Alex Blaze

Health care post

Filed By Alex Blaze | December 22, 2009 3:00 PM | comments

Filed in: Politics
Tags: dean baker, Drew Westen, health care reform, liberalism, united states, us

This post went in a different direction, but I'd be remiss if I didn't link to this blog post from the Center for American Progress on how the Senate's health care bill does nothing to address various unique ways in which the health care system lets LGBT people down.

The Senate hasn't actually passed the bill for health care reform, but we're getting closer to finding out what it'll include in its final form. Lots of other people have written more about it, and I haven't been blogging too much because all the news coming out of that process is so depressing.

Americans are getting fleeced when it comes to health care, and it seems like the Democrats aren't going to do anything about it. Drew Westen, a liberal who studies how centrists vote, has a longer, more coherent article up on the Huffington Post about the process that led us here, and how Obama's "no drama" leadership style is particularly to blame. As we all know, when one side of an argument decides that fighting is too decisive, the other side pretty much automatically wins.

But here's something that particularly stands out to me:

I don't honestly know what this president believes. But I believe if he doesn't figure it out soon, start enunciating it, and start fighting for it, he's not only going to give American families hungry for security a series of half-loaves where they could have had full ones, but he's going to set back the Democratic Party and the progressive movement by decades, because the average American is coming to believe that what they're seeing right now is "liberalism," and they don't like what they see. I don't, either.

Count me in there. I'm young, the only three presidents that I was conscious for were Clinton, GWB, and now Obama. And if this is what liberalism is, I don't want any part of it.

Part of the issue, of course, was my naive belief that even liberals (and I'm using that term to distinguish them from leftists) actually supported the various policy goals they campaigned and voted on. Obama's campaign promises, while not outlandishly great, painted a picture of an America that was in stark contrast to eight years of Bush.

Well, what's actually happened is far short of what could have happened, and on no issue is it more obvious than health care. We never started talking about single payer, Obama advocated a public option during the campaign, the public option got watered down, and then it got eliminated. And the main reason that happened, no matter the confusion all over the left these past few weeks, was because some people have a ton of money, which gives them a ton of influence, and they didn't want the government to get in the business of insuring the population generally.

The bill as constructed isn't anything resembling reform. It relies on its already weak regulations to be enforced, and if there's anything we know about the American government it's that it won't enforce its own regulations. On every issue from food safety to employment discrimination, from sexual harassment law to environmental regulation, the government has shown that it's small-c constitutionally incapable of enforcing regulations against large corporations. The enforcement mechanism for the various bans on health care discrimination will be lawsuits, lawsuits from people who were cheated and might be dying that will go through a court system that's more business-friendly than ever. It's not the best way to keep insurance companies honest.

The other major part of the bill, the subsidies, will eventually be phased out. They are the equivalent of welfare, and both Democrats and Republicans are vocally hostile to such programs. If they eventually get implemented (since we'll have to make it to 2014 to see them), they'll be eliminated within a decade or when the next recession hits. Americans will need a scapegoat, and the fiscal conservatives will look at those subsidies like a great way to prove their lean government creds.

And Americans will continue to get looted by a private industry that will only be given more power, money, and legitimacy as a result of this bill that will force people to buy their product. I was sick recently in France, and, as I posted, a full regimen of prescription antibiotics cost me eleven euro, and I'll be getting reimbursed for that. How much would that have cost in the US, even if you have good insurance?

But, this past week, the Dorgan Amendment, which would have allowed American companies to import drugs more freely and at lower costs, was defeated in an especially bipartisan vote. Dean Baker estimates that that amendment alone would have saved Americans $250 billion a year, yet it didn't happen for any reason other than the fact that over half of our Senate is beholden to those with money (their safety reasons notwithstanding; those reimported prescription antibiotics didn't kill me here).

All of which is rather disappointing. If the Democrats wanted to make themselves seem like the reasonable alternative to the Republican Party, well, they just didn't cut it.

Worse, though, than the politicians failing has been the confusion that I've seen from people who are nominally liberal, progressive, leftist, Democratic, or whatever meaningless term they choose. How many times have I read this past week that people should "stand behind" the president no matter what? How many times have I heard from leftwing activists that you're either with us or against us? How many pundits who claim to be on the left have said that there isn't a politically "realistic" alternative to this bill, that it's as far to the left as America can go?

Perhaps that's true, although I have much more faith in the American people than that. In fact, I have more faith in the politically unaware segments of the American population now than I do in those who claim to be working for an ideology, a set of policy goals, or for specific laws when it's now apparent that they were either voting or advocating for Democrats out of hatred for Republicans or personal identification with Blue State culture. If your political position is, literally, "X person is always right and everyone in our movement should agree with him," then you have no values.

And perhaps that was the problem with the motley coalition put together to get Obama elected: we all pretended to agree enough to work to get Bush out of office, but we were rather unclear and often dishonest about why we disliked him.

Sure, there is an argument to be made for the Senate's health care reform bill from the left. I'm not saying there isn't. But what I thought people would know, and acknowledge, is that the bill is severely compromised and that's because a small group of powerful people have far too much power, both in the White House and in the Congress.

So, yeah, liberalism, schmiberalism. I don't really care who's doing the screwing, I just want it to stop. But apparently there was a strong part of the coalition party that only cares about who's in charge at the expense of actual policy.

