If there is one thing that Democrats and Republicans agree on, it is that the vote on health care was a major historical moment. For Obama, the vote answered “the call of history.” For Republicans, it was “one of the most offensive pieces of social engineering legislation in the history of the United States.”
You’d think that it ranked on the same level as massive spending on foreign wars, trillions of dollars of national debt, and the shrinking tax base sustaining the state. In fact, the cost of health care is trivial compared with any of these problems. Moreover, the indebtedness of the U.S. threatens to undermine any and all health care arrangements: the IMF is talking of forcing advanced economies to cut pensions and health care programs.
The significance of the vote is more political than historical. As Robert Reich points out, it reasserts the role of government in providing solutions to social problems as against the anti-government narrative established by Reagan. That is a real achievement, and it creates the possibility that this principle can be extended in the future.
In itself, however, the bill changes little: it is a centrist proposal not too different from what Republicans themselves were advocating fairly recently. While health care is extended to many who are currently uninsured (and for this we must be thankful), the major beneficiaries of mandated coverage are going to be drug and insurance companies (their shares soared after the bill was passed). It does nothing to deal with the problem of higher co-pays which discourage people from using the insurance they already have.
Yet Republicans are acting as if they had just missed the Second Coming. Clearly, since they stand for the super-wealthy, they have a visceral opposition to extending state benefits to the poor if they should risk losing a few dollars. But the corporate medical industry is going to profit at taxpayers’ expense, just like the banks. Why should Republicans be so opposed?
To preserve their chances of power, Republicans want to roll back the demographic and social changes of the past which are expressed symbolically in Obama’s presidency. They have been busting a gut to delegitimize Obama’s administration by their unanimous legislative opposition to the health bill and by going out of their way to leverage popular mistrust of government. They are trying to harness a real movement which manifests a growing hostility to government and social structures, but they are only successful because of a political vacuum which the Democratic Party can do nothing to fill.
While not specifically tied to the Republicans, the anti-government mood is reactionary in the sense that one of its components is a reaction to the economic erosion of white privilege, manifested in open racism at tea party protests. But there is also real fear and concern about jobs and the economic prospects of future generations.
In TomDispatch.com Andy Kroll discusses the source of this movement, asking the question “Why do so many Americans feel like hapless investors who have thrown away their life savings to pay off guys at the top whose only goal is to screw over everybody else? It’s an unmistakable sign, at the very least, of a deep, simmering distrust and disillusionment, a dark undercurrent of despair spreading through our culture…” This distrust, sparked by recent high-profile Ponzi schemes, “extends as well to the government that finally jailed Madoff and is prosecuting Stanford, but has dealt a free pass to Lloyd Blankfein of Goldman Sachs and Dick Fuld of Lehman Brothers.”
The bank bail-out restored the wealth and power of the financial elites at the expense of social programs. The tension between the two is such that Obama cannot continue to balance between them for much longer. Health care coverage is now at the center of strikes and industrial disputes. We need to look out for a resurgence of union militancy and other forms of struggle, and support organizations that act to link up and unite different class groupings and fight the Republicans’ attempts to split the country using racism.