America, Heal Thyself: Healthcare As A Metaphor For Our National Political Pathology

Are we a sick society?

Oh yeah. You betcha. That's why we need healthcare reform.

Pardon me, however, for wondering if the treatment is just as bad as the disease. At a minimum, the events of the last six months have demonstrated that we have a political system worthy of intensive care, to go along with the broken health of our society that that very political system is supposed to be fixing.

Not to mention, of course, that from obesity to factory farming to tobacco policy, it is the political system which is in large part causing the illnesses that have in turn demonstrated how ill the country's politics are.

And they are sick indeed. America, alone among the developed democracies of the world, has a singular devotion to regressive ideas, no matter how much harm they cause. This patient is in grave condition nowadays, its body abused severely by three decades of regressive debauchery. Here's the unfortunate diagnosis:

SEVERE OSTEOPOROSIS: The Democratic Party seems permanently fixed in a bent-over posture. This is, of course, quite handy if you primary function in life is getting screwed by Republicans, especially with their closeted penchant for, ahem, less conventional forms of physical relations. However, for the national health, this is a disaster. Even when Democrats win, they remain well trained as losers. Remember what George W. Bush got accomplished with bare majorities in Congress, or none at all? Democrats now have massive congressional majorities and some dude in the White House with a D after his name too. And yet they've done nothing for nearly a year now. Even Saturday Night Live is joking about this. The guy portraying the president brags about his key accomplishments so far: "jack" and "squat". And these are the best of times, ladies and gentlemen. Partly due to the natural order of American politics, but especially due to their own fecklessness, the Democrats are going to get clobbered in 2010 and 2012, barring a miracle. At that point, the present inactivity of the government will look by comparison like a six-ring circus cranked out on speed - with a sound track by the Ramones, played at 78.

TESTOSTERONE-INDUCED HEART FAILURE: Republicans, on the other hand, have no such problems. Where Democrats have curved spines, theirs are ram-rod straight and elephantitis-sized. Where Democrats have (or had) a heart, Republicans have instead just had a cashbox installed in their chests, the better to directly receive donations from all their favorite corporate puppeteers. This combination has done more to put the American patient in critical condition than anything in its life history. If it's necessary to tell people that President Obama wants to kill their granny in order to block profit-reducing healthcare reform, no problem. If it helps to turn former ally Saddam Hussein into a Hitler-like monster in order to grab his country's oil, the GOP is your man. Having audacity in directly inverse proportion to anything remotely resembling compassion is always a really dangerous condition. Call it the Republican Disease.

BRAIN-DEAD VEGETATIVE STATE: But who in the world is out there believing this kinda shit? I've had decades now to come to terms with the stupidity of Hillbilly America, and I just can't. This whole 'rationality' thing that I've got going, and that I inherited from the Enlightenment figures who founded this country, keeps getting in the way. How can people who are so insane that they believe Obama is a Muslim-terrorist-socialist-fascist-alien-America-hater actually hold down a job? How can they be literate enough to paint their hate signs and then non-comatose enough to navigate their way to congressional town hall meetings? How can they be knowledgeable enough to even reproduce? The answer, of course, is that it is not about intelligence at all. The biggest single lesson I've learned about politics this last decade is that it is nine parts emotion and one part rationality. On a good day. It's not that these people can't think and learn and comprehend. Indeed, as Noam Chomsky long ago pointed out, start talking with them about sports or celebrities, and they will blow you away with all the arcane data stored between their wax-encrusted ears. But for too many Americans, emotions trump rationality, and none of them as powerfully as fear. If you're scared enough, you can dismiss any empirical reality, however twisted a pretzel you have to become in order to accomplish that. And Americans are very, very frightened. And, hence, very, very stupid about politics. Did I mention 'very'?

SOCIOPATHIC PERSONALITY DISORDER: To me, the most astonishing aspect of healthcare 'reform' is the degree to which we have unflinchingly normalized the greed-driven, self-serving, me-first(-and-second-third-and-last) logic of the legislative process, to the point where we don't really even notice it anymore. Stop and think about it for a second. If you didn't grow up with it all your life, you'd be outraged by the simple fact that everyone has congregated in Washington these days for the sole purpose of making sure that they continue to live the life high by profiting off your lack of health. Doctors, hospitals, pharmaceuticals and especially insurance companies have now mustered literally six lobbyists for every single member of Congress, prowling about the town all for one purpose only. And, not only is that purpose not to make sure you have better health, it is quite often to make sure you have crappier health. It doesn't really matter either way - it's purely about profit, and often completely parasitic profit at that. And 'it doesn't really matter' says it all, except that we've become so used to it we don't even blink anymore. But, simply put, the legislative process surrounding healthcare policy is not remotely about health. Health is an irrelevancy. If it could be included along with monster-size profit-taking predations, great! No one would object. But if not, not. Dump it. Who cares? It's all about the Benjamins. Everyone is just there with their knives and forks sticking the bleeding pig. If there is a better portrayal of sociopathology out there, I'd like to see it. We are, indeed, a truly sick society. But it is our political disease that drives our physical infirmities.

