Monday, July 27, 2009

Depressing reading on the devolution of the 'public option'.

This piece from Andrew Coates of Physicians for a National Health Program (PNHP) traces how the original public plan idea of political scientist Jacob Hacker's was a Medicare-like

"single national insurance pool covering nearly half the population...creat[ing] huge administrative efficiencies….[via] Medicare and Health Care for America...bargain[ing] jointly for lower prices …[and in this way applying] enormous combined leverage to hold down costs."

The hugeness was the core virtue.

Coates compares that with the ideas said to be floating around the Congress now, an idea looking for all the world like the worst caricature of on-the-sly 'tax & spend lib'rulism' precisely because the scale and so also the price-suppressing leverage has been bargained away. It's nuts.

Hacker's plan set the gold standard of what a 'robust' public option should look like, but Coates says even the public plan's congressional boosters--the very ones throwing around the "r" word most, eh, robustly--aren't copping to the fact that what's being passed off in negotiations as Hacker's brainchild looks to be less than a tenth of the scale of what Hacker actually had in mind.

And remember, this is talking about the most fervent proponents of the public plan, a progressive minority within the Democratic tent, surrounded by lobby sharks and the corporate Dems who've got heavy, heavy ideological and material incentives to kill, maim, or otherwise derail anything that resembles a 'public option' from appearing in the final legislation. So who wants to handicap those kind of odds?

Now it's obvious in hindsight what a goods thing it is that John Edwards never won the Democratic presidential primary. But given the way the healthcare debate is being played out, and the unrelentingly bipartisan way the president has managed his rhetoric and agenda since taking office, I'm reminded of the way Edwards distinguished his view of change making from that of fellow candidate Obama.

During the Nevada primary debates early in 2008, Edwards posed to Senator Obama the following question. It's a question that, for me at least, was always a good one, but has come to loom larger in retrospect (Q @ :17):

"...All three of us want to do something about health care in this country. We also know that, until recently, Senator Clinton had raised more money from drug companies and insurance companies than any candidate, Democrat or Republican, until you passed her, Senator Obama, recently, to go to number one. My question is, do you think these people expect something, for this money? Why do they give it? Do they think it's for good government? Why do they do it?"

That's worth remembering, bute I haven't noticed it brought up in media reports at all.

Obama the candidate was showered with drug and insurance company contributions. More and more, it's distressing the degree to which people with left of center politics like mine are having their worst fears confirmed -- not in the "failure" of the Obama presidency, but rather specifically in its cripplingly low-octane "accomplishments".

So the bank bailouts have done nothing visible for ordinary people, and it's clear -- just as was predicted -- that the money being given out by the Federal Reserve will remain cloaked in unaccountable non-transparency. and so it is.

Then the stimulus, with its all-too-bipartisan crafting and not-at-all-bipartisan passage. It's too small by far to fill the gaping hole in economic demand, and too timid in its DNA to get people working, let alone working in some "Green New Deal" context, which might win over hearts and minds while giving Americans a hands-on sense of how reversing climate change might look, feel--and pay--from an on-the-ground economic point of view. And this, of course, is just as people predicted once they saw the split-the-difference legislation coming down the pike.

Ditto climate change legislation. The watered down "cap and trade" pollution market is a wet-kiss giveaway to the financial hucksters who helped bring the nation to its knees in the first place. Huge giveaways of carbon credits (inevitably to the most intransigent, bad-actor corporate polluters) function in no other way than as a kind of "hush money" or "reparations" to the carbon-belching hucksters who helped bring the nation-- the world-- to the edge of environmental calamity. Quite possibly beyond the edge, in fact.

There's the auto industry restructuring, too, with it's savaging of the auto worker unions in "deals" that offer a castrated "ownership interest" (as with the TARP money, the ridiculous bargains struck as one of significant stock ownership carefully stripped of shareholder voting rights).

And now it's health care. And the progressive left, without which Obama the antiwar, un-Hillary candidate (foreign policy being still another, if more easily predicted, can of disappointing worms) could never have won the nomination in the first place... now it is that that progressive left gets sand kicked in its face once again. First, we are told outright that the most fiscally prudent AND socially-equitable solution to the health care debacle -- single-payer -- is, bizarrely, given the merits of its case, just too radical for so much as inclusion into the policy conversation. [Note that the fiscally-bonkers financial crisis handouts are not at all too radical.]

And so, bringing us up to the moment, we now have the gutting and probable crippling of the public option, the 'fallback' without which health care reform will more than likely be just a Trojan horse for more-of-the-same.

And the obvious worry then, is that this Trojan horse analogy -- the "change" that is no change, the "hope" that comes carefully pre-thwarted-- will transfer in due course from underwhelming policies to underwhelming leadership, just in time for a wave of angry-voter retribution. That in 2010 and in 2012 the authoritarian demagogues will be returned to power, just as we've seen happen in Europe.

Edwards' core criticism of Obama and Hillary's approach to change was that there are interests out there you just cannot negotiate with and come away with anything worth the trouble.

Blood-on-the-floor, ballbusting, LBJ style politics--and the young LBJ learned a thing or two from fellow southerner Huey Long, the bar-none king of the political cockpunch--has its place, especially if one is interested to help underdogs (fwiw, what I like about District 8's Congressman Grayson is the sense you get that he understands this very well). Which sugget that this may be the problem with Obama: working people are not the core constituency.

Would Edwards have delivered on this schtick? Who knows? We know he almost surely wouldn't have won the Oval Office, given his hypocritical philandering, so it's a doubly moot point. Maybe triply so, because who knows what a number the corporate sector would've done on a ready-to-rumble (and so divisive-seeming, media-embattled, popularity-challenged) President Edwards and his milquetoast Democratic posse.

That doesn't mean what he's saying here is wrong, though. I think it's dead right, and I agree too with Harvard Med School doctor Marcia Angell, who said on the Bill Moyer show last friday, that

"I would rather see Obama go down fighting for something coherent and practical that the public could mobilize behind, than go down fighting for this amorphous plan that tries to keep these private insurance industry in place."
I think those who responded to the Edwards message in the primaries are getting the cold comfort today of being borne out in their skepticism toward the virtues of faith-based bipartisanship and Clinton-redux corporatism.

(go to 2:00)


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