House passage of health reform legislation is very good news. It is particularly important for those of us who've done such a conscientious job cataloguing the flaws in this bill - and the foibles of Washington politics generally -- to acknowledge that.
The good news lies in the fact that millions of Americans whose health is at risk because they are uninsured will get insurance coverage. Its worth mentioning that they lack political clout. Strip away the misleading middle-class rhetoric and it becomes clear that this is a new commitment by the comfortable majority to protect the vulnerable minority.
That's a generous impulse, quite unlike the creation of the Medicare drug benefit which provided added protection to a politically powerful segment of society that already had insurance coverage (and diverted billions to ease commitments made by large employers like General Motors).
From the start, this issue has reflected an attempt to merge two linked, but very different issues - providing more people with health insurance and making our medical system more efficient. The second task is much more difficult, so it is unsurprising that the legislation stresses the coverage issue.
It genuflects toward the efficiency issue and plants some seeds that may ultimately flower. The debate has resulted in a slightly broader public perception that overconsumption is a serious and expensive problem. And the mere expansion of the covered population will stress the reimbursement system and thus ultimately hasten the day of reckoning.
It is sad that our partisan cynicism and our quest for controversy have led us to focus on tangential issues like abortion and the existence of a public plan. And it is unsurprising but unfortunate that some continue to hunt for villains (greedy drug companies, insensitive insurers) in an effort to suggest that there's a silver bullet out there that would allow us all to consume as many services as we'd like without worrying about how to pay the bill.
The process is a messy one, but the progress is real.