bad and less unpopular.

My marker for Obama was whether he'd get a health care bill with a public option. He didn't. A year ago passage of some sort of health care reform seemed inevitable, and not a tremendous challenge. Only a year of dithering and bipartisaning and gangs of wankers and pre-compromising and, frankly, failure to put forward something simple and popular jeopardized it.

The bill's more good than bad, but it isn't what we should have gotten. It isn't what we voted for.