If it is not yet apparent, perhaps it is time for the last holdouts among us to accept the fact that the American healthcare system is never going to undergo any meaningful reform. Whatever comes out of this Congress and ends up on the desk of the suddenly-not-so-bold President will be watered down, ineffective, costly, and of little use to people who really need it – the working uninsured who are too "rich" for Medicaid and too poor to pay out-of-pocket.
I believe there are three main reasons for the impending and perpetual failure of reform.
First, insurance industry shills and more importantly their ideological allies now have too prominent a pulpit for spreading disinformation. ClintonCare in 1994 represented the last, best shot at reform because it was the last pre-Fox News effort. Fifteen years ago the industry lobby had to engage in a very expensive anti-reform PR campaign, most memorably the "Harry and Louise" TV ads which showed a respect for the truth on par with that of an Alabama used car salesman. Now? They don't even have to spend a dime. The right wing media does the hatchet job for them.
Why bother with PR campaigns when people from national celebrities like Limbaugh down to dopey 7th-string imitations on bad websites and local AM stations will rail against it for hours gratis?
Second, the timing is just spectacularly inept.
Even the d-bag the NY Times hired to replace Bill Kristol understands this:
But in a crisis, all the public tends to care about are jobs and economic growth. It’s not the ideal time to pass costly social legislation that promises to reap dividends only in the long term, if at all. That’s why Franklin Roosevelt waited until 1935, when the Great Depression seemed to be waning, to push Social Security through Congress. It’s why Lyndon Johnson established Medicare at the peak of the long post-World War II expansion. And it’s why Massachusetts’s health care plan and California’s cap on greenhouse-gas emissions both passed at the height of the recent boom, rather than the bottom.
This might have worked after a prolonged period – 12 to 18 months – of sustained positive economic news.
Maybe in late 2011, just in time for the 2012 election. But now? It might not even get to a floor vote. This is an unqualified fuck-up on the White House's part and the first serious misjudgment by a President who suddenly sounds a lot more like Eisenhower than the election year FDR comparisons would lead us to believe.
Third, I have serious doubts about the American public's ability to meaningfully process this issue. It is universally (see what I did there?) recognized as a complex problem with correspondingly complex solutions. They are being pitched to an electorate in which 14% of adults – one out of every seven people sitting on the bus with you – are functionally illiterate. They can't read this blog or the instructions on their Easy Mac let alone understand what a single-payer system would entail and how it would affect them personally. I feel like the public listens up to the point at which they can no longer understand it – which doesn't take long, sadly – and then the shields go up.
After that, they either decide that they fear change or that they should hide their lack of comprehension behind some slogans they heard on Glenn Beck's show. There is a reason elected officials spend so much time talking about what political scientists call easy issues – those for which citizens need no information whatsoever to form valid-sounding opinions (i.e. "moral" issues like gay marriage or abortion, which anyone can declare Right or Wrong).
Until any of these things change, and I'm certainly not holding my breath, it is pointless to even propose a serious overhaul of the status quo let alone expect one to pass.
Angie says:
What a shame and a wasted opportunity. Living in a non-"socialist", universal healthcare-providing country I can't comprehend how much this hurts and how incredibly frustrating it must be for you. As condescending as it sounds, I really feel pity for the US. The propaganda machine is very effective there…
J. Dryden says:
So, basically, everything is going to suck always and forever, and a change in administration is basically cosmetic.
I guess I always knew that, but it felt so good to pretend otherwise for a few months. Fuck it, bring on President Palin.
ladiesbane says:
Please: health insurance is not health care. People don't need affordable insurance, they need affordable medical treatment.
Re your third point: I just had an attorney complain bitterly to me because his partner pays $90/mo. for good coverage, but his own app was declined even though he's in excellent health. Turns out he takes "one little maintenance med" that costs $450 per month. There was no making him understand why he was a poor risk.
This guy may have passed the bar exam, but he's mathematically handicapped. Is there a way to gauge numeracy? I'm tired of educated people who can't do kitchen math telling me they understand anything about insurance. As a group, they are just as guilty as the illiterates of spending beyond their means, bouncing checks, and voting themselves tax breaks on top of huge national debt. I can no longer be surprised that they'll vote for costly, unnecessary wars, but universal care? Hell no. They won't even expand CMS.
I agree with all your points, but my hope is that Obama can cut his losses and move to a new issue to generate momentum and keep morale high. A string of moderate wins would help a lot. I'm off to clap my hands and believe in fairies now. Good night!
