What did we expect, people? I really need to know.
The second biggest problem with health insurance reform –
excuse me, health care reform – no, wait, it is health insurance reform – is the incessant play-by-play by
thousands of people with opinions, but seemingly having no concept of how the
process works. Every single goddamn thing a Senator does with
regard to the health care bill is being put under a microscope and analyzed as
if it was the single factor that will determine whether or not millions of
people get to live or die. The “new media” is proving something; make no
mistake about that. They’re proving that bloggers are, by and large, not
journalists, and only see those facts that make their preconceived notions
Basically, it seems that everyone’s position on health
insurance reform is based on the opinion of whomever he or she has chosen to
believe at any given moment. We have the Republican side, who plainly doesn’t
give a shit about health care one way or another. Oh, sure, one could say they’re
just trying to stop Democrats from doing anything good, but that’s just silly.
The fact of the matter is, they had twelve years to fix health care and didn’t
lift a finger, except to figure out a way to funnel tax money to Big Pharma. The reality is, they just don’t care.
No, the second-biggest problem with the health insurance
reform debate centers on the fact that, while few know what’s actually happening,
but everyone pretends to know what’s happening. And then there is the component of the "debate" who are simply looking for someone to blame when things don't go exactly as planned. What we’re seeing played out is that
old saw, “Opinions are like assholes; everyone has one.” (I’ll leave out the last
part.) We are bombarded by
half-truths, innuendo, insinuation and a whole lot of “blame game.” But we don’t
get a lot of useful information.
I know you’re not used to this, folks, but what you’re
seeing in the Senate is how politics works. Politics truly is the art of
compromise. But compromises happen throughout the process; there isn’t just a
single compromise between beginning and end. This is a process, and it’s never
pretty. What you see in Congress is 535 people, each representing a different
collection of voters with different interests, trying to form a consensus.
Those of you who have ever had to negotiate with family to figure out what to
do with rich Uncle Billy’s estate know how difficult it is to get a consensus
from a dozen people from the same family. Now, imagine the difficulty involved
when 535 people get together in two rooms and try to hash out what has to be
done to reform health care for 300 million people.
What we have with regard to health insurance reform right
now – and I’m talking about the Senate bill here – is a goddamned miracle. If you don’t see that, you’re simply not paying attention. For anyone,
regardless of how much I like them and respect them normally, to suggest that
we scrap the entire bill and start over denotes a level of naiveté that is just
breathtaking. Oh, sure; let’s just toss out a year’s worth of work that gives
us 80% of what the country needs because we didn’t get 100% of what we wanted. What the hell do you think is going to happen
next year, with the same Congresspeople and Senators who are in the body now,
and with the added bonus of election year grandstanding being thrown into the
If you think Congress can simply start this process over with the
same membership and get a different result, you are, by definition, insane.
Here’s an idea. Fight your ass off to try to get the bill up to 90% of what we
want – continue putting pressure on your Congressperson and Senators, and let
them know your vote rides on their decision on this bill. And help Democrats
target those idiots responsible for holding the bill hostage for no reason
other than personal political ambition or vanity. (Joe Lieberman, of course.)But realize that, in politics, no one gets 100% of what they want.
Now, note that I said that the incessant play-by-play and the kibbitzing from the peanut gallery is the second-biggest problem with this "debate." Wanna hear the biggest problem?
The most vexing problem with the health reform "debate" – and frankly,
every other political "debate" at the moment – has to do with unrealistic expectations.
When Barack Obama was elected last year, and Democrats won
majorities in the Senate and the House, just what the hell did you expect? Based
on some of the rhetoric I’m hearing from progressives lately, apparently you
expected him to part the political seas and make a clear path for progressives
to walk through and reclaim the political “promised land.”
After 30 or more years of right wing government, culminating
in eight years of Bush-Cheney, did you really think the skies would open up,
the sun would shine, the trees would dance and sway and the birds would sing
love songs to the poor? Did you really think the ship of state would just do a
quick 180, and we’d suddenly find ourselves on the right track in the space of
Here’s clue #1, folks: President Obama is human. He’s not
perfect, he’s not God, he’s not Jesus Christ, and he doesn’t do magic tricks. He
can’t make every problem we have go away with a wave of his hand, or even by issuing an
Here’s clue #2: President Obama won 53% of the vote in last
year’s election. Democrats won 52% of the overall vote for the House and Senate. No political party won 80% of the vote, and
therefore no one received an absolute mandate from the masses to do everything
progressive Democrats wanted. The mandate they received was to clean
up the stinking mess Bush made, not to revolutionize every area of society and
remake it in a progressive image.
Here’s clue #3: The population the Democratic Congress
represents is roughly the same population the Republican Congress represented
just three years ago. Democrats won 50% of the Congressional vote in 2004 and 52% in 2008. A two percent shift of the voting population is NOT a grand electoral fissure that
represents a revolutionary change in direction for the country.
