Saturday, March 20, 2010

The Time Has Come

The health care bill that the House will vote on tomorrow calls to mind Winston Churchill's quip about democracy being the worst possible system except for all of the others. Now, in the case of health care there are preferable alternatives stretching from a weak public option to single payer. But I've become less and less convinced that those were ever feasible. The Democratic caucus was always split on the issue, and the further legislation moved to the left, the fewer votes it would have gotten. As the Republicans hinged their strategy for returning to power on the failure of any health care legislation, none of them were ever going to vote for it no matter what it contained. At the health care summit, President Obama pointed out that, by opposing the bill, Republicans opposed a number of provisions that they had historically supported.

So, the votes were always going to have to come exclusively from the majority, and the Democratic majority was never unified on the best approach. (In defense of the Democrats, it's a lot easier to unite against a necessarily complex piece of legislation than to oppose it in lockstep.) Moreover, no organized, widespread grassroots pressure in support of single-payer or a public option ever emerged, so there was never any serious pressure from the left for an alternative. Say what you will about the teabaggers, they show up in numbers and make their voices heard; progressives never really got the boots on the ground. (Nate Silver argues here that even if they had, their impact would have been minimal. It's an interesting read in which he applies probability theory as opposed to insider analysis.)

So, we're left with a bill whose abortion provisions abridge the constitutional rights of half the country and that brings 30-35,000,000 mostly subsidized customers to health insurance companies, a group whose greed and pointlessness would make a parasite uneasy. But, I'm for the bill, and in the end it's not even a hard call.

History says that should this bill fail, it will be approximately 20 years before another president takes on health care reform. Harry Truman tried first in 1948. Lyndon Johnson tried again in 1965, one of the peak years of American liberal power, and settled for Medicare and Medicaid. Richard Nixon flirted with health care reform briefly in 1971, but he was distracted by wars in Vietnam and Cambodia and never attracted the support of an indifferent public by pushing seriously against conservative and liberal opposition. Health care reform was tabled was tabled until 1993, when Bill Clinton tried and spectacularly failed.

Since 1993, the current system has developed more cracks than the San Andreas Fault. Rising rates have forced individuals and small businesses to drop insurance and have inhibited the increase of real wages as businesses struggle to maintain benefits. Even so, companies have more and more asked employees to assume higher co-pays for ever more limited coverage. Moreover, the preexisting medical conditions of millions of Americans preclude them from having insurance even if they can afford it. Others have run up against the limits of their policies, and still more have had coverage dropped in the middle of expensive ongoing treatment for pernicious diseases.

Unless something changes, the future appears even more bleak. Sooner or later, financial pressures on state and local governments will force them to consider cutting benefits. Increasing global competition from companies that don't have to worry about offering health insurance will give them a competitive edge over American businesses. Real wages will continue to stagnate and possibly decline. Twenty years from now, the only people with insurance they can trust will will work for the federal government or a successful company in an industry that competes for people. Or they will be independently wealthy. If you're Bill Gates, Mitch McConnell, or a software engineer, you'll be in good shape. All others...

I'm convinced that this is the practical alternative to not passing this bill. Whatever its flaws, the legislation
  • puts a national policy in place for a sector that accounts for 16.5% of the economy
  • allows people with preexisting conditions to obtain insurance
  • ends the inhuman practice of rescission
  • eliminates payout ceilings
  • allows parents to cover their children until age 26
I wish that the House was about to vote on single-payer health care tomorrow. But it isn't. Considering that the alternative is another twenty years of an increasingly malevolent system that pressures doctors, patients, and hospitals to the complete advantage of insurance companies, I must support it...

And, damn it, I also don't want to see the obstructionists and the haters win. I'd hate to see that become the blueprint for legislative success...

It takes a lot of guts to bully a man with Parkinson's Disease, but these teabaggers are more than equal to the task. What's the word for this? "Repellent" comes to mind...

Stupid & Contagious is happy that Bob Dylan's Love and Theft is Newsweek's #2 album of the decade, but wonders what it means...

If you thought the French horn was George Martin's idea, think again:


Roy said...

((sigh)) We really needed that public option. Oh well, at least this one includes the elimination of that "pre-existing condition" nonsense.

I wanted to do serious harm to those guys screaming at the guy with Parkinson's, especially the one who kept throwing money at him. But you and Sean have made the same mistake conflating the Religious Right and the Tea Party movement; they're two different things, and in public they've criticized each other. In general the Religious Right thinks the teabaggers aren't interested enough in their social issues, and the teabaggers don't think the RR pays enough attention to their fiscal and constitutional issues. I wouldn't expect "Christian compassion" from teabaggers because very few, if any, of them make claims to any kind of religious agenda.

Lovely to hear Paul again. BTW, George Martin did come up with the french horns. That video isn't the Paul of the '60s auditioning the song for Martin, that's the Paul of the '80s reliving old times. It was part of a TV special that aired in '87 or so.

Clifton said...

The biggest disappointment I have in this entire health care debate has been how too many Americans failed to see that the public option would have changed things for working people. I work for a small non profit that has health care and people have no idea what that coverage they love so much does to the bottom line of the companies they work for. I am afraid it's going to get worse once people with pre-existing conditions are added. The Democrats and the president did a poor job educating the public on this issue.

K. said...

For some reason, their heart was not in a public option. Historians will uncover the reasons why, I suppose.

My guess is that early on the president and the leadership held out hope for a bipartisan bill and knew they wouldn't get any Republican to support a public option. As last summer and fall dragged on, they must have figured that they would need 60 senate votes and determined that the likes of Ben Nelson, Max Baucus, and Blanche Lincoln wouldn't vote for one.

These were arguably miscalculations, but then hindsight is 20/20. Educating the public on the effect of the current system on pay might have been the way to go, although that's a complex argument that would have been hardest to sell in Blue Dog districts.

Well, these things take time. After all, it's been 60 years since Harry Truman first broached the subject. Soon, hopefully, there will be a policy in place that can be amended in the future. Roy and I probably won't be around for it, but Cliff may yet see the day when we have a single-payer system.

And maybe it will come sooner: Five years ago, I thought I'd never see a black president in my lifetime, much less one with the middle name of Hussein.

K. said...

Roy: I suspect that there's some overlap between the two of them, although the libertarian bent of the teabaggers must also turn off the Religious Right. I mean, the last thing they want is a government that stays out of people's lives. Also, the Religious Right learned a long time ago not to scream and shout and stamp their feet.

The commonality between the two is anti-intellectualism and the profound fear and loathing of anyone not like them. In those senses, they have a shared ideal -- if that's what you want to call it -- for the country.

I don't find the Religious Right to be especially racist. The long-time mission of Evangelical Protestantism has been to evangelize and convert, and I'm guessing that they will take anyone they can get.

The teabaggers are another story altogether. Their way of dealing with the obvious racist undercurrent at their rallies is to deny that it exists and blame liberals and the victims of racism as being disingenuous.

Personally, I don't see how one can explain signs saying "Geld Obama" or depicting a cowardly black president slitting the throat of a white Uncle Sam from behind as anything but racist, but maybe that's just me.

Foxessa said...

The reason the dems had no heart for the public option is because their hands are in the pockets of Big Insurance and Pharma.

This includes everyone from Byron Dorgan and Hillary Clinton.

Love, C.