Universal healthcare has been our fight for 50 years. It is ingrained in our DNA and we are close. There are no guarantees, but Democrats offering tort reform will confound the Republicans, take away one of their most potent arguments, and put us back on the offensive. If that means throwing some trial lawyers under the bus, so be it.

Why haven’t we talked about tort reform during this entire debate? Because we haven’t wanted to bite one of the biggest hands that feed us. That substantial and legitimate disagreement over the effects of medical malpractice awards on health care costs is another. And there is our child-like fear the trail lawyers will abandon us.

On that last point let me be brutally pragmatic. The trial lawyers won’t abandon us because they have nowhere else to go. As a trail lawyer friend admitted to me, “I hate to lose medical malpractice, but there’s a whole lot of suing to do out there that has nothing to do with doctors”. And that’s the point. We’re not talking about massive tort reform. We’re not taking tobacco and asbestos of the table. We’re talking a cap on punitive damages