Cletus Warhol says:
Sheesh, a few minor setbacks combined with some astroturf bloviating from the right wingers and you're already throwing in the towel on health care reform? Good to see that Progressive backbone showing up!
One of the reasons the Repubs are being such obstructionist asses is that they know that the average Liberal tends to wuss out after a little bit of resistance and goes running to cry to mommy (or more accurately, to their nice college faculty health care programs).
What did you think the forces of the health care status quo were going to do? Just sit back and let reform happen? Of course they're fighting tooth and nail with every dirty trick they have, knowing that the bourgeois left (who doesn't really need health care reform) won't have the stomach for a long battle and will drift back into their smug, complacent little bubbles and start hoping for Obama "to move to new issues."
Good Jeebus, at one time Progressives weren't afraid to get their heads bashed in for what was right and now you can't even handle a little whinin' and cryin' from a few paid corporate stooges. Grow a freakin' pair already!
As one of the 40 million plus without coverage, I don't have the luxury of taking my ball and going home to pout about the horrible state of discourse in America, and I sincerely hope that you brave fighters for justice might stick around for a least a minute or two after the going starts to get tough.
.
doug says:
We in the south would say 'New Jersey used car salesman'.
Just so you know how to behave….
Mark says:
Ed, I'm with Cletus on this one. If you are getting discouraged by the propaganda machine from Indiana, just wait until arrive in Georgia. The unintelligible rantings of Glenn Beck and the rest of the FoxNews crowd are gospel to many people down here (kind of like Evansville, IN). Time to man-up, laddy!
comrade x says:
I have to go along with what Cleetus said, albeit more politely. WTF is a little set- back on healthcare reform? Jeez, just think what civil rights leaders and their organizations had to put up with. And look what they accomplished.
Christ, if the bourgeoise liberals can't hack it, let us unwashed and ignorant proles have a whack at it.
JohnR says:
Ed, I'm not sure what this means (nothing good, I suspect, at least from your point of view), but you're only saying what I have long bellieved. I'm afraid that the country has passed beyond the point at which any sort of recovery is possible to government as we used to know it. Teddy Roosevelt's was the last gasp attempt to break the power of big money, and less than 100 years later, everything he did had been undone. It's not that people are uneducated – that's been the norm for most of human existance; it's more that in this country now, being proudly ignorant is the mass-media ideal. Unquestioning faith in The Leader (whether The Leader is local or national; religious or secular, is immaterial) is the way for a huge chunk of the country. The Titanic is beginning to tip, and there are some guys still up there on deck shouting, "Hey, let's turn those frowns upside down, people! We'll be back on course in no time – we just have to think positively!" Yup – all we need is for the great mass of the population to think about the good of the country rather than their own short-term interests. I'll be drinking while I wait.
Cletus Warhol says:
Thank you for that perfect illustration of my point, JohnR.
Why attempt to directly engage any of these people in the thrall of the evil mass media (or do anything) when you can just sit in your drawing room with a nice cocktail and brood about how horrible the situation is?
How noble and poignant you are, in a doomed Updike/Cheever kind of way!
Your liver treatments will be covered by the faculty health plan, so let that wave of ennui and weltschmertz flow over you.
It reminds me of Dr. Kings great essay, "Gosh, these white racists sure are mean and violent, I guess I'll just have a beer and forget about the whole thing."
jazzbumpa says:
Holy shit, you guys. What's up with all the anti-Ed backlash? He presents a pretty accurate wrap up of the status quo, and you make him feckless, Updike/Cheever bourgeois liberal with no cojones. What the hell is he supposed to do, grap the COE of Humana by the throat and beat him senseless?
The right owns the propaganda machine; a significant minority of the population is fucking stupid; the vast majority are fucking ignorant; and big fucking business owns both fucking parties. That's fucking reality.
I disagree about the timing issue though. The depression waning in 1935? I don't think so. GDP growth and private investment had started to rebound by then, but had not gone up very far, at all. And unemployment was still between 15 and 20%, depending on what data set you use. And that's all 20/20 hindsight. I doubt that very many people in 1935 thought they were living in good times.
http://edgeofthewest.wordpress.com/2008/10/10/very-short-reading-list-unemployment-in-the-1930s/
I think the time for reform is when the people have been so beaten down that their misery makes them a powerful enough force to prevail against entrenched economic interests. I can't think of any historical event other than depression or revolution that gets the common folk motivated to that extent.
Cheers!
Cletus Warhol says:
I know I crashed the garden party with some pretty rude talk, but this sort of "Gee, why even bother?" response is just what the architects of this recent campaign are looking for.
