Monday, March 22, 2010

Sausage Making

Last night around 10pm central time, The US House of Represenatives passed the Health Care Reform legislation by a vote of 219-212.  The vote was for the Senate version of Health Care reform and was followed quickly by another vote on the reconciliation package that portends to "fix" the egregious parts of the Senate legislation. 

There are literally hundreds if not thousands of columns, blog posts, tv shows, etc. that have been devoted to health care reform since President Obama launched his initiative shortly after taking the oath of office in January of 2009.  It is now March of 2010, and sometime within the next week the health care reform will be come law with the president's signature.  It will be the most comprehensive health care reform legislation passed since Medicare was signed into law by President Johnson over 40 years ago.

It was not an easy journey to complete, and in quite frankly, the journey is not yet over as there is much left to do.

It is however a historic accomplishment and one that will certainly be discussed and analyzed for years to come. 

The process by which this legislation has made its way through the system is an amazingly byzantine and sometimes overwhelmingly frustrating series of steps that is often referred to as "Sausage Making", which is from the quote from the former German Prime Minister, Otto Von Bismarck, who said "Laws are like sausages, it is better not to see them being made".  Indeed.

This package has been derided by liberals who wanted a single-payer system or at least a system that included a comprehensive public option such as "medicare for all". It has been derided by the conservatives as a "government take-over" of one sixth of the economy and if done, would lead to socialism.  Obama has been compared to Stalin, Hitler, Mussolini and others.   He has been castigated by the progressive community as being weak-kneed and catering to the corporations like big pharma and the insurance companies.

John Boehner, the minority leader in the House of Representatives said in one of his many emotional outbursts on this said "if this passes it will ruin America!".   Bart Stupak, the conservative, pro-life democrat from Michigan who threatened to derail the whole thing unless he could be convinced that there would be no federal funding of abortions in the language was called a "baby killer" from presumably a republican member of the house after speaking in favor of the legislation. 

So, as you can see from these responses from the involved with the legislation that it is not too popular.  So, why did it pass?  Why do we care?

Here's why we care.  Now, for the first time ever in the history of this country, we are very close to Universal Health Care for every American.  This legislation protects and provides coverage for approximately 31 milllion of the 47 million without insurance.  It obviates the ability of an insurance company to deny coverage because of pre-existing conditions.  It ends recission, which is the most heinous of the practices of the insurance companies in that they can essentially cancel insurance "mid-chemo", or exactly when the person needs it most. We care because it will save lives.  Let me say that again.  IT WILL SAVE LIVES.

Is the legislation expensive?  You bet your arse it is.  Will it add to the deficit?  Probably, although the Congressional Budget Office says it is essentially revenue neutral over the next 20 years.  But who cares if it adds to the deficit?  Isn't this the argument made by everyone who wanted to bomb the shit out of Iraq?  Didn't Cheney say "deficits don't matter"?  Wasn't complainnig about the cost of the war considered to  be unpatriotic?  Of course it was.

The Iraq War, since its inception has cost over 1 Trillion dollars.  How many lives has it saved?  It is hard to say.  Has it saved Americans and Iraqis from death by Saddam?  probably.  Has it killed hundreds of thousands of people (about 5 thousand Americans and untold numbers of Iraqis) and displaced over 5 million people from their homes?  Definitely.

Will the Health Care legislation as it has been passed kill hundreds of thousand of people and make refugees out of 5 million people?  Unlikely.

Where would you rather spend the money?

It was a nasty, vile process to watch, this sausage being made.  However, if it keeps someone alive because they can now receive insurance where before they couldn't, then it has been well worth it.

Tell me what you think.