The House of Representatives finally passed the Senate's Christmas Eve version of Healthcare Reform, 219-212. This time, the legislation will go to the President and the Senate will take up a package of changes negotiated between the House and Senate. No doubt after some promised Republican Senatorial-haggling-over-parliamentary-procedure-to-come, the legislation will be signed into law. Healthcare reform, after a century of debate, will be enacted.
The floor debate in the House last night followed the tone of the argument in the country at large. On the Democratic side, there was a general pride in reaching out, finally, to the millions of Americans left uncovered by the current health system. There were members recalling civil rights struggles of the past to include all Americans in the franchise of voting and connecting health care as a right for all to stand alongside other basic freedoms we hold dear. On the Republican side, there were many exhortations about the end of liberty; members warned of losing a battle against tyranny and decried totalitarian tactics.
While both sides looked well beyond the facts to gin up an emotional basis for supporting their positions, it was hard to see the bill as the portent of tyranny promised by the opposition, when all it really does is to end the most tyrannical excesses of the insurance market by banning rescission and requiring coverage of all medical conditions, while also giving the insurers a sure pool of coverage that includes the healthy as well as the sick. One can't do the former without also doing the latter— and the Congress has additionally kept the insurers immensely healthy by making compromises to keep public competition out of their marketplace; there will be no public option in this bill.
The reform passed by the Congress, soon to be signed by President Obama, is essentially a moderate piece of legislation. Only in these United States would there be an outcry that it constitutes a government takeover of the healthcare system, when in fact it leaves the health insurance market entirely in private hands for those under the age of sixty-five and not indigent. But it is still intensely controversial, owing mainly to wild charges thrown at the bill claiming it will spawn death panels, cut assistance to Medicare consumers, and take away insurance from consumers currently happy with their coverage, none of which it actually does.
Republicans have allied themselves both with the most draconian policies of the insurance industry, like cutting off coverage from claimants who have become desperately ill after paying their premiums for years, and also with the most lunatic associations between this bill and socialism, communism, and with some racist free association done by the Tea Party movement, equating the healthcare bill with affirmative action programs. Both the concrete alliance with industry abuses and the more figurative conjuring of fear speech do the Republican Party long term harm in an effort to make election-year hay out of its opposition to reform.
Democrats, meanwhile, should take some pride in finally making good on a promise to reform the system, however imperfectly at the outset. The bill will make a difference in many lives, while still requiring years of tweaking to optimize its costs and extend its promise of coverage to all. The bill has gaps, just as Social Security did when first enacted in the 1930's. They must be addressed in the years to come. But at least the legislation finally moves the country from the Dark Ages of healthcare, when thousands of Americans currently die annually because they have inadequate access to the best medicine available, to a somewhat brighter tomorrow.
It would be callous, however, for Democrats to stop here in this time of great troubles for many Americans. The country needs both jobs and protection from a financial sector still unbound after leaving the nation mired in the wreckage of the worst meltdown since the Great Depression. The healthcare debate has sapped much strength from efforts to get people back to work and to protect us from the worst practices of Wall Street. Hopefully, a victory in healthcare will leave the Democrats and the President feeling empowered to take on the most critical job—making America whole again. If they don't, they will leave themselves open to exactly the kind of demagoguery they've been fighting so long on healthcare— and they will perhaps deserve it.