Christmas and health-care reform have this in common: Not everybody receives the presents they want. But any disappointment concerning the legislation that cleared the U.S. Senate in the early hours of yesterday morning should take into account the value of the offering and the extraordinary nature of the moment.
As President Barack Obama rightly said yesterday, this was both an historic vote and big victory for the American people. All the misrepresentations, the howling of special interests and the lockstep determination of the Republicans couldn't stop this Congress from doing what no other could do -- pass a health-care reform bill that finally confronts problems that the nation can no longer afford to ignore.
It is easy to tick off what is missing in this bill -- no public option, no buy-in for Medicare and no green light for buying cheaper drugs from Canada and other countries. Regrettably, those important concerns were compromised away.
But the perfect should not be the enemy of the good and HR 3590 contains much that is good. It drives a stake through the heart of insurance practices such as denials based on pre-existing conditions and cancelling the coverage of seriously ill Americans. Families are protected at last from the costs associated with health care emergencies that have been bankrupting them. And of course, the scandal of American health care -- the millions of people uninsured -- is largely addressed, although regrettably not completely.
In an age of towering deficits, the cost of the reform is a legitimate concern, which Mr. Obama spoke directly to yesterday. He cited the Congressional Budget Office report that says the legislation will reduce the deficit by $132 billion over the next decade and by as much as $1.3 trillion in the decade after that. While some skepticism is warranted on the promises of any big program, the bill does aim at containing costs and, as Mr. Obama has repeatedly said, the cost of doing nothing is inevitably more soaring costs.
Procedural votes must still be taken and the bill must be reconciled with the one passed by the House. Like an ascent on Mount Everest, the climbers can still tumble down but the summit is now in sight.
One last storm can be expected to disrupt progress. Not everything with the bill is perfect -- some senators shamelessly negotiated special deals for their states for the price of their vote. Other absurdities and offenses against reason are likely to be revealed and these will be used as stones to try and kill it.
In the end, though, the good outweighs the bad. While it is a pity that no Republican wanted to take part in making history, the vote is a holiday gift to many millions of Americans.