Wednesday, August 5, 2009

Democrats' Emerging Healthcare Fiasco, Part I

Note: this is a commentary, not a link to a show.

If you look closely, real closely, at the emerging Democratic healthcare “reforms”, you’re going to get nervous and you should become alarmed. The system in creation is a dysfunctional patchwork nightmare of unneccessary, over-bureaucratized, over-regulatory, mandates, tax subsidies to profitmaking insurance companies, penalties and fines, about which in part II in a few days. There is now a growing possibility that the plan has become so convoluted it will collapse under its own weight come the congressional vote. If it does pass, and the momentum is still in its favor, although the politicking of the August recess will probably determine its fate, we appear to be getting a system that is marginally improved for everyday people but so full of dysfunctions that the system will be an operational nightmare that might even fail and also be open to political attack from the right. This raises a central question for the Left now: do we continue to support reform for the sake of reform and push for the strongest public option, little of which is now even left, and other features or do we join the Republicans, for opposite reasons, and kill this monstrosity before it is born and start from scratch with a simple, efficient, elegant single payer plan. Ironically, regardless of what we do, this might be where events take us anyway.

And here’s another reason to be alarmed. These Rube Goldbergian health bills are everything the Right has always bashed the liberals for, discredited the liberal label and enabled them to dominate American politics for the past 30 years. The liberals are repeating that part of their history that discredited them and this could wreck the Democratic Party in the coming elections and make Obama a one-termer. But maybe that would be a good thing so that enough people are finally shocked into understanding how corporate liberalism keeps the Democratic Party stuck in a decades long cycle of arguing marginal issues with the Republican corporate party which results in see saw elections determined by a couple of percentage points or even the Supreme Court, or whether or not there’s an economic collapse at the time of the election. Maybe a collapse of the Democratic Party is what it is going to take for a progressive reformation within the party, or the ascendancy of the Green Party.

You can hear the discussion of these issues on this week’s Mark Weaver Show, Aug 1, now archived, with guest Tallahassee surgeon Raymond Bellamy of Physicians for a National Health Program.

The deeper I looked at the emerging legislation, the more it didn’t make sense. I swear. I didn’t realize what a mess it is. The impression I had had from the TV reports and cursory readings of the news articles was that we were on track for a much better, more coherent healthcare system. But we’re not. It didn’t make sense. How could these intelligent people be doing this? Slowly I had a revelation, that the reasons behind most of these absurdities wasn’t rational public policy, because it’s not rational, but politicized compromises designed to preserve almost in totality the for-profit middleman health insurance in this country that adds 30% to health costs in unnecessary adminstration and large profit margins , the only one in the world, I’ve heard, while trying to mitigate all of the problems this superfluous brokerage system has caused.

The responsibility for all of this, and the way out of it, lies with President Obama. Healthcare is one-sixth of the economy. This is a reform of historic proportions. It’s a major major effort and it’s hard. It requires a President in charge. Dr. Bellamy pointed out in my interview that Obama’s mistake was to hand health reform over to the congressional committees with little guidance. I agree. Congressional committees are parochial fiefdoms involved in turf wars and ego battles and subject to excessive influence from the business interests that fund their campaigns. A big issue like this requires strong, LBJ style unifying leadership from a President, and specifically a moderately detailed vision from the president of a future healthcare system. Obama has made the exact opposite of the mistake the Clintons made: they presented an overly detailed plan, derived in secrecy, to congress as a fait accompli.

And the vision Obama should have proferrered is single payer. Forget whether single payer is passable. It’s irrelevant. It should have been the foundation for the congressional negotiations. Far better for the nation through the media to have debated, and to have made compromises to a single payer plan, no matter how stinky they may have been to a lot of us, than to bargain away what the Democrats are in the process of bargaining away, whatever that was to begin with. Actually, the House, with strong LBJ leadership, could probably pass single payer by a narrow majority vote. How much better off we would have been, can you imagine?, if the conference negotiations this fall had been over a Senate filibuster-compromised for-profit system and a House socialized system. If health reform collapses we must besiege Obama to start over again along these lines, although that won’t happen. If everday people are to curb corporate power to set high prices for basic needs it is essential to have a strong, principled, committed leader as president. This sycophant Obama is not capable of that and we’re not going to change his personality. It is the great tragedy of his presidency and our country that he arrived at precisely the historic moment when genuine progressive reforms on the order of the Reagan revolution could have been enacted.

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