This is when change begins

It’s no panacea. The process of redirecting the oceanliner of our bureaucracy vis-à-vis health care will take time; the sausage-making process common to American legislation has not been repealed; the full effects won’t trickle down to everyday bedrock for another four years. But today at the White House, President Obama did what at least eight presidents in the modern era before him could not:

With his signing of the 2,409-page Patient Protection and Affordable Care Act, the biggest shift in health insurance coverage for American citizens since Medicare in 1966, about 32 million uninsured Americans are poised to reap the benefits of the closest thing to universal health insurance in the nation’s history.

A change in the social contract between government and governed has been laid upon the table, signed, sealed and delivered.

“Today, health insurance becomes law in the United States of America,” Obama said in the East Room of the White House.

“The bill I’m signing will set in motion reforms that generations of Americans have fought for and marched for and hungered to see,” said the president. “Today we are affirming that essential truth, a truth every generation is called to rediscover for itself, that we are not a nation that scales back its aspirations.”

Up to now, much of the talking on the issue has been about politics and policy. With health-care reform now health-care law, you make the pivot to perception — of the president and his party. Obama’s too polite to throw it out there, but he’s entitled to ask: How ya like me now?

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People forget it was in his special joint session address to Congress, on Sept. 9, 2009, when he made his daring gauntlet throw-down on health care: “I am not the first president to take up this cause but I am determined to be the last.”

Six months and change later, it’s reality. That’s a potent message to put before the voters between now and November, an actualization of his campaign slogan: not Yes He Can but Yes He Did. It’s the kind of big win Obama needed to buttress the Democratic base of supporters tired of congressional gridlock, hungry for the kind of transformational event that Obama’s election showed them was possible in the first place.

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Certainly, some of the disillusioned independent voters who drifted away from the Democrats in the past year will come back into the fold, galvanized by a refreshingly new Democratic focus on getting things done, and the Dems’ apparent willingness to leave the circular-firing-squad behavior to the Republicans.

And that perception of Democrats as winners will resonate further on the president’s behalf. With passage of a health-care law he pledged the American people, Barack Obama already steps into the ranks of the most socially transformational presidents of the last 100 years.

And we’re not even halfway through his first term.

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This is when change begins. But let's give credit where it’s overdue. If we want a shorter, less cumbersome name for the Patient Protection and Affordable Care Act, we might try calling it what it really is: the Dingle-Kennedy Act.

Their legislative contributions form the DNA of the new health-care law. No two members of Congress worked harder for what Obama signed into law than Democratic Rep. John Dingle, the congressional champion of health-care reform going back more than 50 years, and Edward Moore Kennedy, the late Democratic senator from Massachusetts who for 40 years made health-care reform not just his job in the Senate but his mission, his calling, to the day he died last year.

Dingle and Kennedy’s work for the healthcare reform that President Obama signed into law was, among other things, an attempt to level the playing field between haves and have-nots.

The New York Times’ David Leonhard gets that. Writing in the Times today about the economic impact of the Obama health care law, he notes how the law begins to change, or at least challenge, the economic disparities of American life — disparities that had their origins in the Reagan administration.

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“The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago,” Leonhard wrote.

“Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.

"Nearly every major aspect of the health bill pushes in the other direction. … Beyond the health reform’s effect on the medical system, it is the centerpiece of his deliberate effort to end what historians have called the age of Reagan.”

And Leonhard, recounting a story told to him by White House economic adviser Lawrence Summers, reported Tuesday on how Summers, helping his daughter prepare for a college exam, “realized that the federal government had not passed major social legislation in decades. There was the frenzy of the New Deal, followed by the G.I. Bill, the Interstate Highway System, civil rights and Medicare — and then nothing worth its own section in the history books.

“Now there is.”

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Image credits: Health-care bill signing: Pete Souza/The White House. Signature: President Obama. Ted Kennedy: via The Huffington Post.