Friday, 26 March 2010
After a year of intense and heated debate, Barack Obama and the Democratic Party have finally succeeded in passing the cornerstone of their domestic agenda, the Patient Protection and Affordable Care Act of 2010, also known as health care reform. Needless to say, this is a massive victory for Barack Obama and his party.
Let's be clear on the historic nature of this bill. Obama has already had a promising first year in office, but now he has ensured his place in the history books with the most significant social reform in 40 years, one that will be taught in schools alongside the likes of Civil Rights, Social Security and Medicare.
Anyone who has read my writing in the past is aware of my views on the strengths and weaknesses of this bill. But in short, this bill will expand health insurance coverage to 30 million currently uninsured Americans, place limits on the escalation of insurance premiums, prevent insurance companies from dropping coverage when you get sick, and introduce some much needed non profit competition to keep prices competitive and low. It also creates an insurance exchange to assist patients in finding the best insurance package from any company in the country, and allows children to stay on their parents' insurance plans until they are 26, amongst other improvements.
But the bill has drawn fire from both sides of the aisle. This bill is a much more conservative reform of health care than most people expected when electing Obama (though you wouldn't know it by listening to the GOP's extremely artificial outrage), and doesn't actually change the American health care system much, instead opting to tweak and refine the existing system so as to suit the consumer and afford more rights to patients. Indeed the American healthcare system is still completely dependent on the health insurance model, and while this bill will help control prices, it won't change the fact that Americans already spend ridiculous amounts on healthcare compared to the rest of the developed world for a similar quality of healthcare.
Meanwhile those on the right have raised concerns about the legitimacy of the Federal Government to enforce the so called "mandate" which will tax people for not having health insurance, but only if you attempt to seek treatment while uninsured, hence raising the price of premiums for others. It turns out this is covered by the interstate commerce clause, so long as the Government can convince the courts that the health of the nation's workforce is relevant to interstate commerce (it probably won't come to them having to do that though).
In any case, it is hard to claim that this bill is anything other than a massive improvement on the old, woefully designed system, despite its imperfections, and its passage is indeed a momentous occasion.
It is also interesting to look at the potential political fallout from all this. Republicans have been using every tool available to try and slow down and ultimately kill this bill. The Republicans wanted to make sure that nothing positive got done under Obama, thinking that it would make the Democratic majority look bad. They tried, and failed, to accomplish this by scaring the heck out of less politically aware Americans with tall tales and outright lies about the bill in question (Death Panels, Government takeovers, amongst several others) and the result has been a rabidly angry, ignorant segment of the population that has become known as the Tea Party, drowning out any serious debate with rage, racism, homophobia and violent threats. I have written at length in previous articles why this is a risky, and frankly stupid tactic from the Republicans, threatening to drown out any legitimate Republican concerns, painting their contingent as a lunatic fringe, and potentially creating an unstable, angry and most worryingly, delusional, population that might one day bite Republicans in the ass (and arguably it did, way back in NY-23).
I was not the only person saying this. Indeed most rational, free thinking analysts said the same, including many prominent Republicans including David Frum. And it all seems to be crashing down for the Republicans in the wake of what Frum describes as the GOP's "Waterloo". Where Republicans have been forecasting for months that the passage of healthcare would throw Democrats into chaos and destroy Obama's presidency, yet if recent polls are anything to go by the exact opposite effect has been achieved, and indeed the healthcare bill itself has received a fairly large popularity boost, for reasons too long for me to outline here.
The GOP is starting to realise that the conservative media outlets that stirred these people on were not looking out for the best interests of the political party, they just wanted to make money and sell papers by keeping people outraged, and hence interested in current events. They are starting to realise that the increasingly violent and crazy actions of this fringe are hurting more than helping. But most worryingly for Republicans, they are starting to wonder what might have been had they listened to strategists like Frum who advised that the GOP would have stood to gain more in the long run by negotiating, as the Democrats did during the Bush administration, allowing them to share credit for his successes and distance themselves from his failures. Instead Republicans have taken the all or nothing approach and ended up with nothing.
Until now they have been desperately trying to stir the anger of these fringe lunatics to become as loud as possible in order to paint the frankly pretty common sense health care reform package as some horrific anti-American thing that the American people are against. The idea here is if you say something loudly and frequently enough it becomes true. Through staged protests, faked video exposé and massive anti healthcare rallies featuring a million people (with the real attendance being roughly 990,000 people less than that), the GOP have tried to create this fantasy world where Obama is some kind of tyrant, and the American people are on the verge of "taking back the country" through glorious revolution, perhaps in some misguided attempt to try and recreate the atmosphere behind Obama's election victory. But as they lifted the curtain on their big post-vote press conference rebuttal to a mostly empty room, one can't help but feel it may finally be dawning upon them...