Some very smart people have written about what the historic vote on health care reform means. What it means for Republicans, what it means for Democrats, what it means for the public's view of government, what it means for the country. I'm not going to try and retread those well-worn paths. Let me tell you what this battle means to me.
Yes, that's right, me. All politics is local, and all politics is personal. So let me tell you about my journey of learning about why health care matters.
Ten years ago, I started working in the world of social justice. I was a canvasser. I was one of those people who knocks on your door and asks you if you have a minute, and tells you about some political issue you probably weren't thinking about, and then asks you to take action or donate money so that the fight on that political issue can continue.
It was a job. I had just been fired from my last job and had no idea what I was going to do with my life. It was a decent-paying job that required no experience, just the ability to make a good argument and to think on one's feet. I could do that. So I became a canvasser.
I became an activist, in the parlance of the movement. We weren't just canvassers. We were activists. We were community organizers, sowing the seeds of grassroots power, one doorstep at a time.
But the problem was this. We weren't talking about revolutionary issues. We were talking about ... health care. Prescription drug prices. Access to insurance. I didn't get it. I thought health care was a pretty middle-class issue, not very exciting, not very revolutionary. Health care just wasn't that big a deal. Why weren't we talking about homelessness, or defunding the military, or banning nuclear bombs? What did health care matter?
One thing I did notice, though. A lot of people didn't have anything to say, or didn't have time to talk. But the ones who did would open up. Their stories would come pouring out of them, often with tears and shaking voices and anger. And the more I talked to people, the more I saw how important health care really was.
I talked to men who would bring out their handwritten lists of medications - ten, fifteen, twenty different drugs - and tell me which ones they knew they had to have, and which ones they knew they could skip if they couldn't afford them. "These pills all cost money," they explained, "and sometimes, you gotta make choices."
I talked to people who faithfully paid their premiums every month, only to find that their insurance company refused to cover their illnesses when they became sick. They did nothing wrong except to become sick, and their insurance companies suddenly found exemptions, exclusions, limitations in their coverage. Profits over people. It happens more often than any of us realize.
I talked to people who were too young for Medicare, too ill to work, and too healthy to qualify for disability or Medicaid. They were trapped without health insurance, holding their breath and hoping that they wouldn't get sick. Prayer. That was their health care plan. Pray you don't get sick.
I talked to people who knew that if they got sick, their only choice was the emergency room. They couldn't afford the bills. They would get a payment plan if they had to go to the ER, and they would pay what they could, and they would fall behind, and the ER would send their account to a collection agency, and they would probably go bankrupt over it. Over health care costs.
I brought people to Olympia to protest against the high cost of prescription drugs. I helped organize rallies and town hall meetings to demand access to health care. I fought with my heart and soul against proposed increases in health care costs for the poorest of the poor, against threatened termination of our state's Basic Health plan. I met people who would weep when they thought about losing their health care. I met people who knew they would die without health care.
I met people who are dead now. They died because they had no health care, and they put off the visit to the doctor until the next paycheck came in. They didn't get checked because they couldn't afford the bill, and their illnesses got worse, and then when they needed to see the doctor, their choices were emergency rooms and sliding scale clinics with lines going out the door. Yes, people died. Lack of health care kills people in this country, thousands of people every year. People I knew and cared deeply about, and they died because of the injustice of our health care system.
I know that this bill will not solve everything. I know that we - the activists, the grassroots, the netroots - have much work yet to do. But twelve million more people are going to have access to health care now. Medicare and Medicaid will be expanded. More money will be available so people who can't afford health insurance can get it. The foolish policies that kept people with pre-existing conditions from getting health insurance will go away. Insurance companies will be banned from canceling health insurance policies when their customers get sick.
Things are going to get better. God willing, less people will die now because of lack of health insurance. And when they do, goddammit, people will pay attention. Because health care is one of the most important issues facing our country. Our health care system is broken, deranged, a failed machine running amok. This bill will make some long-needed repairs to the machine. It's not a complete fix. It's not a new machine. But we needed a fix, and this is a good fix, and it is too long in coming.
(Once again, thanks to the awesome Jamie Mulligan for the great canvasser picture.)