45 years after the passage of Medicare, (with about fifty per cent of Republicans supportind it), President Obama used all his skills and much of his political capital to get it done. It was a bruising and protracted fight, sprinkled with half-truths, outright lies, misinformation, amd personal attacks, aided and abetted by tens of millions of dollars by the insurance companies and the the private health-care providers, but in the end there was enough votes to pass it and America has become a better place for its citizens, the rich as well as the poor.
This legislation has brought in very significant changes to a system that keeps getting more and more expensive (almost $2.5 trillion) and yet left millions without insurance coverage. Now 32 million have been added to the list of those who will be covered. It imposes an "individual mandate", which requires Americans to buy health insurance or faced being fined. It makes insurance more affordable, with the offer of federal sudsidy for the lower and middle class and expands funding to the states for Medicaid, for the poorest. It bars insurance companies from denying coverage to sick children, and by 2014, will make it illegal to withhold insurance from anyone with a pre-existing condition. It also includes provisions to prevent massive premium hikes ( in some states premiums have gone up by over 30%) and to eliminate the practice of setting lifetime limits on coverage. As Michigan Democrat John Dingell ( who has introduced a universal health-care bill every year since 1956), said "Today is the day that is going to rank with the day we passed the civil rights bill in 1964". Speaker Nancy Pelosi, (who used the same gavel used 45 years ago), added that " the legislation will lead to healthier lives, more liberty to pursue hopes and dreams and happiness for the American people".
It was an historic vote. It was an historic piece of legislation ( many, including Clinton, had failed) and it will make Americans healthier, because a most vulnerable group (32 million) are now going to get coverage and the poorest will get better Medicaid and the insurance companiews will no longer deny care or restrict care or charge exorbitant premiums. It was not easy and it will not be easy to make all the elements work, but now there is going to be better care, especially for the neediest because finally America has a law, which can be used to protect people.
It is a great day for America in general and a good victory for those who fought so long (sorry Kennedy was not there to see it). America has joined the civilised world iin protecting its citizens health. In the "give and take" of American politics, President Obama and the Democratic leadership must be congratulated. Now they have to improve on it.