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.