Definitely not trying to trash Ed (longtime lurker, first time commenter, love the site etc. etc.) or anyone else; just trying to give a little tough love pep talk to those whose spirits are waning in the face of this onslaught of right wing BS.
When in American History (or World History for that matter) was this magical time when the majority of mass communication outlets were NOT controlled by those in power and used to subvert the common good through misinformation and intimidation? Or the average citizens NOT ignorant and gullible? I must have missed that day in history class, because I can't recall this sylvan era ever existing (the 1890's? the 1930's? the 1100's?).
People have struggled in the face of much more dire conditions than we are experiencing now and were able to persevere. And we finally have someone in power who actually believes in reform, so perhaps we shouldn't give up the ghost so soon just because the opposition is pitching a hissy fit (as annoying and unpleasant as that fit may be).
I know how easy it is to fall into that trap. "Oh, the forces of the status quo are just too powerful, we'll never have ____________ (emancipation/woman's suffrage/civil rights/a black President), so let's just give up."
Hell, I may be there next week.
I just hope someone will tell me to get over it and get back to work. /end series of rants
Regards to all.
Michael says:
Maybe I'm wrong, but I didn't get the impression that *Ed* was giving up personally but simply commenting on the particular set of circumstances which are going to contribute to Health Care Reform not passing.
Susan of Texas says:
I think nobody ever intended to give the American people national health care and naturally the insurance companies have bought a win. During prosperous times we're told we can't afford to risk damaging the economy with health care and during bad times we're told we can't afford it.
The American people are, collectively, morons who did not notice their disappearing freedoms and will not notice their increasing poverty until it become desperate for the majority. In the mean time the upper classes will amuse themselves by pitting us against each other and no doubt betting on who will win.
j says:
To me, there is one thing that Obama has done incorrectly on this issue. When he went in front of the AMA in Chicago and said that he opposes putting limits on malpractice suit awards, he got booed big time by the healthcare industry and lost a lot of rapport with them. Then when he wants them to make concessions without the lawyers who get rich off malpractice suits meeting them halfway, of course they are going to fight back! To me, that was the first major misstep of his presidency–hopefully he can recover and get this done.
Parrotlover77 says:
Cletus Warhol – I'm with you! We don't need to fall into the "Defeatocrat" trap they set for us.
comrade x says:
Ed puts up with right- wing b.s. all the time. I think his skin is thick enough to handle a little left- on- left dogfight.
That said, I think the above dialogue illustrates a fundamental difference in the way the pro- capital reformist left and the more socialistic left view the masses. The reformists push a program on the masses from above, trying to balance their interests with those of big business, and despairing when the proles quite logically reject it. Leftists of a more reddish hue see it as progress when you have a majority of the people in the U.S.A. backing a public program such as single- payer healthcare.
It isn't the people dropping the ball on this one. Its Obama and the guys in Congress.
JohnR says:
Thank you Cletus! Sorry it took so long to respond, but here in my drawing room I got carried away with (and after) my cocktails, so I beg forgiveness. Ah, it's so good to have someone who understands my noble and poignant (something vaguely Curly-esque about that word; I have to figure out a way to work it into my ponderous seminars somewhow..) where was I? oh, yes, my noble and yet poignant meanderings in the slough of despond. It is 'slough', right? To be compared to those giants Bob Cheever and Fred Updike in such a positive way brings a lump to my throat, which luckily will be covered by my faculty health plan (alas that my faculty is not a large one, being comprised of myself and my pet koi "Blondie", and that my health plan pretty much consists of cocktails, which I detest).
As for that fellow King, he may have done some sort of rabble-rousing, but he was barred from the Club for his efforts; a fate forward to which I prefer not to look. Don't think I do not fully appreciate your concern, however!
At any event, I shall observe your further efforts with keen interest, and shall not fail to sponge of of any success like the bourgous, um, burgoise, er, burgoo social vampire that I am. Toodles!
Peggy says:
JohnR: You win one internet. Please specify desired size and flavor.
Cletus Warhol says:
Yeah, I did get into a quite a rhetorical lather there, John, and sprayed you (and several others) with some undeserved invective (and I apologize for that).
But my blood has been boiling as of late over the amount of good people who've been retreating into either a state of fatalistic despair or smug complacency over a few minor setbacks in the fight for health care reform (and the Progressive agenda in general). Especially those lucky enough to have the means so that the issue doesn't really affect them.
Fortunately (hopefully), BHO and Company (BHO Overdrive?)seem to be made of sterner stuff than the traditional milquetoast liberal, whatever the size (or species) of their faculty. (Ooops here comes the lather again! Sorry)