March 23rd was the one year anniversary of the passage of the health care reform bill. This date came and went with very little fanfare or media attention. The anniversary was overlooked partially because of the import of today's issues including the no fly zone in Libya, the aftermath of the tsunami in Japan and the ongoing budget fights in Washington, but it was also overlooked because a year after its passage, it is increasingly clear that the health care bill may not have been as significant as it seemed, and was presented, at the time. The text messages sent from the Obama political operation celebrating the anniversary of this bill, and suggesting its historic significance, largely served to underscore that a year after passage, the health care reform bill is not really historic at all.
Although not all of the components of the health care bill have come into effect yet, it is clear that bill will neither push the US down the road not socialism, nor make affordable and decent health care available to all Americans. The bill may have a modestly positive effect by encouraging a few more Americans to buy health insurance, or by keeping some Americans from losing their health care due to preexisting conditions. It will also likely have some consequences that were not foreseen a year ago. Health care companies may become more politically powerful as they gain more clients; or legal challenges may continue to reshape the bill. In general, a year after its passage, it is apparent that this bill will not radically reshape life in America, but will be part of the ever changing and increasingly complex legal framework in which health care is delivered in the US.
As the health care debate of 2009-2010 recedes into history, we can see that the debate was important primarily for political reasons. Passage of the health care bill did not revolutionize health care the way, for example, the Civil Rights and Voting Rights Acts in the 1960s revolutionized race relations. Instead, the health care debate energized the Tea Party movement and changed the face of American politics, contributing heavily to the major Republican victory in the 2010 election. To some extent, the passage of the health care bill also revived a struggling Obama administration as they demonstrated that they were able to get something done.
The notion that a year after its passage the primary impact of the health care bill has been political rather than substantive is indicative of broader problems with the American political system and is further evidence that the American political elite is now much more comfortable with, and better at, politics than governance. The health care debate featured name-calling, doomsday scenarios, dramatic overstatement on both sides, and descriptions of the bill that overstated its import to an extraordinary degree. Both sides played the politics very well and were very comfortable doing that. However, the result was that a deep problem in American society, rather than being addressed concretely was papered over by a bill that may not change very much.
Unfortunately, the triumph of politics over governance is not limited to the health care debate. On the contrary, it is now the norm for most domestic issues ranging from the budget deficit to the economy and most other major concerns. By focusing on politics rather than governance, politicians emphasize taking strong positions, defending the righteousness of their beliefs and either stubbornly refuse to compromise, or compromise not for the sake of a good bill but because it allows politicians to present themselves as pragmatic. The pragmatism is often empty because it is the result of compromise for its own sake rather than resolving questions in a way that gives something to both sides but keeps an eye on a useful outcome.
Politicians have always looked primarily to the next election, so this is not an entirely new development. What makes it new is that politicians, at least on the national level, no longer see passing good laws or governing well as an important key to winning future elections. Thus, the fight around the health care bill became the most important story as both parties presented a narrative that worked for their short term needs. The Republicans screamed about socialism and tried to block everything before eventually failing in that endeavor. The Obama administration, for its part, was willing to bargain away most of the important parts of the bill so that they could position themselves as the pragmatists and the party willing to get something done. At least, in the short run, this did not work out well for the administration, but it may yet be too early to tell.
The first anniversary of the passage of the health care bill is not an opportunity to recognize a historic victory, but another reminder of the depressing and dysfunctional state of governance in the US. It is a reminder of how difficult solving the problems facing the US will be in a climate where political positioning rather than governance, has become almost the only driving force behind our political institutions and debates.
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Bravo Sanders, bravo
The passage of the health care reform law was no victory at all; it was a historic defeat. It was a tragedy. It cemented our corrupt, ineffective, destructive, epically wasteful health care system which puts billions of health care dollars into corporate profits which provides nothing in exchange—and increased that obscene amount of wasted money by obscene proportions by requiring people, even the poor, to buy crummy high-deductible (i.e., zero coverage) plans, thus further enriching the health care industry and perpetuating our slavery to this corrupt system for generations to come. For this, our hapless Democratic leaders claimed victory. Yippee.
Exactly.
Link: http://www.dailymail.co.uk/news/article-1371861/NHS-director-dies-operation-cancelled-times-hospital.html
More Coffee...
R/ PRONESE
You saying that the bill clearly sucks just one year in, although the health care exchanges and the subsidies that will be provided to people to buy insurance won't be available until 2014, is a bit like saying in 1936 that Social Security, which passed in 1935, was a failure even though benefits weren't paid out until 1941. And by the way, Social Security was modeled on private insurance and left out 26 million Americans by not covering agricultural workers and domestic workers. Yet I doubt anyone would today declare Social Security some kind of failure.
