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Zero Public Option + One Mandate = Disaster
Not long ago, the most prominent supporters of the public option were touting it as essential for healthcare reform. Now, suddenly, it's incidental.
In fact, many who were lauding a public option as the key to a better healthcare future are now condemning just about anyone who insists that the absence of a public option makes the current bill unworthy of support.
Consider this statement: "If I were a senator, I would not vote for the current healthcare bill. Any measure that expands private insurers' monopoly over healthcare and transfers millions of taxpayer dollars to private corporations is not real healthcare reform."
That statement is as true today as it was when Howard Dean, former chairman of the Democratic National Committee, made it three months ago in a Washington Post op-ed. But now, a concerted political blitz is depicting anyone who takes such a position as a menace to "real healthcare reform."
After devoting vast amounts of time, money, energy and political capital to banging the drum for the public option as absolutely vital during 2009 and through this winter, countless liberal organizations and prominent Democrats in Congress have made a short-order shift.
You are now to understand that the public option isn't essential -- it's expendable. And all of the sudden, people who assert that a public option is a minimal requirement for meaningful healthcare reform are no longer principled -- they're pernicious.
This dynamic goes way beyond the routine malleability of political positions. While the whips crack on Capitol Hill, what we're seeing is a stampede of herd doublethink.
*****
I continue to believe that guaranteed healthcare -- a.k.a. single-payer or enhanced Medicare for all -- is the only way to solve this country's enormous healthcare crisis. But early last year, before the public option shrank and shrank some more and then disappeared under the bus of the Obama administration, it appeared to possibly be a significant step forward.
But the White House, even while claiming to want a public option, was cutting deals with the pharmaceutical and hospital industries while ditching the public option. For those who doubt that the administration engaged in double-dealing to such an extent, I recommend the March 16 article by Huffington Post writer Miles Mogulescu, "NY Times Reporter Confirms Obama Made Deal to Kill Public Option."
A postscript from Mogulescu voices a broader outlook. I'll quote a couple of paragraphs here:
"Whenever I write blogs which are critical of Obama and Congressional Democrats for making corporatist deals, I get numerous comments from people who believe they are progressive but say they will never vote for Obama or Democrats again, that they will stay home at the next election, or that they will vote for small third parties who have no chance of winning. It's not my intent to encourage those views. Do people making these comments really think bringing Republicans back to power would make things better? . . .
"Progressives need to have a sophisticated and nuanced relationship with elected Democrats. After the 2008 elections, too many progressive organizations demobilized believing their job was simply to take orders from the White House to support Obama's agenda, whatever it was. That was a mistake. It's equally a mistake for progressives to overreact in the opposite direction and think they can abandon electoral politics and do nothing to prevent the Republicans from regaining power. What's needed is a powerful grassroots progressive movement to force elected officials to do the right thing more often and to counter-balance the power of big money in politics. The periods of progressive change in American politics, like the Progressive Era, The New Deal, and the Great Society, have come when strong progressive movements have forced elites and elected officials to enact somewhat progressive legislation."
The dynamic now in full force on Capitol Hill was aptly described by Dean in his Post op-ed midway through December: "In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform healthcare."
A week after Dean's article, the Senate approved the healthcare bill that is now on track to be "deemed" by the House -- with the avid support of Dean and numerous other public-option enthusiasts, and also for that matter with the support of Rep. John Conyers and many other single-payer enthusiasts (including, as of Wednesday, Rep. Dennis Kucinich).
The quality of the Senate healthcare legislation hasn't improved in the three months since Dean condemned it. What has gone over the top is the cacophony of voices and pressures to tout doublethink as virtuous pragmatism.
*****
But there are big problems with skipping lightly past the absence of a public option in the current bill. And none is bigger than the reality of the individual mandate in the legislation.
It's remarkable and sadly revealing that boosters of the bill have scarcely mentioned -- much less publicly come to terms with -- the dire implications of a nearly enacted law that requires people to have health insurance and offers no option other than further enriching the private insurance industry.