Meanwhile, it looks like a healthcare bill now has a better-than-even chance of emerging from Congress and being signed into law by the president. At first glance, that's fairly monumental. Presidents have been trying for a century to fix this policy cesspool of stupidity, wherein Americans spend fifty to one hundred percent more than any other country on their healthcare, only to be the only one of them lacking universal coverage, only to be rated 39th best on the planet by the World Health Organization, and only to have life span, infant mortality and disease prevalence statistics for which you'd have to be Zimbabwean to be jealous. So, woo-hoo, eh? Barack-o-rama appears about to be able to accomplish the impossible.

On closer examination, however, it is - how shall we put it? - rather less than clear that that is what's happening here. Let's face it, you could run a bill through Congress appropriating a couple million bucks to mail a Band-Aid out to every person in America, and call that healthcare reform. Technically speaking, you wouldn't even be lying. And so, at the risk of seeming overly pedantic, the Democratic Congress and president are going to have to produce something more than any old bill with the label "healthcare reform" pasted on it if they want to win my admiration.

How about this one? Well, of course, there isn't 'one' yet, which is part of the problem. There are five bills, produced by five committees. And then there would be the president's emphatic minimal requirements for the legislation too. Would be, that is, if only he had them. Haven't seen any of those puppies floating around yet. That said, my guess is that the final bill will look a lot like the thing Max Baucus put together in the Senate Finance Committee. That, in itself, is lame, because this is a bill written to appease Republicans and right-wing Democrats like Baucus. Of course, I could be wrong about the final version. Nancy Pelosi has said that the House will not be on-board for a healthcare reform bill that does not include a public option. You remember Nancy, don't you? She's the one who promised us that Democrats would end the Iraq war if they gained control of Congress in the 2006 elections. One of those two things did in fact happen.

The other reason I expect a sorry excuse for healthcare reform coming out of Congress is simply that both the Clinton decade and the last three years have now left me well-trained, I regret to say. I've learned that we always lose, when it comes to American politics. Even when we win.

So right now, I'm not sure I know whether I'd rather see the bill I expect to come out of Congress succeed or not. It does include some good provisions, like preventing insurance companies from rejecting applicants, or from ditching subscribers when they start making claims rather than just paying in premiums.

But this is the moral equivalent of painting a smiley face on a 100 ton bomb. The insurance companies are the problem. It's sickening enough - quite literally, of course - that these predatory corporations are not being taken out back and shot dead. But do we also have to even walk away from a public option that people would flock to because of its far superior value and dependability? And then, on top of that, do we have to listen to these same monsters lecture us on the superiority of the private sector over the constant failings of the government? And on how competition and market economies are such wonderful things, except when they actually exist? Moreover, I suspect that the plan that will emerge from Congress will probably loot Medicare and Medicaid, will do nothing whatsoever to control runaway medical costs, will leave tens of millions of Americans still uninsured, will take half a decade to kick in, and will add even more to the already massive pile of debt we are leaving our children to deal with. Given all that, I'm not at all sure I'd prefer to see it pass than not.

Here's an alternative scenario. It might smack too much of progressive hallucination, but we can still dream, can't we? Or did that go out the window too, along with habeas corpus?

What if the Republicans in the Senate blocked passage of the current bill on a filibuster, crushing the signature legislative goal of the Obama presidency? What if Mr. Really-Smart -But-Not-So-Wise got pissed off for the first time in his life, looked over the edge and into the abyss of his failed one-term presidency, didn't at all like what he saw, and then started playing hard ball, throwing elbows, naming names, and treating his and America's enemies like they were - golly, could it be? - actually enemies? What if he and Democrats in Congress wrote a real healthcare bill, one that was really about providing health to Americans, not wealth to corporations? What if they actually used their majorities and their presidency to make it law, rolling over a Republican objection to their use of the reconciliation process as an end-run to a Senate filibuster, just like Bush and the Republicans did to Democrats all across the last decade?

Now that would certainly make losing on this current go-round more than worth it.

But, of course, for that to happen, Democrats would actually have to have some guts.

Unfortunately, 'Democrats' and 'guts' are two words that have not been used in the same sentence - other than in opposition to each other - for nearly fifty years now.