President Obama has just signed a historic piece of legislation that will bring near-universal healthcare coverage to our country within the next few years. It’s most important achievement will be to cover 32 million people are currently uninsured. In her speech before the House’s vote on the bill, Speaker Nancy Pelosi reminded her colleagues of a letter to President Obama that Senator Edward Kennedy wrote before he died:

Senator Kennedy wrote that: ‘Access to health care is the great unfinished business of our society.’  That is, until today.

This legislation doesn’t reform our healthcare system, but it corrects some of the most shameful aspects of it. It creates important mechanisms to make insurance affordable and start controlling cost growth. The bill has plenty of shortcomings, but so did Medicare and Social Security when they were first created. Those two programs have since been improved, and today they allow millions of people to stay healthy, active, and engaged in society.

In a speech to House Democrats before their historic vote on the bill, President Obama gave a useful summary of what this legislation will (and won’t) do and which changes will take effect this year:

As some of you know, I’m not somebody who spends a lot of time surfing the cable channels, but I’m not completely in the bubble. I have a sense of what the coverage has been, and mostly it’s an obsession with “What will this mean for the Democratic Party? What will this mean for the President’s polls? How will this play out in November? Is this good or is this bad for the Democratic majority? What does it mean for those swing districts?”

And I noticed that there’s been a lot of friendly advice offered all across town. (Laughter.) Mitch McConnell, John Boehner, Karl Rove — they’re all warning you of the horrendous impact if you support this legislation. Now, it could be that they are suddenly having a change of heart and they are deeply concerned about their Democratic friends. (Laughter.) They are giving you the best possible advice in order to assure that Nancy Pelosi remains Speaker and Harry Reid remains Leader and that all of you keep your seats. That’s a possibility. (Laughter.)

But it may also be possible that they realize after health reform passes and I sign that legislation into law, that it’s going to be a little harder to mischaracterize what this effort has been all about.

Because this year, small businesses will start getting tax credits so that they can offer health insurance to employees who currently don’t have it. (Applause.) Because this year, those same parents who are worried about getting coverage for their children with preexisting conditions now are assured that insurance companies have to give them coverage — this year. (Applause.)

Because this year, insurance companies won’t suddenly be able to drop your coverage when you get sick — (applause) — or impose lifetime limits or restrictive limits on the coverage that you have. Maybe they know that this year, for the first time, young people will be able to stay on their parents’ health insurance until they’re 26 years old and they’re thinking that just might be popular all across the country. (Applause.)

And what they also know is what won’t happen. They know that after this legislation passes and after I sign this bill, lo and behold nobody is pulling the plug on Granny. (Laughter.) It turns out that in fact people who like their health insurance are going to be able to keep their health insurance; that there’s no government takeover. People will discover that if they like their doctor, they’ll be keeping their doctor. In fact, they’re more likely to keep their doctor because of a stronger system.

So what did we do? What is the essence of this legislation? Number one, this is the toughest insurance reforms in history. (Applause.) We are making sure that the system of private insurance works for ordinary families. A prescription — this is a patient’s bill of rights on steroids. So many of you individually have worked on these insurance reforms — they are in this package — to make sure that families are getting a fair deal; that if they’re paying a premium, that they’re getting a good service in return; making sure that employers, if they are paying premiums for their employees, that their employees are getting the coverage that they expect; that insurance companies are not going to game the system with fine print and rescissions and dropping people when they need it most, but instead are going to have to abide by some basic rules of the road that exemplify a sense of fairness and good value. That’s number one.

The second thing this does is it creates a pool, a marketplace, where individuals and small businesses, who right now are having a terrible time out there getting health insurance, are going to be able to purchase health insurance as part of a big group — just like federal employees, just like members of Congress. They are now going to be part of a pool that can negotiate for better rates, better quality, more competition.

And that’s why the Congressional Budget Office says this will lower people’s rates for comparable plans by 14 to 20 percent. That’s not my numbers — that’s the Congressional Budget Office’s numbers. So that people will have choice and competition just like members of Congress have choice and competition.

Number three, if people still can’t afford it we’re going to provide them some tax credits — the biggest tax cut for small businesses and working families when it comes to health care in history. (Applause.)

And number four, this is the biggest reduction in our deficit since the Budget Balance Act — one of the biggest deficit reduction measures in history — over $1.3 trillion that will help put us on the path of fiscal responsibility. (Applause.)

And that’s before we count all the game-changing measures that are going to assure, for example, that instead of having five tests when you go to the doctor you just get one; that the delivery system is working for patients, not just working for billings. And everybody who’s looked at it says that every single good idea to bend the cost curve and start actually reducing health care costs are in this bill.

So that’s what this effort is all about. Toughest insurance reforms in history. A marketplace so people have choice and competition who right now don’t have it and are seeing their premiums go up 20, 30, 40, 50 percent. Reductions in the cost of health care for millions of American families, including those who have health insurance. The Business Roundtable did their own study and said that this would potentially save employers $3,000 per employee on their health care because of the measures in this legislation.

And by the way, not only does it reduce the deficit — we pay for it responsibly in ways that the other side of the aisle that talks a lot about fiscal responsibility but doesn’t seem to be able to walk the walk can’t claim when it comes to their prescription drug bill. We are actually doing it. (Applause.) This is paid for and will not add a dime to the deficit — it will reduce the deficit. (Applause.)

Now, is this bill perfect? Of course not. Will this solve every single problem in our health care system right away? No. There are all kinds of ideas that many of you have that aren’t included in this legislation. I know that there has been discussion, for example, of how we’re going to deal with regional disparities and I know that there was a meeting with Secretary Sebelius to assure that we can continue to try to make sure that we’ve got a system that gives people the best bang for their buck. (Applause.)

So this is not — there are all kinds of things that many of you would like to see that isn’t in this legislation. There are some things I’d like to see that’s not in this legislation. But is this the single most important step that we have taken on health care since Medicare? Absolutely. Is this the most important piece of domestic legislation in terms of giving a break to hardworking middle class families out there since Medicare? Absolutely. Is this a vast improvement over the status quo? Absolutely.

The entire transcript is worth reading. I’ve also bookmarked it for future reference, hoping that 20 years from now it will astonish me to recall that there was a time when 15% of the US was uninsured, people were routinely bankrupted by healthcare costs, and small businesses couldn’t afford employee health insurance.

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