Last year, when the subject came up, progressive supporters of the White House's general approach were quick to offer assurances that a public option would mitigate the unpleasant aspects of mandated coverage. After all, the story went, people could select a nonprofit government-run entity for insurance coverage rather than being forced to choose between corporate insurance policies.
But now, if the pending bill becomes law, people will be forced to choose between corporate insurance policies.
Meanwhile, all the hype about how 30 million more Americans "will be covered" fails to deal with the quality and cost of their purported coverage, much less how much real access to healthcare will actually result.
For many, the available coverage would be bottom-of-the-barrel quality -- and even then, given thin personal finances, would cause added strains to pay for premiums. In the absence of public-option health insurance run for purposes other than maximizing profits, the built-in unfairness of an individual mandate becomes magnified.
What's more, the very concept of healthcare as a human right will be fundamentally undermined by placing the health-insurance burden on individuals. Many who receive government subsidies will routinely struggle to make ends meet, while making do with shoddy health plans as part of a new configuration of healthcare apartheid. And, inevitably, the extent of government subsidies will be vulnerable to attacks from politicians eager to cut "entitlements."
On a political level, the mandate provision is a massive gift to the Republican Party, all set to keep on giving to the right wing for many years. With a highly intrusive requirement that personal funds and government subsidies be paid to private corporations, the law would further empower right-wing populists who want to pose as foes of government "elites" bent on enriching Wall Street.
With this turn of the "healthcare reform" screw, the Democratic Party will be cast -- with strong evidence -- as a powerful tool of corporate America. But the Democrats on Capitol Hill and the organizations eagerly whipping for passage are determined to celebrate the enactment of something called "healthcare reform."
*****
"When I use a word," Humpty Dumpty said, "it means just what I choose it to mean -- neither more nor less."
"The question is," Alice replied, "whether you can make words mean so many different things."
"The question is," Humpty Dumpty responded, "which is to be master -- that's all."
Many well-informed and insightful people are now hoping that the current healthcare bill will become law and then lead to something better. But few backers want to dwell on its requirement that everyone get health coverage from the private insurance industry -- a stunning, deeply structural transfer of humongous power and wealth that would greatly boost the leverage of an already autocratic corporate state.
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190 Comments so far
Show AllAnything less than Medicare buy-in for all is just jive, and is no reform at all.
That system is already in place, a huge plus.
The insurance industry should have nothing to do with the delivery of medical services, and the present bill, such as it is, appears to lock them in even tighter, and forever.
Obamabots keep reciting the mantra that Obamacare is a baby step toward real healthcare reform while they fail to acknowledge that in addition to not achieving any of the 8 goals for healthcare reform that Obama articulated one year ago, Obamacare will 1) make a fragmented system even more fragmented, 2) further delay retirement for millions of baby boomer, thereby further diminishing job opportunities for young Americans, 3) increases taxes on workers, and 4) increases the cost of health care.
Obamacare is not a baby step forward, it is a giant leap backwards.
Add Obamacare to the Democrats' 21st century legacy...nuclear industry corporate welfare, enabling too big to fail banks to continue to grow, expanding the Ir-Af-Pak occupation...
Now, tell me again why I should vote for ANY Democrat?
"Now, tell me again why I should vote for ANY Democrat?"
I can't tell you why anyone would, but the democratic party thinks you will. As Rahm succinctly stated the administration's position: Progressives are retards.
With that in mind, why wouldn't they expect us to vote for them.
Mr. "more intelligent" Obama thought that the election of Scott Brown in Mass. was an indicator that the party needs to move further to the right?
Man...this guy is such a fuck-up on everything he touches (at least as far as doing what "the people" want), he makes Bu$h seem like a shining light (if that's possible.)
raydelcamino
You left out 5)decreases the access to healthcare further for those on Medicaid 6)where do the newly "insured" find all these new Doctors/Nurses/etc 7)makes it absolutely certain that the people you needed to obtain Single Payer Health Care will oppose ANY form of government mandated or run health care for decades.
"Now, tell me again why I should vote for ANY Democrat?"
