The Revolution Was Televised: Fourteen Random Musings On Health-Care Reform

Three straight days of deep thinking on health-care reform may be a day (or two) too many. But now that we've put away the party hats, swept up the confetti and recycled the Champagne bottles, some random thoughts come to mind:

(1.) Legislation that is nothing less than a moral imperative comes along once in a generation, if that. So it was with the 1964 Civil Rights Act, which effectively cost the Democrats the South. So it wasn't with HillaryCare in 1993, which the then-First Lady must bear most of the responsibility for blowing. And so it is with the 2010 Patient Protection and Affordable Care act, which while attacking income inequality in a huge way also will have negative (short-term) consequences for the Democrats.

(2.) Despite the cries of a socialist takeover, the bill that President Obama signed into law yesterday is a centrist plan that contains several of the provisions that serious-minded Republicans advocated. And then of course voted against with their radical peers.

(3.) Assertions that HCR was rammed down the throats of the American people are ludicrous. It was those American people who in November 2008 elected a president (by the widest margin in decades) and a healthy Democratic majority to enact reform, which passed after a year of robust and very public debate.

(4.) For all the power of special interest groups with deep pockets, it was the grassroots that nearly scuttled and then assured passage of HCR. From all reports, congressfolk who were on the fence got far more calls, emails, faxes and letters from opponents than advocates, but a goodly number of them doubled down and voted yea even if it means losing in November.

(5.) Obama promised post-partisan leadership and failed through only some fault of his own. Pundits who are bloviating over his embrace of liberal Democrats in Congress fail to understand a huge point: HCR was not going to pass without Republican help unless those liberals were on board, and without passage his presidency was doomed.

(6.) I take back all of the bad things that I've written about Nancy Pelosi over the years. The House speaker was a strong and steady voice while the Senate dithered. She took the Massachusetts special election upset as a personal challenge and not an excuse to stop pushing, while her legislative skills were extraordinary.

(7.) Of all the bloviations from Greater Wingnuttia, I find those of John McCain the most depressing. This is because I used to admire McCain, who once put his country first but now fulminates like a brat with clenched fists in declaring the Republicans will be obstructionist about everything and not just HCR.

(8.) Mitt Romney's quest for the 2012 Republican presidential nomination is toast. This is because the final HCR bill is awfully similar to RomneyCare, the plan he championed while Massachusetts governor and now, of course, righteously denounces.

(9.) The Republican post-passage strategy of "repeal and replace" is doomed to failure. Even if the GOP were to gain a majority in the House in the November elections, a Senate majority is a statistical impossibility, while Obama would veto any repeal. State-level efforts will be deemed unconstitutional and the party already is losing once reliable allies like the U.S. Chamber of Commerce.

(10.) The Democratic post-passage strategy of portraying the opposition as the handmaidens of insurance companies will keep Republicans, especially those who are vulnerable in November, on the defensive. Pointing out that these Republicans want insurers to again deny coverage of the basis of pre-existing conditions alone is awfully strong medicine.

(11.) The passage of HCR will make it considerably easier to pass Obama's next two major initiatives -- education reform and financial services reform. Not so for immigration reform, where a toxic combination of Tea Partiers and immigration restrictionists are sharpening their knives.

(12.) Even considering the complexity of HCR, the mainstream media yet again blew a major story, this time by relentlessly focusing on the process and not the product.

(13.) Letters to the editor still matter. If you supported HCR and your representative voted your interests, take a few minutes to write a letter to the editor of your local rag praising him or her.

(14.) And yes, the revolution was indeed televised.

Top photograph by The Associated Press