Last night the House passed the Senates version of the HCR bill and the reconciliation fixes that they had bargained for. With that we crossed a line, but it was not the finish line, not by a long shot. While the bill has a lot of things in it that will measurably improve the amount and availability of health care for millions of Americans (more than zero, but way less than all) that is not really the important and historic aspect of the bill.

What changed last night is the framing of the debate about health care in this nation. Up until now it was an undecided question if the goal should be covering all Americans in one form or another. That question has been decided, the answer is yes.

"Originally posted at Squarestate.net

I know that many of my fellow Progressives and Liberals don’t even see that as a question. It is axiomatic that every person in this country should be able to have affordable access to great health care. It is an issue of both human rights and patriotism to care for the people who reside in your nation. However, this was never a decided issue of law before.

The very idea of blanket coverage for all persons is where the Right has set the roots of its arguments about liberty and freedom being threatened by even the mild changes of the current HCR bill. The fact that it was the liberty to die without health care and the freedom to go bankrupt if you had a serious illness was of no consequence to them. It was still about liberty and freedom.

We are beyond that debate now. We have finally found a way to put the idea (if not the practical methods, yet) in place that we should be working to find a way to cover all of our people and do it in such a way that does not compromise their health or bankrupt the nation. This has changed the frame in which all future debates about health care in this nation will be argued. So we have crossed the starting line, at last.

My Dad said that nothing was ever finished in politics. He was right. The need of the nation change, the methods of achieving our goals evolve and resources needed to address our problems ebb and flow. So while this bill is considerably less than most of the folks reading this would have wanted, the fact that it is enacted does not mean the fight about it is over.

There can be no doubt that the most sustainable and affordable solution for a nation like the United States is a single payer system. The profit motive (and requirement by federal corporate law) does not fit well with the administration of health care. It been limited to 15% to 20% by this new law, but that is still too high a price to pay and it will have to be removed sooner or later.

These savings will have to go straight to the affordability of coverage, since even systems that have single payer have to have some component of individual cost to them. It is unlikely that we can actually cover the costs of covering our nation without rising taxes on the top 2% of earners (anyone earning 250,000 or more a year). All of this will have to be worked out over time. It is a challenge that we must redouble our efforts to address.

I know there are a lot of folks who are pissed off about the nature of the law that has been passed. To which I say; good! That anger and energy is exactly what we need. It will be far too easy for Democratic Representatives and Senators to rest on their laurels and not want to touch this issue. It has been a long and brutal fight with many, many galling compromises and defeats for truly progressive legislation. Yet the length of the fight and the compromises were their fault, and they should not be allowed to leave a flawed and half finished process in place just because they reached a milestone.

We are into a new frame, but getting here took some actions that we must correct. We have had to swallow a decrease in a woman’s ability to control her own reproduction. We have had to live with increasing the profits for the insurance companies in the short term in order to get more people covered by any kind of insurance and prevent the numbers of those who could not buy insurance at any cost from growing. We have had to give up on true competition for money-grubbing companies to bring 15 million more people into Medicare. These are all problems that have to be addressed, but for all those compromises we have moved into this new framing that favors us rather than the Insurance Cartel.

The status quo has changed with this bill. We are over the starting line and can now start to work to getting to the finish line of single payer. We are in a much better place because soon the law of the United State will recognize that it is goal of the United States to have all its people have truly affordable access to health care. This is a huge step forward, but we should not ever kid ourselves it is the last step we will take in this fight. It is merely the crack of the starter’s pistol and that first leap down the track.

So, get stretched out, get warmed up and get ready to wage the fight the real and important reforms that are still needed. Just as Congress can not rest, neither can we. This is just the start, not the finish.

The floor is yours.

Bill Egnor

Bill Egnor

I am a life long Democrat from a political family. Work wise I am a Six Sigma Black Belt (process improvement project manager) and Freelance reporter for Govtrak.org

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