Here’s clue #4: Roughly half the population of the United States
doesn’t remember a time when the right wing didn’t have too much influence in
the government. If you were born after
1970, in fact, it is probably difficult to even remember a time when right wing
rhetoric didn’t rule the day, in part because, since the end of the Vietnam
war, progressives have largely chosen to sit outside on the lawn and bitch
about things that go on in the Big House (Washington). That means we have an electorate for
which a lot of right wing rhetoric rings true.
That will do as a start. That’s more clues than Agatha Christie gives
you, for sure.
The last election signaled the beginning of what could be a major shift in the electoral
politics of the United States. THE BEGINNING, folks; not the culmination of many years of hard
work. After at least 30 years of extreme right politics, we now have an opportunity to re-shape the political
process for the next generation.
Again, I said we have an opportunity. The election that
occurred in November 2008 did not represent a major shift in the space-time continuum.
It was the opening of a door, and we have been invited to join those inside for
the first time in roughly 30 years. Yet, we seem to be bound and determined to
shut the door and stand on the outside screaming at those who chose to go in.
Why do so
many liberals insist on demanding our own way, despite the fact that we have
ZERO political capital in today’s electorate? Oh, you may not know what I mean, so I guess I should add a fifth clue
Here’s clue #5: When your ideology has a lousy record of even
casting votes in the first place, and an even lousier record of participation
in the actual political process, no one actually cares about it when you
threaten to not vote for someone, or
you threaten to stop participating in
the political process. The entire political process is not cowering in fear at
the prospect of losing progressive votes, because the process has gone on without
them for decades, anyway. In order to threaten someone by promising to take away their food, it helps to have been feeding them in the first place.
There is a point where idealism just has to give way to
pragmatism. The Senate’s majority is from the Democratic Party; it is not a
progressive majority. If you want a progressive majority, you’re going to have
to work for it over the course of a decade or two, not simply wish it so. Every hour
you marched through Lafayette Park between 2001 and 2008 to protest a war to a
president who didn’t give a shit what you thought was an hour wasted that could
have been used changing the government by electing more progressives. Every vote for a politician who had no chance of winning was a wasted vote, because it didn’t change the government for the better.
The root word in “progressive” is “progress.” Advocating for the
abandonment of 80% progress because it doesn’t constitute 95% or 100% progress
demonstrates just what’s wrong with the progressive “movement” in this country.
For some reason, we take a lot of credit
for ending the Vietnam war nearly 40 years ago; so much so that we've taken to reproducing that as a way to
solve every problem. We scream about things, and we march all over the damn
place, and we always claim “principle” as our guiding force, even as our
adherence to “principle” leads the country to 30 years of right wing rule.
Again, I ask; what did you expect when Barack Obama won the
presidency and Democrats won 60 votes in the Senate? Did you think the
naturally more conservative of the two Congressional bodies would suddenly
transform and abandon all support for large corporations (which, like it or not, provide the living for the vast majority of the American people) and embrace all social
programs with the idealism that progressives claim to possess?
The Democratic Party has 58 members in the Senate, and 40-45
of them are at least somewhat progressive in many ways. But there are at least 10 who
represent states with huge Republican populations, if not Republican
majorities. Senate rules allow one Senator to block legislation in a way
that requires 60 votes to overcome it. There are those absurd expectations
again. Many progressives saw that “magic” number 60, and imagined saints rising from the dead and had visions of dogs and cats singing Hallelujah together in backyards all over America. We
imagined that, on every issue, Democrats would do what Republicans do, and
forego representing the people of their state in favor of representing their
chosen ideology, which in our case would be what, exactly?
Many progressives also went into this process
thinking that the “public option” was a slam dunk because, well, we already
agreed to a compromise when we “allowed” Congress to abandon single payer. Okay, I'll give you one more clue, but that’s all you’re
Here’s clue #6: If you include a DOA provision like single
payer in a health insurance reform bill, you guarantee it will never go farther
than your wet dreams. A “robust public option” was a starting point, not a
compromise. To implement a single payer system would require scrapping the entire system altogether. That transition alone would cost trillions of dollars, at a time when
the economy’s in the crapper and we’re running record deficits. Therefore, the
concept that “the public option represents a compromise” is idealistic bunk. If we wanted everyone in the United States to be given a free car on their 18th birthday, would "Cash for Clunkers" be a "compromise," or would that just be "realistic"?
Frankly, we came far closer to creating a public health
insurance system than I ever thought we would, and some form of public option
could still happen; this won’t be over until January or February. But to throw
the entire bill away because of it would be phenomenally stupid and
Even if the public option is missing, the bill will fundamentally change the way private insurance companies
do business. It will make them more responsible to policyholders, and the changes in the system will
benefit everyone, including the 80% of the population who currently carry a
health insurance policy. Without a public option, 35 million more people will be covered and prices in
the health care industry will stabilize to a significant degree, which will
serve to reduce the federal budget deficit and also remove the major rationale
insurance companies use to increase premiums now. With the creation of an insurance
exchange, there will be some level of competition, as well, which will
stabilize prices further.
