Health reform denouement

Now that the vote is nearing and we can prepare finally to not be exhausted by the whole issue of our health insurance system (not our health care system, which remains untouched even as a topic of debate), we can review the fallout from this whole messy episode while they rack up the yeas and nays.

I take it as a pretty much done deal that the votes are going to come through in the end to pass the thing, despite some of that last-minute nail-biting that the drama queens in Congress so adore. So in anticipation of the passage of the landmark restructuring of how we (over)pay for medical care, I herewith allow myself the following musings:

Plus side for Obama & team:

• Passage of a major reform of a key social service. Despite the unbearably long wait to get where we are, the Obama style has proven as workable as it did during the campaign: patient slogging along with a focus on the outcome, largely undistracted by the breathless, horse-race coverage emanating from the Beltway punditry;
• Image of flexibility and non-ideological pragmatism in the face of hysterical, non-stop hissy-fit from the increasingly deranged opposition;
• Maintenance of the limping, ailing, fractured, dysfunctional Democratic Party coalition cobbled together for the purpose of replicating and sustaining itself without any identifiable ideological glue (albeit barely and perhaps temporarily).

Down side for Obama & team:

• Pathetically inept political management of an issue that should have united decent-minded people from the jump given the obvious, gaping holes in what we laughingly call our health system. Obama’s stumping in the last days using human-interest stories of people denied this basic human right was effective and persuasive, but approximately 18 months late. How on earth could these sophisticated politicians not have known that that was the strategy to deploy from Day One while remaining on the attack against Republicans who dug in their heels to defend the status quo and crowed about it?
• Failure to maintain the promise of transparency of negotiations with the special interests. Admittedly, this may not have been possible if they were to avoid getting Harry & Louised to death. But it looked rancid.
• Utter failure to incorporate the Obama millions in any meaningful way into the fight and, far worse, open sniping at them (us) from the smart-ass Emanuel who instead should be sucking us off like the Republicans do their grassroots.
• Related to the above: grotesque priority placed on ‘bipartisanship’—whatever that could mean at this point—allowing the minority to hijack the process and make the winners from November 2008 feel disenfranchised. Impact on 2010 elections to be seen.

All in all, a debilitating experience and a considerable disappointment. Still, something got done, and if there is any political capital still left after Sunday night’s vote, something more could get added later on. But that is the question, isn’t it? Does Obama have an Act II? I’m inclined to think so, but we will have to wait and see.

[P.S.] Of course, if Nancy Pelosi loses the vote tomorrow, I have my head up my ass.