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The Ride of a Lifetime

Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.

I began this post headed to the White House, where I hope to watch President Obama sign health reform into law. It seems in keeping with my previous efforts that this was a frantic last-minute dash made possible by frequent flyer miles and the free night I had earned at a crummy suburban hotel. I almost didn't make it. My taxi was disabled by a road obstacle.

Surmounting the last-minute hijinks, I made it to the East Room in time to see President Obama sign this bill into law. As Jonathan Chait already noted, by achieving the centerpiece initiative of his administration, the President thereby signed himself into the history books, as well.

The event will be a personal milestone for me, as well. I've been at this for 30 months now. I've made hundreds of phone calls, knocked on hundreds of doors, written backstage memos and email appeals, penned perhaps 200 columns and blog posts, organized petitions of academic and medical experts supporting health reform. Much of the work was fun. Some was a slog. I have marked myself as a liberal partisan. The label is accurate enough. It brings real benefits. It comes at some professional cost, too.

Working for health reform was the most significant thing I have ever done. In his beautiful speech to the House Democratic caucus, President Obama reminded the assembled politicians of the awesome responsibility one assumes by approaching people who are in real pain, and seeking their votes.

…every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, you’re right, the system is not working for you and I’m going to make it a little bit better….

Every single one of you has made that promise, not just to your constituents but to yourself. And this is the time to make true on that promise. We are not bound to win, but we are bound to be true.

These are tough promises for any elected politician to keep. They face hard votes. Even if they didn't, our political system is hard to move for both good and bad reasons. And our $2.4 trillion medical economy is even harder to move.

Anyone who's knocked on doors catches a whiff of that responsibility. Sometime in late 2007, I was asked to help test out the new computerized phone system in a boiler-room set up on the west side of Chicago. For some unfathomable reason, I was assigned a long call sheet of African-American voters in rural South Carolina. It became quickly apparent that Barack Obama had an excellent chance of sweeping the African-American vote. "Can this guy really win?" was the only critical question I was asked.

The depth of human need was also palpable. Most people on my call sheet were middle-aged or older. Many faced worrying health problems.

One man started telling me in detail about his own and his wife's infirmities and their accompanying medical bills. I got the feeling that he didn't talk with college professors very often. He conveyed a poignantly optimistic view of what I could do to help. He couldn't have been more supportive. Yet he took me aback with a simple direct question: "If Barack Obama is elected, will he help me?" This man didn't want any Will I Am video or some inspiring speech, he was asking what Candidate Obama would specifically do to handle the pile of bills on his kitchen table.

That straight-up question hit like a punch in the stomach. I told him "If Senator Obama is elected, he will work hard every day…" yada, yada yada. I encountered many others struggling with chronic illnesses, and many family caregivers too. Most of the time, I entered their lives for a brief moment on the phone or at the doorstep. Some of these men and women signed on with the Obama campaign. Some were Clinton or Edwards supporters. No harm there. This was always a much bigger issue than any one candidate. Many expressed real hope that big things would happen.

And what would we do? So many people were placing great, maybe unique faith in Barack Obama. I couldn't anticipate the coming health reform trench warfare. I knew enough to know that millions of people might be let down.

The Obama campaign was making a big implicit promise that he and his team would have the political appeal, legislative and policy skills, and sheer determination to get this done. That was no little promise. Not only was there the checkered historic record. We were elbowing aside Hillary Clinton, who was no less committed than Barack Obama was to health reform, who brought long policy experience and who had spent the better part of a decade assembling a juggernaut domestic policy team with a deeper bench than the Obama team had yet assembled.

I didn't know if the President and his allies would live up to that responsibility. This thing was a nail-biter to the end. I still wish we could do more to help that South Carolina man, and to help millions more like him. I wish that we didn't have to wait until 2014 for much of this bill to become operative.

Still, with today's events, America accomplished something huge. Despite many missteps, obstacles, and disappointments, President Obama, House and Senate leaders vindicated their decision to pursue comprehensive health reform. In doing so, they brought to fruition the efforts of thousands of people, few of whom are in any way famous, many of whom would not live to see this happy occasion. This bill somewhat vindicated our ossified political system, too. It showed that large accomplishments are at least possible, if one is lucky, and if one is willing to pay a great political cost.

The President today called health reform "remarkable and improbable." So it was. It was the ride of a lifetime, for the bit players no less than for the stars.

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