Damned if I know, but if you do there won't be any wait for you at the voting machines. You will be lonely.
Veritas, I live in Texas too (east Texas) and even if the dems. were to pull off something that truly benefitted the people, these people around here would fight them tooth and nail. I constantly hear about this healthinsurance bailout bill being touted as "socialized medicine" by the yokels.
Some local businessman in Tyler yesterday invited KKKarl Rove to visit the city, and the dumbfuck people were falling all over themselves trying to get their picture taken with the piece of shit. It was sickening I tell you...sickening!!!
aussidawg
"I constantly hear about this health insurance bailout bill being touted as "socialized medicine" by the yokels"
I got this off another string and I can't wait to use it the next time someone says "Obama is bringing us socialized medicine" I don't want socialized medicine of course but tyhey don't know the difference between that and Single Payer.
"Conservatives oppose the bill for the wrong reasons, because they think that it is bringing us socialized medicine. WOULD THAT IT WERE! "
I saw the Tyler paper front page with jolly old Karl's picture big as life. And you could get a signed copy of his book too!! Regugitation required!
Veritas, my mother has worked in nursing since the late 1040's and practices to date. She, of all people, agrees that the time has come for "socialized medicine."
She is a graduate of UT Health Science Center in San Antonio with a Masters in Nursing. She begin her career at Brackenridge in Austin, and has seen the devolution of medicine and escalating prices resultant from the for profit system we now have. She is (now) a conservative politically but argues strongly for universal healthcare. She has said herself there is no alternative.
I don't understand why some people have a problem of turning our corrupt health insurance industry into a service that will save money while providing *EVERYONE* equal but high quality care. I guess our population has been that dumbed down, where they don't know or care what is good for themselves.
Only expected to be shortCHANGEd by Obama, so I am not surprised or disappointed.
I too believe that some form of public, single-payer option is the minimal requirement for anything worthy of being called "Health Care Reform". And I was disappointed that Kucinich - whom I was coming to regard as the last principled member of the Senate - switched his position. I have to say, I hope this Frankenstein's monster of a bill fails to pass. While Republicans will claim victory in thwarting Obama, they can also be blamed for having sabotaged meaningful reform and once again screwing the average citizen. Perhaps some progressive leader (are there any?) could use this to advantage.
Actually, I'm a bit surprised that Republicans oppose this bill, as it is a massive corporate windfall and is the first example I can think of that actually legislates the transfer of wealth from citizens to corporations.
Also, I was disturbed the other day to hear Obama urging Congress to "have the courage" to pass this bill. Where was his courage on single-payer - which he used to know was the right thing? Had he pushed for single-payer, could he possibly have faced more political opposition than he does now? Has he actually benefitted from whatever corporate money and support he may have gotten for compromising?
Re: the Mogelescu quote, "What's needed is a powerful grassroots progressive movement to force elected officials to do the right thing more often and to counter-balance the power of big money in politics." Hear, hear!
But where is this movement? I can't find it. How can a lowly average citizen such as myself get involved and become a part of a meaningful progressive movement?
-"Actually, I'm a bit surprised that Republicans oppose this bill, as it is a massive corporate windfall and is the first example I can think of that actually legislates the transfer of wealth from citizens to corporations."
Let me try this one. The Republicans are opposing this one because it is a win-win-win for them. Medically, The bill, most agree, is terrible. It will have terrible results. What good points it has, most don't kick in for years, and there is a big down side, which kicks in immediately. Costs will still go up for patients and the sick will still have to fight to get coverage from their mandated insurance company.
Politically, the bill is easy for the Republicans to run against. It has many flaws, many put in there by Republicans, it is highly unpopular with the public, and will quickly be seen to be financially difficult for the poor and middle-class and possibly even unconstitutional. If it passes, it does so at great political cost for the Democrats.
Thirdly, while opposing the bill, the Republicans know that it will pass anyway, and will greatly profit the insurance/pharma/medical industries. These are sought after contributors to the Republicans, just as they are to the Democrats. Being seen to oppose the bill, while allowing the lobbyist written law to pass will curry favour with the lobbyists even as the Republicans reap the dividends of publicly opposing a bad bill.
