Sunday, August 16, 2009

Health Reform: What'sTo Like

The headlines today say it all: The New York Times--Obamans ready to ditch public option in favor of insurance cooperatives, a system the Office of Technology Assessment found in the mid-1990s would save not money, and health debate fails to ignite Obama base. Ignite? The Obama has correctly identified the insurance companies as a large part of the problem, proclaimed that they are 'holding America hostage.' But rather than take the next logical step and demand a system that does not permit that, rather than go on to articulate the basic right of everyone to health care and work to see that become real, he tells people that his reform will require them to purchase health insurance from those same companies. The only sop he threw to his base was a 'public option," which diehard Obamans hoped or persuaded themselves would, as insurance companies feared, win any cost competition. Now that is probably gone.

Commenting on my last entry, Retrieverman said he believes that Obama in his "heart of hearts" supports and wants a single payer national health insurance plan but doesn't think he can get there from here. Retrieverman also points out that the anti-reform campaign has been noteworthy for its vileness. That all true. But if the Obama had listened to what people told him he couldn't do, he wouldn't be where he is today. That he seems to have forgotten how to challenge and beat the odds is sad enough; that he has done so with the stakes so high is tragic.

1 comment:

Retrieverman said...

I think the real problem is that there is a serious malady at the core of the Democratic Party. It never really has the confidence to actually challenge things because within its intelligentsia and culture are the deep wounds of the Reagan "Revolution." To them, there is always this lingering suspicion that they are wrong and that there is always another Reagan or Gingrich-wannabe waiting in the wings.

Never mind that conservatism has lost most of its legitimacy with the American people. Never mind that the really scientific polls suggest that Americans are far more progressive than the policies enacted by the leadership of both parties. The Democratic Party isn't sure of itself. And that's why it concedes so much.

Now, there are lots of things that work against Democrats ever gaining confidence. One is that the upper echelons of the party have been "centrist" (right-wing) DLC followers. One of the reasons why the Clintonistas and the Obama team were able to bury the hatchet is because Obama agreed to take on Clinton era staff-- Emanuel being the best example. These people operate from a totally different framework than progressives.

The other problem is the health and pharmaceutical lobbies aren't fools. They've built up a fund-raising and thinktank structure in the halls of power that really do affect policy to the point that they actually set the way policy makers think about what is possible.

I also think that Obama actually believed his rhetoric to a certain degree. He actually thought that he could get along with the Republicans. His presidency would be post-ideological, if not post-racial. He was sorely mistaken. I also think he liked having approval ratings in the 60 percent or more range. Why rock the boat when the people love you? Of course, after this health care debacle, that is also falling apart.

That's why I think Obama conceded on single payer and maybe the public option. It's very possible that we won't actually now-- not even co-ops. The progressive Democrats in the House have banded together to refuse to vote for any bill that doesn't include the "public option" (which the Republicans and tin-foil hat crowd call "socialism." I've never heard of socialism that you had to buy.) And at the same time, you have "centrist" (right wing) Democratic Senators (Conrad, Nelson, Baucus) who don't want any public option at all. Such ultimatums mean that both chambers have set themselves up for gridlock.

The only thing that can save the public option is for the public to get involved. I would love to have single-payer, and maybe this public option can lead to single payer. But I do believe you are correct that Obama should have come out for single payer long and not worried too much about making sure the Republicans were happy.