Thank you, Mr. President.

How’s this for history? The first black President and the first female Speaker of the House just brought America’s health insurance system from the 19th century to the 21st century, doing what no politician before them was able to achieve.

The new law, while insuring 30 million and lowering the deficit, is not perfect. It does little to address cost containment. It contains a mandate without strong enough subsidies. The Medicare reimbursement issue persists. You might blame Barack Obama for these imperfections. You might say that had he shown more forceful leadership, he would have had a stronger bill. And you might be right. But consider this:

In 1993, President Clinton tried to pass health care reform, and didn’t even get a floor vote.

In 1974, President Nixon tried to pass health care reform, but couldn’t quite close the deal with the late Senator Ted Kennedy.

In 1965, President Lyndon Johnson opted to pass Medicare rather than universal coverage, believing it more politically doable.

In 1945, President Truman, like Clinton, proposed universal health care but was unable to get a vote.

In 1935, President Franklin Roosevelt wanted to pass universal health care, but thought it too politically unpopular and didn’t even try.

In 1912, former President Theodore Roosevelt campaigned on the promise of universal health care and couldn’t even recapture the White House.

You can claim that the bill’s inadequacies are proof that President Obama failed to show true leadership on this issue, but history will tell you otherwise. He showed the courage that LBJ and FDR lacked, and his persistance did what Clinton, Nixon, and Truman were unable to do. I call that leadership.

Some things are worth losing over, and this is one of them. To last night’s 219 heroes and to President Obama, Speaker Pelosi, and Majority Leader Reid: thank you. This is the most important progressive victory since the Civil Rights movement. Sleep well knowing that whether you lose your next re-election or retire in 30 years, it was worth it.

Tags: health care reform, Barack Obama, Nancy Pelosi, Harry Reid, Ted Kennedy, history (all tags)

Comments

34 Comments

And it's coming together in style, as well.

The deeply flawed senate bill is being followed by Alan Grayson's bill which simply removes the age limit requirement on medicare - and allows people to buy their way in by cash - into medicare without age requirement.

 

This is truly a country we can be proud of. In the next few days someone will dig up the amount of money the manglers and the lobbyists and those that have tried to club our country over the head for the past 10 years - and it will be astonishing. The level of corruption that has been turned back is beyond belief. It won't die easy.

This was like the battle of Waterloo. The Republicans threw everything they had - but they miscalculated, just as Napoleon - and it destroyed them completely.

A few simple observations.

First. Alan Grayson's amazing bill will come next, and it will fly through the house since they already voted the same issue and a good majority of the people who had trouble getting this senate bill done - will fully support the Grayson bill.  That bill will create a national health service out of medicare.

Second, the attempt to repeal this legislation will rapidly fail. Americans will almost immediately embrace this legislation. 72 percent of them supported it. They were confused why it ran into so much trouble in the senate.  The senate will have to clean up its act. Fast.  But the concept that there will be states that will repeal it or ban it - is laughable.  We are going to witness an amazing turnaround for people who thought this kind of reform was 'socialist medicine'. And hospitals, doctors, and patients will get better care.

 

I cannot also ignore the fact that we have just secured our country. The concept that a biological catastrophe could occur and we would not have been ready - is one that hasn't taken root in the American consciousness - but the bugs are getting trickier. This makes life better, safer - and ...

 

Ok. You get the idea. It's cool.

Gratz!

 

 

by Trey Rentz 2010-03-22 01:03AM | 2 recs
Hallelujah!

Nancy, Harry, and the president all deserve a bunch of praise and thanks. The whole MSM was against health care reform from the start and it is truly a feat that we got it done. We need to work on getting a media that tries to clear up confusion rather than spread it.

by Lolis 2010-03-22 01:08AM | 1 recs
Nancy is the best
Speaker of the House Ever. If only Harry Reid was half as good as Nancy, we would have the Medicare for all already. But he isn't, so we have to settle for one step closer to total victory.  As Of today Health Care is consider a right and no longer a Privilege. So now starts the battle to make sure each and every citizen of the US gets the Health Care that is their birth right.
by srliberalguy 2010-03-22 01:13AM | 4 recs
Barack Obama comes into his own

For too many far too long, Barack Obama has been compared to other Presidents. Now, other Presidents will be compared to him.

