The Politics of Health Care Reform

In the wake of health care reform's successful passage into law by Congress and President Obama, a lot of attention is being focused on how this all plays out in November and beyond.

What I think will become increasingly clear over the next several months (and years) is that the sky is not falling, Armageddon is not just around the corner. This health care reform law is not a government takeover of America's health care. It's not some Bolshevik plot. In fact, it leaves the decentralized, private health care system largely in tact, merely reforming it around the edges. Most Americans will either benefit immensely from this bill or experience no change at all--at least for the first several years.

Jonathan Chait points out that the health care bill that was signed into law by President Obama is a very moderate, even centrist Republican, bill. It closely resembles the reforms Mitt Romney signed into law in Massachusetts in 2006, as well as the Republican alternatives to "Clintoncare" in 1993. At its core, the bill relies on the existing private system that's in place, only marginally increasing the number of people who get their health insurance from a government program.

Already we are beginning to see a shift in public perceptions of the bill. A new Gallup poll shows that more people now support the passage of the reform bill (49%) than oppose it (42%). This is largely due to the following:
(1) Liberals who were reluctant to support the bill previously--due to its aforementioned centrism--have now come on board. These "opponents" of the bill were generically counted in the "oppose" column of public opinion surveys, even though said opposition was because they didn't think the bill went far enough. These folks have now gotten behind the largest expansion of the social safety net since Medicare, despite its perceived inadequacies.
(2) Success breeds support. Through the often rough legislative slog, the public became disillusioned in the process and the rhetoric. That part is now over, and in its place is a pretty good bill.
(3) We now have a definitive bill with definitive reforms. As the public's understanding of what's actually in the bill increases, support has increased. And I expect even more of increased support in the weeks and months and years ahead. People will realize that, contra Republican rhetoric, the sky is not falling. Before the Democrats had a single, actual bill, politicians and pundits and advocates had a difficult time defending the legislation against some of the more outlandish criticisms. That now changes.

And what about the 2012 Presidential election? Many viewed Mitt Romney as a favorite to win the Republican nomination and possibly challenge Obama for the presidency. In many ways, as Matt Yglesias points out, that ship has sailed. This plan so closely mirrors Romney's 2006 Massachusetts plan that it will be nearly impossible for Romney to justify his past embrace of health care reform to the far-right of his party.

Inside Health Care Reform

We've all heard the shouting, the anger, and the misrepresentations. But, in reality, what exactly will this bill do? What's in it? And how will it affect you?

How much will health care reform cost?

Many of the provisions in the bill don't go into effect immediately. Here are the provisions that go into effect within the first year.

What does the bill do to control health care costs? Here are the five most promising cost controls in the bill.

The health care bill is projected to insure 95% of all Americans by 2019. Who will be left uninsured?

The health insurance "exchanges" are a major aspect of this bill. What's their role and how will they work?

Did the health care reform process lack sufficient transparency?

What does the bill do for prevention?

Want to know how your family will be directly impacted by health care reform? Here's an easy to use calculator.

UPDATE: How does the individual mandate work?

A Victory for Freedom

Health care reform is now the law of the land. It is an historical achievement that builds upon the progress of Social Security and Medicare in protecting all citizens against financial and physical uncertainty and risk. It continues in the long line of progressive reform that runs through the New Deal and the Great Society.

Make no mistake about it: This legislation is a victory for freedom--what FDR called freedom from want and freedom from fear. No longer is health care security dependent on employment, or income, or a person's ability to avoid bad luck.

Health care has always been a human, personal issue. It is also a societal issue. The growing plight of an increasing segment of American society cannot be--and with this bill, will not be--disconnected from the health of society as a whole. With passage of health care reform, American society has become a bit more humane, a bit fairer, and a bit more supporting in the face of unexpected, unplanned physical calamity. With health care reform, we've taken a large step in ensuring that our individual medical risks are collectively pooled.

And emerging from this arrangement is an increased sense of human freedom--a freedom that will not be stifled by crushing, unexpected medical costs or bankruptcy.

The Weekend Link

The health care polling memo all Democrats are currently reading.

Jon Cohn on why health care cost control is so difficult, both politically and practically.

Ezra Klein debunks ever more conservative myths about health care reform.

The Democrats' health care proposals have come under fierce fire from conservatives and, to some degree, the public at large. But what, exactly, would a Republican health care plan look like?

Republican congressman Paul Ryan's budget proposal provides us with a chilling preview of Republican budgetary goals, should they regain power.

And here's a paper from the Center for American Progress comparing public spending levels and priorities among OECD countries.