Op-ed by the Vice President in the New York Times

Why the Senate Should Vote Yes on Health Care

by Joe Biden

If I were still a United States senator, I would not only vote yes on the current health care reform bill, I would do so with the sure knowledge that I was casting one of the most historic votes of my 36 years in the Senate. I would vote yes knowing that the bill represents the culmination of a struggle begun by Theodore Roosevelt nearly a century ago to make health care reform a reality. And while it does not contain every measure President Obama and I wanted, I would vote yes for this bill certain that it includes the fundamental, essential change that opponents of reform have resisted for generations.We have been here before.

In the past, as the moment of decision drew nearer, criticism from both the left and the right grew louder. Compromises were derided. The perfect became the enemy of the good. Most recently, in 1993, Democrats had a chance to forge a compromise with Senator John Chafee, Republican of Rhode Island, on a health care reform bill. Congress's failure to pass health care reform that year led to 16 years of inaction - and 16 years of exploding health care costs and rising numbers of uninsured Americans.We can't let that happen again.

While it is not perfect, the bill pending in the Senate today is not just good enough - it is very good. Insurance companies will no longer be able to deny coverage to those with pre-existing conditions or drop coverage when people get sick. Charging exorbitant premiums based on sex, age or health status will be outlawed. Annual and lifetime caps on benefits will be history. Those who already have insurance will be able to keep it, and will gain peace of mind knowing they won't be priced out of the market by skyrocketing premiums. And more than 30 million uninsured Americans will gain access to affordable health care coverage.

That is not all. President Obama and I know we have to put our fiscal house in order. This is why those who claim they oppose reform because they fear for our country's fiscal stability should finally acknowledge what the nonpartisan Congressional Budget Office makes crystal clear: not only is the Senate bill paid for, it is this country's single largest deficit-reduction measure in a dozen years. I share the frustration of other progressives that the Senate bill does not include a public option. But I've been around a long time, and I know that in Washington big changes never emerge in perfect form.

Those in our own party who would scuttle this bill because of what it doesn't do seem not to appreciate the magnitude of what it has the potential to accomplish. Howard Dean was head of the Democratic Party. I respect his leadership on health care, and I understand his criticism of the bill. But it is worth noting that on some of the key health reform issues - like ensuring that Americans have access to stable, affordable coverage, and doing away with abusive practices by insurance companies - the reforms in the Senate bill would do even more than Vermont, the state he governed, has done. And they would do it for the entire country. What's more, this bill would expand both choice and competition in an insurance market that, for many Americans, has offered far too little of either.

The issues in the health reform bill are complicated, but the consequences of failing to pass it are straightforward. Those who would vote no on this bill need to look into the eyes of Americans who don't have health care now and tell them they're going to be better off without this bill - better off continuing to live without health coverage. They should explain to all those Americans who are denied coverage because they have pre-existing conditions or whose insurance ran out because of lifetime caps that they don't need this bill. And they should tell the families who have insurance and the small-business owners who provide it that the relentless rise in their premiums without this bill will somehow make them glad it didn't pass.Is America better off today because a chance at a compromise health bill was missed in 1993?

For my friends on the left, the rising toll of the uninsured provides an emphatic no. For my friends on the right, the soaring share of federal spending on health care likewise provides a no. Let's not make the same mistake again.

If the bill passes the Senate this week, there will be more chances to make changes to it before it becomes law. But if the bill dies this week, there is no second chance to vote yes. What those who care about health insurance reform need to realize is that unless we get 60 votes now, there will be no health care reform at all. Not this year, not in this Congress - and maybe not for another generation.