Since the days of the primaries, President Obama has been held up by his detractors as inadequate. We can be honest here -- I do believe some of this on the right was due to race. He was often criticized for lacking leadership, experience, and strength while any objective accomplishment was attributed to luck and improbability, as if Barack Obama simply stumbled from one success to the next.

Do you remember during the primary, the cries over why Barack Obama couldn't close the deal? Do you remember the handwringers during the general election, waiting with baited breath for any misstep? Reverend Wrihgt and Sarah Palin? The (supposedly) disenfranchised and those under the bus?

And (for admittedly too long) the vultures waited in the wings for Obama to fail on healthcare reform. The waited and waited, and in the dark days of January, it looked like they might have been right all along.

But President Obama never gave up in his belief that we are capable of great things. He wielded his amazing intelligence and persuasiveness as a deadly weapon against his detractors, and ultimately accomplishing what no other could do.

President Obama has showed amazing leadership, moxy, and strength in his own unique way to achieve healthcare reform. He did not do it like FDR or LBJ. He did it like Barack Obama.

by NoFortunateSon 2010-03-22 01:17AM | 3 recs
20th Century, not 21st

I think it would be more accurate to say this brought the US to 20th century health care, not 21st century. Although this is a huge accomplishment, we still have a long way to go on health care to take care of our citizens properly and to catch up with the more progressive nations in the world.

by edgeplot 2010-03-22 01:21AM | 1 recs
RE: 20th Century, not 21st

Fair enough.

by Nathan Empsall 2010-03-22 01:47AM | 1 recs
From the 18th to the 19th Century

Bismark brought Health and Pension Insurance to Germany in the 19th Century.

by Jeff Wegerson 2010-03-22 09:25AM | 1 recs
Great, but....

I don't think it's fair that LBJ and FDR lacked "courage", they faced different challenges and choose different priorities - Civil Rights and Social Security among others. Obama's achievement - nay the Democrats achievement - today doesn't quite measure up to those.

But I will note this begins, with student-aid reform and medicare advantage reform, the roll back of some 20 years of the government out-sourcing service to private profiteers. That's big.

by vecky 2010-03-22 01:53AM | 3 recs
RE: Great, but....

FDR was a courageous man, there is no doubt. But Obama is not backing down from climate change, financial regs, immigration, credit card reform, tobacco reform, jobs bills, or Afghanistan because of a fear of overreach.

by Nathan Empsall 2010-03-22 01:56AM | 0 recs
RE: Great, but....

It is not clear yet what the White House will back down from.  Let's savor our moments of courage one at a time. :)

by Steve M 2010-03-22 02:30AM | 1 recs
How does this reduce the deficit

I am just curious? How exactly does this bill reduce the deficit? I heard the same thing on Bill Maher's show. But I could not understand how it worked.

I wish there was a public option because the lawmakers dont seem to know how to remove the cartel like behavior of insurance companies. :Plus another reason for public option would be this: even if profit seeking corporations act more honorably, there will always be a citizen whose health condition is so severe, it is unfair for a company to shoulder that burden. So in such cases, I want the government to take care of such individuals.

What I do not see is why competition between insurance companies hasn't translated to lesser profit margins? If one company is making obscene profits, shouldnt the marketplace work such that the other insurance companies try to steal those customers? Nothing wrong with profit oriented healthcare. I just dont like seeing statements saying healthcare should be run only by non profit entities. What we need to see is why can't we find a way to force these companies to compete with each other more aggressively so the profit margins can't remain obscene.

Despite my reservations, I have to laugh at the republicans who are making such crazy statements that the constitution has been violated. Say what?

by Pravin 2010-03-22 02:38AM | 0 recs
RE: How does this reduce the deficit

I am just curious? How exactly does this bill reduce the deficit? I heard the same thing on Bill Maher's show. But I could not understand how it worked.

