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The Underlying Divisions in the Health Care Debate

Ed Kilgore has a very perceptive analysis in The New Republic about the underlying (and largely unexamined) ideological and strategic differences among progressives that are at least partially driving the rift over the health care bill.  He argues -- correctly -- that the current debate "displays a couple of pretty important potential fault lines within the American center-left" that have manifested in other disputes as well.  That was the principal point of this much-maligned Daily Kos post observing that many (but not all) of the progressive bloggers most vehemently demanding passage of the health care bill also supported the Iraq War.  As the author of that post (Jake McIntyre) explicitly said, his intent wasn't to suggest that those individuals shouldn't be listened to because of their Iraq position six years ago (that would be an invalid and unfair claim), but simply that -- as Kilgore says -- there are underlying and significant differences in strategic and ideological outlook driving the health care debate that have been present for some time but are typically ignored.

Shared contempt for the Bush administration (at least once Bush and the Iraq War became discredited) largely obscured these differences when Bush was in office.  The desire to undermine the Bush GOP and dislodge that movement from power subsumed all other objectives and united people with vastly different political outlooks and agendas.  There is still a shared revulsion towards the Palin/Limbaugh Right, but that faction is too marginalized and impotent to serve the same function.  With the unifying force of Bush/Cheney gone, the divisions Kilgore describes are now vibrant and increasingly potent.  In addition to health care and Iraq, roughly the same progressive fault lines are seen over the bank bailout, escalation in Afghanistan, Obama's economic team, tolerance for Obama's embrace of Bush/Cheney civil liberties polices, and even the reaction to Matt Taibbi's recent Rolling Stone article on Obama's subservience to Wall Street. 

There are many reasons for the progressive division on the health care bill.  There are differences over the narrow question of health care policy, with some believing the bill does more harm than good just on that ground alone.  Some of it has to do with broader questions of political power:  if progressives always announce that they are willing to accept whatever miniscule benefits are tossed at them (on the ground that it's better than nothing) and unfailingly support Democratic initiatives (on the ground that the GOP is worse), then they will (and should) always be ignored when it comes time to negotiate; nobody takes seriously the demands of those who announce they'll go along with whatever the final outcome is.  But the most significant underlying division identified by Kilgore is the divergent views over the rapidly growing corporatism that defines our political system.

Kilgore doesn't call it "corporatism" -- the virtually complete dominance of government by large corporations, even a merger between the two -- but that's what he's talking about.  He puts it in slightly more palatable terms:

To put it simply, and perhaps over-simply, on a variety of fronts (most notably financial restructuring and health care reform, but arguably on climate change as well), the Obama administration has chosen the strategy of deploying regulated and subsidized private sector entities to achieve progressive policy results. This approach was a hallmark of the so-called Clintonian, "New Democrat" movement, and the broader international movement sometimes referred to as "the Third Way," which often defended the use of private means for public ends.

As I've written for quite some time, I've honestly never understood how anyone could think that Obama was going to bring about some sort of "new" political approach or governing method when, as Kilgore notes, what he practices -- politically and substantively -- is the Third Way, DLC, triangulating corporatism of the Clinton era, just re-packaged with some sleeker and more updated marketing.  At its core, it seeks to use government power not to regulate, but to benefit and even merge with, large corporate interests, both for political power (those corporate interests, in return, then fund the Party and its campaigns) and for policy ends.  It's devoted to empowering large corporations, letting them always get what they want from government, and extracting, at best, some very modest concessions in return.  This is the same point Taibbi made about the Democratic Party in the context of economic policy:

The significance of all of these appointments isn't that the Wall Street types are now in a position to provide direct favors to their former employers. It's that, with one or two exceptions, they collectively offer a microcosm of what the Democratic Party has come to stand for in the 21st century. Virtually all of the Rubinites brought in to manage the economy under Obama share the same fundamental political philosophy carefully articulated for years by the Hamilton Project: Expand the safety net to protect the poor, but let Wall Street do whatever it wants.

