Even when the "fixes" that have to be approved by the Senate are made, the health-care bill will still be something of a mess. But it's a glorious mess, because it enshrines the principle that all Americans have the right to health care -- an extraordinary achievement that will make this a better nation.
It may take years to get the details right. The newly minted reforms are going to need to be reformed or at least fine-tuned, and those will not be easy battles. But the social movements that allowed Obama to become president and Pelosi to become speaker proved that the arc of history bends toward fairness and inclusion.
Needed change must not be thwarted, even if some people find it hard to accept. Obama got it right in his remarks following the vote: "We did not fear our future. We shaped it."
Historians will see this health care bill as a masterfully crafted piece of legislation. Obama and the Democrats managed to bring together most of the stakeholders and every single Senator in their party. The new law untangles the dysfunctionalities of the individual insurance market while fulfilling the political imperative of leaving the employer-provided system in place. Through determined advocacy, and against special interest opposition, they put into place numerous reforms to force efficiency into a wasteful system. They found hundreds of billions of dollars in payment offsets, a monumental task in itself. And they will bring economic and physical security to tens of millions of Americans who would otherwise risk seeing their lives torn apart. Health care experts for decades have bemoaned the impossibility of such reforms--the system is wasteful, but the very waste creates a powerful constituency for the status quo. Finally, the Democrats have begun to untangle the Gordian knot. It's a staggering political task and substantive achievement.
There will be years of wrangling over the system's costs and how it works in practice. Every successful health system in the world confronts such arguments. This new law will not end all our health care problems (no law could), but it does a great deal for access, and it makes solving other problems a little easier. Above all, it puts us on a new path.
For Obama, this struggle was transformative. He began his administration full of hope that his campaign pledge to achieve concord across party lines was a realistic possibility. But, when faced with implacable Republican opposition, he jettisoned the happy talk and came out fighting.
If bipartisanship is more fashionable than partisanship, partisanship with a purpose is infinitely preferable to paralysis. Obama has made clear that he will reach out when he can, and do battle when he must.
By temperament, the president is more a consensus builder than a warrior. But he is also a practical man who wants to accomplish big things.
On Sunday, he did just that on health care, and he earned a place in history.
The flip side of Obama's perhaps naive belief that he can win Republicans over is his ability to show them up. Americans are confused about the plan, but they are not confused about the man. By large margins they trust Obama more than they do the Republicans to produce rational solutions to the country's problems. In the past month, he exploited his mastery of policy detail, his pragmatism, his focus on effectively alleviating the suffering he spotlighted, and his willingness to stake his political future on getting this bill passed to the utmost. The full eloquence and passion of the campaign came back to his lips in forum after forum and speech after speech. To Democratic legislators, his message was that this bill epitomized why they had sought public office and why they were Democrats; it was the raison d'etre for their careers; in effect, passing it was worth their careers (and would make or break his own). In the bipartisan summit, he framed a core contrast: the Democrats would rein in the health insurers' worst practices; the Republicans would further enable them by weakening existing regulations. In rallies, he emphasized human suffering caused by leaving people uninsured and underinsured and enumerated the bill's benefits for ordinary people. As noted before, too, he presented the effort as a litmus test as to whether the Federal government was capable of taking meaningful action to solve national problems. He moved the needle of public opinion enough to move enough House Democrats to "yes."
The process may have been frustrating, and long, and ugly, as Obama told the crowd at George Mason on Friday. But it was also glorious. Obama has been telling crowds since 2007 that change wasn't going to be easy, but that it was possible with focus and persistence and courage. He just proved it.
It is a staggering achievement that Nancy Pelosi, Barack Obama, and others have carried this reform to the end despite these circumstances. Unfortunately, the toxic -- and easily manipulated -- political environment remains, and a lot of anxious moments still lie ahead. It's certainly dangerous to launch such a major program with one political party entirely committed to stirring up a backlash; "Repeal and Replace," we're told, will be the Republican motto in the fall. It's possible that the law's popularity might not rest on its true success – it may be blamed for insurance rate increases or credited for unrelated improvements.But that's too narrow a view of the bill's long-term effect on our political culture and the possibilities for further progressive movement. Social Security, for example, is not just politically successful in the sense that it's popular. It's successful because it dramatically reduced the fear associated with old age or disability. It gave Americans a confidence that they would be protected, a confidence that led to a greater generosity when it came to later efforts, such as Medicaid and Medicare. Health reform will succeed politically not by being popular but by working. That is, by giving Americans a much greater sense that they are not on the brink of losing everything, that they can change jobs or start their own business or admit to a medical condition without risking disaster.
