Health care reform passes the House; Now the work begins
"Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate," said President Obama, "the United States Congress finally declared that America's workers and America's families and America's small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they've worked a lifetime to achieve."
A historic vote 100 years in the making: "This is what change looks like," President Obama said, congratulating House Democrats on the passage of the Senate's Patient Protection and Affordable Care Act. If this is what change looks like, change can look a little ugly. The racist subtext that accompanied a lot of the resistance to "Obamacare" rose to the surface when tea party protesters harassed and insulted African American members of Congress this weekend. Michigan Democrat Bart Stupak will wake up tomorrow excoriated by the conservative Catholic blogosphere that had been lauding his character and convictions as late as Sunday morning. He has already been called a babykiller on the House floor.
The breakthrough he achieved in wrangling an executive order  from the president explicitly accepting the abortion restrictions of the Hyde Amendment on health care reform going forward has already been dismissed as window dressing by many elements of the prolife advocacy community. But their persistent movement of the goal posts on health care reform and its intersection with abortion has reduced the credibility of their position, suggesting some at least are more interested in preventing health care reform at all costs than anxious about its real-world impact on the U.S. abortion rate.
Certainly millions of Americans will awake to a changed country tomorrow, one that promises to finally reign in annual health care cost hikes which are contributing to the demise of middle class America and industrial competitiveness, one that promises to extend rational health care to 32 million citizens currently falling through all health-care related social safety nets. This has been a dramatic and impressive week for democracy in America; it has been a tough week for the Catholic church in America. The good sisters and the good bishops are in disagreement—not on reform itself but the impact of this Senate reform package on abortion—but among the people in the pews, the dispute has been uglier and more personal if the unpleasant exchanges on blogs and comment forums are any actual indication of the impact of this policy schism on real Catholics. (Reminder to self: it ain't necessarily so.)
I think in the final analysis this great undertaking of health care renewal toward universal coverage will be a step forward for U.S. society and the U.S. economy, but its success now is far from certain and its current reach, not what many of us had hoped. Millions of immigrants to the United States have been left out of this reform; acute attention still needs to be paid to provisions for the conscience protection of medical staff; the worst-case scenarios on abortion detailed by the analysis of the U.S. Conference of Catholic Bishops will have to be constantly attended to as reform moves forward. Also requiring much attention in the near term are institutional and personal relationships within the church that have been strained, even ruptured in the last few dramatic days.
It is a shame the church has to end this campaign with such discord when it has worked so tirelessly over decades to achieve the recognition of adequate health care as a basic human right. It is too bad that a more unified church could not celebrate the House's achievement as whole-heartedly as our President who said: "Tonight, at a time when the pundits said it was no longer possible, we rose above the weight of our politics. We pushed back on the undue influence of special interests. We didn't give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges. We proved that this government—a government of the people and by the people—still works for the people."