On Nov. 7, the House of Representatives finally passed, with a five-vote margin, House Resolution 3962. It occurred at 11:19 a.m. on a Saturday morning. It consisted of 524 pages, all of which describe legislative reform designed to increase the number of Americans able to afford health insurance, and every single representative voted on the bill, with none voting "present." It will now go to the Senate, where it will undergo months of surgery to secure 60 votes and the $900 billion price tag targeted by President Barack Obama. There is still, however, a high probability it will fail to pass through the rest of Congress' remaining edits and votes. This is a far cry from the sweeping reform promised by Obama during his campaign, a plan that would have brought the entire health care industry under government control, as it is in other Western nations, and as such, the Obama administration has been less than effusive about the passing of HR 3962. The president has gone so far as to call the bill a "sliver" of the reform he has endorsed since he first started campaigning three years ago. But did Obama fail? True, reality does not match his vision. But the president's blind ambition and optimism may be strong enough to affect a more gradual change in our nation's institutions. If he cannot achieve perfection, it seems like Obama will settle for improvement. And this tenacity might be the most effective weapon in his political arsenal, and the most important lesson from his first-year in office.
This is not the first major health care bill to run its course through our Rube Goldberg legislative system. Bill Clinton attempted similar reform after his election in 1992 and, even with a majority in both houses of Congress, was defeated by a well-organized front of conservatives, libertarians, and special interests from the insurance industry. Truman tried national health care as part of his Fair Deal, but even as European nations were using Marshall Plan dollars for their own welfare states, Americans rejected the idea. LBJ didn't even try, even with a strong Democratic majority. All of these examples go to show that it is prohibitively difficult to convince the nation's lawmakers that their constituents could be comfortable with national health care - something that carries dirty socialist connotations with it wherever it goes. Then, as now, it seems like health care reform has been doomed by its own pre-existing condition: our limited ability to absorb change in a small amount of time. The largest American paradigm shifts of the twentieth century, such as the creation of Social Security in 1935 or the exponential growth in defense spending in the 50s, were responses to international change; without a worldwide depression or cold war, there is a finite quanta of possible reform per unit time in this country, and health care always requires more flexibility than is available. There is simply no good time to introduce a paradigm shift like socialized medicine, a lesson Obama is learning now, 17 years after his last Democratic predecessor discovered it for himself.
But Obama knows his political history. He has demonstrated an intimate connection with the American people, or at least a better innate understanding of the electorate than is found in most politicians, something he proved during his worst-to-first campaign. He was elected on a platform of reform, but he knows he was not elected unanimously or by a population fully supportive of his policies, so - unlike his predecessor - he has never attempted to cash in the "political capital" his election brought him. So did he honestly expect to realize his vision of nationalized health care? True, it may be impossible to underestimate the optimism of a man riding into office on the laurels of a perfectly-executed presidential run. To introduce such an initiative in the midst of a barely-understood economic collapse, with a war on two fronts and double-digit unemployment, though, seems like a sure recipe for failure. It shouldn't surprise anyone then to see the newest health care bill be systematically dissected and pruned and pared into a "sliver" of change. This, though, does not constitute a failure, because the most important part of Obama's health care reform is not the actual reform. Obama's willingness to pursue change, his willingness to take risks like reforming health care, provide enough of an impulse to effect change on a very stubborn nation, even if that change is many orders of magnitude smaller than his dreams. Harry Truman failed to pass national health care, but he settled for the Housing Act, one of the most important acts in the history of U.S. welfare; Lyndon Johnson skipped the fight for health care reform in a broad sense, but pushed Medicare and Medicaid instead; and Clinton, in losing his own health care fight, managed to bring skyrocketing insurance premiums back in line with the rest of the economy - an achievement that evaporated during the Bush administration, when health care premiums doubled. If Obama's compromises continue this trend, as HR 3962 suggests, his health care fight can hardly be called a failure. Obama envisioned a world without private health insurers fighting every claim tooth and nail. But even if this is replaced with a public option, health care premiums are still expected to fall - and that was the administration's original campaign promise.
The White House knows it faces unyielding resistance with every reform it promises or introduces, and Obama's administration understands that not every initiative will be an immediate success. If the United States - one of the most conservative republics left in the West - is the disorganized flock of sheep, with every individual or group headed in opposing directions, then Obama is the indefatigable collie, running around the country in an attempt to move the group in a general direction. His is but one administration, one-year old, but its sheer energy is enough to move something much larger, albeit much more slowly. Our society is too big, too diverse, and too polarized to be nimble enough to accept all of this new president's initiatives, especially when he launches them all at once, like he has done in his first year. Health care is but one example of a sweeping reform reduced to slow, but hopefully steady, progress. It is true the Obama administration has failed to deliver its audacious campaign promises, but it is possible that the president never expected to. What he has given, though, is a tenacity and ambition not seen since the grit of LBJ or the cool hand of FDR, and it is that positive energy and optimism which will eventually move this nation forward.
Tyler Slack is a Viewpoint writer for The Cavalier Daily.
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