The Obama administration and the Congressional Democrats are finally hitting the inevitable wall that was bound to confront them because of the president's congenital inability to be a bold leader, and because of the party's toxic decades-old decision to betray its working class New Deal base in favor of wholesale corporate whoredom.
The wall is health care reform, which both Barack Obama and the Democratic Party had hoped would be the ticket for them to ride to victory in the 2010 Congressional elections and the 2012 presidential election.
But you cannot achieve the twin goals of reducing health care costs and providing access to health care to 50 million uninsured people, while leaving the profit centers of the current system--doctors, hospitals and the health insurance industry--in charge and in a position to continue to reap profits.
Watching President Obama address the American Medical Association was a cringe-inducing experience as he assured the assembled doctors he was not going to expand Medicare payments "broadly" to cover all patients, or end the current "piece-work reimbursement" system that has so enriched physicians, or as he told them that savings would "not come off your backs." It was particularly cringe-inducing when he told the AMA that he knew that making money was not why its members were in the profession, saying, "That is not why you became doctors. That is not why you put in all those hours in the Anatomy Suite or the O.R. That is not what brings you back to a patient's bedside to check in or makes you call a loved one to say it'll be fine. You did not enter this profession to be bean-counters and paper-pushers. You entered this profession to be healers--and that's what our health care system should let you be."
Oh please. I know there are plenty of wonderful doctors who are dedicated to their patients and to patient care. But I also know plenty of doctors who have told me how half their classmates in medical school were mainly in it for the money, and that study halls and cafeterias of American med schools echo with the conversations about what can be made working in particular specialties. Not to mention the corrupt and insidious profit-sharing arrangements doctors enter into with labs, CAT-Scan and MRI test centers, pharmaceutical companies and other businesses, to earn profits by sending patients for unnecessary tests and treatments.
One can only imagine what he would be saying to insurance industry executives about his "reform" plans.
Because Obama and Congressional Democrats are unwilling to cut themselves off from the lucrative campaign-funding bonanza that is the health care industry, they cannot address seriously either the cost or the access crisis that plagues health care in the US, and that makes health care in this country cost 20 percent of GDP--twice what it costs in any other modern nation on a per capita or GDP basis, and that still leaves one in six Americans without ready access to even routine health care.
The answer to this crisis is obvious: a single-payer "socialized" system, in which you still have private doctors, and private or publicly run hospitals, but where the government sets the payment rates for treatment, and provides all compensation to health care providers.
If Democrats in Congress were serious about health care reform, they would immediately order the Congressional Budget Office to conduct a cost study of instituting such a program--a study that would include an estimate of the savings to individuals and employers if health care costs were lifted entirely off their backs (because obviously it would require considerable new government revenue to fund a single-payer program, but that's only half the equation--the other half, the savings, is simply ignored by critics and doomsayers on the right and in the health care industry). Instead, Obama and the Democratic Congress are studiously avoiding even allowing any mention of the single-payer option. (A New York Times report today on the various health care plans working their way through Congress, and coming out of the White House, completely blacked out any mention of a single-payer bill in the House authored by Rep. John Conyers (D-MI), chairman of the House Judiciary Committee, which the House leadership has prevented from even getting a token hearing.)
Obama's unwillingness to lead on this issue will doom his health care plan. There is obviously no way Congress is going to shake off its corrupt leech-like attachment to corporate sponsors and their cash-spreading lobbyists, but had the new president wanted to make a historic mark and cruise to victory in 2012, he could have, like President Lyndon Johnson before him in his campaign for Medicare in 1965, put himself solidly behind a single-payer plan and made the case that it could cut America's collective health bill in half while opening the door to every American.
Instead, he's likely to end up with worse than nothing--that is with even more uninsured Americans come 2012, and with health care costs moving up as a share of GDP--and could well find himself out of a job. The policy that his handlers, like White House Chief-of-Staff Rahm Emanuel, had conceived of as Obama's ticket to re-election, health care reform, could well prove instead to be his Waterloo.
That is if his adoption of a policy of expanded war in Afghanistan--another example of a failure to lead--doesn't prove to be this president's bigger policy disaster.