Health and the Republic

As of a few days ago I was fervently hoping some Democrat — progressive single payer proponent or Blue Dog or insurance industry stooge, whatever — would resist the pressure and refuse to vote for cloture on what I see as a deeply flawed health care “reform” bill, and that as a result Reid would go the reconciliation route to push through better legislation on a simple majority. That didn’t happen, of course, and there’s a case to be made that it would never have happened: that Reid would have seen to it that the public option and Medicare buy-in would be scrapped even if Joe Lieberman’s vote were made irrelevant. Anyway, the question is moot. There are progressives trying to get one of their favored Democrats to take a stand against the bill and block it on one of the procedural votes, but now that it’s come this far, I don’t see that happening.

Then what? I hope something better will come out of a House-Senate conference, but I don’t think that’s the way to bet. Keeping the support of all 60 Senators will be challenging for anything even slightly more progressive. I tend to think the conference will produce something very similar to the Senate bill, with all its faults: a massive gift to the insurance industry in the form of an individual mandate, with little in the way of serious cost reduction measures, funded by a tax on insurance policies that will apply to more and more policies every year and drive employers to offer less and less coverage at higher and higher prices, and with no government-run alternative to private insurance that would apply pressure to keep the insurance companies efficient and honorable. It’s likely to be a hugely unpopular system and an albatross on the Democrats in the 2010 elections.

Nevertheless, I’m less certain now than I was a few days ago how bad a scenario this is. As badly as we’ve been served by Emanuel and Obama and Reid and Nelson and Leiberman in this debacle, I still believe the Republican party of the early 21st century is far more evil — and I use that word deliberately and mean it literally — than the Democrats. And I suspect that, as bad as passing this bill will be for the Democrats, it will be no worse, perhaps a bit better, than failing to pass a health care bill at all. After all “they crammed socialized medicine down our throats” is less potent than “they tried to cram socialized medicine down our throats but we stopped them.”

Here is a very interesting article, well worth reading; one that got me thinking and gave me, I think, a clearer picture of the grave problems our Republic faces. It’s an interesting argument that the teabaggers and the advocates of single payer health care are being stoked by a common enemy: the corporatization of government or, if you prefer to look at it differently, government intrusion into the corporate world. Or to put it a third and perhaps more correct way, the growing symbiotism of government and Wall Street. When government and business own a controlling share in each other, wage earners get frightened; and if they buy the propaganda of the right, they blame government and become teabaggers; if they buy the propaganda of the left, they blame Wall Street and become socialists. From where I sit the teabagger movement seems more built on ignorance and duplicity than the left wing is, but exact symmetry isn’t important. The point is that both ends of the conventional liberal/conservative spectrum oppose the Senate health care bill for a similar reason: abhorrence of its furthering of government/Wall Street symbiotism. And that illustrates how un-useful the traditional right/left picture of political variation is.

In other words, if I address myself to people politically similar to myself: Conservativism is not the enemy. Corporatism is. Corporatists may think themselves liberal, and want to work government policy through corporate practice, or they may think themselves conservative, and want government to serve the cause of business; but either way they’re the ones seeing to it that the needs of working families are being sublimated to the wants of the powerful elite.

Looking specifically at health care, I think any honest assessment that takes into account what’s happening in and outside of the US — an assessment few politicians are willing to make — shows that private, for-profit health care historically delivers worse health care at higher prices than public, not for profit care. I am not utterly opposed to capitalism, and in some areas I believe capitalism has worked pretty well, but I am convinced health care is not such an area. Profit and quality of care are just too often in opposition to one another, and therefore profit-driven care is not quality care. Yet proponents of single payer health care in America are immersed in a Quixotic dream. The health care industry is too deeply entrenched in the American economy, it has too much power, for its dissolution to be possible by any means short of revolution. And of course, if anything like the Senate bill becomes law, it is about to become more so.

So either one acquiesces in corporatist government, or one becomes a revolutionary. But what kind of revolution? A bloodless one, one hopes, and one that avoids the excesses that revolutions are prone to. Not easily done, that. And what is this revolution to aim for? The dismantling of corporatist government? But how, and with what to replace it? Doing away with corporations? It’s not clear that’s to be desired. It’s not even clear there shouldn’t be symbiotism; but what there needs to be, and is not, is some way for the profit motive to work with, or at least not against, the goal of making the Republic work for the benefit of all its people, and not simply the enrichment of its most powerful.

It’s 1 am and this will probably look dreadful in the morning. But I’ll post it anyway.

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3 thoughts on “Health and the Republic

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