Health Reform Notes From All Over

In my copious spare time, I'm filling out forms for a non-tourist ("class 457") visa to Australia, for regular visits I'll be making as part of the new U.S. Studies Centre at the University of Sydney. That's a whole promising story for another time.  Here's the relevance now, during Health Care Reform Showdown weekend:

In all the piles of documentation to provide the Australian authorities, two required items got my attention. One was a copy of my marriage certificate, so that my wife and I can travel together. (Hmmm, ours was written in cuneiform. Where would that be now?) And the other is: certificated proof that we both are covered by an "adequate" health insurance policy. Otherwise, they won't let you in. It's part of the principle that, of course, for shared social risk and as a bulwark against bankrupting individual surprises, everyone must be insured.

Every so often there is a reminder of how unusual, in world terms, the lack of such an assumption and system has been in the United States. In the nearly two generations since the passage of Medicare, Americans have come to take for granted that of course there will be some safety net for older people with the inevitable maladies of age. Exceptions to that are seen as scandals. On the highway, everyone understands that it's irresponsible and anti-social, along with illegal, for people to drive without insurance. What if they cripple someone? What if they plow through someone's front yard and damage their house?

Whatever happens tomorrow, and it seems as if the Democrats may finally have 216 votes, I bet that a generation from now Americans will have the same "of course everyone needs it!" attitude about health insurance that we now have about car insurance and Medicare. Few people who weren't around in 1965 can imagine how bitter, emotional, and divisive the debate about passing Medicare was at the time. If anything the fears of impending socialism were greater than they are now -- because back then, there was no Medicare in existence about which people could say: "Well, that program's OK, but anything more would be socialist." I think the incredible fury of this year's debate will have the same hard-to-recreate quality once health insurance becomes as matter-of-fact as -- yes -- car insurance is now. As I mentioned when the Senate pulled together 60 votes last summer, this is a moment to notice and remember. And, I'll be watching the vote.

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James Fallows is a national correspondent for The Atlantic and has written for the magazine since the late 1970s. He has reported extensively from outside the United States and once worked as President Carter's chief speechwriter. His latest book is China Airborne. More

James Fallows is based in Washington as a national correspondent for The Atlantic. He has worked for the magazine for nearly 30 years and in that time has also lived in Seattle, Berkeley, Austin, Tokyo, Kuala Lumpur, Shanghai, and Beijing. He was raised in Redlands, California, received his undergraduate degree in American history and literature from Harvard, and received a graduate degree in economics from Oxford as a Rhodes scholar. In addition to working for The Atlantic, he has spent two years as chief White House speechwriter for Jimmy Carter, two years as the editor of US News & World Report, and six months as a program designer at Microsoft. He is an instrument-rated private pilot. He is also now the chair in U.S. media at the U.S. Studies Centre at the University of Sydney, in Australia.

Fallows has been a finalist for the National Magazine Award five times and has won once; he has also won the American Book Award for nonfiction and a N.Y. Emmy award for the documentary series Doing Business in China. He was the founding chairman of the New America Foundation. His recent books Blind Into Baghdad (2006) and Postcards From Tomorrow Square (2009) are based on his writings for The Atlantic. His latest book is China Airborne. He is married to Deborah Fallows, author of the recent book Dreaming in Chinese. They have two married sons.

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