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: