Government takeover of incrementalism
In the last few days, we've heard no reports of elderly citizens sent to their graves by death panels. We've seen no political dissenters shipped to FEMA camps. And one has to guess that the vast majority of Americans haven't received surprise visits in the dead of night from gun-confiscating government agents.
No, none of that happened last week when Obama signed the health care bill. But here's what did happen: The nation took a few reasonable but important steps down the road to a saner health care system wherein people aren't discriminated against or crushed financially just because they get sick. This country didn't solve all of its health care problems, but it began to do so.
In time, as the moderate reality of the law becomes clearer to the public, conservative opponents' fervor against it will wane. (For the general public, that process already has begun.) For those whose hearts were set on a Canadian-style single-payer system, the disappointment may last longer. But it's important to remember just how significant of a victory this law really is for tens of millions of Americans -- just how meaningful it is to have done a lot of common-sense things that nonetheless took almost 100 years of effort to achieve.
For 32 million uninsured people, including more than 640,000 Alabamians, the law means gaining health coverage that they don't have now. For millions of people barely getting by, that will mean newfound eligibility for Medicaid. For millions of middle-class Americans, it will mean a more affordable private plan with the cost defrayed by a government subsidy. And for millions of senior citizens on Medicare, it will mean lower prescription drug costs.
Just as importantly, the law will forbid insurers from dropping policies just because their customers ended up with a costly illness. It will bar insurers from saying they won't cover your medical bills anymore because suddenly they're too high. And by outlawing exclusions of pre-existing conditions, the law will end what a Newsweek columnist last year called "a shameful era in our nation's history when we discriminated against people for no other reason than that they were sick." And the law installs all those coverage expansions and consumer protections while taking some creative steps that actually reduce the deficit.
Is the law ideal? Of course not. Millions of people will remain uninsured. The law doesn't allow the federal government to negotiate lower prices for prescription drugs -- something that should be a no-brainer in the American free-market economy. Without a public option to compete with private insurers, it may prove difficult to slow premium increases. And without the ability to select a public alternative, people will be left with two choices: Pay a fine or buy insurance from the very companies that played a big role in driving up costs in the first place.
Despite its flaws, perhaps the most important thing about the health care reform law is the moral statement it makes to the nation and the world. It says the United States has chosen to be a country where, as Obama said, no one deserves to go broke just because they got sick. It says we're a country that recognizes the value -- economic, social, and moral -- of doing our best to keep people healthy and productive, even people we don't know and will never meet. It says we're a country that believes no one should be treated as disposable.
Health care reform isn't finished by any stretch of the imagination. But after a century of lawmakers and activists and everyday Americans banging their heads against the health care wall, the first bricks have broken free at last.