So, to re-cap, the Republicans, albeit with crocodile tears, will have a field day pointing out the bill's shortcomings for the sick, it is a strong polorizing issue to run on next election, putting the Republicans on the right side of public opinion, and finally doing all this still ends up maximizing profits for the corporate backers who support the Republicans.
I think most Repugs secretly love this bill too--but the question is--will they help to kill it? I hope they do.
They are assholes too but if they can kill this bill and put the lights out of the Obama/Dem Party for good--that will make it worth it. Then Progressive Indies can take out the Repugs later. It will be one down, one to go.
I say allow the Repubs to destroy the Dems.
Will it happen?
>>Actually, I'm a bit surprised that Republicans oppose this bill, as it is a massive corporate windfall and is the first example I can think of that actually legislates the transfer of wealth from citizens to corporations.
They only APPEAR to oppose it because they are not the majority party and recognize trhe Public hates this thing. By appearing to be against it, they hope to curry favor with the Public in the next election.
Were they the party with a majority in the Congress, The Senate and holding the White House, I suggest a bill very like this one would have been proposed.
See Bushes Drug Care bill.
The Republicans get an A+ for strategy, no matter who is grading them.
Obama will be happy to see Republicans control Congress after the 2010 elections since he will no longer need to fib when he says Republicans are obstructing his agenda.
Obama will continue to do a great job of pleasing his corporate paymasters irrespective of what party controls Congress or who sits on the Supreme Court.
Good article Norm.
"The Democrats are digging their own grave with the passage of this fundamentally corrupt and compromised bill."
Hardly. They get material support when they pass the bill. Subsequently, Congress incumbents have a high chance of retaining their seats, regardless of taking positions that lack popular support. Gerrymandering helps. if they somehow do lose their seats, there is always a nice corporate/ lobbyist/ fellowship job awaiting. Keep a future watch on the media to see where retiring or defeated members of congress or the executive branch go. Their close relatives attain similar remunerative and recession free jobs, which is unlikely if they take populist positions.
Neither party risks much with passage of these bills. That is why they continue doing it.
Every time you or I vote for an incumbant we contribute to the problem, not the solution.
Too true, sea salt.
When the curtain is puuled back, it reveals a very deep and ugly pit of corruption.
"The Democrats are digging their own grave with the passage of this fundamentally corrupt and compromised bill."
Ahh, but they too shall rise again after a couple of election cycles. (Unlike the poor suckers who really will be sent to their graves.)
Visiting Professor
We are in absolute agreement.
When the people that these taxes are going to hit...and its NOT the rich as you know, all the money in the world won't help anyone retain their seat. These folks are living in a dream world cocoon.
There will still be 30 million Americans without healthcare, actually more unless you use a static demographic. They forgot to mention that.
That's why they scheduled it to kick in after the next presidential election. They are counting on the average sucker not to figure out what's going on until it's too late.
IMHO ... I'm afraid it'll be at least another 40-50 years before healthcare/health insurance reform is actively persued again. We ... WE THE PEOPLE ... have unfortunately lost a true opportunity to change the direction of our supposed democratic republic.
In 40-50 years half of the readers of this post will have died of old age and the other half will be living in third world poverty thanks to Obamacare, Obama's pandering to the banksters, war profiteers and nuclear industry, and Obama's other supply-side actions.
The opportunity wasn't lost, it was stolen by Barack the Backroom Betrayer and his corporate mob.
Pelosi: We need to pass this now, or we won't get another chance for many years, maybe decades, there will be nothing we can do!
Pelosi: Once we pass this, we'll get right to work on improving it, nothing will stop us..
It's called 'compartmentalization' - how to hold 2 opposing thoughts in your head at the same time..
