I'd add to this that my read of the history is that social policy programs generally get better, rather than worse, over time. Right now, there are a lot of people who worry they'll lose something they have if health-care reform passes. But no one is currently receiving benefits from the plan. If it passes, however, then health-care reform develops its constituency, which has the power to protect its important provisions and expand where necessary. That's how Social Security grew, and Medicare, and Medicaid. [emphasis supplied]

Without the public option, there is nothing in this bill that remotely resembles Social Security, Medicare or Medicaid.  An exchange is not a "social policy program," it is a marketplace.  An exchange holds no guarantee for anyone.  And heck, the principle behind the exchange (market competition) is not exactly a progressive approach, it sounds more Republican than anything else.  Give Republicans something to run on if it works!  Great!  I can totally see them using the Exchange as a pretext for destroying all of the social policy programs listed above.  But I digress.  Who believes the public option can be inserted later if the bill is passed without it now?  C'mon.  

And as far as Bowers goes, he falls into the same "moral" style of argumentation that Yglesias and Klein have previously used.  It's just a guilt trip.  And it is done really, really poorly - instead of making the moral argument for the most progressive parts of the bill, they only use it for the least progressive parts of the bill, and only throw out the "moral" argument when they are being defensive of it.  It would have been nice to see progressives use the moral argument on offense, and make a better bill.  But Obama didn't do this, so his sycophants did not either.

I'm just wondering, getting paid by whom?

Wilmington, N.C.: Hi Ezra. In reference to Chris Bowers' support for the current bill, you refer to the way historically social programs (Medicare, Medicaid, Social Security) expand. But with the exception of the public option, what significant "social policy program" is in the health bill? I don't consider an insurance exchange to be a "social policy program" for example. Thanks!

Ezra Klein: The individual mandate, paired with the subsidies and the insurance regulations and the exchange, are a major new social policy program. It is a basic structure for universal health care, which we have never had in this country. And as more people move to the exchanges over time, and the mandate and subsidies are strengthened to go the final few miles to universal health care, it will become more so.