Healthcare Mess

I'm one of the many Obama supporters who is deeply disappointed with his handling of healthcare reform. The lack of leadership, from such a talented and gifted politician, has been striking. Whatever happened to Yes We Can? From the beginning, he failed to frame the debate by leaving it all up to Congress. There, the usual interests have polluted the proposals so badly that they are hardly recognizable as anything we progressives had hoped for. First off, a single-payer plan was never even on the table, and was replaced by a public option with nothing given in return. When even that failed to appease the Republicans and Blue Dogs, the public option was downgraded to health cooperatives. That still didn't appease the opposition. Then the progressive caucus rebelled, and the public option was back in. Or is it? There's been so much flip-flopping lately it's hard to tell where the administration stands. Obama still talks of working with Republicans. When will he realize that's impossible?

From the beginning, Obama allowed opponents to frame the debate. Rather than talking about healthcare for all and the huge cost savings that could be possible with a single payer plan, or at least a strong public option, the debate was about a government takeover of 1/6 of the economy. Rather than talking about how people with insurance are trapped in their jobs because they had the misfortune to get sick and now couldn't get insurance anywhere, the talk is about socialism or communism. Rather than talking about how badly healthcare is currently rationed in the US to those who have insurance or money or both, the debate is about pulling the plug on grandma. Rather than talking about how the US spends twice as much per person as any other country on the world with far worse outcomes, the opposition lies about people in Canada or Britain not getting hip replacements or heart bypass surgery. The lies are absolutely incredible to anyone who has any knowledge of universal healthcare in the rest of the Western World.

Obama claims to have cut deals with big pharma and big insurance to save billions of dollars. Of course the medical industrial establishment will give up a few pennies to make billions if health insurance is mandatory! The only thing that has any hope of controlling costs is a strong public insurance option that will keep the private insurers honest. Health co-ops have no chance of doing this. I have a catastrophic health insurance policy with Group Health here in Seattle. They have their own doctors, hospitals and clinics and provide decent service, but the monthly cost for insurance isn't a whole lot lower than Regent Blue Shield for similar coverage. There are only a few working healthcare co-ops in the country, and it's hard to imagine how this model, even if it worked really well, could be set up nationwide.

And then there's the cost issue. Numbers like a trillion dollars in extra spending over ten years are routinely thrown out there. Obama says he can save billions by eliminating fraud and abuse in Medicare. But he talks about it like typical politicians talk about waste in government. He doesn't say that 10-15% of Medicare costs are fraudulently billed by his new-found friends in the medical industrial establishment. He doesn't talk about why Medicare costs in McAllen, Texas are twice the national average. He doesn't talk about how at least twenty-five cents out of every healthcare dollar goes to overhead, administration and profit. He doesn't talk about how the medical-industrial establishment will bankrupt us all, assuming that the financial-industrial establishment hasn't already done so.

Obama's campaign was all about Change, and Change We Can Believe In, and Yes We Can. And a lot of us believed it. We couldn't stop the march to war in 2002 because Democrats would lose the congressional elections. Guess what, they lost anyway. We couldn't stop the war even though Democrats won a majority in the house in 2006. Democrats also won a razor-thin majority in the Senate, but Bush still had veto power, etc. etc. So in 2008, the Democrats won big in the House, a 60 seat filibuster-proof majority in the Senate, and the Presidency. What is their excuse now? If the Democrats don't manage to bring real change to the healthcare system in the US this year, they deserve to be in the political wilderness forever.

Let the Palin era begin!