Mr. Mitchell is just one of the "emotional liberals" Lyndon Johnson once derided as follows:
"They believed in controversy and could never reconcile themselves with anyone who believed in achievement. To such men, the words ‘compromise’ and ‘betrayal’ are exactly the same. They cared less about delivering results than they did about the purity of their route to a nonexistent accomplishment.”
You mean it has forced 31 million Americans via a mandate to buy a privately owned product, the price of which the Health Care Industry can still raise 30% to 40% a year on premiums, of which there are weak to no price controls whatsoever.
What this is called isn't socialism - it's fascism.
I cant accept that and here's why:
40 years? No, a single payer was promoted by Truman in the 1940s. 60+ years, we liberals have promoted health care - federal, single payer.
Instead, Obama supported a private sector, for-profit health insurance scam most recently passed by a Republican Governor. The 'reform' mandates that every citizen, under penalty of law, must purchase from a private sector, for profit health insurance provider a policy (which, like your banking 'agreements', are largely controlled by the industry). So, Obama did nothing the 'liberals' wanted; he did something the insurance industry wanted.
Second, it was not just 'liberals'. Most informed individuals in the US knew exactly what they wanted in terms of health care reform.
In June 2009, a New York Times/CBS poll found:
72% of Americans supported "a government-administered insurance plan—something like Medicare for those under 65—that would compete for customers with private insurers."
So, Obama not only turned his back on 'the liberals', but on the majority of the American people.
The Republicans cant significantly alter the 'reform' without hurting health insurance companies; so, they wont.
But the Supreme Court will save us from Obama, Max Baucus, Pelosi and the other nominal Democrats. Then, the question "Whither the Health Reform Bill" will be answered. And election of a Democratic House, Democratic Senate and Democratic President will have been wasted.
I know many people with pre-exisiting conditions who have no insurance and would not be able to afford it if they were able to buy it. Most would be willing to pay as much as they can afford if that would make a difference. The subsidies legislated in the bill might enable them to do so. And for those who thing the mandate is unconstitutional, you probably are healthy and choose not to be covered or you have insurance and fear yours might cost a little bit more to help those who are less fortunate. I personally don't care what you think. People are suffering and loosing their homes and livlihoods. This is more a moral question than a legal one. And those who seek to have this law invalidated have no shame.
The passage of the bill was historic in that it presaged the utter contempt the Republican party has had for the legislative process since this time, using the process to make cheap political points rather governing with the party chosen by the people. The Democrats and Obama made a big mistake when they allowed the Blue Dog Democrats to have so much say in watering down the lesislation to where it lost a lot of support from the liberals and leftists. And where was the left when Tea Party thugs were bussed in to disrupt congressional town halls on health care. I saw no effort on the part of the left or the Democratic party to confront this abuse of democracy and challenge the falsehoods being spread by the looney right.
I have payed too much in health insurance for too little in health care but would be brook and homeless without it. I have a pre-existing condition (who doesn't) and can't shop around.
The Supreme Court will decide the healthcare mandate is just a tax and it will stand.
Errr, the states have always had that constitutional freedom. (Ever hear of Romneycare?) What's UNCONSTITUTIONAL is the "mandate," which the insurance lobbyist insisted up along with killing the public option. Guess who obeyed, instantly? http://www.pbs.org/wgbh/pages/frontline/obamasdeal/view/?utm_campaign=viewpage&utm_medium=grid&utm_source=grid
At least in Vermont they haven't sold out to the corporatocracy like this golf playing president did.
That could've been achieved by passing a piece of legislation. The federal government did not have to take over a 6th of the economy in order to do that. CrapCare was shoved down Americans' throats for one reason: the man of change wanted a place in the history books as the guy who achieved what other Dem presidents before him had failed to do. This was always about Obama's legacy: period. And to achieve his goal, he went diving into bed with the insurance lobbyist (a mere seven weeks into his change-you-can-believe-in presidency), who had insisted he chuck the public option and institute her money-making "mandate" if he wanted her cooperation in getting CrapCare through: http://www.youtube.com/watch?v=5PwqSCJmbxk Is it time to put the Kool-Aid down yet, folks?
The good news is that the King George-style mandate is so laughably unconstitutional, it's predestined to be killed by the Supremes.
All he was doing was trying to get out in front of the inevitable demise of CrapCare, once the Supremes get hold of it. His statement was tantamount to saying, "Well, after CrapCare gets killed and you're free to do whatever you feel is best for your state, I'd like to encourage you to do whatever you feel is best for your state." Duh.