Of course, it's not a given that any of this will happen. We're still waiting to see what comes out of Senate Finance Committee, the last of five committees with jurisdiction over health reform. There, a bipartisan group of six senators are trying to hammer out a deal--and their progress has been slow. They seem likely to disgorge legislation that reaches even fewer people and offers even skimpier benefits. But the senators on the Finance committees, just like all members of Congress, respond to political pressure. The more pressure they feel to be ambitious, the more ambitious they will be. And that’s important, since Congress must eventually reconcile all the committee bills, taking into account whatever Finance produces.
If the possibility of lesser reform doesn't motivate liberals, then maybe something else will: the possibility of no reform. Twice in the last few decades, once during the Nixon era and then again during the Clinton years, liberals largely shunned compromise efforts at universal coverage because they didn't live up to progressive ideals. But holding out didn't lead to better legislation. It led to twenty years of trying to rebuild the momentum for reform, followed by a debate over proposals that are, if anything, less sweeping than their predecessors.
But forget all of the strategic second-guessing. There's a more basic and tangible reason why, even with compromises, progressives should engage fully in the reform battle. It's the fact that tens of millions of Americans go without health care, or endure financial hardship, because they can't pay for sky-high medical bills. If something like the House bill passes, life for these people would get immeasurably better--soon if not right away, for most if not all. They wouldn't have to give up their life savings, endure avoidable pain, or, in the worst of cases, watch a family member get sick and die because affordable medical care was not available. Surely that's a goal worth fighting for.