That sort of hatred of the other side has supplanted policy goals among liberals, so it's kinda hard to want those folks to be in charge, especially as they look down their noses at us, the "unrealistic" rabble who support policy that's far more popular than the bill they want (I'm sure a mandate to buy an expensive product people either don't want or can't afford from an dishonest, murderous private industry is going to be so popular). Liberals do own this bill, and the policy result is terrible.

So it'd be great to have an actual left in the US.


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I passed this Drew Westen piece around to some friends because it so very well summed up my feelings about this president. Obama could fix all of this by growing a backbone and being the president he promised to be. He's content to let anyone and everyone drive the agenda so long as he doesn't have to get his hands dirty in the process.

Alex,

I enjoyed your observations. It is frustrating.

This supposed HealthCare Bill is really the Insurance Industry Bill.

Business interests in healthcare have spent more than $700 million lobbying Congress in just the last 18 months. So, it's bought and paid for.

The big problem with Obama is he campaigned on "limiting lobbyists influence," but he hasn't. He hasn't regulated Wall Street, either. Or been a "fierce advocate." I'm not sure what he's actually done.

The proof will be in what ever they cobble together in the confrence committe then shove down the members thoats in a dont read it bill.So we shall see what they finaly come up with as there will be some kind of Health Bill the President can sign come January.

Poltics is a contact sport with no rules.

I think you are mistaken in opposing the bill. My sense is that progressives are mistakenly seeing this bill as the end, and I see it, like all laws, as the beginning. A law is a screwdriver, not a hammer. When it is first enacted, it is an educational tool. It only becomes an enforcement tool when it grows up.

I agree that HCR is seriously flawed, but I don't agree that we should despair or vote against it. Politics is the art of the possible, not the ideal. The truth is our country has long been a seriously divided one, and although there is a political majority, there is no ideological majority. I don't think we could get a better bill now or ever, and I think strident demands by the President or a few progressive Senators would not be efficacious.

It's also important to recognize that legislation is simply an authorizing document, and it is up to the executive branch to breathe life into it. Nothing much happens on day one, or day 100, after a bill is enacted. I feel strongly that once the Administration is authorized to reform health care, the executive branch will use the authority it has been given to reform the industry. When more authority is needed from Congress, and if the reform effort is seen as positive by right-leaning Americans, later changes will be non-controversial.

Supporting the bill is not a matter of blind obedience. It's a calculated risk.

I disagree. Health care reform (HCR) is mostly about providing a means for politicians of both parties to skim money from the public. What motivation could there possibly be for any administration to kill this golden goose in the interests of helping the public?

Just for fun I'll bet you (Dr. Weiss) $100 that within one year of HCR being signed into law we'll be reading about financial scandals involving politicians skimming money from the program and/or mis-directing funds for non-medical purposes such as road construction. Need I mention there will be no laws in effect to appropriately punish these transgressions?

In a commentary in the Arizona Republic about a month ago, I predicted the Senate health care bill would turn into the insurance industry's wet dream; that it would follow the Massachusetts model which simply made it illegal to live in that state and not have health insurance, with a vague promise the state would, somehow, find a way to have the uninsured defined as a "class," so that they might qualify for some type of group coverage. I also predicted the Feds would subsidize the insurance industry as a form of reducing premiums for those with poverty-level (or below) incomes.

I didn't predict the other "give-aways" to the insurance companies.

No lifetime maximum on use of benefits sounds great, until it's coupled with an allowed annual maximum use of benefits - so, say, an insured lives to be 110 years old, they will have insurance... but only to the tune of "x" number of dollars per year, every year.

Taxation on unions who have negotiated excellent health care coverage for the employees - not of the union, itself - of the companies who hire the employees the union represents.

Instead of the initial tax that would have been levied against individuals with an income of over $ 1,000,000, now the public subsidies of this bill will be paid for by a tax on someone who has a "cadillac" insurance plan. And instead of a 3% tax on those with a million-dollar income, it will be a 42% tax on some nebulous "difference in premium price" between what will be the government's basic health-insurance coverage guidelines and the plan(s) negotiated by a union for a company's employees. To avoid paying that tax, all an employer has to do is drop coverage to the minimum federal suggested guidelines.

Wow. So "health care reform" means employers with union-negotiated health care packages are going to slash the benefits of those packages for their workers. Less is better, I guess.

I've been living in heart failure for 10 years. I've been on the heart transplant list for almost 4 years. Three times a heart has been available, but all three times, that heart was diverted to others in "critical medical need." I understand that, and understand that if I am going to receive an organ donation, it will probably be because, at that moment, I am also experiencing a "critical medical need." Until that time, my cardiologist will just have to continue implanting things in my chest that pace, that shock, that bypass and that replace.

Absolutely none of that could have been achieved without the benefit of my spouse's employer offering Domestic Partnership Benefits - the company's share of premiums are added to my spouse's income, per year, and are taxable. After this bill is approved, if approved as written, I'm absolutely certain my spouse's employer, to eliminate paying a tax on "excessive coverage," will immediately eliminate DP benefits.

And, at that point, I'm dead; it may take six or seven months, unfortunately - six or seven months in which my spouse will spend every penny we have, and max out every one of our credit cards, in a fruitless attempt to keep me alive. I want to be very clear on this, though: I will do and say anything and everything to prevent him from doing that, as I've made my peace with the whole situation, literally, decades ago (the heart failure was caused by a congenital abnormality that was originally diagnosed to kill me by age 5).

If this bill passes, as is, and is signed into law, perhaps in 100 years historians will refer to it not as The Comprehensive Health Care Reform Act of 2010," but as The Population Control Act of 2010.