The passage of the House Finance Committee health bill was a remarkable day. It showed that you can still get something through Congress even in these politically coagulated times when anything other than a purely party line vote becomes a major news item, in this case because Olympia Snowe voted with the Democrats. The Democrats in the hearing room gave one another very somber and respectful congratulations for something that is, after all, just one committee’s version of a bill, and not even that, because it has not yet been put in legislative language, that left to “technicians”. Yet, in today’s political context, it would seem that Rahm Emanuel is the one who should win a Nobel Prize for politics, even as his boss won one for peace. The Republicans seem to have run out of ammunition, their lines of attack having to do with abortion and costliness not having grabbed public attention in spite of their deliberate efforts at spreading fear during the August recess when it became clear, one more time, that the Republicans do not have an agenda for the nation but only a set of monkey wrenches to be thrown, one after the other, into the fire to see if they will burn if the heat is made hot enough. It seems now that something will get through Congress.

Getting a health care reform bill will not only be a triumph because it will show that some legislation of major consequence can get through, not just tax rates that get changed upward only for the rich when the Democrats take control and downward only for the rich when the Republicans take control. Getting health care legislation through is more like trying to reform the tax code rather than tax rates. There are so many constituencies to deal with that any jiggering with the system is bound to lead some group to veto, for example, a tax on so-called Cadillac health plans. Moreover, the health insurance system, like the tax system, has so many built in assumptions that any significant change is likely to snowball in unexpected directions. Imagine removing home interest as a tax deduction. It would do worse damage to the housing market than the foreclosure crisis, and yet elementary fairness would argue that renters should not be deprived of a break on their housing costs if homeowners are allowed one. So it is perfectly reasonable to suppose that employers will dump their employees on whatever public option might be provided. Now, that might be a good thing or a bad thing, but it certainly would be a significant departure from how health insurance is now provided. Major legislation does bring about change.

Another reason to cheer health care reform as a victory for representative democracy is that it pits against one another two fundamental principles of government. Forget the details. In this bout, conservative hesitancy about any government intervention in the private sector (except those that enhance private profits) confronts the liberal idea that intervention by the government is a good way to solve economic and social problems. Government, to a liberal, is part of the solution and rarely a large part of the problem. It looks as if the liberal philosophy will win and that the conservatives will just have to wait for another day, refusing to sign on to what they do not believe in, even as it is not clear what their beliefs amount to once you scratch the surface. Do they really think the government is not good at writing checks for social security payments or managing air controllers or the weather service or any number of other things that government does? See this as a triumph of the engagement of two political philosophies that was distorted but not hidden by the fractiousness of the debate, the issue resolved not so much by changing the minds of legislators as by allowing the majority party to use its institutional power to overcome the objections of the minority party. That is what Ronald Reagan did; it is what Barack Obama does.

There is a case to be made for at least the libertarian version of the opposition to health care reform, an issue which Republicans have not made as much of as they could or should. The House Finance Committee Bill, the most conservative of those that are to be blended together, has a requirement that every citizen buy health insurance. That is a truly radical step. There is nothing else quite like it in legislation. The Democrats rather lamely argue that it is like being required to buy auto insurance if you own a car. But that is a state requirement rather than a federal one. You can avoid the state requirement to buy auto insurance by not buying a car, just as you can avoid searches and seizures at airports by not taking a plane. And anyway, that latter federal measure is justified as a national security measure rather than as part of a definition of the requirements of citizenship. The idea that in “ordinary” times citizens will be required to do something that had previously been voluntary is new.

A draft of the citizenry into military service is the closest thing there is to a statement of a requirement of citizenship. You may be required to put your life at risk for your country. Yet even there, aliens are required to register, as they are also required to pay taxes. Here alone, with regard to health care, is there an insistence that there are residents who are not covered by an obligation, however much it is presented as part of a system that will provide a benefit to everyone who is in the pool. Never mind the epidemiological arguments that illegals can still spread germs or go to an emergency room; the idea is that this is a benefit of citizenship. That is the way it is with insurance schemes: they turn benefits into obligations. You are required, first of all, to pay, and then arises the question of what you will get when you have paid, given the variety of plans you now will have available to you if you choose not to pay the excise tax instead.

Moreover, there is no way round the fact, despite Obama’s denials, that required health insurance constitutes a tax. It is levied against everyone and is offset by grants to those in lower brackets. You cannot get out of it if it is enforced, just as you can’t get out of IRS taxes if they go after you. It may be a worthwhile tax in that you are getting a lot for a little money, and get it more cheaply than you would in a private market, even a supervised one, but there is no question that health insurance will have become a collective purchase rather than an individual one because Congress can impose discipline on insurance because of the taxing powers of Congress. That is the flip side of the fact that health care will have become a right: if it is a right that is guaranteed by government than government has a right to tax people to secure that right for all, even if, in fact, the amount you pay in taxes will be less than the amount that is now paid in private insurance. That is what the Republicans oppose even though they give no reason for opposing it other than a distrust of government.

The closest thing to required health insurance, which was, by the way, a crucial part of the Clinton health care bill, though it was better hidden there, is compulsory school attendance laws. They, like the health mandate, are honored in the breach in that they are enforced by custom rather than by truant officers (or, in this case, by fines). The point of those laws was to keep children out of employment rather than to insist they go to school, the reasoning being that if they aren’t earning money, parents are more likely to let them attend school. Attendance laws, however, did not require any direct transfer of funds, though tell that to a family that wanted to put its child to work in a sweat shop so that there would be some more food on the table.

I share the libertarian reluctance to have the government require you to do anything except what is essential, such as get drafted for a war and, maybe, go to school. I don't even like the European idea that you can be fined if you don't vote. But health care, like compulsory schooling, may be exceptions because they are in the service of two institutions access to which Americans have come to think of as rights rather than luxuries. I hope the debate over this issue is an enlightened one where the libertarian side is defended by others than the likes of Rush.