When Lyndon Johnson convinced Congress to pass Medicare and Medicaid in 1965, few suspected it would take four more decades to again pass health reform to cover more Americans that would reach the White House for signing. Medicare and Medicaid didn't instantly improve health care, but it did strengthen the safety net that protects folks when extraordinary things happen.
Yet despite that historic achievement, and the magnitude of the accomplishment, the very real flaws in the bill have been far more in focus than the benefits or the history. Democrats appropriately wanted more. Republicans wanted to lie about what was in the bill, and denigrate what they could not stop. Between the two, the media and the blogs had plenty to talk about.
Still, at least for a day, it's worth focusing on some of the achievements. On the Arena today, I wrote:
In the end, Republicans have to decide how far they want to believe their own myths about what they’ve been saying about Democrats. For example, lies about death panels and socialism won’t get anything done (elitists always have trouble with faux populism), but there’s always room for reining in government spending as soon as the recession passes.
And in the end, we are going to pass health reform, 30 million people will have an easier time getting insured, the industry will be regulated better (pre-existing conditions and recission), and passing health reform will – thanks to Republicans - be a strictly Democratic achievement that no other President since LBJ was able to pull off.
That's, of course, not the only view of this. Interestingly, though, on our Abbreviated Pundit Roundup yesterday, we highlighted the Republican rumblings that don't always get covered (despite the facade, there are misgivings in the GOP about how this has played out.)
From the predictable (David Broder lamenting the lack of bipartisanship) to the unusual (left blogs and conservatives making common cause), some of thge commentary that has most impressed me comes from Jonathan Chait, writing about the historic nature of this bill, and where the discussion has taken us.
The sum total effect of this legislation is fairly simple. It would redirect a large chunk of the money sloshing around the health care system away from ineffective treatments and toward providing care for the uninsured. On top of that, it would prod the system, in dozens of ways large and small, to adopt cutting edge methods. It is not the kind of plan liberals would create if they could design it from scratch. Rather, it is a centrist compromise of the best variety, combining the ideas of the now nearly-extinct moderate wing of the Republican Party with the smartest bipartisan technocratic reforms.
What, then, is not to like? Conservatives have attacked reform with a potent combination of populist attacks against cost controls, aimed particularly at terrified elderly voters, along with more intellectually-respectable attacks protesting the lack of cost control, aimed at winning elite opinion. The first set of attacks whips up fears of Medicare cuts, death panels, or any provision that might cause anybody to lose his employer-sponsored health-insurance. Anything Democrats do to protect themselves against those attacks opens them up to the opposite charge of failing to sufficiently cut the health care budget, and vice versa.
In fact, my favorite quote comes from Georges Benjamin (Exec. Dir. American Public Health Association):
At three o'clock in the morning when your kid gets sick, you want the help; you need the help. When political rhetoric hits the cold reality of sickness, quality, affordable health care wins every time.
The fact is that Americans need the safety net. I cannot begrudge any steps toward making that possible, even if this as yet doesn't go nearly far enough. But until we have something that does, we need to move the deadlines up, strengthen the affordability, and make this bill better before the President signs it.
And for Republicans, they need to guard against reading their own talking points and thinking that's a substitute for real life. Chait, again:
The opponents of reform have succeeded both when they have made the debate too narrow—a skeptical and often paranoid focus on small features of reform ripped out of all context—and when they have made the debate too vague—with broad-brush denunciations of corporatism and socialism.
which was also ably summed up by Steve Benen:
Progressive activists and progressive wonks are at each other's throats this week, but they want largely the same goals. Their differences are sincere and significant, but the intensity of their dispute is matched by the potency of their arguments.
And then turn your attention to the other side of the divide, and notice the quality of the arguments conservatives and Republicans have offered -- and continue to offer -- in this debate. Death panels. Socialism. Hitler. Government takeover. Socialized medicine. Incomprehensible charts. Incessant whining about the number of pages in a proposal.
Once can't help but think that relying on Sarah Palin and Michele Bachmann as the go-to health care analysts for the GOP isn't going to turn out well (for them.)
Next steps are the difficult reconciliation process, but don't bet against this bill passing. There's too much history, and too much Republican effort to scuttle the bill to make that palatable for Democrats. And for the 30 million people that don't have insurance now, they can't wait for the perfect bill. Think of them this holiday season as you celebrate with you and yours.