One finds this in far more than just economic policy, and it's about more than just letting corporations do what they want.  It's about affirmatively harnessing government power in order to benefit and strengthen those corporate interests and even merging government and the private sector.  In the intelligence and surveillance realms, for instance, the line between government agencies and private corporations barely exists.  Military policy is carried out almost as much by private contractors as by our state's armed forces.  Corporate executives and lobbyists can shuffle between the public and private sectors so seamlessly because the divisions have been so eroded.  Our laws are written not by elected representatives but, literally, by the largest and richest corporations.  At the level of the most concentrated power, large corporate interests and government actions are basically inseparable.

The health care bill is one of the most flagrant advancements of this corporatism yet, as it bizarrely forces millions of people to buy extremely inadequate products from the private health insurance industry -- regardless of whether they want it or, worse, whether they can afford it (even with some subsidies).   In other words, it uses the power of government, the force of law, to give the greatest gift imaginable to this industry -- tens of millions of coerced customers, many of whom will be truly burdened by having to turn their money over to these corporations -- and is thus a truly extreme advancement of this corporatist model.  It's undeniably true that the bill will also do some genuine good, as it will help many people who can't get coverage now to get it (though it will also severely burden many people with compelled, uncontrolled premiums and will potentially weaken coverage for millions as well).  If one judges the bill purely from the narrow perspective of coverage, a rational and reasonable (though by no means conclusive) case can be made in its favor.  But if one finds this creeping corporatism to be a truly disturbing and nefarious trend, then the bill will seem far less benign.

As I've noted before, this growing opposition to corporatism -- to the virtually absolute domination of our political process by large corporations -- is one of the many issues that transcend the trite left/right drama endlessly used as a distraction.  The anger among both the left and right towards the bank bailout, and towards lobbyist influence in general, illustrates that.  Kilgore says that anger among the left and right over corporatism is irreconcilable, and this is the point I think he has mostly wrong:

To put it more bluntly, on a widening range of issues, Obama's critics to the right say he's engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. They can't both be right, of course, and these critics would take the country in completely different directions if given a chance.  But the tactical convergence is there if they choose to pursue it.

This supposedly irreconcilable difference Kilgore identifies is more semantics than substance.  It's certainly true that health care opponents on the left want more a expansive plan while opponents on the right want the opposite.  But the objections over the mandate are largely identical -- it's a coerced gift to the private health insurance industry that underwrites the Democratic Party.  The same was true over opposition to the bailout, objections to lobbying influence over Washington, and most of all, the growing anger that Washington serves the interests of financial elites at the expense of the working class.  

Whether you call it "a government takeover of the private sector" or a "private sector takeover of government," it's the same thing:  a merger of government power and corporate interests which benefits both of the merged entities (the party in power and the corporations) at everyone else's expense.  Growing anger over that is rooted far more in an insider/outsider dichotomy over who controls Washington than it is in the standard conservative/liberal ideological splits from the 1990s.  It's true that the people who are angry enough to attend tea parties are being exploited and misled by GOP operatives and right-wing polemicists, but many of their grievences about how Washington is ignoring their interests are valid, and the Democratic Party has no answers for them because it's dependent upon and supportive of that corporatist model.  That's why they turn to Glenn Beck and Rush Limbaugh; what could a Democratic Party dependent upon corporate funding and subservient to its interests possibly have to say to populist anger?

Even if one grants the arguments made by proponents of the health care bill about increased coverage, what the bill does is reinforces and bolsters a radically corrupt and flawed insurance model and and an even more corrupt and destructive model of "governing."  It is a major step forward for the corporatist model, even a new innovation in propping it up.  How one weighs those benefits and costs -- both in the health care debate and with regard to many of Obama's other policies -- depends largely upon how devoted one is to undermining and weakening this corporatist framework (as opposed to exploiting it for political gain and some policy aims).  That's one of the primary underlying divisions Kilgore identifies, and he's right to call for greater examination and debate over the role it is playing.

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