Spending cuts and taxes out-way the projected expenditures. This bill is paid for in other words.

I wish there was a public option

Tell me about it.

What I do not see is why competition between insurance companies hasn't translated to lesser profit margins? If one company is making obscene profits, shouldnt the marketplace work such that the other insurance companies try to steal those customers?

The goal in health insurance is to have a pool of members who are healthy while kicking out those who are sick. There are only so many healthy people to go around so it's not easy to steal customers. Besides the easiest way to steal customers is to make sure you have a better healthy/sick ratio than your competitor. Then you can charge less then they do and vola, all the healthy people folk to you. The sick can't transfer and eventually get kicked out of the system all together.

Nothing wrong with profit oriented healthcare. I just dont like seeing statements saying healthcare should be run only by non profit entities.

Health Insurance did not start off as a for-profit industry. This article has a brief history of how Blue Cross started for example:

http://www.tnr.com/article/health-care/tangled-up-in-blue

The idea of profits is that it fosters innovation, marketing and competition thus increasing efficiency and choice. That's all good, but a for-profit system also has some perverse if unintended consequences, so needs some regulation. That's why the new regs include guaranteed-issue and a cap on MLRs (medical loss ratios - i.e: how much they spend on stuff other than health care). That's a good start.

 

by vecky 2010-03-22 02:58AM | 0 recs
RE: How does this reduce the deficit

Please explain your logic on how insuring 30 million additional people will save us money? Are you using the 10 year projections where we raise the revenue for the full ten years but only provide services the last six? Are you counting the separate bill that provides funds to keep medicare reimbursements at the current rate? Do you think it is logical that we can use 500 billion from Medicare to pay for the new plan and still claim we are making Medicare more solvent? Has any government entitlement program ever cost less than originally predicted?

The HIC is a lot of things, but let's not deluded ourselves about it saving money. The math doesn't add up. 

 

by tpeichel 2010-03-22 12:01PM | 0 recs
RE: How does this reduce the deficit

Please don't delude yourself - the only tax that starts immediately is the 10% tax on indoor tanning, which goes to pay for the immediate benefits of the small business tax credit. Most other taxes start only in 2013 some not until 2018, so drop your talking points.

 

by vecky 2010-03-22 12:34PM | 0 recs
RE: How does this reduce the deficit

I trust the CBO, which doesn't just look at the first ten years about also the second decade. And no, I don't count the separate Medicare reimburesment bill, because that's a separate issue. We've been passing that bill over and over for years. It's part, as far as I'm concerned, of the current system and deficit that the new reform is being grafted on to. In other words, this doesn't raise a smaller deficit; it lowers a bigger deficit.

by Nathan Empsall 2010-03-22 12:51PM | 0 recs
RE: How does this reduce the deficit

I agree that the best part is reading the crazy Republican reactions.

by Jerome Armstrong 2010-03-22 05:14AM | 1 recs
RE: How does this reduce the deficit

For me a good part is reading the reactions expressed here at MyDD, which have been really nice so far. But the BEST part is not reading the reactions of those who hate this victory, as they haven't yet posted since the vote...for the most part.

by QTG 2010-03-22 05:35AM | 2 recs
Yeah, where are they?

I must say that many of the strongest opponents of this bill have been quite magnanimous this morning. We all know there is more work to do; specifically providing a not for profit alternative to mandated coverage.

I hope that we all can work together to get some form of not-for-profit/public option passed soon.

As for those who hate this victory, my schadenfreude of the day comes not from the crying on Red State, but from the PUMAs now turning against Jane Hamsher. Their argument seems to be: Jane Hamsher, a woman, was a hero a daya go for trying to kill this bill, which would have (also) been a huge defeat for Obama, but because she favored Obama in the Democratic primary over Sec. Clinton two years ago, and Obama was elected and passed healthcare reform, which made illegal the sexist practice of treating being a woman as a preexisting condition, but in doing so, had to reaffirm existing abortion law, she therefore is worthy of their ire today.

by NoFortunateSon 2010-03-22 02:06PM | 0 recs
"historic"

