Sunday, 20 December 2009

"We did it, Mr. President"

Reports are that a deal has been reached that both pro-choice and anti-abortion sides can live with. Plus a little extra cash just for Ben Nelson's Nebraska constituents.

There's an old saying that politics is like sausages in that if people could see how they are made no one would swallow it. Well, no one could say the process of passing this bill has been anything but ugly. Such is the life in our lunatic legislature.

But the passage of this bill will be a major achievement for America, for Senate Leader Harry Reid, Speaker of the House Nancy Pelosi, and for the President. A weary but fervent congratulations to them all for getting us here.


Taylor_Democrat said...


I admire your enthusiasm for this Bill. You are a tireless advocate and committed optimist and we could all use a bit more of those qualities as we continue to push for positive change in the US.

I do very much hope that the Bill will eventually prove to be a positive change for the American health care system. I will be waiting patiently, but meanwhile I am very happy to stay here in England under the protection of true universal health care.

God Bless and Happy Christmas.

Taylor Kunkle

Obama London said...

Hi Taylor,

Thanks for the kind words - it means a lot to me. And thanks for listening so patiently and responding so intelligently to all my tediously detailed thoughts.

You and I are in the same boat here - we are both hoping against hope that this bill will begin the kind of change that our country needs.

I've come to the conclusion that where there's a difference in perspective between us it's due to the direction we are facing. We're both standing in the same place on a long path, but you're looking forward in frustration seeing how very far we still have to go.

I'm looking backwards and seeing how far, how rocky, how seemingly impenetrable was the road we just walked.

But as soon as we really reach the current peak, I'll be turning around and setting out with you to climb the peaks ahead.

Julian said...

I agree with you, Karin. There are many flaws with this bill and there is a lot that disappoints me. However, this bill definitely makes progress and is clearly better than doing nothing. I am not convinced that doing nothing for months or years longer would create a more sensible political atmosphere in which to reach a better deal. Rather, I am afraid that waiting longer would create more time for hysteria to cloud all logic and for the political will and capital used in this debate to disappear. We'd then be stuck where we are for another ten to twenty years.

If you want a microcosm of my claim that the political will to get this done will die if we don't take what we can, I offer myself. I can honestly say that despite my passion for healthcare reform that has grown over the course of several years as I have learned and advocated about the issue, I am now exhausted by it. I have trouble imagining that politicians who have other priorities will become more interested in siding with progressives if we demand that this be the sole issue until our demands are met.

Once we've got this bill passed and have had a breather, we will have to press our elected officials to make amendments to the law to make further improvements. This is a hell of a beginning, not a hell of an end.

I'll be writing to my representatives and voting for politicians who want to:
1. Increase the level of income-based healthcare subsidies;
2. Expand access to the health insurance exchange to anyone who wants it (with all subsidies and employer contributions made fully transferrable to anyone using the exchange, along the lines of Wyden's earlier proposed amendment); and
3. Create a Medicare buy-in that is gradually expanded until it is available to anyone who wants it;
4. Increase the level of regulation applicable to private insurers within the exchange.

I suppose I'd also like to see abortion coverage made standard to make good on the Democratic Party's longstanding commitment to keep abortion accessible to all women regardless of ability to pay. However, I don't view abortion as central to the healthcare issue and am annoyed that this debate was used to turn a complex policy debate into a culture war.

Obama London said...

Thanks Julian,

As always, thoughtful and relevant.

One other thing I find fairly encouraging is that this has been an actual debate - people on our side have really had a chance to focus on some of the different ideas for how to fix health care and to think about their relative merits. Medicare buy-in, for instance, isn't something that I have thought much about before the proposed compromise, but I'm now sold on the benefits.

You may say that doesn't matter since many of these good ideas didn't make it into the bill, but I think it does. As you say, progressives are now tired and ready to pause from all this.

But when we take up the issue again we'll be better informed, more focussed. There are now a small list of discrete items that we can lobby for - the list that you came up with here is a pretty good start.

And that list now has a fired up constituency. We know what we want. If we don't drop the ball we should be able to get a lot of this done in the years to come.

Happy holidays!