The Final Health Care Vote and What it Really Means
Sunday 21 March 2010
by: Robert Reich | RobertReich.org

(Image: Jared Rodriguez / t r u t h o u t; Adapted: takomabibelot, Josh Self)
It's not nearly as momentous as the passage of Medicare in 1965 and won't fundamentally alter how Americans think about social safety nets. But the likely passage of Obama's health care reform bill is the biggest thing Congress has done in decades, and has enormous political significance for the future.
Medicare directly changed the life of every senior in America, giving them health security and dramatically reducing their rates of poverty. By contrast, most Americans won't be affected by Obama's health care legislation. Most of us will continue to receive health insurance through our employers. (Only a comparatively small minority will be required to buy insurance who don't want it, or be subsidized in order to afford it. Only a relatively few companies will be required to provide it who don't now.)
Medicare built on Franklin D. Roosevelt's New Deal notion of government as insurer, with citizens making payments to government, and government paying out benefits. That was the central idea of Social Security, and Medicare piggybacked on Social Security.
Obama's legislation comes from an alternative idea, begun under the Eisenhower administration and developed under Nixon, of a market for health care based on private insurers and employers. Eisenhower locked in the tax break for employee health benefits; Nixon pushed prepaid, competing health plans, and urged a requirement that employers cover their employees. Obama applies Nixon's idea and takes it a step further by requiring all Americans to carry health insurance, and giving subsidies to those who need it.
So don't believe anyone who says Obama's health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama's health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option.
The significance of Obama's health legislation is more political than substantive. For the first time since Ronald Reagan told America government is the problem, Obama's health bill reasserts that government can provide a major solution. In political terms, that's a very big deal.
Most Americans continue to be suspicious of government. That distrust is deeply etched in our culture and traditions. Our system of government was devised by people who distrusted government and intentionally created checks and balances, three separate branches, and almost insuperable odds against getting big things done. The period extending from 1933 to 1965 — the New Deal and the Great Society — was an historical aberration from that long tradition, animated by the unique crises of the Great Depression and World War II, and the social cohesion that flowed from them for another generation. Ronald Reagan merely picked up where Calvin Coolidge and Herbert Hoover left off.
But Reagan's view of government as the problem is increasingly at odds with a nation whose system of health care relies on large for-profit entities designed to make money rather than improve health; whose economy is dependent on global capital and on global corporations and financial institutions with no particular loyalty to America; and much of whose fuel comes from unstable and dangerous areas of the world. Under these conditions, government is the only entity that can look out for our interests.
We will not return to the New Deal or the Great Society, but nor will we continue to wallow in the increasingly obsolete Reagan view that we don't need a strong and competent government. Today's vote confirms our hope that we can have both strength and competence in Washington. It is an audacious hope, but we have no choice.
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Applauding the Retard. Reich
Mon, 03/22/2010 - 14:53 — Chip (not verified)Applauding the Retard.
Reich writes: "Medicare built on Franklin D. Roosevelt's New Deal notion of government as insurer, with citizens making payments to government, and government paying out benefits..."
Uh.. actually that was Bismarck's idea in 1888. Teddy Roosevelt then cribbed in 1912 with his proposal for national health care.
It is important for Americans to understand how socially retarded their country is.
There is no "libertarian" virtue in this. This idea that the many exist for the profit of a few is simply vile. Obama's health care proposal is just another variation on the theme of trickledown.
"But the likely passage of
Mon, 03/22/2010 - 15:09 — Liced-Christ (not verified)"But the likely passage of Obama's health care reform bill is the biggest thing Congress has done in decades,...."
OK, let's be clear about this meaning: you are saying that Congress has done NOTHING IN DECADES.
Absolutely right, unless you count the wars.
Yes Congress has done
Mon, 03/22/2010 - 18:10 — whaler (not verified)Yes Congress has done nothing for decades. But if you want us to accept that this legislation is going to get the job done, we the American People WON'T. Because you are far from correct. There MUST be a public option, and ultimately, health insurance will self-destruct as we move into single payer Medicare. Ronald Reagan was a criminal. Richard Nixon was also. To discuss this as if their policies were actually on intelligent decision-making in the interests of the American people is absurd. They both make me want to vomit. Richard Nixon is primarily responsible for this catastrophic MESS called the health insurance industry that we are entangled in. If we had gone the way of Canada instead back then, look where we'd now be! Remember too what we did in Latin America with Ronnie? Or how he blacklisted and hunted Americans down during the McCarthy era? Made his fame and fortune in politics thereafter? I'm so sick of listening to the "new liberalism" polishing these creatures from the lagoon up as if they don't have all that slime dripping from them!
More "Mendacity of Hype".
Mon, 03/22/2010 - 18:14 — Vic Anderson (not verified)More "Mendacity of Hype". I'm not working it up anymore!
Let's help Greyson of
Mon, 03/22/2010 - 20:16 — Anonymous (not verified)Let's help Greyson of Florida with his simple bill to offer medicare to any one who would like to buy into it. The game is not over, it is just the first quarter.
It was vitally important for
Mon, 03/22/2010 - 20:24 — An American Patriot (not verified)It was vitally important for the Republicans to prevent OBAMA from getting this legislation passed. They had to show their constituents that they could still block the President.
Somewhere along the way the Democrats, behind President Obama, flexed their muscles. The cross-country campaigning that Obama did reinforced his leadership qualities and, hopefully, alerted the Democratic defectors that they might defy the party program, but there could be a day of reckoning for them. This was an absolutely test for President Obama, and HE WON!!