As much as this sort of "historic" post rather writes itself, the reality is buried early on: "The new law, while insuring 30 million and lowering the deficit, is not perfect" is beyond understatement. At every step along this route - whether its was when the House committees passed bills out of committee, when the House bill passed the House or the Senate bill passed the Senate, to last night - there has been this self congratulatory, heavy backpatting moment where we tell ourselves that what we have is better than it is, and a great "first step", ignoring that the painful process, badly constructed bills, and bare majorities signal that doing more is deeply, deeply unlikely. What we've got is what we're likely to get for a good long time. And what we got has nowhere near the grandeur placed upon it.

Bottom line, here's the biggest problem the bill sets up, with no real will or interest in solving: we are about to push - if you buy, though we probably shouldn't, that all of this happens on the ludicrously long time frame mapped out in the bill - millions into Medicaid wihout the adequate funding to cover their insurance, never mind their care. We are forcing every woman who goes into that system to give up her right to a necessary medical service that she may need in the event of a pregnancy (that's not Stupak, or Nelson... that's the Hyde Amendment). And we maintain the exceptionally broken system of delivering "block grants" to 50 states, with 50 different approaches to Medicaid, rather than taking the sensible, and painful step of nationalizing the program and fully funding it.

I understand the need to celebrate what's happened here - it's a time, and a Presidency, which has been painfully lacking, for many progressives, in the kind of positive developments which would underline all the hope, and hope for change, invested in Barack Obama. But it's cheerfully naive, and has been all along, to keep insistng with every so-so step in the healthcare process, that this is "wonderfully historic" and just where we wanted to be. This is nowhere near where many progressives want to be, whether its the pie-in-the-sky notions, still, of single payer or "Medicare for All" or merely the hope that we'd take an extremely poor approach to healthcare - most basically, crafting a system built around employment - and try to slowly undo it, rather than cast it in deeper amber. If we're lucky - and nothing in the past weeks or months suggests anything of the sort - we may be able to actually, over time, get this bill to approximately do what it is claimed to do, wthout bankrupting our country. The idea that this is the first step in some magical plan to completely overhaul health insurance is a fantasy, a dangerous one, and one that progresives have been dreaming out loud throught the past year. In the reality of where we are, a bad bill passed the House last night, with some popular adaptations of our employer based insurance system, some costly additions, and a potential fix which may give some increased access to insurance to more people. We've done little to address cost of care, quality of care... and we'll remain, in the long run, stuck with many painful choices that no one, really wants to face (most obviously, the avoidance of serious plans to address the rising costs of Medicare will be impossible to ignore very very soon). That's the reality, and I'd feel better about the possibility of future progress if I thought we were at least starting from a clear understanding of the present, rather than this wish to live in a pretend future tense.

by nycweboy1 2010-03-22 06:12AM | 2 recs
RE: "historic"
You and I are on the same wavelength.
by desmoinesdem 2010-03-22 08:57AM | 0 recs
RE: "historic"

pie in the sky is right -  UHC was never going to pass.    So, what would you propose?  Begin the laborious path of incremental progress, or just wait and hope for the day that progressives controlled Congress so we could just easily, and without breaking a sweat,  convert to UHC? 

Defeatism is unreasonable if you never had the opportunity to achieve it.  So I find your diatribe about the new bill to be unfounded.

I don't consider it perfect, but this is the path to UHC.  It will not be pretty, nor easy.  Though once people start to obtain better coverage and enjoy this as a right and not a privilege, American's perspectives will change.    Once Americans start to become less anxious about the fear of losing their entire financial security from an illness, they will start to truly appreciate the benefits of coverage, even if controlled by the government.  In due time, there won't be cries against soclialism, there will be demands for socialized medicine. 

