Wednesday, September 23, 2009

The Best Thing (on Health Care) I've Read All Week

(I seem to be having a hard time getting anything up on the blog these days. Thank goodness I programmed my Friday Morning Videos in advance, or else September would have ended up being a pretty empty month.)

Last night, I went to a meeting of our local chapter of the DSA. I pigeon-holed one of the long-standing members and asked him: what became of the local efforts on behalf of Health Care for America Now? There were all sorts of meetings and discussions about various registration drives and public actions during the summer; what became of it all? And the story, as it so often is, was simple: nothing ever got off the ground, because every meeting descended into arguments over the details and compromises contained in the various Democratic proposals in Congress. Would it include a public option? What would become of Kucinich's single-payer amendment? How much has Obama already sold progressives out to the insurance companies? (For many people, it wasn't a question of whether or he had; it was assumed that he had, the only question how much he'd already given away.) There was grousing about Democrats, about Republicans, about the public forums all over the internet, and all that grousing led to disagreements and accusations, and that fighting ultimately led people to decide that--par for the course!--it wasn't just going to be impossible to put anything together around here. The Left defeats itself again. [Update, 10/4: Janice Bradley has set me straight about a lot of good and necessary progressive work in favor of health care reform which did happen in Wichita, completely aside from HCAN's big plans which came to naught. See the comments below to get her perspective. Thanks very much for the correction, Janice, and for the example you set in keeping up the forward motion despite local resistance!]

It was with this on my mind that I checked out The New Republic this morning, and a slap upside the head, via Jonathan Chait:

If health care passes, will it be a grand historical achievement, or a crushing disappointment? The answer, I predict, will be both. The American health care system is an indefensible morass of waste and cruelty. The distance between the status quo and the ideal is therefore so vast that we could—-and probably will—-end up with a reform that massively improves the system, while coming nowhere close to the ideal....[O]ver the next few years, President Obama’s political capital will hinge in part on whether Americans see health care reform as genuine progress or a political fig leaf. And his biggest foe in the perception battle seems to be the liberals....

My liberal friends seem convinced either that Congress will reject health care reform, or that it will pass a meaningless palliative. The main exception among this admittedly unrepresentative sample consists of liberals who study health care reform for a living and those (like me) who regularly communicate with them. These wonks (and wonk acquaintances) all think Obama will sign a historic health care bill. Sadly, the wonk cohort is starkly outnumbered.

So, it’s worth pointing out that, for all the flaws of the process, Obama appears to be on track to sign one of the towering social reforms in American history—-the most important change in our social contract since at least 1965, or (I’d argue) even longer. Even the most conservative of the bills working its way through Congress would regulate the health insurance market to prevent the discriminatory practices that ruin the lives of the sick and make vulnerable workers fear to change jobs or strike out on their own. It would start to rationalize the practice of medicine and slow the explosive growth in costs that have gobbled up any growth in wages for many years....And, of course, every bill would establish a practical entitlement to health care....So why are liberal activists, bloggers, and even members of Congress so sullen?


Chait asks a good question, and he gives a couple of good answers: suspicions about the involvement of the private insurance industry (which Obama has made very clear he wants reform plans to work with and build upon, not replace), or a fixation on the public option as the only possible route to decent health care. But I would add to those answers this simple fact: we have developed (or have allowed ourselves to be mostly developed into) a political culture which by and large divides us into complainers or boosters, and the former is always easier than the latter. There is much, to be sure, to complain about this process and the bills it has produced thusfar, especially from a progressive perspective, and particularly from my own convoluted populist-localist-socialist perspective. But folks, seriously; how about at least a little bit of boosting here?

The way I see it, unless you're a Friedmanesque fiscal conservative and genuinely believe that any possible health care reform which comes out of Washington DC will positively bankrupt us once and for all and send the nation back to the Stone Age, or unless you're Hitleresque fascist and genuinely believe that any attempt to make more effective the meager health care options available to the poor or unlucky in our nation will lead to total cultural meltdown, you need to lighten up here. There is much that can be productively debated about what's happening in Congress right now, much that, in turn, both liberals and conservatives may have reason to oppose. But good grief: these are proposals that, whatever else they do, will result in fewer medical bankruptcies and fewer uncompensated costs from unnecessary emergency room visits, and by and large leave everyone who is satisfied with the current insurance alone. What could possibly be wrong with any of that? That there is much which could be better, I'll happily admit. (Single-payer, all the way!) But we're looking at the likelihood in a real improvement in an area that's been a growing, frequently-patched-up-but-never-truly-fixed mess since the Truman administration. That's a real victory, I say. Thank goodness for writers like Chait for calling it like it is. Now if all the rest of us on the left, and all the rest of the decent, even-if-only-just-moderately-egalitarian-and-compassionate Christians out there, would realize the same thing.

