Assuming, as expected, that the Senate plays ball, we will have Health Care Insurance Reform.
This is indeed an important victory and an historic moment. And it is testimony to Obama’s political skills and the policy chops of Senate and House Democrats.
Although the process has been exhausting and frustrating and the deal-making ugly, the result is impressive. Ezra Klein provides an excellent summary of the accomplishment:
This was a hard bill to write. Pairing the largest coverage increase since the Great Society with the most aggressive cost-control effort isn’t easy. And since the cost controls are complicated, while the coverage increase is straightforward, many people don’t believe that the Democrats have done it. But to a degree unmatched in recent legislative history, they have.
Furthermore, the bill reduces the federal budget deficit.
All of this was accomplished in the face of lies about “death panels” and “government takeovers”, deep cynicism, outright threats, an utterly polarized electorate, and powerful interest groups who could easily have scuttled the effort. Ezra Klein again:
This year, the Obama administration succeeded at neutralizing every single industry. Pharma supports the bill. Insurers are incoherent on it, but there’s not a ferocious and united campaign to kill the proposal. The American Medical Association has endorsed the Senate bill. The hospitals have endorsed the bill. Labor has endorsed the bill. The business community is split, with larger employers holding their fire.
The legislation isn’t perfect—far from it. And one could argue that Democrats should have pushed for a better bill, ditched the attempts at bi-partisanship that failed to garner a single Republican vote, and resisted the influence of the insurance companies who will likely come out winners from all of this.
But truth be told, there was not a lot of room for maneuver. The compromises were probably necessary given the political climate.
The unsung hero here is Nancy Pelosi who mastered the end game and guided this legislation through a House Democratic caucus with sharp ideological differences in an election year.
But with all the celebration, a note of caution is in order. As Robert Reich wrote recently:
Nothing that’s legislated is perfect and in my view the good that will come from passing health care legislation outweighs the bad, but be warned: the pending House bill (that will go to the Senate for a “reconcilation” vote) does not repeal the antitrust exemption for health insurers, nor does it contain a public insurance option. It thereby will allow health insurers to continue to consolidate into even larger entities, gain as much market power as they can, and charge ever higher prices. Yet Americans will be required to buy health insurance from them. Assuming the bill becomes law, this dissonance spells trouble. It will have to be addressed before 2014, when the bill takes effect.
The real work starts now. This is complex legislation that must be implemented correctly if it is to have the desired effects on health care coverage and cost reductions. And much of the bill does not take effect until 2014—that is a lot of time for mischief-makers to derail the effectiveness of this much needed reform.
Dwight Furrow is author of
Reviving the Left: The Need to Restore Liberal Values in America
For political commentary by Dwight Furrow visit: www.revivingliberalism.com
