Sam Smith, Progressive Review - The health care debate has come down to a struggle between greed and hypocrisy. The Republicans see health as a prerogative of wealth while the Democrats want just about anything they can call reform in the next election and have sold themselves to the insurance companies in the process. The public is clearly left out in this discussion.
Further, the Democrats are hurting themselves even more than usual. They don't understand, for example, that when they label as Nazis their opponents at fake town hall meetings, many other ordinary citizens with doubts about the Obama approach may take that personally. And when they stiff single payer, they are all but shoving progressives out the door.
And some of it doesn't have to do with healthcare. One of the town hall protesters, when interviewed later, seemed mainly concerned about the soaring number of "czars" in the Obama administration. There was a time when Democrats wouldn't think of calling one of their appointees a czar.
At the same time, there is the quality that Neal Cavuto nailed, namely that Obama is approaching this matter like a used car salesman - don't worry about the specifics of the deal, just get the customer to buy into it as fast as possible and don't let them leave the lot before they do.
Then there's the rationing controversy. The Obama crowd acts as though it's all nonsense, when in fact it's a major medical issue that should be openly discussed and not concealed under a cloud of spin. For example, rationing fan Peter Singer wrote in the New Times Magazine, "In the current U.S. debate over health care reform, 'rationing' has become a dirty word. Meeting last month with five governors, President Obama urged them to avoid using the term." Why did Obama have to warn five governors not to refer to an issue that the president claims doesn't even exist? Besides, when you commodify health care you are talking about rationing whether you use the term or not.
Further, hidden just behind the Democrats' current troubles is their assumption that "we can do it better than you can." It's there in all the regulations and controls slowing down the stimulus package; it's there in the extraordinary invasion of local control of public schools; and it's there in the health care effort.
When you don't trust people, they know it. There has been a growing snottiness about non-elite America among the liberal czars and czarinas that is playing a role in the kickback over healthcare.
Michael Lind recently offered an example
[][][] In a recent Washington Post column, Kathleen Parker quoted Ohio Sen. George Voinovich's assertion that the Republican Party is "being taken over by Southerners" to suggest that the GOP risks becoming a permanent minority party of the old Confederacy. In itself this is a legitimate point that I and many other critics of Republican conservatism have made for years. However, at Mother Jones, the blogger Kevin Drum used Parker's political argument as an excuse for all-too-typical liberal Southern-bashing. According to Drum: "There are, needless to say, plenty of individual Southern whites who are wholly admirable. But taken as a whole, Southern white culture is [redacted]. Jim Webb can pretty it up all he wants, but it's a [redacted]." Drum did the redacting on his own blog post, explaining he'd blacked out the offending text "on the advice of my frontal lobe." Drum's creepy bigotry becomes clear when other groups are substituted: "There are, needless to say, plenty of individual blacks who are wholly admirable. But taken as a whole, black culture is [redacted]. Barack Obama can pretty it up all he wants, but it's a [redacted]." [][][]
Finally, the public may not know the figures, but it knows it's not at the table, that something bad is going, something of the sort described by Bloomberg News:
[][][] If there is any doubt that President Obama's plan to overhaul U.S. health care is the hottest topic in Congress, just ask the 3,300 lobbyists who have lined up to work on the issue. "That's six lobbyists for each of the 535 members of the House and Senate, according to Senate records, and three times the number of people registered to lobby on defense. More than 1,500 organizations have health-care lobbyists, and about three more are signing up each day. Every one of the 10 biggest lobbying firms by revenue is involved in an effort that could affect 17 percent of the U.S. economy. [][][]
So here are. We're not going to get single payer. We may not even get a public option. Yet hidden behind all the uproar are a number of reforms that Democrats could pass on their own, or even with GOP help. And if the Republicans try to block the measure because of some of the items, they could be put in a separate bill and passed anyway.
The result would not be the historic, ground-breaking, earth shaking measure that Obama has obsessed over, but a modest measure improving the state of healthcare in America. Here are some existing proposals that might be included, taken from a list compiled by Joshua Holland for Alternet:
[][][] Insurance companies could no longer deny coverage to people because they've had health problems in the past, nor could they charge hugely different rates for different groups of people (premiums could only vary by age, geography, tobacco use and family size).
- The House bill bans the insurance industry's habitual practice of collecting premiums until someone gets sick, and then digging through their histories for an excuse to cancel coverage.
- Insurers wouldn't be allowed to cancel an individual's coverage for reasons other than failing to pay the premium.
- Insurers would no longer be permitted to impose annual or lifetime caps on benefits.
- Insurers that sell insufficient, cheapo plans that leave people vulnerable to medical crises would be required to disclose that fact to their customers.
- All insurers would be required to disclose how much of their spending is on health care and how much goes to costs like overhead, advertising, etc.
- If the House measure passes, individuals would face a maximum of $5,000 in out-of-pocket expenses a year, and families no more than $10,000. For poorer families, the limits would be much lower: $500 per year, for example, for a family making less than 1.33 times the poverty rate.
In 2007, Harvard researchers studied thousands of bankruptcy filings and found that medical causes played a role in more than 6 in 10.
- In the House bill, individuals making less than 400 percent of the poverty line -- $43k per year and families earning under $88k -- will be eligible for subsidized coverage on a sliding scale.
- Many small businesses would be eligible for tax credits for insuring their employees.
- All of the plans being considered by Congress make more of the working poor eligible for Medicaid by lifting the income limits on eligibility. [][][]
There you have it. A bill that could be passed in September filled with good things most of which you probably haven't even heard mentioned in the debate, thanks to all the bipartisan showboating. And the only thing odd about this is that it is a compromise being proposed by progressive populist and not by those who yammer all the time about their love for the middle.
It's not single payer; it's not a public option. But neither is it the present disaster.
