Obama’s Health Care Reform bill wins vital vote. Not even the beginning of the end?

March 22, 2010

The House of Representatives reluctantly reached sufficient consensus for President Obama’s Health Reform bill to win the vote permitting its progress to a next stage of so-called reconciliation. The world watches and learns much more of the complexity of the American political process. The nature of battles ahead is becoming clearer to the outside world

For students of leadership, the story has become a must-study case. It contains all the ingredients of tough game-changing events and actions so often found in business cases. The “facts” are important. But marshalling and evaluating the information can be mind-boggling challenges. Another benefit of a thorough case-study study approach is that it permits refinement of analysis from colleagues and students, avoiding the dangers of instant punditry.

The bill passed by 219 votes to 212, with no Republican backing, after hours of fierce argument and debate. It extends coverage to 32 million more Americans, and marks the biggest change to the US healthcare system in decades. “We proved that we are still a people capable of doing big things,” Mr Obama said in remarks after the vote.

“This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction.” The President is expected to sign the legislation into law shortly.

Steps along the way

Events building up to this vote were summarized by the BBC in December 2009

The Senate passed its version of a healthcare reform bill on 24 December [2009]. This must now be squared or “reconciled” with the House bill passed in November, a process that is expected to begin in mid-January. With the various players in the debate all wanting different things from the reform process, the final passage of the legislation will still need much discussion.

The article shows how complex are the forces involved.
The Republicans
Republications were (and still are) presenting a united opposition which has blocked hope of a bi-partisan approach. This may have given Obama a fighting chance to present a semblence of unity among the Democrats, in view of their razor-thin majority in the House of Representatives.
The Democrats
But the democrats may be simplistically split roughly into two camps: liberals wanting less dilution of the Bill’s original powers, and the more conservative blue-dog coalition organized enough to build a political base around the proposed bill
[Blue Dog website, downloaded 22nd March 2010: “Currently, the U.S. Debt is estimated at: $12,278,635,997,966.88. Your share of today’s public debt is: $39,934.67”].
Assorted lobby groups
Not to mention assorted big-hitting and lobbying members of the Health Industry: (Insurance companies, The American Medical Association, Big Pharma) and the media, mostly lined up with the Republicans and Fox News. In the Senate, blue dog Ben Nelson had eventually been brought on board after receiving numerous benefits for his home state of Nebraska, along with promises on tighter curbs on abortion, which he opposes.

The Vote Approaches

As the vote approached in mid March 2010, President Obama cancels international commitments to add one final squeeze to wavering voters. The Economist [March 20th 2010] points out the significant political role that was being played by House speaker Nancy Pelosi.

“An effective Speaker need not be loved or think original thoughts. Her job is to round up votes and at that Mrs Pelosi excels… So she has been coaxing waverers, calling in favours, breaking fingers and pulling toe-nails.. It will take all [her skill and some] ugly parliamentary manoeuvres. But if Mrs Pelosi succeeds, she will take her place in the Democratic pantheon”.

The Vote

The roller-coaster that is President Obama’s destined mode of political travel screeches to a temporary halt. The President and others in the front car step out wobbly-kneed. They have made it back to ground level. And wearily, he and his entourage head back to the next car for the next ride.