David Frum, former Bush speechwriter, came down hard on Republicans.
I saw another Republican dismiss Frum by saying as a former WH staffer he's never been accountable to anyone, which I interpreted as meaning he's never been accountable to Republican voters, who are batshit crazy.
Here are some of the lovely messages Bart Stupak's been receiving:
Jim Clyburn talked about Republican leaders responsibility to tamp down the rhetoric:
Bob Herbert has had it with Republicans:
For decades the G.O.P. has been the party of fear, ignorance and divisiveness. All you have to do is look around to see what it has done to the country. The greatest economic inequality since the Gilded Age was followed by a near-total collapse of the overall economy. As a country, we have a monumental mess on our hands and still the Republicans have nothing to offer in the way of a remedy except more tax cuts for the rich.
This is the party of trickle down and weapons of mass destruction, the party of birthers and death-panel lunatics. This is the party that genuflects at the altar of right-wing talk radio, with its insane, nauseating, nonstop commitment to hatred and bigotry.
Glenn Beck of Fox News has called President Obama a “racist” and asserted that he “has exposed himself as a guy, over and over and over again, who has a deep-seated hatred for white people or the white culture.”
Mike Huckabee, a former Republican presidential candidate, has said of Mr. Obama’s economic policies: “Lenin and Stalin would love this stuff.”
The G.O.P. poisons the political atmosphere and then has the gall to complain about an absence of bipartisanship.
David Shuster calls out Sen. Coburn and others for the kind of hyperbolic language that incites violence:
Dems have flipped the script on Republicans:
Tom Jensen says "repeal" has its risks for Republicans (besides it, you know, being impossible):
The health-care bill that hung around Democrats’ necks for the last several months – right up to the final vote Sunday when some vulnerable congressmen were convinced to support it – has suddenly become a weapon.
If politics were war, Republicans would have just been lured from their walled city to chase a force they thought was retreating, only to find Democrats suddenly turning and attacking them head-on.
Even before the bill passed, President Obama had begun pounding the message that the new legislation would immediately benefit many Americans, and cast Republicans who opposed the bill as on the side of greedy insurers.
Hours after the bill passed, White House press secretary Robert Gibbs set the talking points: “[I]f people want to campaign on taking tax cuts away from small businesses, taking assistance away from seniors getting prescription drugs, and want to take away a mother knowing that their child can’t be discriminated against by an insurance company … we’ll have a robust campaign on that,” he said at the Monday briefing.
One of the biggest problems for Democrats on this issue and one that has contributed to the bill's unpopularity is that health care is not high on the list of things most Americans are concerned with right now. They've overwhelmingly focused on jobs and the economy, and they've seen the Democratic fixation on health care as a distraction from more important and pressing issues. We've seen over and over that much of the actual content of the health care bill is perfectly popular. It's the overall process that has really turned voters off and for that Democrats have received the blame.
If the Republicans now keep health care in the spotlight by trying to repeal it, they will be the ones independents voters see as having skewed priorities and they may start to pay the price. Yes, repeal will play well with the base. But focusing on that has a high potential to turn off independent swing voters who have been leaning toward the GOP but are sick of the health care debate and want Washington to be more focused on something else.
Some behind the scenes accounts:
WaPo: How Obama revived HCR
Ambinder on the vote
Here's 3000 words worth of Tom Toles:
Here's a nifty little tool that will tell you how the health care bill will affect you.
It was looking rough there for a while:
But he pulled it out:
(lots more photos here)
... but I still vote Nancy for HCR MVP
Sara Mosle (Slate):
She is both ruthlessly effective and quietly feminine. After the House passed health care reform last November in a narrow, difficult vote, Politico reported that Pelosi walked out of the chamber and commented serenely: “That was easy.” Indeed, she's so calm and collected, she makes Obama look like a drama queen. When he was freaking out after Scott Brown's election, she coolly told him to get a spine and helped salvage his top domestic agenda. She never appears to lose it or even raise her voice. (Love her or hate her, no one can credibly accuse her of being hysterical or a harpy.) Indeed, she often seems to talk in a breathy whisper. At the same time, she may be the most able politician and strong-arming vote-getter since LBJ. But far from resenting her power as a woman, her mostly male colleagues in the Democratic House appear to idolize her (in much the way conservative men in Britain used to adore Margaret Thatcher).
Here she is walking to the Capitol with John Lewis and other Congressmen, holding the gavel that passed Medicare, while protesters shout at them.
What a badass.
I'll end with Obama's rousing statement on what HCR means for America. Definitely watch, it's what the guy is all about: