It would seem that meaningful health care reform has been killed in the Senate. Really and utterly destroyed. Joe Lieberman, Bill Nelson, and a few other conservative "Democrats" have said that they will not vote for the bill as it stands. Let us take a brief detour through the history of this process.
Medicare was created in the U.S. in 1965 under Lyndon B. Johnson. It is offered to those who are U.S. citizens or have been living as legal permanent residents for 5 years or more, who are 65 and older, and have been paying taxes for Medicare for at least 10 years. Medicare is a single-payer system, and in fact is the largest single-payer system in the world, covering 43 million Americans in 2007. The program has been under constant scrutiny since its inception, and indeed has a lot of problems - one of the largest being huge fraud issues. Medicare has been updated several times since its creation, and largely has gotten better by most measures of such things. Conservative opposition has always been the strongest, and typically fall along two pillars - 1) It's too expensive; and 2) It leads to socialism.
As to expense...yes, I'll give them that. The Medicare system needs significant overhaul to cut costs and perform audits on treatments. Clean up the program, and you will probably see significant savings. Al Franken has made this a huge talking point - the guy is very much in favor of Medicare, but recognizes it needs significant work.
As for the second pillar, that of fear-of-socialism...well, I offer this to the conservatives. If you really and strongly are opposed to all "socialized medicine," and are so concerned about principles and values as you claim, then propose an amendment to eliminate Medicare. Get rid of it. Tell all your constituents that Medicare is "evil" and "socialized" and is ruining American freedom and that you're going to eliminate it and allow the elderly to exercise their freedom of choice and buy their own health insurance out of their own savings (because subsidizing them would be exactly the same problem). You'll be saving money and protecting American values. I don't understand why you haven't already done this when you controlled Congress and the Presidency.
More below the fold...
Let's jump ahead to the Clinton administration. A bit arbitrary and skipping over some things, definitely, but this is a blog post, not a history of health care in America. Clinton made it an important part of his presidency (in some parts spearheaded by the First Lady) to introduce health care reform. Part of the problem was that it wasn't sold very well, and conservatives and the health care industry made their case loudly and well (whether or not it was a valid case is an entirely different point, but here is the problem inherent in humans - we don't often, if ever, make choices based purely on logic). Clinton tried and got little done - it was all basically shot down by Congress. We had no meaningful reform, despite the fact that so many conservative members of Congress claimed that they were quite happy to legislate reform, so long as it was the right reform.
Let's skip to the Obama administration. This is not as arbitrary. For more than a decade very little was done with health care, despite conservative control of government. That silence may, in fact, be the most damning evidence against them of all.
Obama campaigned primarily on promises of health care reform, on significant reform in foreign policy, on constitutional adherence and on transparency in government. In foreign policy...well, he's done a pretty good job. He has restored a large part of foreign nation's relations with the U.S., and has taken a tough but measured stance on specific groups. While I don't fully agree with the idea of sending 30,000 more troops to Afghanistan if your only purpose is hunting down the reported 100 or so people left, I'll give it to him, it's a strong political message, and at least he's showing he is attentive to the situation there.
However, Obama has made little moves to eliminate or reduce Bush's foreign or economic policies. I see this as a significant failure. The Patriot Act, tax cuts, even the TARP bailout. Let me be the first to state that I do agree that some sort of bailout was necessary to prevent a deeper depression - whether or not we should have had a bailout may not be the right question. How the bailout was carried out...that is entirely a different question. The bailout should not have been, I think, at a $1:$1 ratio, nor do I think that it should have come without any oversight or regulations. Basically, nothing has been done to fix the basic system. Obama's speech in the past few days about the bankers' responsibility? Please. A glorified publicity stunt - a public slap on the wrist, nothing more. He's asking them to self-regulate. The media complains that the White House doesn't have much leverage in this situation. Please. My ass the White House doesn't have leverage. Let's look at it this way - the only reason most of these banks are still afloat is because the American tax-payers bailed them out. Obama, as the representative of the American taxpayers, should be able to tell the banks a few things, as that we own a rather large stake in them now. And what should he tell them? Well, first of all, that they're going to open up lending again. And if they need a little assistance in that, well, we could just eliminate the whole credit default swap mess that got us into trouble to begin with. Executive decision - regulatory power, hell, use whatever agency you want to decide that they're fraudulent and just effing ban them. That's a big stick right there.
