The most recent battle ended today, Christmas Eve morning, with final approval of the Senate compromise bill, after which Congress and the President recessed for the holidays, leaving the reform process in a "good news/bad news" state of flux. Work resumes after the holidays, when a House conference committee commences to craft final legislation from the respective House and Senate bills, ostensibly culminating in the end of the Hundred Years Health Care War's current major campaign. The legislation institutionalizes a federal mandate of universal health care for US residents (the good news being the de facto articulation of medical care as a right for all). Unfortunately (the bad news), little - if anything - is on track via the Senate bill to improve health care access or to control the financial effect on health care consumers and Point-of-Service providers.
Ancillary to to the nuts and bolts of the federal intervention into health care delivery and finance, which lawmakers, citizens, and the courts will continue to tweak over the coming decade or two, is the issue of power politics, which will provide some intense - variously amusing, infuriating, and gratifying - drama during the more immediate months and years. In the media, the battle lines have been drawn as a Democratic/Republican Party or a left/right divide. The truth is a bit more complicated; since what we are witnessing now is actually the result of an alliance among Congressional Democrats and Republicans (and Independents!), the White House, Health Care Insurers, and big pharmaceutical corporations arrayed against the expressed desire of the majority of U.S. health care consumers.
I believe this moment in the ongoing war, this Christmas armistace, presents interesting opportunities for working Americans, the poor, and organizations that advocate on their behalf to consolidate power and exert influence on a process that has worked effectively to shut them out of the process, on health care and a variety of other issues including the environment, the economy, foreign affairs, and civil liberties. On these issues, legislation and policy have almost universally reflected the will of entrenched moneyed powerful elite interests (the political class and corporations) at the expense of the will of the people. The kind and amount of pressure we exert during the House conference proceedings could set the stage for altering the frustrating power imbalance between the government and the governed, if we play our guerilla warfare options intelligently. One potential pressure point of leverage is President Obama’s stated desire for final passage ahead of his 2010 State of the Union address to Congress. Jane Hamsher of FireDogLake is already strategizing this kind of asymetrical warfare, by forging alliances with Libertarians and small government conservatives in service of mutual goals. Her bold audacious initiative is risky and represents a controversial new way of achieving progressive goals; the potential for backfire and unintended consequences is great, Say what one will, though, it does not represent repeatedly doing the same thing over and over again and expecting different results.
We'll see (h/t Charlie Wilson's War).
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