Thursday, August 6, 2009
It was another confusing week, but when the dust settled, one thing was clear: Health-care legislation had passed the U.S. House of Representatives and was headed to the Senate.
It’s unlikely that lawmakers will act on the package before the August recess. But the steps toward progress are all the more impressive since they were conducted amidst the usual acrimony, with Republican scare tactics reducing public support for the badly needed reforms.
Although President Obama keeps saying, rightly, that leadership needs to come from the bottom up, he deserves the credit for pushing the debate forward.
The guy has a disconcerting habit of trying to deliver on his promises, disappointing critics on the left – who deplore his willingness to compromise with Blue Dog fiscal conservatives – and on the right, who deplore everything about him, resorting to bogus questions about his citizenship.
But he’s doing what he said he would: recognizing that politics is the art of the possible, seeking solutions that will work and refusing to give up.
Among other things, the forward motion reminds us of one of Obama’s forgotten skills – he’s a master politician, and someone who understands the fine art of keeping his friends close and enemies closer.
The last presidents to make major accomplishments in health care were Franklin Roosevelt, with Social Security, and Lyndon Johnson, with Medicare. The fact that Obama is able to look so resolutely unpolitical compared to these legendary predecessors at the same time his surrogates are cutting the requisite deals is another sign, as if we needed one, of his savvy salesmanship.
It’s easy to see how people could get lost in the complexities of dueling health-care proposals. The acronyms alone are daunting, as Obama demonstrated in his diffident press conference on the subject before getting drawn into the debate between Professor Gates and the Boston cop.
The policy wonks can fight it out, but the basics are pretty simple. Every American president since Harry Truman has said a national health plan is required, and every reform similar to the one currently being offered has been defeated by the powerful combination of medical and insurance company lobbies.
The system is obviously broke, but until now, we haven’t had the political will to fix it (though Hillary Clinton certainly tried).
Perhaps a personal example is in order. Three years ago, I underwent minor surgery for a condition that was upsetting to my personal sense of immortality, but trivial compared to the serious grief American families are going through every day.
At the time, I was covered by Kaiser, which serves as at least one model for low-cost, deliverable health care. I listened to friends and family who were skeptical of Kaiser’s reputation and got an outside opinion from a private doctor, who advised me that Kaiser would give me not only the cheapest, but the best treatment possible.
He was right, and everything was fine – until I lost my job. My former employer covered me for a year; after that, I was on my own. To add insult to injury, even though I had sailed through the operation successfully, I now was saddled with two words that strike fear in every citizen’s heart: “pre-existing condition.’’ My rates, no longer covered by my employer, were artificially high, even though my doctors agreed – in writing – that I could get on with my life without future medical repercussions.
Dealing with all of this was almost as unpleasant as the surgery, but so it goes. There are millions of people in far worse situations every day, which only underlines why it is so important to make progress on this issue.
The current system costs too much and hurts too many people. Dealing with the catastrophic illness of a loved one is hard enough to deal with emotionally – it’s one of the unbearable facts of life – without the additional burden of worrying about how you’re going to pay for that care.
My family has been lucky in that regard. My mom has a generous policy that covered her and my dad for life, so we didn’t have to sweat the economics of hospitalization at the same time we were dealing with his loss. My wife’s family had a rougher go – her father prepared for everything in his life but the unexpected reality of Alzheimer’s disease – but got through it OK.
Obama has promised that no one who likes their current medical care is in danger of losing it, and he’s right to make that promise. Americans believe in choice, and also in compassion.
People who can afford it should have the best health care possible. So should the rest of us.