Saturday, November 7, 2009

Health Care Passes In The House

The House of Representatives passed its version of health care reform today. TPMDC has a great analysis of the issues here.

The bill passed the House 220-215, just a couple of votes more than needed. Abortion, a long-simmering issue, exploded in the debate in the last couple of days, as some conservative Democrats decided that they couldn't vote for Federal funding for abortions. They got their way. I'm not thrilled with that, and lots of feminists and liberals are going to be disappointed, but I'm not surprised this happened. Abortion is one of the last battles of the culture wars that is still open, and conservative Democrats need to feel like they won something in this debate. As a percentage of the actual money involved, I'm sure funding for abortion is miniscule. But it's a very high-profile issue, and Democrats from culturally conservative districts can use this vote to demonstrate their independence from "Washington elites."

Obama, as I expected, used some of his political capital at the end, showing up on Capitol Hill to bang some heads and twist some arms. Just a few days after the votes in Virginia and New Jersey that were allegedly so bad for him, he achieves a major victory.

Momentum breeds momentum. As Democrats have come together, they have, collectively, ever more reason to vote together, to make something happen. They must all hang together. They don't all have to vote for the bill to get it to pass, and I'm sure Nancy Pelosi, Steny Hoyer, and James Clyburn have a very good sense of who they can bring on board under what conditions. As they get closer to passing the final bill, they get closer to defining the political reality. And conservatives and Republicans get closer and closer to losing a major battle. That's one reason that they are fighting so hard, and using such absurd rhetoric - if they lose this one, they don't just lose on the issue - they lose their ability to be obstructionist. Some members of the base will be ever-more frustrated and vitriolic. But a fair number of Republicans are going to be deflated and demoralized. And a fair number are going to be disgusted at the tactics of this highly vocal minority. There are still many, many moderate, tolerant, decent, open-minded conservatives and Republicans who still believe that respecting your opponent is a key quality for being successful in a democracy. Those Republicans, by definition, are not rabble rousers. They are not the ones raising signs on the steps of the Capitol. Which means that they aren't the ones being noticed in this debate. But there are millions of them, and they are paying attention.

Reading the article in TPMDC, I finally started to pick up a good understanding of what is at the core of the debate. I finally get the basic issue. We have lots of uninsured people in this country. Taking care of them costs the rest of us a lot of money. We have to get those people insured. There are a couple of ways to do that: abolish all private insurance, and enroll everyone in the same government program, or encourage/force everyone to buy insurance on their own, or encourage/force all employers to offer insurance. The problem with encouraging/forcing all people to buy insurance on their own is that many of them will not be able to afford it, and many will resent having to buy insurance when they haven't had to before. So, to make it possible, and to ease the pain, the government will do two things: 1) offer subsidies so people can afford to buy insurance, and 2) set up a government-run insurance program for people to buy into. To level the playing field, and to make insurance work better, the government will also be imposing new restrictions on insurance companies.

I finally get it. It's great not to have to worry about the constant battle over fine details of political gossip - which Senator said what about what obscure part of the bill, and how did the White House react, and how did the Senate leadership react, etc. I found the news coverage - particularly on the liberal blogs, TPM, DailyKos, and HuffPost - getting bogged down in that kind of detail. That's a subject for a post-mortem.

But the bill passed the House. On to the Senate.

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