This bill is a first step towards UHC.  You can say it's not, but then you'd be ignoring the main point for the republicans' and insurance industries' objection to the bills - slippery slope to UHC.

by KLRinLA 2010-03-22 04:29PM | 0 recs
RE: "historic"

KLR - While I do, in the long run, believe in some sort of single payer solution... I think in order to get there you'd need to start from somewhere far different from where we've been: most Americans - still - do not understand all the issues we face in healthcare, why they matter to anyone, or why proposed changes are the right things to do. If we're lucky - and as above, I don't think we are - people may begin to have some of those discussions in the context of wider and different insurance options. But for many, nothing will change and they will likely lose interest.

"UHC" is a buzzy acronym that doesn't mean all that much - and to that end, I think calling this biull a "start towards UHC" is about as useful as saying it's a start toward ice cream cones. Given the divisive, unhappy process of concocting this bill, I'd say we're inlikely to see big appetites for future changes anytime soon, and to the extent that we'll see momentum on healthcare, I suspect a good bit of it will be backwards. It's clear Republicans will press some sort of rollback of reforms given a chance and some election successes (which, still, seems well within the cards for the midterms)... and that will be compounded by, I'd also suspect, attempts to roil seniors, especially seniors in Medicare Advantage, many of whom will probably be dropped as insurers exit the program as the payments are reduced.

None of this, really deals with major problems that many progressives have deliberately ignored: Medicare's poor fee for service structures which need substantial change which no one will like, as well as the far more unpopular note I keep sounding about the near-criminal failures to address inequities and structural problems with Medicaid (it's worth pointing out that, after over a year of substantial debate, many lefties still think Medicare and Medicaid are about the same thing, never mind Republicans think of both). We're not doing anything to change hospital based approaches to care, or how docs practice, never mind far more complex issues around mental health, rehab services of all sorts... and on and on. "UHC"? That's about as unserious as I can think of about where we need to go next.

Just to be clear, I think one can't help, as a Democrat, but feel somewhat heartened that Democrats united (sort of) and prevailed... but to what end? We've rewarded private insurers with more customers, a substantial guarantee of fees, and done little to improve care or cost for millions of people, who are bound to discover that insurance, will not solve their healthcare issues or needs. That's "historic"? Well, perhaps... but not in the way I suspect many want to have a positive impact on the future. To do that... will take more work, more painful choices, and more willingness to take on the hard stuff. I don't think we're anywhere near any of it.

by nycweboy1 2010-03-22 05:59PM | 0 recs
RE: "historic"

Nice response, I hear you, especially your last sentence, which is true, this bill is a small step towards meaningful coverage, progress, and cost and quality control.

OTOH, I would say that this is an enormous victory for people that have had loved ones die because their coverage was dropped, or to those that have lost their savings due to an uncovered illness.  If you've never had this experience, then you probably cannot fully appreciate the value of these safeguards this bill provides.

I understand that over the year the American people have  developed a bad taste in their mouth for this debate, it is nauseating.   But this wasn't a fight that lasted one long monotonous year, we've always had this fight. We have to continue fighting. 

As for momentum, once you increase coverage and access to healthcare, and people become accustomed to it, rolling back is not going to happen.  For one, it would be political suicide.  It's like talking about rolling back social security, it wont happen, nor will the people support a move.

That is where the momentum helps us.

I would suggest that although we've given more customers to the insurance companies, the companies now have to actually pay for the care and not just reap the premiums and deny coverage any longer.  Plus, there is a reason why many people are uncovered right now, they have costly illnesses, and this isn't the client base the insurance companies were hoping for.  They did spend a good deal against this bill, too, so I don't consider it a corporate giveaway. 

Medicare reimbursement - hopefully dealing with the massive fraud will help - I am at a loss as to how to fix this problem beyond that.

You make excellent points, my only criticism is that I see a laundry list of items that need improvement, and a call for more educated national dialogue, but where are the solutions?

by KLRinLA 2010-03-22 07:51PM | 0 recs
Ted Kennedy

is looking down from heaven smiling, knowing that we have finally taken the first big step.

 

I do have my grievances with the bill, but its benefits outweigh the costs in my opinion.

