Health Care Reform REDUX

Finally, I present my run-down of the last year's events leading to the passage of the Affordable Health Care for America Act. So, the bullet-ed run-down:

*About one year ago, early in his first term in office, President Barack Obama laid out an ambitious goal: to have health care reform passed before the end of his first year in office.

*He wanted it to be hopey, changey, and bipartisany. Mistake number 1.

*So, in the Senate, a "Gang of Six" -- Max Baucus (Mont.), Jeff Bingaman (N.M.) and Kent Conrad (N.D.); and GOP Sens. Charles Grassley (Iowa), Mike Enzi (Wyo.) and Olympia Snowe (Maine) -- was assembled. The thought was that if bipartisan ideas went into the legislation (WHICH THEY DID), both parties would be able to vote for the bill. Mistake number 2.

*The "Gang" stalled and stalled, got nothing substantive done before the summer recess. Giant Mistake number 1.

*Media, special interests, opposed legislators, and any and all saboteurs-de-healthcare descended on the "Summer of Townhall Hell" where angry constituents admonished their democractically-leaning colleagues for hinting that they were supporting A) Death Panels, B) Health Care rationing, C) The Government interfering with Medicare, D) Mandatory and state-sponsored abortions, E) Defying the will of a minority of elected officials (Republicans), F) All of the above, and then some.

*With endless lies, spin, misinformation, and anger widely disseminated by the media, public support for health care legislation began to decline. Recognizing that bills are drafted, debated, voted upon, and passed by the legislature, the White House declined to intervene too much (per its role to sign bills into law and to enforce existing laws of the land). Constitutional role be damned, Giant Mistake number 2.

*Remarkably, despite death panels and major updates on health care reform from such renowned experts and Sarah Palin and Betsy McCaughey, by Christmas legislation had cleared both the House and the Senate. All that was left was for the two bills -- which had similar amounts of spending, deficit reduction, language on abortion, proposed changes to medicare; while differences on excise taxation of Cadillac union healthcare plans and kickbacks for equivocal moderate Democrats' participation -- to be merged in conference, filibuster prevented by 60-member cloture vote, and sent to the President's desk before long.

*Martha Coakley -- Attorney General of the State of Massachusetts -- managed to lose the special election for the Senate seat long held by Ted Kennedy. With Scott Brown, the Republicans had their 41st vote -- enough to successfully filibuster any and all changes to the Senate health care bill after conference committee between the House and Senate. Pundits of all shapes and sizes, party affiliations and persuasions, declared health care reform dead.

*Then, Democrats -- most notably Pres. Obama, who has a knack for coming back from behind (as an example, see this video of him dismantling Clark Kellogg in the presidential version of H-O-R-S-E, aka P-O-T-U-S), grew a pair and remembered how all parties in the majority have tended to use budget reconciliation as a way to bypass the often outdated/overstated/all-too-often-threated filibuster. So, despite objections to the contrary, they put "on the table" budget reconciliation. It came down to this: if the House could pass the Senate Bill verbatim along with another bill making changes to the Senate's bill, then the Senate could pass the changes using budget reconciliation. However, people wondered whether Mr. Obama could support this. He was still giving the impression that "all options were on the table."

*On 29 January, 2010, President Obama schooled the shit out of House Republicans. He showed that, unlike his noble objectors, he had thought through why reform needed to happen, and relatively all at once. He demonstrated that he had anticipated the kinds of questions he would be asked. And when conservative mouthpieces like Fox news cut away, while liberal mouthpieces like MSNBC are so happy it looks like they are scandalously satisfying themselves on air, you know something big has happened. And indeed it had. The rest of what happened was relatively predictable.

*More opposition and rabble-rabbling occurred. The "summit" at the Blair House produced no evidence of consensus or Republican support. And the President continued to look like the adult in the room. And he said, pretty unequivocally, that he was done playing games and he expected health care reform to pass.

*Then, Nancy Pelosi went to work, whipped up the votes over a period of about two months. A few hiccups here, a few there (such as the "deem and pass" almost-debacle which wasn't necessary because it wouldn't have changed anything anyway, but WSJ always seems not to care about the facts), and suddenly, it was down to "just" abortion (yay!) and with a little wrangling here and there an executive order would confirm what was already in the Senate bill to begin with.

*Late in the evening of 3/21/2010, the House passed the Senate Bill, along with some fixes. Two days later, this was signed into law. By the following week, all of the changes were, too, passed into law.

I will post my photo, in front of the Capitol, on 3/21/2010 as soon as I can find it.

The real work of fixing health care -- insurance, delivery, disparities, outcomes, disease management, coverage for everyone, and so on and so forth -- is what comes next. I intend to vigorously follow and post on how this can and will be accomplished.

Many tweaks will be needed, perfection is not a realistic goal, but doing nothing is certainly no option...