Monday, March 22, 2010

HCR Passes!!

Jonathan Chait leads the cheers for Obama and the historic passage of healt care reform.
Let me offer a ludicrously premature opinion: Barack Obama has sealed his reputation as a president of great historical import. We don't know what will follow in his presidency, and it's quite possible that some future event--a war, a scandal--will define his presidency. But we do know that he has put his imprint on the structure of American government in a way that no Democratic president since Lyndon Johnson has.

The last two generations have no model for such a president. The only two other Democratic presidents of the last four decades are Jimmy Carter, a failure, and Bill Clinton, who enjoyed modest successes but failed in his most significant legislative fight. Obama, who helped pull the country out of a depression and reshaped the health care system, has already accomplished far more than Clinton. (This isn't necessarily Clinton's fault--he lacked the votes to break a Republican filibuster that Obama has--but the historical convention is to judge a president by what he and the Congress achieve together.) He will never be plausibly compared with Jimmy Carter.

Historians will see this health care bill as a masterfully crafted piece of legislation. Obama and the Democrats managed to bring together most of the stakeholders and every single Senator in their party. The new law untangles the dysfunctionalities of the individual insurance market while fulfilling the political imperative of leaving the employer-provided system in place. Through determined advocacy, and against special interest opposition, they put into place numerous reforms to force efficiency into a wasteful system. They found hundreds of billions of dollars in payment offsets, a monumental task in itself. And they will bring economic and physical security to tens of millions of Americans who would otherwise risk seeing their lives torn apart. Health care experts for decades have bemoaned the impossibility of such reforms--the system is wasteful, but the very waste creates a powerful constituency for the status quo. Finally, the Democrats have begun to untangle the Gordian knot. It's a staggering political task and substantive achievement.