The signing into law of the new health care reform package has all the earmarks of a historic victory in more ways than one.
It was not all that any of us wanted – but neither was Social Security to earlier generations when it was first enacted into law. It was in the course of subsequent battles that it was improved.
Similarly, health care reform will take many more fights and a radically changed political environment before it becomes fully enshrined in the Bill of Rights, as an amendment to the Constitution guaranteeing free health care for all as a basic human right.
To those who attack the law I say:
Ask a person with pre-existing conditions who cannot get medical care at a reasonable cost, or at all, what they think. Or ask the working class family, whose income falls between the poorest who are entitled to Medicaid and the rich who need no help, what they think.
The law is the federal government’s biggest attack on economic inequality since President Reagan 30 years ago began the offensive to redistribute wealth in favor of the large corporations and the rich.
Big chunks of the money to pay for the law come from payroll taxes of households earning more that a quarter of a million dollars and from cutting medical subsidies for private insurers.
Unfortunately, some pitted single payer, in which the private insurance carriers are put out of business, against this legislation in its changing permutations.
These folks fail to appreciate the importance of struggling for partial demands that can be won in the short run because they are broadly supported while pressing for more advanced demands that may not yet have wide support but that can be won in the course of struggle.
Even if single payer were widely supported by the public, as some claim, that certainly was not the case in Congress, especially in the Senate.
That we could not win the public option despite majority public support for it was mainly the function of the present balance of forces in the Senate, where it was blocked by a rock-solid Republican opposition and weak-kneed conservative Democrats.
Unlike the new health care law, Social Security and Medicare were initially passed with majorities that included a substantial number of Republicans in both houses of Congress.
In 1935 Republicans in the House voted in favor of Social Security 81 for, 15 against; in the Senate 16 for, 5 against.
In 1965 House Republicans voted for Medicare, 70 for, 68 against; in the Senate 13 for, 17 against.
Instead, last week Republicans gave health care legislation a big zero in both houses of Congress.
The Republican Party of today has evolved into the political home of the most reactionary sections of big business and of the far right.
To me, today’s health care battle points to two things:
One, that it was a formidable opposition that had to be overcome, making the victory all the more significant.
Two, if we expect to improve on this piece of legislation or not lose ground on it, we’d better do everything in our power to defeat more Republican members of Congress in November and, where possible, replace more conservative Democrats with more liberal if not progressive ones in the primaries.
One of the significant things about the health care victory is that it’s re-energizing the coalition that elected President Obama, especially at the grassroots.
At the same time, it is disorienting the Republican rightwing opposition.
Despite the nay-sayers, President Obama, progressive and even moderate legislators, organized labor, the people’s movements, and a majority of Americans who backed the main tenets of the health care package deserve a big hand for a job well done under heavy political fire.
With the wind at our back, a more confident labor and people’s movement can now move to the next major fight – bank and financial regulation, jobs and immediate relief for the people – on the way to the crucial midterm elections.