AS OF yesterday, America had the most screwed-up health-insurance system in the developed world. As of today, America probably still has the most screwed-up health-insurance system in the developed world, but it's significantly less screwed-up than it was yesterday. The American health-insurance system we had yesterday was screwed up in many, many ways, but the most fundamental symptom of its dysfunction was that it failed to insure 17% of the population. Today, we are on the way to getting 95% of Americans insured by the end of the decade. The law will do that in part through increasing efficiency. In part, however, it's going to extend government subsidies so that more people can buy insurance. It pays for those subsidies in two ways: it taxes the rich; and, more importantly, it redistributes existing government benefits from those who have them to those who don't.

As the New Republic's Jonathan Chait and Jonathan Cohn have written, that redistributionist element is increasingly the focus of the opposition to the reforms: many opponents are voicing a simple blanket rejection of the idea that the wealthy or fortunate should be obliged to sacrifice anything to help out the poor or the unfortunate. But here's the thing: many of the people who think of this as a government effort to take their benefits away, and give them to someone else, don't realise that right now, they're unjustly benefiting from discrimination by the government and by insurance companies. To a large extent, this reform isn't about Robin Hood-style taxing and spending. It's about taking the Robin Hood-style taxing and spending we're already doing, and shifting it around so it's more fairly distributed.

Let's look at how this works. First of all, the government subsidises health insurance for people who work at large companies by making health insurance tax-free for employers. That employer health-insurance tax exclusion amounts to about $250 billion a year, almost three times the cost of the bill Congress passed yesterday. Those government subsidies go only to people who have jobs at companies that offer insurance. The self-employed, the unemployed, and employees of companies (mainly small businesses) that don't offer benefits have to buy insurance themselves, on the more expensive individual market, with no tax subsidy. There's no rhyme or reason to this discrimination, but it's one of the major reasons why many people don't have health insurance. The new law takes a step towards reducing that discrimination by capping the exclusion, taxing the health-insurance plans of people who get very high-value "Cadillac" insurance (worth more than $27,000 for a family policy) through their employers, and using that money to pay for subsidies to low-income people (earning up to 400% of the poverty level) who have to buy insurance on the individual market.

Second, under the old system, insurers demanded that people who had been sick in the past, and were thus more likely to become sick again, pay much more for insurance. There's nothing evil or dastardly about insurers doing this. In an unregulated system, they have to operate this way; if they didn't, they would go out of business. But the idea that people who get sick should have to pay vastly more for insurance violates people's basic ideas of fairness, and indeed the entire concept of insurance. (A health-insurance system that can't insure people who are likely to get sick is pretty clearly not doing the job society needs it to do.) Essentially, the old system forced insurers to discriminate against people who were prone to sickness, and in favour of people who weren't. Americans strongly agree that insurers should not be allowed to discriminate on price against people with pre-existing conditions. (An ABC/Washington Post poll in early February found 80% agreed the government should bar insurers from rejecting those with pre-existing conditions.) With health-care reform passed, insurers will have to stop rejecting sick people, or charging them more, beginning in 2014. And this isn't a problem for insurers, either. As long as no company can discriminate against pre-existing conditions, the playing field stays level; insurers have not opposed this part of the reform.

Third, under the old system, a lot of healthy younger people decided that premiums had risen so high that it wasn't worth it for them to buy insurance. They figured they were better off taking their chances. In so doing, they were freeloading off of the rest of society. In America, emergency rooms are obligated by law to treat anyone, regardless of their insurance status. (That's because Americans are decent people who don't believe you should die because you're poor.) But healthy people who forego insurance are playing the same game as "too big to fail" financial institutions: they know that ultimately, if they're hit by a car, the hospital will have to treat them, and if they can't pay the full cost, the rest of society will, through higher treatment costs and insurance premiums. They're drawing the emergency-care benefits of the American health system, but they haven't paid their dues. The new law fixes this by mandating that everyone buy insurance. If you can't afford it, you'll get subsidies to help. But it will no longer be possible for healthy people with adequate incomes to decide they'd rather spend that money on a nicer car, and let the rest of us pay for their care when they fall ill.

Fourth, and most controversially, there is the issue of Medicare. Under America's old system, there was a vast disparity between 55- or 60-year-olds and 65-year-olds. Once you hit 65, you were more or less set. For the ten years before that, you'd been more or less screwed. Your premiums were much higher than those of younger people, and unless you were truly indigent and qualified for Medicaid, there was no government help. The new system limits the degree to which premiums can discriminate based on age, and it provides subsidies for those who can't afford private-sector premiums but aren't poor enough for Medicaid. It gets some of the money for those subsidies by cutting Medicare spending. And it gets much of the rest by raising Medicare taxes on the rich (specifically, from 1.45% to 2.35% of income, for those with earnings above $250,000).

Now, some of these Medicare cuts will be pure fat; there's no reason why the Medicare Advantage programme should be paying for-profit private companies to do a job the government does more cheaply. (Indeed, paying for-profit private companies to do things the government does more cheaply seems to have become a bit of an epidemic over the past 25 years.) And studies show that perhaps one-third of Medicare spending generates no difference in health outcomes. The new MedPac commission should be able to identify and cut out a lot of non-productive treatment practices. Some of the cuts, however, may represent real reductions in care. But look: America created Medicare because it wanted to guarantee health care for its seniors. It's unfair to create an absolute guarantee of first-rate health care for anyone 65 or over, while doing nothing at all for the middle-aged, leaving many of them unable to obtain any kind of coverage. Seniors may need to accept some limits on public spending on their health care in order to provide subsidies so that non-seniors can afford health insurance, too. And using an increase in direct Medicare taxes to free up money to make insurance affordable for working-class non-seniors seems fair.

There is one piece of old-fashioned redistribution involved in the new law. Because the cap on the employer health-insurance tax exclusion was unpopular with labour, businesses, and the public, the Obama administration postponed its implementation and made up for some of the revenue with a 2.9% surtax on investment income for families earning over $250,000. That sort of tax on the wealthy may be unpopular with the Tea-Party crowd. But it's extremely popular with the country as a whole. In January another ABC/Washington Post poll found the public preferred this approach to capping the tax exclusion for Cadillac plans, 58% to 22%.

In short, those who oppose this bill because it's a Robin Hood bill are not wrong. It does involve redistribution. But that redistribution is largely about reducing the unfairness of redistribution that already exists. There's no reason why taxpayers should be subsidising the health-insurance premiums of people who work for large companies but not those who own small businesses, why sick people who pay high insurance premiums should be subsidising the emergency-room guarantee for healthy young people who choose not to buy insurance, or why we should all be paying the insurance premiums of a wealthy 65-year-old while doing nothing for a working-class 64-year-old. The new system isn't going to eliminate the unfairness and discrimination in the American health-insurance system; we didn't turn into the Netherlands overnight, let alone France. But we do wake up today with a system that's significantly less unfair than it was yesterday, and most of that has to do with a fairer distribution of the benefits the government was already handing out.