A few things:
First it’s not a perfect bill. Everyone knows that. But politics is the art of the possible, and for the first time government is trying to do what one task it should do: coordinate. It’s more like a bill a liberal Republican in the 1970’s would have passed than a Democrat, who throughout the century have worked for a federal plan.
Second, this bill will help more poor people, and more African-Americans in concrete ways. The long term effects will be enormous, and will go a long way to mitigate health care challenges between the races.
Third, this bill will put more pressure on insurance companies, big pharma, hospitals and doctors to work together.
Fourth, by 2016, it will reduce the likelihood of families being bankrupted by poor health.
Last, this bill demonstrates Obama’s strong, sensible leadership. If he had pushed harder, he would have not gotten any further. He allowed the bill to come from the legislature, not from on high. He’s done what no president has done before. It is clearly political leadership – not prophetic leadership. It is practical leadership, not idealistic leadership.
The difference, perhaps, between Obama and the previous president is that Obama was conservative enough to let institutions do their work. He was a strong enough leader to make them do it.
It’s a conservative bill. It’s not a perfect bill. But it will help millions of people and reduce long term costs.