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EDITORIAL: Health care history - but can political culture heal?

When President Barack Obama signs health care reform into law, as is expected today, it will mark dramatic progress in the nation's difficult quest to deliver quality health care for all. This is a historic moment.

Enacting the most sweeping changes since the advent of Medicare and Medicaid in 1965 is a genuine accomplishment for a nation that sometimes seems paralyzed in the face of big challenges. But after Sunday's climactic House vote, a nagging question remains: What did this cost our political culture?

The legislative process was messy and long - too long. And the political battle was nasty, devolving into epithets based on race and sexual orientation that protesters hurled as representatives entered the Capitol Sunday. Inside the chamber, colleagues yelled insults as abortion was debated.

We have to reason together, civilly and constructively, despite passionate differences. That means not over-promising, like claiming with certainty that medical costs will be contained. It also means resisting unprincipled tactics like warnings of "death panels" to ration care. Embellishment may be a staple of politics, but it sows distrust and dysfunction.

Too much remains to be done for that. Reform must now be moved from words on a page to reality in people's lives. As rules and structures are implemented, Washington needs to keep a sharp eye on costs. Containing the price of care and insurance won't be easy with an aging population. But it has to be done. And that requires a willingness to keep what works and dump what doesn't, as we gain experience with the changes.

The public has to rise to the challenge, too. The latest drugs and technology can seem to offer miracles. But we can't continue to demand every treatment imaginable - based on the mistaken belief that more care is always better care - and expect that costs won't soar.

This reform has flaws. All legislation does. But it's an important step on an essential journey. hN


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