Simple It Should Be

Over the past year, I have talked to a fairly large range of people perched on various rungs of the socioeconomic ladder and of different ethnicity, and I must say that when it comes to health care, they are largely confused.  They want absolutely to have access to medical care when they need it without worry or hassle.  They want absolutely not to pay more than they now are unless it is for something demonstrably better--and that includes the people not paying now because they are young and invulnerable or can't afford insurance.  They reflexively proclaim, because that's what they've been taught to say, that they don't want government more involved in their health care for fear it will limit their ability to choose their own doctors, but asked whether they can choose their own doctors now and whether they know of an insurance program that allows them to do so without paying large sums, they invariably answer, "No!" and "Medicare."

In short, the Obamans had to propose a health reform bill that would guarantee that everyone has access to the doctor and treatment they need when they need them. That's all.  There are other reforms that make those two goals possible--reform of the ways doctors are paid, medical malpractice reforms, progressive tax rates to pay for the expanded Medicare program--or whatever the national health insurance program is named.

Politicians and pundits claim it is impossible to enact such a program because it is too socialistic, or liberal--many of them don't seem to know the difference--for Americans who don't want Government interfering in their lives.  In making that argument, they throw out phrases that are red meat to large swatches of an American public conditioned to salivate at the mere sound of the words.  But it doesn't take long to realize that the Pavlovian frothing hardly represents a deeply held or carefully thought out position, that it can be overcome with relative ease--with the proper program--and desire--a desire the Obamans never had.

Short, Not Sweet

The Obama released his edited version of the Senate health reform bill and from early descriptions and a quick look through, it is the abomination his worst enemies wished he would produce.  He leaves out the only thing in this whole reform drive people care about,  according to all polls--a robust public option--and he leaves in the one thing that drives everyone to distraction, if not actual paroxysms of rage--a legal mandate that everyone purchase insurance from one of the private insurance companies that continue to rip them off.  And it remains obscenely complicated.  If this thing passes, we will all be subjected to the fruits of a monumental failure of our collective political leadership--Democratic and Republican.

X is better than W[hat]

Without repeating myself, I'll call attention to the comment on my last blog from Retrieverman on the Massachusetts special senatorial election.  He's right--people are pissed at the banks; they're pissed that there are no jobs or that their job is gone next week or that people are walking away from mortgages and houses with impunity or that "too-good-to-be-true" offers from big banks to lower the interest rate on their mortgage are more of a hassle than they are worth; and they're pissed because their guts tell them that Obamacare is a fiasco wrapped in a monumental giveaway to insurance companies.  They are right.  They know that no matter how you justify it, insurance that costs them more than $5,000 a year for a family of 4 and then covers only 60 percent of costs, which the Senate bill deems affordable, is not advantageous to them.   It's amazing really, Rahm Emanuel has been so busy working to get anything passed in order to ensure the Obamacare is not Bubbacare that he has made something far worse. Now all the Obamans can do is whine that the cost of inaction on healthcare will be their ruination.  Then so be it.  

The Obamans decided at the start what they could not do--expand Medicare to cover everyone.  Indeed, they never wanted or intended to do that.  Nonetheless, many people bought the spiel called "hope," and sent the Obama to Washington.  What the Obamans didn't take into a account but the Republicans sensed intuitively--and doubtless through polling--is that it is far better to keep people hopeless and despairing, than to first raise and then dash their hopes and expectations.

Health Care X Massachusetts

The political classes most heard have declared that yesterday's election of Scott Brown to fill out the departed Edward M. Kennedy's seat in the Senate is, among other things, a repudiation of the health care bill now slouching toward denouement that would not pertain to Massachusetts in any event.   That means as nearly as I can tell that the good citizens of a state founded by religious intolerants fleeing religious persecution have voted into office a man who voted for a health care bill in Massachusetts authored by Republicans that served as a template for the Congressional bills that same senator-elect has sworn he will vote against once he assumes his seat, even though it will not affect his own state. Right.  No one will ever accuse these Republicans of consistency or intellectual integrity.

Brown's election is significant only because it cuts the Democratic majority to 59 votes, meaning they can no longer vote in a block to kill Republican filibusters. Given the sorts of vile deals the Democrats stuck to gain and hold those 60 votes, I'm not sure that losing that majority was such a bad deal.  Any time you pass a bill that satisfies no one, that doesn't meet its primary objective and that is inherently punitive, simply because you've convinced yourself that anything is better than what is, you have major problems, including ignorance.

