Health Insurance Reform: The End of the Beginning

The course leading to the House vote on health insurance reform was clearly a case of winning ugly. We’ve all had an overdose of exposure to legislative sausage-making. But, in the end, the 219-to-212 vote was a huge step forward, an historic moment in the history of this country.

More than 30 million uninsured people will get coverage. The ability of insurance companies to bar people with pre-existing conditions and cap lifetime benefits will come to a close, paid in part by expanding the pool of the insured to include millions of younger, healthier people. Individuals would have to buy coverage, as they do in Massachusetts. Small businesses would have to provide coverage but would receive tax credits to do so. Both individuals and small businesses would be able to participate in groups to negotiate better rates with private insurers. Seniors would start getting help closing the so-called donut hole, the gap in Medicare D coverage of prescription costs.

The Congressional Budget Office says that the legislation would reduce the federal deficit by more than a trillion dollars over two decades. That may have given some in Congress the cover they needed to vote Yes, but the history of such cost projections is checkered at best. This is still a work in progress. Adjustments will need to be made, just as they had to be made with Social Security, Medicare and civil rights legislation.

Minority Leader John Boehner says that “millions of people are scared to death” of the bill. But why is that? Because John Boehner and his pals have deliberately scared them – about death panels, government takeover of health care, a looming radical Socialist experiment. All nonsense.

Majority Leader Steny Hoyer points out that the Harry and Louise anti-health reform ads in the 1990’s warned that, under the then-proposed legislation, everyday folks would pay more and get less. The health bill back then was defeated. And what happened? We’ve been paying more and getting less.

The sausage has been made. President Obama thankfully stopped over-learning the mistakes of the Clinton health care fiasco and finally became fully engaged. Partisans of the left and right can find much to vent about. But the newly passed bill, as the President and health care economists have pointed out, “runs straight down the center of American political thought.” It’s far from perfect. But it is a step forward on a journey that couldn’t begin without that first step. To paraphrase Winston Churchill after the Second Battle of El Alamein in 1942, “This isn’t the beginning of the end; it is, perhaps, the end of the beginning.”

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