Well said, Mr. Solomon. I think you pretty much nailed all the important points about the "Health Insurance Company Perpetual Subsidy Act"
But there are two other points I think merit consideration:
First, this bill, or any bill dealing with only with access, does not address the underlying issues: cost of hospitalization, cost of doctors' fees, cost of doctors' malpractice insurance, cost of drugs, lack of sufficient doctors, lack of sufficient non-doctor healthcare givers and cost of malpractice trial damage awards.
Second, while I applaud your 'call to action' for a grassroots progressive movement, I think it's too late for that. The only chance we have left, and I think it's a slim one at that, is to force a constitutional convention and rewrite the Constitution, We're past grassroots movements being effective or third party movements for that matter, we need to do something really fundamental or the next steps will be really ugly.
I feel your pain... really. No BS.
I started agitating for a new Constitution 2.0 over a decade ago. Unfortunately, we've gone too far over the crest for it to happen now. I honestly believe that we have no options left at this point but to wait for the straw that breaks the camel's back and watch the revolution happen.
If the people could manage to get a Con-Con called, what would happen to prevent the current scumbags, whores, cheats, liers, gamblers, and thugs from writing the new constitution?
How about this... should we allow lawyers, cops, judges, etc. to be involved in the Con-Con? Before you knee-jerk an answer, think about it... should the people responsible for enforcing the laws be allowed to MAKE the laws?
It's easy to say we need a Con-Con... but be careful what you wish for.
I don't think this country can be repaired. And they'll never permit a constitutional convention. More likely, the greed that drives the war machine will eventually bankrupt us and the country will disintegrate in the same way the Soviet Union did.
Yup, that's my guess too as to what will happen to Amerika.
And, the sooner, the better.
I'd really like to disagree but you're probably right. A CC would certainly attract all the bottom feeders you mention but my thinking is that the context of a real chance to address the fundamental problems we all see would also bring out the real thinkers and doers who have long ago abandoned politics.
Look, at worst a CC would accelerate the revolution, at best it might prevent one. I don't see that we have much to lose at this point.
Until the US experiences and unprecedented epidemic of anti-incumbant fever, healthcare and everything else in America will become more anti-worker and pro-corporate.
Everytime you or I vote for an incumbant you contribute to the problem and hamper the solution.
Yes - real health care would include access to nurse practitioners, support for family doctors, cost control on drugs, medical supplies and procedures, best practices based on patient outcomes. Right now it is all profit driven. That leads to bypassing simpler treatments when expensive tests and procedures are available. When it is a matter of life and death, the profit motive morphs into extortion.
This bill goes further and mandates extortion. It requires that everyone pay for "protection", just like the Mafia does to a local Mom and Pop store. There are few quality control or cost control requirements on the insurance products. With a few exceptions (pre-existing conditions, for example) they can charge what they want and restrict coverage at will. The subsidies for low income people are a good thing, considering, but very limited in size and scope.
I know sincere people who believe we must pass this bill and then work on fixing it's deficiencies. I disagree. I predict that people of moderate means will be so strapped by their protection payments that they will react against any government health care.
Let's have Medicare for all. Then if there are problems, we can work on fixing that!
Joe
What you said.
Plus, remember that all the insurance and subsidization in the world won't help you if you can't see a Doctor.
And this bill addcress's absolutely none of the problems you delineate in your first paragraph. Not one. Nor will it ever.
Well, after over a year of procrastination, double-speak, and posturing, what do we get???
NOTHING - but a massive giveaway to the Insurance Industry at the expense of all the American citizens, especially those who can afford it least!
And Congress has the NERVE to call this healthcare reform!!!
There's no possible way to deny it now: Our Congress is totally CORRUPT!!!!!!
The only way Obama can prove he isn't part of this CHARADE perpetrated against the American people is to VETO THE DAMNED THING!
Obama is not going to VETO a bill he worked overtime to get passed. It is exactly the bill Obama and his insurance and drug industry backers wanted all along.
The 2700 page bill was written by the industry and is loaded with what attorneys call weasel clauses that create a heads I win, tails you lose relationship between the industry and the victims (you and I).
Unfortunately, Obummer is the most corrupt pol in DC
This legislation is a sack of sh-- and the word isn't sheep.
