Change has come to America

By Michael J.W. Stickings

Well, it's done. Pretty much.

After all that's happened -- after all the right-wing tea-party and town-hall protests, after all the Republican lies about death panels and whatever else they could make up, after all the news media's ignorant reporting and regurgitation of Republican talking points, after the election of Scott Brown in Massachusetts, after all the compromise to reach 60 votes in the Senate, after all the whip counting in the House -- health-care reform is now a reality, or will be once President Obama signs the bill into law, which, it is being reported, will happen by Tuesday at the latest.

It was riveting. I had intended to live-blog the House votes, or perhaps even to write a summary post about all that had happened, about how we had gotten to this point, about what might lie head, but I just sat on my couch with my BlackBerry and tweeted as I watched, transfixed.

History was made tonight -- and, yes, it was televised.

The House passed the Senate bill 219 to 212, and, after yet another obstructionist Republican effort to derail the process, passed its reconciliation bill, its "fix-it" bill, 220-211.

For my Twitter posts, click here. I'll just highlight one of them:

-- "Congratulations to all my American friends and family. Your country just took a huge step forward."

And one more:

-- "Now it's time for the Senate to act. And for Obama and the Dems to speak directly to the American people about this historic reform."

Republicans, including the shameless one who called Rep. Stupak a "baby-killer," acted like petulant children, desperate and pathetic in the face of defeat. They are on the wrong side of history. Again.

As for the Democrats, Speaker Pelosi deserves enormous credit for getting this done. Of course, much is left to be done in the Senate -- this isn't over yet. But the reality is that Congress has passed a reform will and the president will sign it. It will be, soon, the law of the land. It has taken decades, generations even. But it has, at long last, been achieved.

Change -- reform of an unjust, unfair, and costly health-care system -- has come to America.

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James Fallows put it well a few hours before the vote:

For now, the significance of the vote is moving the United States FROM a system in which people can assume they will have health coverage IF they are old enough (Medicare), poor enough (Medicaid), fortunate enough (working for an employer that offers coverage, or able themselves to bear expenses), or in some other way specially positioned (veterans; elected officials)... TOWARD a system in which people can assume they will have health-care coverage. Period.

That is how the entire rest of the developed world operates, as noted yesterday. It is the way the United States operates in most realms other than health coverage. Of course all older people are eligible for Medicare. Of course all drivers must have auto insurance. Of course all children must have a public school they can attend. Etc. Such "of course" rules offer protection for individuals but even more important, they reduce the overall costs to society, compared with one in which extreme risks are uncontained. The simplest proof is, again, Medicare: Does anyone think American life would be better now, on an individual or a collective level, if we were in an environment in which older people might have to beg for treatment as charity cases when they ran out of cash? And in which everyone had to spend the preceding years worried about that fate?

There are countless areas in which America does it one way and everyone else does it another, and I say: I prefer the American way. Our practice on medical coverage is not one of these. Despite everything that is wrong with this bill and the thousand adjustments that will be necessary in the years to come, this is a very important step.

Here's Jonathan Chait with some historical context:

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.

*****

Historians will see this health care bill as a masterfully crafted piece of legislation. Obama and the Democrats managed to bring together most of the stakeholders and every single Senator in their party. The new law law untangles the dysfunctionalities of the individual insurance market while fulfilling the political imperative of leaving the employer-provided system in place. Through determined advocacy, and against special interest opposition, they put into place numerous reforms to force efficiency into a wasteful system. They found hundreds of billions of dollars in payment offsets, a monumental task in itself. And they will bring economic and physical security to tens of millions of Americans who would otherwise risk seeing their lives torn apart. Health care experts for decades have bemoaned the impossibility of such reforms -- the system is wasteful, but the very waste creates a powerful constituency for the status quo. Finally, the Democrats have begun to untangle the Gordian knot. It's a staggering political task and substantive achievement.

*****

We can't know what the future holds in store for Obama. It's entirely possible that Republicans will gain control of the House in November and block any further domestic progress, unemployment will stay high, and Republicans will win the White House in 2012. Yet he's already left his imprint on history.

And here's Jonathan Cohn with more:

The Democrats' victory represents the culmination of a quest that stretches back to the early 20th Century, when medicine first entered the modern era and became more expensive than many Americans could afford. It also represents a remarkable victory for the Democrats, who seemed on the verge of losing this fight just a few weeks ago, when the special Senate election in Massachusetts deprived them of the power to break a filibuster.

President Obama can stand tall tonight, as can Speaker Pelosi and every Democrat who voted for the bill. And so can the many, many people -- activists, academics, analysts, politicians, staffers, and, yes, bloggers -- who worked so hard for this for so long.

It is a new day in the United States of America.