Healthcare Reform Post-Mortem: What Obama Must Learn from the Victory

Roger Bybee

Thanks to the last-minute efforts of President Obama and House Speaker Nancy Pelosi, the first national health plan is being signed into law today.

One of labor’s most sought-after goals has been achieved, however imperfectly, after nearly a century of effort. Labor played a central role in developing and funding coalitions, mobilizing the foot soldiers at rallies around the nation, and lobbying effectively to move some conservative Democrats into the yes” column.

Moreover, the victory also showed the potential for transforming the nation if President Obama gives up his naïve illusions of winning over Republicans and instead uses his considerable skills to fire up the public against the special interests blocking reform on job creation, cleaning up Wall Street and global warming, to name just three issues.

If Obama approaches the urgent need for job creation programs with the same fire and determination he did in the final stage of the healthcare battle, the labor movement will finally have the activist partner in the White House in whom it invested so many hopes and so much effort.


But as move forward, we need to frankly acknowledge that the healthcare reform plan lost popularity in recent months because its complexity made it an easy target for absurd Republican and rightist caricatures (“a government takeover,” death panels,” etc.) Few people could understand the plan, so the Republicans were able to come up with their own descriptions and make them stick. Also, the dropping of the popular public option cost the reform plan popularity.

Still, the bill has a number of important positive features that will make a difference in people’s lives: the elimination of pre-existing condition”; forbidding recission,” the practice of insurers deciding that your expensive illness is a good reason to drop your coverage; guaranteed coverage for children, and expansions of Medicaid, SCHIP, and community health centers.


However, the reform plan just enacted is fundamentally flawed, as Jane Hamsher outlines in detail on FireDogLake and argues persusively at Common Dreams. After citing valuable aspects of the bill, Hamsher continues:

But there is also cause for serious concern. Never before has the government mandated that its citizens pay directly to private corporations almost as much as they do in federal taxes, especially when those corporations have been granted unregulated monopolies.

This bill fundamentally shifts the relationships of governance in order to achieve its objectives. It was hard to reconcile the President’s campaign against the evils of the insurance industry with a solution of corporate tithing” that drives millions of people onto their rolls. We have empowered another quasi-governmental, too big to fail” industry with alarming nonchalance….


Ironically, Obama regained momentum for the stalled health plan with a set of blistering populist attacks on the widely-despised health insurance industry whose privileged role is nonetheless maintained in the new law.

Where last fall Obama at times minimized the appalling greed of the insurers by labeling it as mere monkey business,” he recently lit up crowds around the nation with hard-hitting talk about 39% rate increases (which the reform does nothing to control) and telling about real-life cases where insurers dropped consumers when a serious illness struck.

Imagine what we might have achieved in terms of more far-reaching reform had Obama begun the drive on healthcare by going after the insurers.

In recent days, we also saw what the Republicans and their even more zealous allies (like the thuggish, racist and homophobic protesters on Capitol Hill) are capable of. Along with egging on their Tea Party-type allies in the House Gallery to disrupt proceedings on the House floor, they dragged the level of congressional debate to a new low with their accusations of the socialist” and totalitarian” nature of the very modest package of reforms.

Even conservative David Frum felt compelled to distance himself from the increasingly extremist message and methods of the Republicans. Instead of the Waterloo” for Obama’s presidency that Sen. Jim DeMint (R-S.C.) last year predicted smugly, the outcome was disastrous for Republicans, as Frum argues:

We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat…

So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.

Meanwhile, Paul Ryan (R-Wis.), who has become a media darling playing the role of the Republicans’ kinder, gentler deep thinker,” slipped into the fire and brimstone mode of Rev. Cotton Mather or one of the other old Puritans in denouncing the reform bill.

Our rights come from [our] nation’s and nature’s god, not from government,” Ryan thundered in his speech to the House. Should we now subscribe to an ideology where government creates rights and is solely responsible for delivering these artificial rights and then rations these rights?”


The notion of government assistance in healthcare for more Americans – not even all of the 50 million uninsured – as being an artificial right” shows how backward and barbaric Republicans have become.

Now that Republicans have openly allied themselves with reliable Tea Party” shock troops to take over townhall meetings, intimidate congresspeople, and openly spew racism and homophobia, you have to wonder how much public credibility the GOP will have left by the November elections.

But at the same time, President Obama and the Democrats had better realize that their refusal to consider generating jobs through large-scale public programs has tarnished them as well. They cannot afford to rest on this victory as November draws closer.

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Roger Bybee is a Milwaukee-based freelance writer and University of Illinois visiting professor in Labor Education. Roger’s work has appeared in numerous national publications, including Z magazine, Dollars & Sense, The Progressive, Progressive Populist, Huffington Post, The American Prospect, Yes! and Foreign Policy in Focus. More of his work can be found at zcom​mu​ni​ca​tions​.org/​z​s​p​a​c​e​/​r​o​g​e​r​d​bybee.
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