How does this reduce the budget deficit

Another thing to consider is preventative procedures.  With more people covered, those who would typically have put off getting care without coverage will now be much more inclined to seek medical attention in the beginning.  I think its pretty good rule-of-thumb that the more serious a medical condition gets, the more expensive it gets.

by Chuckie Corra 2010-03-22 07:56AM | 0 recs
RE: Ted Kennedy

The post ended with a picture of Kennedy, but MyDD is having trouble with pictures right now... they disappear after an hour or so...

by Nathan Empsall 2010-03-22 11:59AM | 0 recs
I can't see how Obama's leadership

can be compared to FDR's in any meaningful way. Obama abandoned at least a half-dozen campaign promises on health care reform to buy the support of drug companies, insurance companies, and hospital groups. It's like the polar opposite of FDR's "I welcome their hatred."

This bill will help a lot of people, but unfortunately a lot of other people will find the coverage they have getting worse, or out of pocket costs continuing to skyrocket. Insurance companies will find new ways to cancel sick people's policies and discriminate against people with pre-existing conditions, because this bill creates no real competition for them.

I don't think Grayson's bill has any prayer in the Senate, but it is the best approach for improving on the bill that just passed.

The student loan reform is welcome news.

by desmoinesdem 2010-03-22 09:01AM | 1 recs
RE: I can't see how Obama's leadership

Lincoln-FDR-Obama, drink up!

by Jerome Armstrong 2010-03-22 09:17AM | 0 recs
RE: I can't see how Obama's leadership

FDR remains the greatest president and my second favorite after his cousin. But my point is this: Obama passed health insurance reform and the beginnings of care reform; no other president, not even FDR, could or thought they could do that.

by Nathan Empsall 2010-03-22 12:00PM | 0 recs
Well, maybe not the leadership styles...
I can't see how Obama's leadership... can be compared to FDR's in any meaningful way. Obama abandoned at least a half-dozen campaign promises on health care reform to buy the support of drug companies, insurance companies, and hospital groups. It's like the polar opposite of FDR's "I welcome their hatred

I don't think the leadership styles can be compared anymore. But the reactions to the historic achievements by progressives do have eerie similarities.

FDR might have welcomed their hatred while Obama embraced it, but FDR was nonetheless branded a sell-out by then progressives for compromising on social security coverage.

I strongly suggest reading the history of social security, and the controversy over its creation for historical parallels today.

by NoFortunateSon 2010-03-23 01:23AM | 0 recs
Hillary Celebrates Obama's resolve

Secretary of State Hillary Clinton celebrated the passage of landmark health care reform Monday, in a rare moment for a woman who was once one of the leading voices on the issue.

"If you ever doubt the resolve of President Obama to stay with a job, look at what we got done for the United States last night when it came to passing quality affordable health care for everyone," Clinton said during a speech to the American Israel Public Affairs Committee.

Hillary is right, and gracious, and right.

by QTG 2010-03-22 12:45PM | 2 recs
RE: Hillary Celebrates Obama's resolve

When Obama spoke last night with Biden behind him I thought Hillary should have been there too. But I understand that as SoS she has to keep a little distance from domestic politics.

 

by vecky 2010-03-22 01:11PM | 0 recs
RE: Hillary Celebrates Obama's resolve

Me too. I wonder what Obama told her when it passed and where she was.

by NoFortunateSon 2010-03-23 01:24AM | 0 recs
the polls show

that many progressives have come home in the last few weeks. I understand it.

While I still have my reservations about the bill, seeing the President actually fighting hard for it, and seeing the GOP tear out their hair over it has made it difficult to do anything but root for it recently.

Policy-wise, I'm still not sure that this bill is very good or even a net win by itself. Emotionally, it feels really good to recapture a little bit of the magic of november 2008.

I hope this new-found momentum can be used by the Democratic Party to continue trying to make it better and to get other important stuff done. And I hope Obama has realized the importance of taking a stand and fighting like hell. We want to follow, and we will when he leads.

by jeopardy 2010-03-22 12:59PM | 2 recs
RE: the polls show

I saw earlier that Noam Chomsky was for the bill.  And here I thought Kucinich was the ultimate tipping point...

by Steve M 2010-03-22 08:28PM | 0 recs

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