The Big Vote: Part 1

So, Waxman and Rangel's healthcare reform bill (The Affordable Healthcare for America Act HR.3962) passed the House 220-215, with 1 Republican voting in favour, and 39 Democrats voting against the bill. It was always likely to be a very tight vote, but the margin was even smaller than I'd expected, and certainly narrower than I'd hoped, even after the Stupak amendment on federal funding for abortions was added at the last minute following an agreement with Nancy Pelosi.

Now, the HELP committee bill, introduced by Max Baucus, merged with the bill introduced by Chris Dodd, will get a vote in the senate, and this is expected to be an even tougher fight, with Olympia Snowe holding out for a 'trigger' mechanism before she supports the public option, and senators like Joe Lieberman and Lindsey Graham causing havoc by claiming that the bill is 'DOA' Dead on Arrival. It's going to be a formidable challenge for Harry Reid to line up the 60 votes he needs to avoid a filibuster, but he seems strangely confident at the moment, and so does the White House. Maybe they're just putting a brave face on it, or trying to call the Republicans' bluff - 'go ahead and filibuster us, Motherfuckers, and see how popular you are...'

If the Senate does pass the merged bill, the House and Senate versions will also have to be merged, in a Conference Committee, before the legislation goes back to both chambers for a final vote. Only then can it be signed by Obama and come into effect. So there's still a huge distance to go, still a mountain to climb, but even so, the House vote was a huge triumph for Obama and the White House. They've demonstrated an amazing tactical nous and strategic vision to get healthcare reform this far, further than any administration for the last 60 years, further than many thought possible.

I turned on C-Span late in the 'debate' just as John Boehner was explaining why the bill would endanger Seniors, drastically cut medicare, and massively increase the deficit. In other words, giving out a pack of lies on behalf of his insurance industry PAC buddies. Go on, go and check out his campaign contributors. It's a really impressive list- http://www.opensecrets.org/politicians/pacs.php?cycle=2010&cid=N00003675&type=I. Fortunately, after he left the podium, it was free for John Dingell. Jr, who has introduced health reform in every session of Congress since he was first elected, to put the record straight again, which he duly did with great equanimity and concision.

There were then votes on the Stupak amendment, which passed, as expected, and on Boehner's substitute bill, which included virtually no reform to speak of, and was simply a way of channelling mre money to the HMOs. It failed, as expected.

Finally the real vote came, and as the totals in each column crept gradually upwards you could see that it was going to be fucking close, all the way to the end. Considering that as many as 60 percent of the public support reform, it seems amazing that it's so contrversial in the House, but politicians are politicians, and they need those campaign funds from somewhere. Ain't no little old ladies gonna keep them boys in fine suits and private planes. But it did pass, and that's what counts. The only question now is whether Harry Reid has got his numbers right and he hasn't jeopardised he bill by going for a strong public option, too.

If he hasn't, and if a decent bill gets through the Senate, then 50 milion Americans are going to have access to affordable healthcare. The queues of desperate people waiting in line outside football stadia in the middle of the night to be seen by a Remote Area Medical volunteer doctor or dentist won't have to drive from hundreds of miles and wait years just to get their teeth looked at or get a pair of glasses. No more children will have to die because their dental abscesses go untreated for so long that the infection spreads to their brains (don't believe me - http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html). Nobody will be denied treatment for cancer because they have a pre-existing condition like acne. Isn't it time for the richest country in the world to provide affordable healthcare to all of its people?

I'm from England, so what do I know? After all, Daniel Hannan, no less, that friend of Fox News, and scourge of Gordon Brown, pointed out that the NHS was a 60-year mistake. Well as far as I'm concerned Daniel Hannan can go and throw himself on the mercy of the Glenn Becks and Sean Hannitys of the world, because if I were the Director of Public Posecutions I would charge him with Treason. It's far from perfect, but at least it is an acknowledgement that everybody has a right to a high standard of medical care, regardless of their circumstances. To me that seems an eminently civilised idea, not to mention the bare minimum a state should provide its citizens. I love America, and that's why I find it intolerable that they don't enjoy the guarantee of affordable healthcare that we have long taken for granted - so long, it seems, that people like Mr Hannan can criticise our system with short-sighted impunity.

I don't wish, as some do, to attack America for its perceived indifference to the suffering of some of its poorest and most vulnerable people. I could never doubt the philanthropic and charitable disposition of most Americans (which often outshines our own) towards their neighbours and their communities, but that is all the more reason to hope that they will soon have the healthcare system they deserve. Sunday's vote brought that hope one step closer to becoming a reality.