Yet that's exactly what the Democrats were.  Now they might have to revert to a better strategy, which is to develop a simple, clean efficient bill that expands Medicare over time to include everyone and includes necessary tort and compensation reform and sufficient funding, much of it gained by taxation of the wealthy, especially the bonus babies of finance.  The Republicans, including Brown, who have declared themselves friends and defenders of Medicare, would then have to put up or shut up.    In either case, the Democrats would have something to run on that was  easy to understand.  The key for the Democrats and this means the Communicator in Chief would be to cast the expansion in a positive light--not hard.  It would shore up Medicare; it would provide health care for all without rationing or limits; it would remove a major source of stress, financial distress and early death from Americans; it would guarantee a fundamental human right.

Taking this step would take political courage of a sort not manifest in the Obama Administration, which seems intent on riding its slouching beast of a bill into the dustbin of history.

Say It Ain't So!

New York Times columnist and economics Nobel laureate  Paul Krugman, who once was insistent on the need for a "public option" in any health reform bill, on Friday, December 18, 2009,  urged passage of a health bill everyone knows is a giveaway to the insurance and pharmaceutical industries, on the grounds that it will be easier to fix this 2,000-page hoax than start from scratch.  Krugman cited Social Security as a program that started with gaps and flaws and has been steadily improved since then.  But his comparison is wrong.  Social Security's counterpart in health is Medicare.  The expansion of Medicare to cover everyone would be the equivalent of closing gaps and loopholes in Social Security.  The Senate health 'deformation' more closely resembles a Social Security privatization scheme that would require people to put a certain percentage of their income in 401 Ks or some other mutual fund or private investment vehicle controlled by one of a small number of companies devoted to managing "pension" accounts.  Once it's in place, it will be nearly impossible to change.  This bill is garbage produced because Congress can't, as a lifeguard at a local pool says, manage to provide healthcare for all Americans.  That's really sad, he says.  Indeed.  I hope Obama is being cynical when he calls this bill, which meets none of his goals, a great achievemen.  It insures 30 million out of 47 million and climbing uninsured.  It does nothing to curb insurance policy increases; rather it rewards insurance and drug companies with massive infusions of government funds in the forms of subsidies.  It turns a fundamental human right--access to healthcare--into a legal mandate that everyone purchase insurance from a rapacious company. It cuts Medicare benefits.  Iit curbs the right of women to control their own bodies.

At this point, were I a Republican, I would simply step back and let the Democrats have the Senate deformation, since it will guarantee Republican victories and resounding Democratic defeats for at least another generation , no matter whom they run.

Were I a Democrat, I would scrap the House and Senate bills and introduce an expansion of Medicare.

Senator Bernie Sanders, Vermont's erstwhile democratic socialist, told the New York Times's Sheryl Gay Stolberg, when describing his own struggle over the Senate health 'deformation,' that he was certain the "insurance companies and the drug companies will be laughing all the way to the bank the day after this is passed."  It is hard to see how that can be called reform.

[revised to get out most of the gremlins, 12/30/2009.]

Health Care Obamanation

-With the Senate's virtual abandonment of any "public option," even one of the most anemic sort, and its deep-sixing of the plan to allow people 55 to 64 to buy into Medicare if no private plans are available, healthcare reform has turned into a hoax disguised as fiasco with Joseph Lieberman, the putative independent from Connecticut  presiding and gobbling up all the attention he can get for being the paid lackey of the insurance industry.  He's ego tripping; he should be ejected from the Democratic caucus and ignored.  But the sad truth is that the Democrats, for the past 60 years a party of political cowardice, has now become a party of political cowards, although just what they fear, short of exposure of their own perfidy is hard to imagine. Note that I have called them "political" cowards, not personal cowards, since I'm sure many of them are quite brave physically.  But here they are preparing to pass a healthcare reform bill that no one in the public, except a few experts, perhaps, understands or supports because it does not include the one item a majority has consistently endorsed--some kind of  "robust" public option or the option to buy early into Medicare.

 To pander to and please Lieberman is to pass a bill only insurance companies and their paid representatives can love, but that exactly where these bills taking us.  The Democrats are so eager to claim a victory that they will pass a bill that will make things far worse for patients and institutions that serve the poor.

Afghanistan

My plan for Afghanistan is direct and to the point.

Call in Taliban leaders and tell them they can have their rocks under two conditions:
1. Produce Osama bin Laden's head on a pike.
2. We will airlift from Afghanistan all women and children and non-corrupt males who choose not to live under Taliban brutality.

After that, they are welcome to each other.