Does it go far enough? Of course it doesn’t. But it will
improve things, and with 35 million suddenly receiving coverage, there will be
increased pressure to cover the other 15 million. In other words, by mitigating
a problem, you actually create greater impetus to achieve even greater
mitigation. In the last 30 years the Republican Party has transformed a “can-do”
nation that could send men to the moon and solve any problem into a “can’t do”
nation that swears it can’t do anything because everything costs too much. We
used to see paying for infrastructure and social programs as “investment.” Now,
we see them as “costs” to be “contained.” That sort of mindset can’t be changed
overnight, but proving that the government can change the system for the better will make people more open to even greater changes in the future. A reform movement will take years of re-training; it just won't happen overnight.
If we play our cards right, over the next few years we can
increase our margin in the Senate to 65-67 votes, with a larger number of
progressives. Just as importantly, we can help moderates take back the Republican Party, and create a healthy two-party dynamic once again. One of the problems we have right now is that the right wingers are purging their party of anyone who isn't Goering-lite, and driving them to the Democratic Party. Right now, we have Democrats acting as both parties at once, with the right wingers holding 40 seats and refusing to even participate in the debate.
Of course, changing the dynamic will require progressives to get MORE involved in the
Democratic Party, not less, as is so often threatened.
I’d also like to take to task those want to blame
President Obama for the loss of the public option. Give me a goddamn break,
will you? I love Russ Feingold, but can we get real here for a moment?
Russ Feingold is a Senator. Barack Obama is president. Presidents have absolutely no real power in the Senate. I don't blame Feingold for the failure of the public option, but the reality is, he has more power in the Senate than Obama does. In the current political
climate, what would he have liked the President to do, exactly? Did he imagine
that he would call the Blue Dogs into the Oval Office and give them a right “talking
to”? How much influence does he imagine Obama might have over Senators from
states like Montana, Nebraska and the Dakotas?
A long time ago, I wrote that it would be a huge mistake to
demagogue the public option to the point that we end up losing the rest of the
bill, and I am not alone on that. President Obama understood that quite well. A public insurance system is
necessary for complete reform, and I want that very much. Hell; I was pushing
for an expansion of Medicare on my first blog almost eight years ago. But how
much of the rest of bill should we trade for the public option? If
we created a public insurance system without any of the other reforms that are in
this legislation we would be left with a private system
that does exactly what they do now, which is to cover only healthy people. In the meantime, the public insurance system would only cover the sick.
Do the math, folks; this causes a couple of problems. Such a system would cause the national debt to
skyrocket, and it might kill the very idea of a public insurance system for a
generation or more. And if you think it would create "competition," think again. Private insurance would only be covering the healthy, so they could afford to cut rates to the bone if they wanted to, while the public insurance system would have to increase premiums to pay for the sick. For any insurance system to work, it has to allocate risk
amongst all elements; if too much risk is front-loaded into any single
element of the system, the entire system will collapse and fail. In fact, that’s
the key reason we eventually need to end up with single payer.
Now, here’s the question you need to ask yourself. If we
ended up with a public insurance system that failed because most other
necessary reforms were missing, what happens to the logical end result, which
is a single payer insurance system? It would be dead.
In other words, President Obama played this exactly right, politically. He told us what he wanted the bill to do, without pushing one part
of it down anyone’s throat. By taking a “mission-based” stance, he actually
ended up getting at least 80% of what he wanted. Name the last president who
ever got 80% of anything he wanted from the Senate. I’ll give you a hint; his
initials were FDR. And remember the last president who made demands of the
Senate on health insurance reform? That president was Bill Clinton. Here we are, 15
years later, we’re finally getting back to the trough for another try.
Yes, if the public option or expanded Medicare remain scrapped, they have to remove the individual mandate from
the bill, and they will if the public option is actually dead. But it’s just not realistic to think we can simply
dump this process and start over and not see any negative effects. If progressives
are going to claim the moral high ground, how does that square with a
position in favor of killing expanding health insurance coverage for 35 million
people and making health insurance companies behave honestly, because it doesn’t
cover all 50 million?
Here’s the deal, folks. You can disagree with me all you
want, and I'm sure many of you will. You can make all the demands you want of the Senate, and you'll do that as well. You can adopt an attitude
of “I’m gonna get what I want or I’m gonna take my ball and go home” all you
want. But if you actually consider yourself a progressive, start committing yourself to making “progress.” Understand that progress isn’t always revolutionary in scope and it doesn’t
always happen right away. Understand that the process of compromise among 300 million people in a democracy means you'll be lucky if you get your way .05% of the time. We have an opportunity to change the world for the
better, but we can’t do that when a large portion of our “movement” is locked
in a struggle with itself, because it expects too much.The process of switching from a majority wingnut government to a moderate one has just begun,
folks. It takes more than one or two election cycles to change hearts and minds.
And ultimately, that is what has to be done if we’re to become a better
Copyright 2009 The PCTC Blog