Will we get healthcare reform?
Yesterday I called Senator Amy Klobuchar’s (MN) office to give thanks and support for her recent decision to jump on board the growing number of Senators who have agreed to vote for healthcare reform with a public option, through the reconciliation process. The number of Senators on board this movement now numbers 30, with five new converts, including Klobuchar. Obama’s summit meeting last week left no doubt that Republicans will uniformly vote no on the healthcare bill, so reconciliation, which requires a simple majority to pass (including the Vice-President’s tie-breaking vote in the case of a 50-50 tie) is the only option left in the Senate. Our other Minnesota Senator, Al Franken as been on-board this approach almost from the get go. Although the public option is not listed in Obama’s revised healthcare plan, which is biased towards the previously passed Senate version, he will certainly sign the bill should it pass. Furthermore, a bill with the public option may find an easier time in the House, where a number of progressive members do not like the Senate bill and have hinted at disapproval, threatening with a no vote. Some visible progressives, including film-maker Michael Moore, have pushed for gutting the entire healthcare bill and starting over. I think the Democrats, most of whom already know this, will face an even angrier electorate in the fall, should this entire bill come to nothing. Passing it will be hard, but selling it to the public will be far easier, even with its likely flaws.
I viewed Obama’s healthcare summit last Thursday as a huge success for him, his Presidency and the Democrats. With the exception of Bill Clinton, no President in memory, certainly not the last three Republican presidents (Bush I, Bush II and Reagan), could ever have managed to directly challenge the best of the opposition, face to face, without avoiding the appearance of detachment bordering on idiocy. Obama was at home in the confrontational environment of the summit, where he came across as nothing less than an admirable policy wonk. He was more knowledgeable about the bill and issues than any Republican and was unassailable in argument if slightly grim in demeanor. More than anything else, his grim demeanor signaled the end of hope for any support from Republicans. The summit meeting helped to reinforce the idea, hardly original, that Republican presidents are figure-heads, not seriously interested in pursuing the common good, but solely committed to protecting the interests of big business, and, in the case of GWB, even more narrowly committed to the financial centers of the new world. Obama is both committed to some form of healthcare reform and displayed deep knowledge of the options and data that drive the legislative process. The mainstream media seemed to completely miss this important feature of the debate, where Obama won lots of support. As much as any event imaginable, the healthcare summit clearly demonstrated that Democrats care about healthcare reform and Republicans could care less.
Although he is late in coming to the front of the healthcare debate, his entire Presidency could be decided by whether his political strength and strategy can get meaningful legislation passed. I hope all Democrats read the poll numbers after the Massachusetts Senate election, in which Kennedy’s prized progressive seat was won by a fairly conservative Republican. Those polls showed that the majority of voters favored a public option component in the healthcare bill. The anger with many voters, including those Democrats that didn’t vote, reflected the timid, cautious nature of the Democrats, including the past behavior of our President. Hopefully, the summit meeting with Republicans helped Obama to press the “reset” button.
I happened to be watching a lot of the healthcare summit on C-span, which entertained intermittent call-ins. I noted the Republican line, whenever it was not occupied by a crazy or a tea-bagger (perhaps the most common callers), had a few thoughtful callers, presumed Republicans, who had no trouble identifying the hidden deceit of the Republicans, who simply want to preserve the autonomy of the private insurance companies and in doing so, throw out random roadblocks as if they were the free-floating electrons dashing about with all the uncertainty that Heisenberg described for atomic particles. But, for the Republicans, the uncertainty is only in the form of the deceit tactic they decide to use for the moment. When Social Security passed in the 1930s, it did so without a single Republican vote. The Republicans knew then, just as they know now, that any healthcare reform, particularly one of sweeping change, will further erode the stature of their party by surrendering the high ground on an issue which everyone agrees must be addressed as if it was an acute national emergency–just like emergency surgery. While I admired Obama’s performance at the summit last week, I wish that he had been a little more forceful and combative with Republicans when they cited polls and suggested that the American healthcare system was the best in the world. If that is true, why are we ranked 37th overall in the 2000 WHO report and why does the best healthcare system in the world reside in a country that ranks 50th in the world for life expectancy, according to a CIA report (a summary of reports can be found here).
The easiest healthcare bill to sell, that of a single payer plan, is the most difficult one to pass in either house of congress. The single payer option can be sold on the basis of two very different but powerful principles. The first is to simplify and make virtually automatic healthcare coverage for all (”Medicare for All”). By putting everyone under a single plan, any rationing of healthcare, which may be required down the road, will be much more transparent as such changes should effect everyone in the same way. The second great advantage of the single payer plan is that of removing healthcare coverage from our employment. The unification of healthcare with our jobs was an aberration of history, when employers were trying to outbid one another during the acute labor shortages after WW II. By freeing healthcare from employment, businesses can prosper with greater certainty and profit and the competitive pricing of our manufactured products will be more visible and affordable in the international market, particularly when we stop our current Cold War trade policies and start enforcing trade on the basis of improving the economic lives of all Americans, but especially the middle class and poor. Poverty in America is the other disaster that has been partially created by our disgraceful healthcare system that comes close to barbaric in nature for far too many of our citizens. Selling healthcare as a new way of supporting business in America would, for the Republicans, be the most damaging of the two forks of a national, single payer healthcare plan, because this robs them of votes taken out of their own nests. So, why not do it now? Why not convert every decent Republican into a Democrat and leave the remainder as permanent tea-baggers?
RFM
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reshape their party into a new alignment based on a more sensible correspondence with public preferences, they would stand a much better chance of running against the Democrats for leaving out those components that truly make a difference with voters. Many Democrats feel betrayed by the current iteration of our healthcare bill. The bill is only acceptable to many of us if it gives us a Trojan horse, an initial step to have sweeping changes in the future (because the healthcare bill we are going to get will not solve our major healthcare delivery problems) through a single-payer plan that strips healthcare out of its current connection with employment, where it was placed originally because of failed policies of the past.