But Obama consistently makes deals with the bankers and continues to open loophole after loophole for them. I believe that he is smart enough to realize that he does have the ability to push for regulation, (certainly Britain and France have recognized it). I believe that if he had the will to do it, he could accomplish it relatively easily. Which leads me to believe that he simply doesn't want to do it.
So now let's look into health care. If we go with the most progressive/liberal option, Obama could have pushed for a single-payer system. This would essentially be like expanding Medicare to everyone. The basic pros would be everyone would be covered with health insurance, and assured coverage. The basic cons would be costs and likely tax levies. But, instead of pushing for this, they compromised to a strong public option - a government run insurance plan that most anyone could buy into. This would also have come with significant regulation reforms to bring down costs in other areas such as Medicare. I was in support of this plan to begin with, but again and again the Democrats compromised, and the White House stood basically silent or encouraged such compromising. Now the public option, if it happens at all, seems likely to be a completely toothless measure that would cover very few people, be vastly more expensive than it would have been to begin with, and chock-full of loopholes. I am not in support of this type of public option.
Now, granted, the House passed a proposal with a public option. It's not everything that we would want, but...maybe it's a bit of a step forward. But let's look at the Senate. Here we have the utter breakdown. The Obama administration has again and again called for "bipartisan support" for this bill, and has signaled his willingness to compromise again and again to get even one Republican vote. But that's exactly the problem - they have given you the laundry list for what it will cost to get even a single vote from their side of the aisle. We'll have to eliminate the possibility of a public option, we'll have to eliminate the expansion of Medicare, we'll have to mandate that everyone gets private insurance coverage, we'll have to reduce regulation. Essentially, if we take out all meaningful reform and fill the coffers of the private insurance companies, then we might get a Republican vote or two...but probably not.
So here are the basics - the Senate's bill does not include a public option. That got eliminated due to "conservative Democrats" like Joe Lieberman and Bill Nelson. Then someone proposed that we could expand Medicare to people 55 and older in special cases. But Joe Lieberman didn't like that, so, of course, we have to bow our heads to him. The Obama administration has made a deal with him and has basically told Harry Reid to accept whatever Lieberman says. Lieberman says that not only will he not vote for any bill that has a public option or Medicare expansion, but that he will join a Republican filibuster.
Let's look at the situation. If the Democrats had any spine at all, this would be a very easy fix. There is a special option for budget resolutions in Congress called reconciliation - it's a fairly drastic measure, but let's be honest...the Republicans used it all the time when they were in power, including to get the Bush tax cuts passed. Back when they were in control, reconciliation was just another means of doing business, while filibustering (the Democrat's option at that time) was a horrible and obstructionist policy. Now that the Democratic Party controls Congress, reconciliation is a means of railroading policies and destroying American freedoms, while filibustering is a noble venture to protect the people. Hmm...politics as normal.