If he follows up and reads from the Book to the Democrats defectors AND the Republican obstructionists, we may be seeing the emergence of a powerful President. The opposition has GOT to feel the lash!!!
Was it a great piece of legislation? Hell no - too many concessions were made. But it can be improved, and once in place, what legislator will dare to vote to get rid of it?
Reich is correct. Certainly
Mon, 03/22/2010 - 20:37 — Byron S (not verified)Reich is correct. Certainly there are many who wanted more than this legislation provided. But this is much more significant than my good friends on the left are willing yet to acknowledge.
Let's not forget that being progressive means that you make progress. This is a big progressive step that can be built upon. Had we missed this opportunity by fighting among ourselves, we may not have had another opportunity for a generation.
Oh, Robert Reich, please!
Mon, 03/22/2010 - 21:47 — S. Wolf Britain (not verified)Oh, Robert Reich, please! "Strong and competant government"? What we have in the way of "stronger government" now---and the new health insurance law(s) and further "taxation without representation" are NOT making it better, but are making it worse---is an increasingly invasive government that is seeking more and more to control almost every aspect of our lives. It's steadily been getting worse and worse for decades, but now we see things becoming more authoritarian and even totalitarian. And, now that the draconian and totalitarian laws have been put into place, we're going to see greater totalitarianism in the U.S. taking shape and becoming much more common place in a very short time, in just the next couple of years, as everything is happening very fast now. So, please come out of your fantasy world and face just how serious things really are; and that, if We the People don't put a stop to it, the U.S. is in its death throes, and the totalitarian repression is about to begin, if it hasn't already begun (which, on a thus far relatively small scale, it has begun already)...
The U.S. is being turned
Mon, 03/22/2010 - 21:48 — S. Wolf Britain (not verified)The U.S. is being turned into a version of communist China, but with virtually all major goods and services outsourced to them. Our human rights and civil liberties to be left alone by government are being done away with; and, increasingly, "Big Brother" is becoming more and more intrusive in our lives. But, because most "Americans" have been indoctrinated and conditioned to blindly trust government for decades, or do little or nothing about its intrusions and ever-increasing controls, more than they allegedly "distrust government", and because they've been intentionally and negatively acclimated to believe things are supposed to be this way, and/or that they "can't do anything about it anyway", enough people aren't doing enough to put the brakes on out-of-control government, and those who are seeking to do so are considered to be "traitors", "terrorists", "national security threats", "enemy beligerants", "communists", "hippies", "niggers", "ragheads", "Islamo-fascists", "conspiracy theorists", "crazy", etc., by the majority of brainwashed, "good German", Americans...
Add to that the fact that
Mon, 03/22/2010 - 21:48 — S. Wolf Britain (not verified)Add to that the fact that most of those so-called "Americans" have also been brainwashed into believing that revolution is always wrong, etc., and you've got a recipe for disaster. "We the (so-called) People" are giving the government license to get more and more out of control; so, if we think they're not going to take advantage of it, and do just that, get even more out of control, then we're intentionally living in avoidance and denial, and not paying attention. Face it, most "Americans" have little or no clue what's really happening, and they willfully, and completely irresponsibly, don't want to know; so, just as designed, they are going to allow the U.S. to be completely destroyed, which it is well on its way to being. It's all almost over, unfortunately; and I oh so much wish I was wrong; but, very sadly, I'm not wrong. With the majority of "Americans" not rising up against all of the out-of-control government insanity and madness now, the U.S. is all but already, and completely, destroyed. Much to my great consternation, concern and unhappiness about it.
FOR THE SAKE OF DEMOCRATS
Mon, 03/22/2010 - 21:52 — Anonymous (not verified)FOR THE SAKE OF DEMOCRATS and any future 'They' might dream of, I hope a significant part of this new Healthcare Legislation is dedicated to SPINAL RESEARCH....
Democrats will lose seats in
Tue, 03/23/2010 - 12:14 — Anonymous (not verified)Democrats will lose seats in the next election. That's what it means.
Saying that this legislation
Tue, 03/23/2010 - 14:50 — Chris Lugar - author, The Incredible Dream Computer (not verified)Saying that this legislation passed is worth anything to anyone but the corporations (read insurance companies) that forced its terms, and is anything more than a subterfuge to attempt salvaging Obama’s poor record of achievements by claiming that he achieved SOMETHING... is like waving a fist in front of someone’s face while sucker-punching them in the gut. It is like saying that a little bit of mercury in drinking water is better than a lot, that nuclear power is green, or that vegetables irrigated with sewage can be organic because sewage is natural, fluorine in drinking water is safe, and pork is the other white meat. Yet people believe almost anything when government officials put their stamps of approval on absurd statements fraudulently derived. Well, this health care “reform” was fraudulently derived. Nobody asked the people what they want – and when surveyed, the people wanted a public option and less monopolistic insurance company control of health care. So it’s all right that anyone, even a minority, is forced to buy something they don’t want or can’t afford? And that a few senators can negate women’s rights for abortion coverage? I bet those same self-righteous sages would scream bloody murder if someone tried to legislate non-coverage of Viagra. Yes, sewage is natural, this “new deal” stinks, and the pork in this legislation has been carefully trimmed and basted by the rich white men who have been grilling the people and feeding us poison literally and figuratively while they dine on ambrosia. It is time for us to learn how to sucker punch back. And not be afraid to do so. A few well-landed blows to the fat guts of the self-made gods who dictate our daily lives would open their eyes, because a little pain, they are saying, is good to suffer... until something better comes along to take it away, right? Most of us will be unaffected, a few will be adversely affected, and a few more will benefit... while a select few... will still profit greatly. How is this really better, or any different than what it alleges to reform?