The Washington PostDemocracy Dies in Darkness

This moment in health care … and democracy

People rally against efforts by Republicans in Congress to repeal the Affordable Care Act. (Justin Lane/European Pressphoto Agency)

I’m at a conference (where I just moderated a session with the great economist Paul Krugman — I’ll post the podcast at some point), so I don’t have time to write much on what happened last night in health care. But if I don’t write something, I’ll burst, so here are some quick reflections.

It ain’t over, but what a great win, thanks to numerous people and forces:

• the three Republican senators who voted down the latest, and for now, probably last repeal effort;

• Senate Democrats, who held fast against a terrible assault on both health-care policy and the political process (more on that point next);

• the research and analysis community, with a loud shout-out to my colleagues at the Center on Budget and Policy Priorities who quickly, deftly and with consistent accuracy, explained the human costs of the Republican plans — for the record, to do what they did is much harder than it looks;

• the progressive advocacy community, which came together and relentlessly pressed the issue;

• the health insurance lobby (yep …), whose members clearly pointed out the extent to which the latest Republican plan would destabilize markets;

• the doctors, via the American Medical Association, who were a consistent and authoritative voice against the damage the various GOP plans would do to people;

• I’m sure I’m leaving out some important groups, people. Please add in comments.

I’m a pretty hard-boiled old-timer who’s seen more than his share of D.C. cray-cray, but the process by which Senate Republicans were trying to change the way we deal with 18 percent of our economy, and a part that’s existentially important to people, was unlike anything — ANYTHING — I’ve ever seen. At one point, they basically wrote a health-care  overhaul “bill” over lunch.

So, yeah, it’s a great day, and for now, the system worked. But just barely — by one vote. It’s crucial not to lose sight of how unrepresentative the process has been, how a major party is working against the will of the majority, and how it’s doing so in a way that is utterly irrational, with no deliberation, no factual input (“Quick, let’s get this to the floor before the CBO can score it!”), false claims (“Obamacare’s imploding!”) and no transparency.

Yes, most 10 year olds run their lemonade stands better than that, but the larger point is that this isn’t democracy. I’m breathing a lot easier for now, and just maybe this — in tandem with what partisans from all sides agree is peak chaos at the White House — is a sign of the fever breaking a bit. But we’ve a lot more work to do to get back to where we need to be.