Anyway, the point is, you could have a Senator, one of the ones already locked in to vote for a reform bill, go on any of the programs that Lieberman and Nelson are touring and say something like the following:
"Oh, hi Mr. Lieberman, Mr. Nelson. I'm sorry to see that you've been wasting your time on these talk shows. You see, we've decided to split the bill. Yeah, it's going to be a headache, but, here's the thing. We're going to put in a public option, or an expansion of Medicare, or whatever the American people want, and make it a budget matter. Then we're going to push it through in reconciliation. I'm sorry, but you are effectively irrelevant now. Oh, what's that you say? It's going to cost too much? Well, it's up-front costs, maybe; but the Budget Office has already returned estimates that show that these measures would save us a helluva lot of money over the next decade. So, at the very least, it's budget-neutral. What about that war that's going on? I notice the conservative senators across the aisle never had any budget problems when Bush was in office. How odd it is that they and you are complaining about the budget now. Oh, and we're going to push private insurance out of business? Look, I really don't think that's going to happen - FedEx, UPS, and the USPS all coexist quite happily. And if they have to trim their belts a bit and offer better services, well, that's capitalism for you. Socialism? To begin with, that's ridiculous, and on the other side of it, a majority of Americans want significant health care reform and are in favor of a public option. So, you tell me, if the American people want it, why are you standing in their way? Even if it does smack of socialism to you?
"You see, (interviewer's name), the problem is that most of us in America believe that when you have two opposing views, the truth must be somewhere in the middle. Our issue is that here we have one side, the conservatives and people like Mr. Lieberman, who are so far off into non-reality, that even when you take the middle ground between them and the facts, you're still wrong. It's like when you split the differences between American progressives and the "pure" Republican party, you're still pretty conservative. We need a fact-based approach to this, and here are some basic facts - private insurance premiums have continued to rise unchecked in the past years; health insurance is covering fewer and fewer people for fewer and fewer conditions, and thus excluding more people for more conditions; the majority of American tax-payers, who people like myself and Mr. Lieberman are ultimately accountable to, want strong health care reform like a public option; the people elected Obama, who ran on a platform of strong health care reform; and no significant reform has happened in quite a long time. Beyond these basic facts, there are the numbers of comparing different health care systems around the world. On any standard measures, ours ranks fairly low. Conservative congressmen are wont to say "Our health care system is the best in the world." I can only assume that they include the V.A. and Medicare in that, as they often tout our treatment of veterans and the elderly. If that is so, why are they so opposed to a government-run plan for the rest of us?
Could it be that these senators and representatives are not truly representing the will of the people? Could it be that they have been bought off by private insurance companies? We know they receive significant amounts of money through that lobby, and it seems that opposition to health care reform is directly correlated with the amount of money being received from them. Which brings us back to Mr. Lieberman, senator from Connecticut. You stand to gain a lot from revenue increases for private insurance companies, Mr. Lieberman, and have proven time and time again that you have no real interest in actual reform. Thus, we have decided to cut you out of this process. We are going to reconciliation, and we will spend every nickel we can to run an actual progressive against you in Connecticut in the next election. Don't pretend to be surprised or angry. You can pack your things and move to the other side of the aisle if you want, but for now, you've effectively been cut out of the debate."
You want to tell me that the Democrats don't have leverage to spare right now? Fuck, it's like everyone's taken a stupid pill. I think the issue here is that, with a few notable exceptions, no one, including Obama, is really interested in creating real reform in this area. Maybe the lobby is too big and there's too much money in it for them; maybe they were never interested in reform to begin with but just wanted to garner some of the progressive vote - I don't know. What I do know is that Obama has completely given up on a lot of his campaign promises. While I think that's normal for politicians, it's also disappointing to have allowed the process to go this far and then have the guy who proposed it in the first place stomp it down.
I know that Rahm Emmanuel has his strategy - gather whatever support you can from conservatives by compromising, because progressives will never vote for the other guy. They're expendable. Well, maybe that's true. We're not so crazy as to vote for ass-hats who have been coming to the forefront of the conservative movement recently. But, maybe we're not so stupid as to keep voting for people who are going to turn out to be conservative-lite in the end.
So, for now, I'm probably not going to be voting for Obama again. Don't caution me about voting against whatever crazy-person the Republicans offer up...at this point, I'd almost relish knowing again that the person in power has no intent to do anything but selfishly promoting their own power and control. I'm not sure that it's less dangerous than having someone who promises so much and not only fails to delivers, but purposefully does the opposite. Obama can win me back, but it's going to be a hard, hard fight.
Read More...
Summary only...
Posts