AD
AD
HEAR,HEAR!!!!
Stepping back and taking an overview of the global political and natural climate, the straws that the camel is carrying are 'straw dogs' of centuries of western conflation of life defined as being valuable only if one becomes 'lord over'- overlords of ... what exactly? the right to usurp not only the origin of life, the earth, but precisely the way in which life is thought about - increasingly no-think.
no thank you on the no think
the straw dogs will break the camel's back
Lovely way to put it. It is western life and respect only for things..rather than say relationship, or animals, or nature or the unknown- especially the unknown. Straw and a little clay.
Only the lowest of scum to America would vote to betray the American people this way.
Sure we will get to "universal coverage" this way. You betcha! Do they really tkink this will stand after they pass it.
Political suicide for nothing. Lemmings live.
sierra7
The passage of the current health bill will be another step in the progress of crushing American labor to a world level playing field.
In summer of 2009 I said "health care reform" would be dead by Christmas.
I was right.
Both parties are corrupt. The American people do not have the will to change our system.
We haven't yet matured enough to distinguish between, "life-style" and "Quality of Life". Until that distinction is made we will know the "price of everything" but "the value of nothing."
What if they gave an election and nobody came?
"... crushing American labor to a world level playing field."
Actually BELOW most of the rest of the world in terms of public health care which will then need to be bought down to USan level in order to accomodate the globalized labor market. They're working very hard on the nearest (Canadian) threat to that agenda already and have been for some time now.
Interestingly, some former major players (e.g., what's left of the North American auto industry) are opposed or at least ambivalent, but their influence under the current global financial-economic system is much diminished.
Seems like all the progressive locksteppers here are eager to see healthcare go down this time. Not the folks who are currently not covered and would be if the bill passes, however. Not the folks with pre-existing conditions. I see no reason to regard the present reform effort as antithetical to Medicare-for-all. It is different from that system; it lacks cost controls; it increases profits for insurers. Adoption of the present bill does not preclude expanding Medicare in the future. Sometimes it seems like progressives (since they have all the right answers) are never willing to make the concessions required to actually gain power. Too bad--ideas from the left have power--it's just that people can't stomach going against values they have imbibed over the last three generations. That takes time.
Values? What values? You mean like an insurance industry that provides value-negative skimming of private profits with no health care benefit whatever for anyone? Even Adam Smith would have serious problems with that version of "free enterprise capitalism."
No, values like the infallibility of free markets and the wastefulness of government programs. I do not share those values, but, thanks to fifty or more years of propaganda via the MSM, they have taken root within the popular mind. You cannot undo those values in a couple of years, not after a lifetime of only hearing one side.
Those aren't values. They're inculcated myths. And they won't ever be undone by pandering to their promoters.
Quack Quack Quack Quack. What are you, the new Tom Friedman? I find it telling that you sidestep the issue of a public mandate that forces ("provides" in double-speak) individuals to purchase a product from a monopolized industry. You perfectly illustrate the so-called "progressive" that would feel quite comfy with an inside the beltway job licking the heels of the powerful. As far as "progressives" being unwilling to make concessions required to actually gain power. I would ask, when does conceding become acquiescing? Bill Clinton, and the DLC sent the Democratic Party down the long road of acquiescing to the big money powers of Wall Street, in an act of triangulating power, and look at the absolute disaster the Democratic Party is today. The last twenty years has been nothing but "progressives" making concessions, or making deals with the devil. It is ironic, that your major point completely misses that fact, and especially in light of what the author points out i.e. that the public mandate isn't just wrong on principle, but absolutely stupid politically.
Being "for" Obamacare does not mean you are against single payer or even that you are impeding it. You settle for the small victories you can get--that's all. You and many others imagine that if healthcare reform fails completely, then it becomes more likely that your plan will win out in the end. I question that assumption. Did electing Clinton mean that we put off real reform for another decade? Not really. Electing Clinton meant that one more Alito or one more Roberts did not sit on the Court. Change comes slow in this country. With the exception of the Great Depression, it always has. So why do so many progressives imagine things are different now?