10 comments:

Anonymous said...

The fixation, as you call it, on the public option is simple. It's immune to regulatory capture in a way that much of the rest of the stuff is not. The reason SS and medicare have staying power is the costs to attacking them are *or* eroding them are high.

Russell Arben Fox said...

Why would you say that a public option would be immune to regulatory capture? Obviously spreading out the benefits which a publicly subsidized insurance option would make available to many is a good way to prevent it being wholly captured (though of course, the question remains whether any public option which survives Congress would even have sufficiently funding to be able to compete for the great bulk of middle-class subscribers, which is what would really be necessary if the public option is going to be anything more than an easily attacked boutique program for poor people), but I'm not sure anyone familiar with the workings of Medicare would deny that various interests have done a good job in bringing it in alignment with their own goals. It would seem to me to run the same risks of capture as they do.

Stuart said...

Chait's post was the best thing I've read on health care recently.

Yours wasn't bad either.

Russell Arben Fox said...

Thanks for the kind thought, Stuart. Yes, Chait really nailed it with that piece; I hope every progressive or populist or liberal or whomever sees it and gives it a read.

Incidentally, I've come across your blog a few times, and I've been meaning to blogroll you (not that anyone uses blogrolls any more...). Drop me an e-mail sometime, okay? Us Wichita bloggers need to stay in touch.

hampshire said...

I don't think about more but if health care passes will be a grand historical achievement...

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Anonymous said...

"What became of the local efforts on behalf of Health Care for America Now? There were all sorts of meetings and discussions about various registration drives and public actions during the summer; what became of it all? And the story, as it so often is, was simple: nothing ever got off the ground, because every meeting descended into arguments over the details and compromises contained in the various Democratic proposals in Congress."

Russell, I must take issue with the idea that nothing got off the ground on health care in Wichita. The PSJC, DFA, PNHP and others worked through a coalition called Kansans for Universal Health Care. We were strong single payer advocates but had a fairly general petition drive through which we sought to educate people about the complex issue of hcr. We almost immediately saw the need to change the language and gave up single payer in favor of "Medicare for All." It made sense and people could understand the idea.

We collected 1600 petition signatures (in group drives and individually), passed out several hundred "Medicare for All" leaflets in Eng. (200 in Spanish) at sign holding vigils in large intersections and at Tiahrt Town Halls. We organized to attend several Tiahrt town halls in Wichita and surrounding areas and spoke out and encouraged others to do so against Tiahrt and his support of the status quo. There were over 26 different actions and events that we worked for health care in the last 4 months in Wichita. It's true the one public meeting from HCAN didn't happen, but plenty of activist, educational work did. The work is ongoing.

Russell Arben Fox said...

Anonymous, thanks very much for setting me straight about the educational work which HCAN did in the Wichita area. I placed some phone calls myself, back in the summer, but obviously there was much more taking place than that which I was aware of. Blame it on my being a teacher, I guess, and thus 1) busy when the semester started up in mid-August, and 2) big on lecturing and discussing, and thus perhaps overly interested in a general HCAN public meeting. I'm glad to hear there's a lot more to the story than that which I took away from the DSA meetings back in June and July!

Anonymous said...

Russell, I wrote the anonymous post about the work on hcr in Wichita. It was NOT done by HCAN. I don't know of anything HCAN did in Wichita, save organize 2 meetings of activists, and call off the public forum they wanted to organize.

The work was done by a coalition of other groups, including, the Peace and Social Justice Center, Democracy for America, Molly's Brigade, Democratic Socialists of America, and Young Democratic Socialists. Individuals from the Sedg. DP and the Butler Co. DP and NOW also attended some of Tiahrt's Town Halls and one action at Roberts'/Tiahrt's offices on Medicare's Birthday.

HCAN was nowhere as far as I know.

Anonymous said...

There was a rep. from HCAN at the Medicare 44th Birthday Action outside Roberts'/Tiahrt's offices (corretion my second post)