I’d be lying if I didn’t admit to some pretty strong emotions when I watched those 216 votes come in last night on C-SPAN. As somebody who, perhaps foolishly, believes that the point of politics isn’t to merely score more points than the other people, but to enact real programs that lead to a better life for everybody, these kinds of victories are few and far between. Considering that health care reform has been almost a century in coming, these things are far between indeed. This may be the most important bill I will see in my lifetime, on par with Social Security and Medicare. To undertake a significant transformation of how health care is viewed in this country has been foolhardy; to see it succeed is nothing short of astonishing.
When the reports were rolling in on Sunday, and passage of the bill became more and more inevitable, it made all the phone calls, lit drops, roads trips, and door knocking worthwhile. Sure, there are other important issues other than health care out there. I like fiddling with tax policy and transportation, there’s the environment we need to take care of, there’s energy policy, and a thousand other things. But universal health care is the big one. America has long been on the wrong side of this issue, apart from all other industrialized countries, and our health and pocket books suffer as a result. Universal health care is the last large promise that we can make as community: that if you get sick, you will be covered. Even if you were sick before, even if you aren’t working right now, you will be covered. This is a far cry from a system where you get care if you pay for it, and if you don’t have the money you are at the mercy of others. That’s fine when it comes to luxuries, it’s even fine when it comes to some of life’s necessities. But to dole out health care based on ability to pay is not only unfair, it damages our communities in the long run.
This bill is by no means perfect. It needs to be improved. But the first step has been achieved: health care will now be seen as a right, not something to leave entirely up to the whims of who has money and who doesn’t. We’ll have problems along the way. We’ll screw up. But we’ll also find what works, and we’ll share those solutions. We’ll work together to reduce the cost of care, to reduce mistakes, to eliminate pointless treatments that do no good. We’ll eliminate the dead weight in our economy that this wasteful spending hangs around our necks.
But more importantly, we’ll tell those people who are sick that they no longer have to fear. If they lose their jobs, they don’t have to worry about losing insurance. They don’t have to worry that if they get too sick, or become to “expensive” to their insurance company, they’ll be left to fend for themselves. For people in good health, these seem like academic exercises. For all those people with so-called “pre-existing conditions”, however, this is not abstract. It’s a matter of life or death, and even those people who oppose health care reform will soon know a friend or loved one who is helped by this, if they don’t already. I know that I do.
Am I happy about how this was done? No. I’m saddened that insurance companies, having decades to prove that they could cover everybody regardless of health at a reasonable cost, chose instead to pursue profits at the expense of people. I’m saddened that too many Republicans chose to take themselves out of the process instead of working for common solutions. Ideologically, this bill is incredible moderate. It differs little from what Republican Mitt Romney did in Massachusetts, or what Republican Richard Nixon proposed when he was president. It took single-payer off the table from the start, and abandoned even a public option and Medicare buy-in. If Republicans had been at the table from the beginning instead of trying to torpedo reform, it may have been a better bill. Now we’ll never know.
I’d like to see changes to this bill. I’d like to see a public option. I’d like to completely decouple insurance from employment (as well as decoupling other things from employment like 401(k) plans to reflect a more mobile, fluid, and information-based economy). I’d like to see more flexibility in providing primary care to people: not everybody needs to see an M.D. I don’t care much for the Hyde amendment. We’ll need to see what cost-control measures work best and expand them.
These things will come in time. For now, it feels good to achieve something meaningful, something that fundamentally improves the lives of millions.