Barack Obama’s organic approach to health care reform is a type of Darwinism applied to politics that I think I can endorse. Though it’s not 100% certain, it appears that Barack Obama will have a living, breathing health care reform bill to sign very soon.
And how, in the merciless desert of American politics, did he ever get this extraordinary creature to survive up to this point?
Answer: he set a couple of broad targets (under a trillion dollars, deficit neutral etc.) and then let the legislative process, by the most strenuous and vicious trial and error, produce an organic package that actually appears capable of getting 60 votes in the Senate and 220 votes in the House of Representatives. In other words, Obama let time sift through and weed out every weak idea—or politically unfeasible idea—and put something out into the world that is living.
Put still another way: Obama let trial and error match a bill to the sensibilities of the country’s elected representatives, and it was a bill that rigorously stayed within the realms of American democratic political reality, and matched exactly what a majority of the country’s representatives could stomach.
Obama was patient, and let time expose and kill folly (and by folly I mean anything that showed itself unable to survive in our contemporary political climate). While his opponents have been playing the short game, Obama has been playing the long game, and he’s about to win.
Prometheus Unbound 
Can you sum up what’s in the bill? What is it that you’re actually talking about? And what significance does its current content have to anything that it might have in the future, assuming it goes to resolution and back to its respective houses?
How important is the question of whether a lot of holdouts were looking for pork and/or quid-pro-quos (cough-bribes-cough) of some sort as compared with selection? Do you think that selection might be window-dressing?
Tom,
The bill that exists today is unlikely to be tweaked because one Democratic Senator has said that he won’t vote for the final bill if it’s messed with when it leaves the Senate. It’s essentially frozen.
As to what’s in the bill, I can sum it up in one sentence: What’s in the bill gets 220 House votes and sixty Senate votes.
I’m not being glib. The bill has been fussed over by media outlets, Fox News, lobbyists, and hundreds of congressional staffs prying for flaws and weaknesses. What remains is an organism that can pass. The “DNA” of the bill (it’s written content) is strong. If it wasn’t, the bill wouldn’t garner 60/220. As for the horse-trading, that’s part of the bill—that’s the price of admission.
There’s lots of proposed bills and ideas that could have (in theory) gotten this far a year after Obama’s election, but this one (in the real world) actually did. It’s a complicated survivor in a tough ecosystem, like you and me.
—Santi
I really hope this bill, this reform, makes health care better. More accessible, and more affordable for everyone.
In reality I think it will just be more customers for insurance companies, and just more of the same.