Monday, March 22, 2010

Finally, Health Care Reform

They passed it. The President will sign it. The Senate will debate and pass the clean-up "reconciliation" bill. But, mostly, the drama is behind us.

This law is the most significant piece of legislation in decades. It is also far less sweeping than it's critics claim and fear. It is comprehensive, smart, and essential reform. It is not a government take over of health care.

The irony is after a year of arguing and endless hour of debate and breathless news coverage, most Americans have little concept of what the law will actually do. This is a strange by-product of the process. The bill's broad framework has remained consistent, but the details have always been a moving target. In the media, and especially from the right-wing media, there been a relentless focus on the daily talking points, conflict, partisan hyperbole, and politics over policy. Misinformation crowded out information from the beginning. So, it bears repeating what this law will actually do.

 The core components of health care reform are:
  • Private insurance companies can join health care exchanges that will be able to sell insurance nation-wide.
  • Health insurance companies will not be able to reject individuals because of their health history.
  • Some people who don't have health insurance will get a tax credit to help purchase it.
  • There are a number of policies and pilot programs aimed at controlling health care costs.
  • It will be paid for by extending the %2.6 Medicare surcharge to include income greater $250K.
Most Americans will see no significant change to their health care insurance, to their relationship with their doctor, or to their taxes. For most Americans this is no big deal. Health care reform is a big deal for the uninsured, for people (like my family) who buy individual insurance, for anyone who loses their job, or wants to change job, or wants to start a new business, and for anyone dealing with chronic illness. The safety net just got stronger and wider.

This is also a big deal for anyone who cares about the effect of rising health care costs on their personal, state, local, and business finances or who cares about the national debt and deficit.

 For anyone craving more detail about what this law will actually do, I'll direct you to the excellent Ezra Klein who explains it all in great clarity and detail.

 Unlike the policy details, the politics of health care reform have probably gotten too much attention. Nonetheless, I'll offer my thoughts.

 A nice summary of the politics of health care reform comes from Lamar Alexander's comments during the President's conference:  

'Your stories are a lot like the stories I hear. When I went home for Christmas after we had that 25 days of consecutive debate and voted on Christmas Eve on health care, a friend of mine from Tullahoma, Tennessee, said, "I hope you'll kill that health care bill."
And then, before the words were out of his mouth, he said, "But we've got to do something about health care costs. My wife has breast cancer. She got it 11 years ago. Our insurance is $2,000 a month. We couldn't afford it if our employer weren't helping us do that. So we've got to do something."
And that's about -- that's where we are.'
Lamar's friend from Tullahoma captures the sentiments from the right and much of the American electorate. Reform opponents have been so vigorous and relentless in demonizing health care reform that even those who need it most, and who will benefit the most when it become law, are terrified and angry about it.

It is my hope that when health care reform becomes law some of the smoke will clear. Americans will realize that these are sensible, centrist reforms that provide great benefit to all Americans at relatively modest cost. It's my hope that the American people will realize that the tales of tyranny, taxation, redistribution, rationing, death panels, and government takeover bear little resemblance to the policies being enacted into law. It's my hope that people will recognize who has been feeding them this pack of lies and stop listening to them. And stop voting for them.

 The President and the Democrats should celebrate this victory. They should be proud of it. They have succeeded against mighty opposition from every quarter. They have prevailed where many have failed. This is good policy. It is also good politics. Victory polls better than defeat. The juicy sausage will be much more popular than the sausage making. I'm grateful for my own representatives Congresswoman Carol Shea-Porter and Senator Jean Shaheen. Both of them stood tall through it all and kept their promises to all of us.

Yes, we can.

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