United States of Japan 

The health-care vote is one more step on a long, slow journey.

Mitch McConnell is right. The Republican Senate leader, a man whose vision is to deny others theirs, told The New York Times that President Obama's health-care proposal was part of an attempt to "turn us into a Western European country," which, the good Lord willing, is what will now happen.

I, for one, could use a dash of Germany, where there are something like 200 private health insurance plans and where everyone is covered and no one goes broke on account of bad health. It's great to be healthy in America, but for too many Americans, it's better to be sick somewhere else.

I would also take France or Switzerland, but mostly I'd like Japan, where medical care is as good (or better) than it is here and much less expensive. What all these countries have in common is the recognition that health care, like food or education, is a universal right. The United States, to McConnell's evident chagrin, is now moving this way.

Do not underestimate the importance of last week's House vote. It was momentous, and it will not be repealed by the results of the November elections. Just as, against the hopes and insistence of the GOP, America did not reverse Social Security or Medicaid. The worth of these programs became evident, and thus they became politically sacrosanct.

When Americans figure out that insurance companies can no longer deny them coverage because, as it happens, they urgently need it, and when they discover that their kids can remain covered until age 26, and when they can for the first time afford health insurance themselves, this law will become untouchable. Self-interest usually trumps ideology.

This battle was never entirely about health care. The fury of the opposition — not a single Republican vote — is as historically significant as the passage of the legislation itself. There is something cleaving this country, something represented by the election of Barack Obama — the change he either promised or threatened, take your pick — and the hyper-exaggeration of the ideological threat the man represented. Caricatured as a socialist, a radical, a hard-left liberal, and even an alien, he is actually the very soul of center-left moderation, cautious to a fault.

It is the same with the health-care package itself. Whatever it is, it is not socialism. For all the fulminations about the American free enterprise system, private insurance companies are retained. The government will not do what governments all over the world do — provide either health insurance or health care itself. Does the legislation provide for a government role? Yes. But there is a government role in virtually everything — or haven't you noticed the tag on your pillow?

The reason this fight took so long is that the culture is about evenly divided. It's not that the political system is broken. On the contrary, it's not supposed to work without consensus. It did as designed — marched in place and bided its time until Sunday, when it moved just a bit. Consider how long it has taken. Harry Truman wanted this bill.

Anger comes from fear. What was once a white Protestant nation is changing hue and religion. It is no accident that racial epithets were yelled at black lawmakers on Saturday in Washington and a kind of venom even gets exclaimed from the floor of the Congress: "You lie!" "Baby killer!" The protesters were protesting health-care legislation. But they fear they are losing their country.

Ever since the New Deal, the GOP has been the Party of the Past. It said no to the New Deal. It said no to Social Security. Important leaders — Barry Goldwater, for instance — said no to civil rights, as they now are saying no to gay rights. The party plays the role of the scold, the finger-wagger who warns of this or that dire outcome — not all of it wrong — and then gets bypassed by progress. The GOP then picks itself up and resumes its fight against the next innovation. Usually, it wins some battles; usually, it loses the war.

McConnell had his point. Europe is way ahead of us in compassion for the sick. Its systems, though, are hardly perfect, and government debt is always a concern. Still, we know which way we are going. The culture wars will continue, but the outcome, Mitch, is no longer in doubt.

Richard Cohen writes for the Washington Post Writers Group.

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