Health reform: a start

Victory finally came, but only for those who were hanging onto the shreds of earlier wishes, and it wasn’t ever pretty. Watching C-SPAN on Sunday, in fact, was a little like watching grass grow, with every other blade sniping at the blade just around the corner. But at least that much is over.

Congress gave final approval on Sunday to legislation that would provide medical coverage to tens of millions of uninsured Americans and remake the nation’s health care system along the lines proposed by President Obama.

By a vote of 219 to 212, the House passed the bill after a day of tumultuous debate that echoed the epic struggle of the last year. The action sent the bill to President Obama, whose crusade for such legislation has been a hallmark of his presidency.

“This isn’t radical reform, but it is major reform,” Mr. Obama said after the vote. “This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction. This is what change looks like.”

Minutes after thebill was approved, the House passed a package of changes to it and sent it to the Senate. The Senate majority leader, Harry Reid of Nevada, has promised House Democrats that the Senate would quickly take up the reconciliation bill with the changes in it, and that he had secured the votes to pass it.

But while the Senate is bracing for a fierce floor fight over the reconciliation measure, the landscape was permanently altered by passage of the original Senate bill. Should the reconciliation bill, which cannot be filibustered, collapse for any reason, the core components of the Democrats’ health care overhaul would move forward. Indeed, Senate Republicans were quickly faced with a need to recalibrate their message from one aimed at stopping the legislation to one focused on winning back a sufficient number of seats in Congress to repeal it.

It was mean and divisive and ugly, and will surely get more so, but at least it’s a start. We can finally begin to reform what is a cruel and unworkable system. And maybe, just maybe, there will some day be access to health care for all. Does anyone remember when there was no Social Security or Medicare?

House Approves Health Overhaul, Sending Landmark Bill to Obama – NYTimes.com.

Health care reform: comatose but breathing

Virginia Governor McDonnell, who proclaimed in his rebuttal to President Obama’s State of the Union address that we have “the best medical system in the world” has my qualified agreement on one point. My personal medical system is the best in the world. As a member of Kaiser Permanente, I consider my physicians among the best in the world and my care right up there. I can e-mail any of my physicians with any question; most of them reply in 24 hours or less. I can schedule appointments with specialists with ease; usually I see anyone I want within a few weeks. Medicare helps me pay for all this.

Problem is, not everyone in America enjoys such care at such cost. Millions of my fellow Americans – who might not agree with Governor McDonnell – would be happy for any kind of medical care at any remotely affordable cost. Millions of Americans are suffering and dying for lack of care. Maybe, to correct this, I’ll have to settle for just moderately excellent care rather than the best. So be it. Maybe my costs would go up. So be it. It is morally wrong for people in this country to be without health care.

(In a recent comment on this page written very late at night I attributed Governor McDonnell’s interesting phrase to former Virginia Governor Tim Kaine. Even before my astute True/Slant editors had caught the gaffe an astute reader had brought my attention to it. After I thanked him, Astute Reader replied, “Virginia might be better off if you did give it back to Tim Kaine.” We’ll see.)

But back to health care. Although it has faded slightly into the background, word is that House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid are still hoping to salvage the sprawling bill. It could be done, if the Senate bill’s sprawl. As Noam Levey reported in Sunday’s Los Angeles Times,

(I)n the coming weeks, Pelosi and Reid hope to rally House Democrats behind the healthcare bill passed by the Senate while simultaneously trying persuade Senate Democrats to approve a series of changes to the legislation using budget procedures that bar filibusters.

At the same time, leading consumer groups, doctors and labor unions that have backed the healthcare legislative effort for more than a year are stepping up attempts to stiffen lawmakers’ resolve.

These included scaling back the Cadillac tax, boosting aid to help low- and moderate-income Americans buy insurance, closing the “doughnut hole” in the Medicare prescription drug plan, and giving all states the assistance that Nebraska secured to expand Medicaid.

But many House Democrats do not want to vote on the Senate bill until the Senate passes the fixes they want. And it is unclear whether the Senate could approve a package of changes to its bill before the House approves the underlying legislation, according to senior Democratic aides. Democratic leaders hope to agree on a procedural path forward by the end of this week.

Despite the hurdles, there is a growing consensus that a modified Senate bill may offer the best hope for enacting a healthcare overhaul.

“The more they think about it, the more they can appreciate that it may be a viable . . . vehicle for getting healthcare reform done,” said Rep. Gerald E. Connolly (D-Va.), president of the Democratic freshman class in the House.

Sen. Tom Harkin (D-Iowa), who chairs the Senate health committee, noted that even before the Massachusetts election, senior Democrats had substantially agreed on a series of compromises that addressed differences between the House and Senate healthcare bills.

This space still hopes that “the best medical system in the world” can be made available to a few of the millions in America who still so desperately need it.