Some thoughts on the health care reform bill

March 22, 2010



The blogosphere is abuzz and the tweets are flying about the House's historic vote to pass the health care reform bill. First, let me say that I'm very happy the bill passed, even though it isn't perfect. While my feelings shouldn't be a surprise, I did want to go a step further and share some of the many thoughtful reactions that I came across today.

"Why This Moment Matters" at The Atlantic, by James Fallows

For now, the significance of the vote is moving the United States FROM a system in which people can assume they will have health coverage IF they are old enough (Medicare), poor enough (Medicaid), fortunate enough (working for an employer that offers coverage, or able themselves to bear expenses), or in some other way specially positioned (veterans; elected officials)... TOWARD a system in which people can assume they will have health-care coverage. Period.

There are countless areas in which America does it one way and everyone else does it another, and I say: I prefer the American way. Our practice on medical coverage is not one of these. Despite everything that is wrong with this bill and the thousand adjustments that will be necessary in the years to come, this is a very important step.

"Waterloo" at FrumForum, by David Frum

Talk radio thrives on confrontation and recrimination. When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say — but what is equally true — is that he also wants Republicans to fail. If Republicans succeed — if they govern successfully in office and negotiate attractive compromises out of office — Rush's listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

So today's defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it's mission accomplished. For the cause they purport to represent, it's Waterloo all right: ours.

"Make It Count" at Talking Points Memo, by Josh Marshall

The Democrats won that battle because they said to themselves and the country: on this ground we're willing to lose. And in addition to all the hard work and everything else in their favor, that commitment stiffened their spines and made them credible to the public at large. It made the political victory possible.

A genuine willingness to lose means just that: you might lose. You might lose big. And the dynamics of a mid-term election, amidst crippling unemployment and an energized right, have certain unavoidable implications. But I suspect the effect for the Democrats of actual passing this legislation will be considerably more positive than people realize.

"Get Ready" at A plain blog about politics, by Jonathan Bernstein

The oddest thing about the health care debate, at least in my view, is that Republicans basically did not engage on the actual substance of the bill. Lots of stuff about death panels, and lots of stuff about procedure, lots of stuff about backroom deals (most of which will be gone after reconciliation) but shockingly little about the individual mandate — or, as Tim Noah points out, about the actual taxes that really are being raised for this. The only real substantive complaint they highlighted was Medicare, where they argued against their own position.

"Will health reform wreck us? Hardly." at Philadelphia Daily News, by John Baer

What really happened, finally, is a House elected by a majority decided to act in the majority's interest. What happened is the start of an effort to fix a problem that sooner or later touches everyone. And what happened is a step toward ending America's moral deficiency as the sole industrialized Democracy not offering health care to its people.

I don't recall rage over budgeting $144 billion more last year for two wars halfway around the world. Or over foreign-aid costs, which grew from $17.5 billion in 2000 to nearly $42 billion in 2007, according to the U.S. Agency for International Development.

I don't pick up similar sniping over spending on the misguided, seven-year-old folly in Iraq, the long-term cost of which the Congressional Budget Office puts at $2.4 trillion - enough to twice pay for the health-care bill, with $520 million left over for, say, children's cancer research.

No, siree, Bob. So focus, people. The only thing to be angry about regarding health-care reform is that it took so long to get it started.

"219 to 212." at The Atlantic, by Marc Ambinder

Republicans had bet that throwing everything into to killing the bill instead of working with it would result in the bill's defeat. The entire strategy was predicated on killing the bill. Now that the bill has passed, it means that the health care system has been fundamentally changed, and there's no way — and there will not be the votes — to repeal it. No one will tell seniors that the donut hole will be opened up, or people promised new insurance that they'll have to look elsewhere, or that rescission will once again be legal. Democrats will work for to force Republicans to talk about repeal as often as possible.

"The Dour and Monolithic Have Managed To Unite the Opposition" at The Atlantic, by Abraham Verghese

I have been trying to explain to my youngest why this is such an exciting moment: front line soldiers in Afghanistan and Iraq take personal risks, put their lives on the line. But so few politicians put their careers on the line, even though they make decisions that have an impact on soldiers. President Obama (and to some degree every Democrat who supports this bill) is putting his political career on the line. The idea that you might do what you think is right and pay a penalty has been so foreign to politics that it surprises us when we see it. I think my son is surprised to hear all this. He assumes at 12 years of age that people, especially people we elect, go to Washington to do the right thing.