The Health Bill and the Legacy of Teddy Kennedy

As the historic health care reform bill approached House passage last night, Speaker Nancy Pelosi evoked the legacy of the late Sen. Edward M. Kennedy and his lifelong fight on behalf of Americans without health insurance.  When the vote reached the magic number guaranteeing passage, the Senator's son, Rep. Patrick Kennedy of Rhode Island, could be seen celebrating on the House floor.  And immediately afterwards, Sen. Kennedy's widow Victoria released a statement saying that finally her husband's health reform  "cause becomes more than a dream, it becomes America's commitment."

So what would Teddy think?  The congressional bill that heads to the White House for President Obama's signature Tuesday is a far cry from the universal health coverage and total overhaul of the health care system that he had championed throughout his career.  But toward the end of his life, the lion of the Senate came to peace with the prospect of major compromises in order to finally get a major health care bill over the finish line.

It was not always so.  In the late 1970s, as a young health reporter for the Washington Star newspaper, I spent countless hours on Capitol Hill and traveling the country with Sen. Kennedy and his crack health team listening to the heartbreaking stories of mothers, fathers and children without health coverage.  The media-savvy Kennedy hearings ushered in the modern political era of personalizing the problem and guaranteed television time on the nightly news.

At that point, Kennedy was the liberal standard bearer for the Democrats and a potential presidential candidate who would take on sitting President Jimmy Carter.  He was uncompromising in his support of a cradle-to-grave national health insurance plan that would be run by the government.  Carter, in contrast, supported a more moderate, incremental approach to health reform. 

The battle swords were drawn and Kennedy and his liberal cohort fell on their swords rather than allow anything short of the monumental reform that they championed.  Surely there would be another day to get what they wanted.  They never dreamed that that day would be more than three decades later: the Reagan revolution stopped health care reform in its tracks in the 1980s, the Clinton administration failed miserably in the early 1990s, and the Bush administration derailed major social reforms for much of the last decade.  Meanwhile, the cost of national health care spending skyrocketed, from about 8 percent in the late 1970s to about 17 percent today.

So when an older Senator Kennedy joined forces with the young Barack Obama in 2008, he had his eyes squarely on the prize.  Surely now was the time for monumental health care reform.  But the financial crisis and the growing partisanship in American politics -- and flat-out refusal of Republicans to play ball on this one -- nearly derailed the latest health care bill once again; it was pronounced dead more than once, particularly after Massachusetts stunned the country by electing a maverick Republican, Scott Brown, to take Kennedy's vacant Senate seat.

The compromise legislation that was resuscitated in the House will not reform America's health care system from top to bottom as Sen. Kennedy had once envisioned, even if the Senate passes the House reconciliation package.  But it will expand health care coverage to about 32 million of those currently uninsured, increase government-run Medicaid coverage for the poor, subsidize private coverage for low and middle-income American citizens, and remove discrimination against the sick with preexisting conditions.

The late Massachusetts Senator, who died of brain cancer last August at age 77, would have approved.  As Vicki Kennedy, who is scheduled to give an exclusive interview tonight on the premiere show of CNN's John King, said last night:

"When Ted stood with Barack Obama in 2008, he said he had new hope that we would break the old gridlock and guarantee that every American -- north, south, east, west, young, old -- would have decent, quality health care as a fundamental right and not a privilege.  And now they do and from now on they will.  In the last words he wrote, Ted said that 'if you persevere, stick with it, work at it, you have a real opportunity to achieve something.  Sure, there will be storms along the way.  And you might not reach your goal right away.  But if you do your best and keep a true compass, you'll get there.'  Ted knew we would get here, and all of us who loved him and shared his hopes for American are deeply grateful."
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Cristine Russell is a senior fellow at Harvard Kennedy School of Government and the president of the Council for the Advancement of Science Writing.

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