Anthony Painter

In a neat symmetry, healthcare reform passed in the US just as Katori Hall’s incredible The Mountaintop won a Laurence Olivier best new play award here in London. I reviewed Hall’s play a few months ago. Following the passage of healthcare reform, President Obama now stands on the Mountaintop, the fog has cleared, and once again the promised land- an American shifted decisively in the direction of greater justice- is visible one again. What’s more, his adversaries, the Republicans to the very last man and woman face humiliating defeat.

Here is Anita Dunn, Obama’s former White House Director of Communications, on Meet the Press yesterday:

“I think that the, the Republican characterization of the bill, a “government takeover, next week you won’t get to go see your doctor, you’re going to be kicked out of your insurance and some bureaucrat in Washington is going to take over,” which doesn’t happen, it just won’t happen, that I think that the way the Republicans have framed this thing and the scare tactics they’ve used will work against them once this becomes law because the bad things will not happen.”

David Frum, George W Bush’s former speech writer, sums up the Republican predicament thus:

“At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.”

and he concludes:

“…today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.”

For the first time since last Summer, the Obama administration is on the front foot. The Republicans have badly miscalculated. They tried to break the Obama presidency and now they will own their extremist rhetoric as time shows that their scare machine was hysterical and wildly inaccurate. Their biggest problem is that they have continually claimed the costs would be short term while the benefits will be long term. And they are very wrong about that too. Here are just some of the benefits that Americans- insured and uninsured- will enjoy in the first year of this reform package (courtesy of Reuters):

*Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.

*Insurers will be barred from excluding children for coverage because of pre-existing conditions.

*Young adults will be able to stay on their parents’ health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.

*Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

*A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.

*Medicare drug beneficiaries who fall into the “doughnut hole” coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.

*A tax credit becomes available for some small businesses to help provide coverage for workers.

And Americans will also realise that they can keep their doctors, their elderly parents are not going to have to justify their existence before a Death Panel, their kids aren’t going to be forced to join Obama Youth, and they are not going to be punished with forced labour in a gulag in Alaska just for loving freedom.

The challenge for the Democrats in advance of the midterms is clear: communicate the benefits and force Republicans to own their own extremist rhetoric. For the White House, it now has to urgently show that its job creation measures are working. That has to become the number one priority. If the Democrats do not have a good story to tell on jobs come November then they will struggle.

But perhaps something bigger is happening. National Journal columnist Ronald Brownstein, concludes that Obama is seeking to do something more fundamental- and healthcare reform is just one part of it. He is endeavouring to bend the trajectory of US politics towards a more activist form of government. As Brownstein says:

“The fight has opened a second window into Obama. The key here is his 2008 campaign assertion that “Ronald Reagan changed the trajectory of America” more than Richard Nixon or Bill Clinton did. The health care struggle suggests that Obama views changing that trajectory as the ultimate measure of a presidency’s success. His aim is to establish a long-term political direction — one centered on a more activist government that shapes and polices the market to strengthen the foundation for sustainable, broadly shared growth. Everything else — the legislative tactics, even most individual policies — is negotiable. He wants to chart the course for the supertanker, not to steer it around each wave or decide which crates are loaded into its hull.”

So yesterday was just step one. Financial reform, immigration reform, jobs, infrastructure investment, education, greening of the economy are the next areas for focus. He might want to devote his attention now to those areas that provide immediate potential short term wins. What is clear is that we are starting to get a picture of how the Obama Administration might shape up over its remaining two and a half years- a vision of active government, achieved pragmatically. The destination is set. The course remains unclear. That is what real, practical leadership is about.

This morning Obama stands on the Mountaintop again. The promised land is visible once more. Phase one of his presidency is over. He has his definitive success. Now it’s time to walk, step by step, into the promised land.