The greatest problem with the Senate health care bill is not that it does “too little” to help people. The problem is that the bill does too many terrible things to help all the bad actors.

The Senate bill further entrenches the private health insurance system. It continues the terrible pattern of privatizing our social safety net in such a way that business skims 20% off the top. It makes sure the big, life saving medications of the future remain incredibly expensive, so as to enrich the drug industry. It takes a giant step towards eroding women’s reproductive rights. It wastes hundreds of millions to fortify the same, broken health care system that is crushing our economy. The worst part is I don’t see anything in this bill that might serve as a path to real reform. There is no public option or Medicare buy-in. There is no proper state single payer waiver. There is no mechanism to move to an all-payer system and/or a clear path to force for-profit companies out of the health insurance market.

I would gladly fight for a smaller health care bill that just gave Medicare to people over 50 who don’t want to keep their current insurance. That would help fewer uninsured people, but would do it the right way. It would be real help, and it would be done in a simple, cost effective, and fiscally conservative manner. It would be a small step, but, importantly, it would be a step in the right direction. That would actually be a health care reform foundation I would be proud to build on.

I have no problem fighting for incremental reform as along as it is improvement done the right way, or at least with a pathway in the right direction. What I do have a real problem with is taking big steps if they are steps in the wrong direction. If anyone can actually explain how this bill, which will funnel hundreds of billions of dollar into private hands, and force millions of Americans to be customers of the same private health insurance companies that helped ruin our health care system, will actually serve as a vehicle for the real reform we will eventually need, I would love to hear it. Personally, I just don’t see how the fight will be easier in the future, once the health insurance industry is a few hundred billion dollars richer, and already has a captive market thanks to the IRS.