Health Care Reform Reax

[Re-posted from late last night. My take here.]


Let me offer a ludicrously premature opinion: Barack Obama has sealed his reputation as a president of great historical import. We don't know what will follow in his presidency, and it's quite possible that some future event--a war, a scandal--will define his presidency. But we do know that he has put his imprint on the structure of American government in a way that no Democratic president since Lyndon Johnson has.


If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.

Abraham Verghese:

I have been trying to explain to my youngest why this is such an exciting moment: front line soldiers in Afghanistan and Iraq take personal risks, put their lives on the line. But so few politicians put their careers on the line, even though they make decisions that have an impact on soldiers. President Obama (and to some degree every Democrat who supports this bill) is putting his political career on the line. The idea that you might do what you think is right and pay a penalty has been so foreign to politics that it surprises us when we see it. I think my son is surprised to hear all this. He assumes at 12 years of age that people, especially people we elect, go to Washington to do the right thing.


What I hope is that the Democrats take a beating at the ballot box and rethink their contempt for those mouth-breathing illiterates in the electorate.  I hope Obama gets his wish to be a one-term president who passed health care.  Not because I think I will like his opponent--I very much doubt that I will support much of anything Obama's opponent says.  But because politicians shouldn't feel that the best route to electoral success is to lie to the voters, and then ignore them.

I don't think anyone will hold up the bill that will pass as exemplary, but it does reflect elements of health care reform that Democrats campaigned on and won on in 2008.  So I have a hard time seeing this as doing violence to the will of the people as it is typically expressed in our electoral system.  Elections matter.  This is how they matter.


Do not believe anyone who tells you they understand the path American politics will take after this vote. It is truly unique. And yet a few things are clear. One, the idea of the "pro-life" Democrat should be tossed into the dust-heap along with such outmoded concepts as cold-fusion. Two, Obama will achieve a short-term bump in his political capital, and likely his poll ratings, because he will have achieved something that every Democratic president since Harry Truman has been unable to accomplish. And three, Obamacare is a testable proposition. The proponents of this legislation have made distinct claims regarding its costs and consequences that should not be forgotten -- especially when America encounters its first debt crisis some years from now.

Jonathan Bernstein:

The oddest thing about the health care debate, at least in my view, is that Republicans basically did not engage on the actual substance of the bill.  Lots of stuff about death panels, and lots of stuff about procedure, lots of stuff about backroom deals (most of which will be gone after reconciliation) but shockingly little about the individual mandate -- or, as Tim Noah points out, about the actual taxes that really are being raised for this.  The only real substantive complaint they highlighted was Medicare, where they argued against their own position.


Democrats are going to stress the parts of the bill that kick in immediately, including small business tax cuts, closing the Medicare donut hole, allowing adult children up to the age of 26 to stay on their parents' health care plans, insurance industry reforms (ending recissions), free preventative, and temporary coverage for early retirees, among others.

Larison tackles Kristol:

Large-scale change naturally provokes anxiety, uncertainty, fear and resistance, which is inevitable and as it should be. It does not follow that the later backlash against large-scale change will be great enough to undo the change. The Medicare prescription drug benefit was not passed by large margins in the House, and its eventual passage was the product of some significant arm-twisting, maneuvering and vote-buying. It was also unfunded and therefore incredibly fiscally irresponsible! It was phenomenally bad policy! That doesn’t mean that there has been a groundswell of outraged voters ready to support its repeal. As far as I know, no one on the mainstream right, least of all the editor of the magazine that once championed big-government conservatism, has even proposed repealing it. After all, it is their monstrosity. It has become part of the structure of our unsustainable, disastrous entitlement system, and no politician with any self-preservation instinct would so much as suggest eliminating a benefit that millions of likely voters enjoy receiving.

Josh Marshall:

The Democrats won that battle because they said to themselves and the country: on this ground we're willing to lose. And in addition to all the hard work and everything else in their favor, that commitment stiffened their spines and made them credible to the public at large. It made the political victory possible.

A genuine willingness to lose means just that: you might lose. You might lose big. And the dynamics of a mid-term election, amidst crippling unemployment and an energized right, have certain unavoidable implications. But I suspect the effect for the Democrats of actual passing this legislation will be considerably more positive than people realize.

Ari Kelman:

I’ve been saying for many months that if healthcare reform passes, I believe that Obama, for all of his myriad flaws, will be the best President of my lifetime and one of the ten best in the nation’s history.

Matt Steinglass:

To a significant extent, Ms Pelosi is viewed negatively because Americans think of her as a loser. This impression is understandable when you look at the way mainstream media have covered this Congress, but it's utterly misplaced. She has presided over one of the most effective sessions in the history of the House [and she has] emerged the victor in the bloodiest battle America's legislature has seen since the impeachment of Bill Clinton, if not longer. Maybe people (Democrats, at least) will finally start giving her the credit she deserves.


Now that it’s done, Barack Obama will go down in history as one of America’s finest presidents. It’s always possible of course that, like LBJ, he’ll get involved in some unrelated fiasco that mars his reputation. But fundamentally, he’s reshaped the policy landscape in a way that no progressive politician has done in decades.


Make no mistake: the more virulent GOP opposition to the plans became - and, if you like, the more hysterical - the more Democrats had to pass it if only to save face. Sceptical Blue Dogs, Pro-Lifers and Leftists were all forced to club together for the greater good of the party. Left to their own devices they almost certainly couldn't have agreed on a bill, any bill.

E.D. Kain:

In the end, perhaps the greatest thing going for this bill is the possibility that it will open future avenues for better reforms down the road. That is not a very compelling argument, of course, but who knows? It may in fact be the most important argument of them all. The future will demand reform, and we may as well begin the process.

(Image: Lights are on at the US Capitol as the House of Representatives works during a rare Sunday session on March 21, 2010 in Washington, DC. By Mark Wilson/Getty Images.)