Time for Our Second Bill of Rights

In his powerful new book, “The Healing of America,” T.R. Reid asks, “Which inequalities will society tolerate? Is it acceptable that some people are left to die because they can’t see a doctor when they get sick? That question encompasses a more basic question: Is health care a human right?”

President Franklin D. Roosevelt had the answer when he offered his “Second Bill of Rights” as the nation was nearing the end of World War II in 1944. He looked ahead to a postwar world where Americans had the right to a decent job, home, education and “adequate medical care and the opportunity to achieve and enjoy good health.”

President Barack Obama and Senate Majority Leader Harry Reid are pursuing that long-sought goal as they muster support for legislation that would greatly improve an unfair, inadequate system that denies affordable health insurance to many, including most of those with preexisting medical conditions, calamitous illnesses or no access to group insurance.

On Nov. 21, Reid put together the 60 votes needed to send the measure to a Senate debate. It was a big victory for Obama, and it came as critics from the left and right—and the Washington media mob—mocked him as a hapless loser. His strategy of giving the ball to Democratic congressional leaders, rather than dictating his own health plan, now looks like a smart move.

Unfortunately, the significance of the vote was buried by the mass of bad reporting and punditry on the president’s nine-day Far East trip, which began Nov. 13. The trip was generally portrayed as a journey of submission, if not surrender, to the Chinese and even the Japanese. (An American president bowing to the emperor? What would Gen. Douglas MacArthur have said?)

As it turned out, however, the trip wasn’t about submission at all. After Obama’s visit, China joined with Russia in voting to demand that Iran stop building a nuclear facility that the Islamic Republic had long kept secret. China also set new anti-pollution targets. Diplomacy can work. As James Fallows wrote on the Atlantic’s Web site Nov. 28, “… ten days after the trip’s completion, the apparent results are closer to the high end of what the Administration could reasonably have expected than to the across-the-board humiliation and disappointment that ‘analyses’ of the trip generally proclaimed. There is evidence of at least first-stage engagement by China on all the issues that mattered to the United States. First-stage is not completion, but it’s something — and something most of the press, viewing the trip as if it were a campaign swing, missed at the time.”

The challenges facing the president are immense. He has the all-but-impossible job of convincing an increasingly skeptical nation that Afghanistan is not a quagmire. He must move ahead quickly and decisively to reduce rising unemployment.

The Republicans, dripping crocodile tears, say this is too much for Obama to do. “The war is terribly important,” Republican Sen. Richard Lugar said Sunday on CNN. “Jobs and our economy are terribly important. … I would suggest we put aside the health care debate until next year. …”

What a phony argument! The Republicans ignored Afghanistan in their support for President George W. Bush’s Iraq disaster. Suddenly, Afghanistan is their cause. And their solution for a still-weak economy and joblessness is tax cuts for the wealthy. The only reason they want to “put aside” health reform is to kill it.

The legislation is imperfect. Rather than reform the health system by providing Medicare for all, or single payer, the legislation passed by the House and awaiting Senate action merely improves the health insurance system. And the most important feature—creation of exchanges where people can buy policies without current restrictions—wouldn’t begin operating until 2013. Still unsettled is the huge question of whether the government would sell policies—the public option—on the exchanges to provide competition to private insurance companies and control costs. As it stands now, these companies remain big winners.

But the reform promises immediate help in several areas, available as soon as President Obama signs the bill.

The House-passed bill would immediately create an insurance program for those who are without insurance, providing policies until the exchanges get started. Premiums in such programs would be limited. In addition, insurance companies could no longer cancel policies when sick people filed claims unless the firms could prove fraud. Young people could remain on their parents’ policies until they were 27. Insurance companies could no longer impose lifetime limits on coverage.

Drug benefits for Medicare recipients would be improved.

Exactly what will emerge is unclear. In the Senate, Republicans will try to insert many amendments and to filibuster. Each time, it will take 60 votes to break the filibuster. This will take weeks. You may want to turn away in frustration or boredom.

But don’t. It will be a historic moment when the federal government begins to accept responsibility for all Americans’ health. Even critics of reform can see the importance. “Reform would make us a more decent society but also a less vibrant one,” David Brooks wrote in The New York Times on Nov. 24. “It would ease the anxiety of millions at the cost of future growth.”

President Roosevelt did not have such a crimped view. With the Depression ended and wartime victory in sight, he saw a nation rich and imaginative enough to provide the health care promised in his “Second Bill of Rights.”

We are still that nation. This is what we have to remember as the Senate immerses itself in the politics and numbers of health care beginning this week.