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March 23, 2010

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I've seen a few comparisons of this bill to an earlier one (from the Clinton years, perhaps?) proposed by Republicans, and my question becomes would the reactions ("historic")be the same if this bill had passed under GW?

Intriguing post. Interesting and well written. One quibble:

"As a former fundraiser and local party Chair, I'm convinced that she reflects a partisan sense of policy held in service to party goals."

Are you the former fundraiser or is Pelosi? ;) (I ask in semi-seriousness, given your past NYC work.)

I don't know what to make of all the celebrating; I feel a bit excited myself, by the occasion of it all, I confess. Today at the MD I had to sign a form about some testing that some pp opt to pay out-of-pocket, we could only surmise from the form language, because they worried it would trigger suspicion of a pre-existing condition down the line. But this was several hours after apparently we have this new law that no longer allows that. So that seems like a good thing.

And I think it's a good thing that we have compulsory insurance here in MA. Affording it and getting in to see the doc, well...ok, we're working on that... ;)

Anyway, I do think the bill is probably underwhelming compared to the fanfare Obama is and forever will receive for it. And here's David Axelrod on Charlie Rose as I head to bed - the permanent campaign indeed.

Thanks for the catch (and where is J when there's bad subject/object agreement?); I fixed the referencing, since the alternative was to start a career in local politics. :)

To your points about specific improvements: I think we can all, generally agree that the most popular and common sense provision of the bill (preexisting conditions) is a fine achievement; and yes, many other elements of the bill (mandates, subsidies and such) do flow from that step. And you make the point that insurance does not equal care and insurance reform is not cost control. But as I said, I think the key here is that the policy choices were guided by what will get future votes, and not by, say "let's get the best policy together... and even if it's unpopular, we'll know we did the next right step." For many people, there will be some helpful outcomes (I have seen, clearly, the joy of many under 25 slacker kids thrilled to get insurance via their parents). But I think the bigger question is, in the long run, are we getting the truly substantial reforms that will transform healthcare, and clearly, that's a no. Popular, feelgood fixes that extend deeper problems are the real hallmark of this bill.

That said, I love your observation about David Axelrod - I wasn't even thinking about the role he (or say David Plouffe) play in the current White House, an extension of putting Karl Rove into the last Administration. Permanent Campaign, indeed.

Also, to J's point about this being a "moderate Republican" bill: I think Republicans, in the past, envisioned some sort of insurance mandate, and probably some fixes meant to address the risk pool issues insurers have covering everyone. But Republicans, of any stripe, wouldn't have crafted an expansion of Medicaid (they hate it, like most poverty programs), and they wouldn't eviscerate Medicare Advantage as the Dems have done - it's been a long Republican dream to turn Medicare into a more private sector enterprise. Remember to that George Bush's "health proposal" was what became John McCain's: push people out of employer insurance into the individual market, by ending the tax break on employer benefits. While a similar result may, theoretically, be a result of this bill (on the notion that people get pushed wholesale into the exchanges), I'd argue that this is exactly the way Republicans never wanted it to happen, with government subsidizing premiums and defining the insurance product. And, if anything, I think the last election was a referendum on McCain's proposal, which soundly lost.

check out this diary; I think it relates to this post quite well

http://seminal.firedoglake.com/diary/37191

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