The morning after the historic vote on healthcare brings the realization which no one can take away: that the healthcare delivery system has been changed at its fundamental core. President Barack Obama set out to define his presidency in some way, for better or worse, with a nod toward progressivism — a designation that shouldn’t carry the partisan political definition, but rather one which denotes movement in an entirely different direction. As healthcare delivery was redefined midway in the 20th century to acknowledge the evolving sociopolitical demographics occurring its midst (formation of Medicare and Medicaid), the entrenchment of these legislative steps forward practically ensured their essential nature within the fabric of public policy as it relates to healthcare. That is, one cannot imagine health policy without the delivery of healthcare financed or influenced in some part by these federal guarantees. Ironically, it was the presence of such entitlements which the GOP felt compelled to defend as part of its antipathy for any movement or evolution toward sustainable healthcare delivery in the rapidly changing sociopolitical environment of the nascent 21st century.

Barack Obama understood this and tried to take control and possession of the movement. Yesterday’s historic vote by the House underscored his desire to do so, again — for better or worse. The coming days, weeks, and months will bring punditry on either side of the issue which — at the very least — will make for stimulating and educational discourse. And, perhaps that is a good development. Social legislation such as this requires national discussion, as change of this import will probably not take place quietly — nor should it.

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