by BAR managing editor Bruce A. Dixon
This week the Senate's Harry Reid announced the consolidation of the Senate Democratic caucus version of health care reform. How central the “public option” is or is not depends on who you ask, as do precisely how many people it would be offered to and on what terms. What is clear is that it remains a Massachusetts-style bailout plan to subsidize private insurers, rather than one providing universal care at affordable rates. Meanwhile the gap between the actual public option and the imaginary ones sold by progressive Democrats is growing. How long it can be concealed, and what will happen when it is revealed are anybody's guess.
Harry Reid, Democratic Leaders and the White House Still Faking the Funk on Universal Health Care
by BAR managing editor Bruce A. Dixon
This Halloween a couple of persistent spooks haunt Congressional Democrats and the White House on the health care front.
The first is the overwhelming public sentiment in favor of a government-run, everybody in nobody out Medicare For All type health care system. The proper name for this kind of setup, single payer, is rarely mentioned or acknowledged directly, except in tandem with exculpatory phrases like “...but it's politically impossible...” or “...I'm in favor of it but we don't have the votes...” or dismissed with in favor of some “...uniquely American solution...”
The fact is, single payer is so popular that Congressional Democrats have taken to describing their so-called public option to voters in terms that make it hard to tell the difference between it and a real single payer system. This deliberate falsehood has been perpetrated by some Democrats in the progressive caucus from the beginning of the current congress, and it continues to this day.
Single payer partisans were the first to call it. Back in May Kip Sullivan of Physicians for a National Health Care Plan detailed the differences between the real public option and the one described in glowing terms by progressive legislators. He called it a “bait and switch” job. And when Howard Dean declared on Democracy Now that the public option is best thought of as Medicare, Harvard's David Himmelstein labeled him a liar. That kind of deception works fine as long as there are multiple versions of the Democratic health care bill, each well over a thousand pages long in dense legalese, studded with hundreds of cryptic references to other legislation. It holds up as long as most people don't know the effective date at which the uninsured will begin to be covered under the president's plan is 2013. It's good enough as corporate media stick to the script and mention few or none of these things, and the day of reckoning is months or years away. Lies are good and useful things, until you get caught.
Thanks to the relentless work of single payer forces, including some members of the Congress, the web of deception around the public option is unraveling. The day the Senate version of the health care bill was finalized even Rachel Maddow got around to posing many but not all of the same deal-breaking questions Kip Sullivan, PNHP and others single payer activists were asking five months ago, questions that the public option's sponsors couldn't answer then, and can't answer now.
How can the public option “compete” with private insurers to lower their costs when it will be limited to only a few million people?
How can the public option “compete” with private insurers when its pool will be disproportionately poor and sick?
Why must we wait until 2013 for the Democratic plan to cover the uninsured?
The behavior of some leading Democrats on single payer is positively schizophrenic, poo-pooing, downplaying and dismissing single payer while they describe their incredibly complicated some-of-you-in and most-of-you-out versions of the public option and the “robust” public option as Medicare For All in everything but name and unique American-ness. There are, of course other questions Maddow and company could ask whose answers, or non-answers would be even more damning. But these are a good start.
The second scary trick looming ahead of Democrats is of course the 2010 election cycle. When the truth comes out, and voters eventually see the gap between what they want, what Democratic leaders are claiming for their versions of the public option, and what they seem likely to get, it's easy to envision a lot of very unhappy Democratic voters, and not so easy to predict what they might do. Many of them won't vote Republican in any case, but might stay home in numbers big enough to tip the balance in some congressinal districts.
The foundation of the president's plan, and the plans of Democratic leaders isn't single payer, it isn't Medicare For All, and it's not even any kind of public option, robust or otherwise. The foundation of of their health care reform remains bailing out the private insurance companies, guaranteeing them a lucrative market by forcing Americans to buy their policies, some of them with taxpayer subsidies and funds squeezed from existing Medicare, Medicaid and other care for those at high risk and low incomes.
Democrats can lie about or suppress discussion on these things for a little while to come. But the truth will come out, much of it well before the 2010 elections. The standard alibi of blue dog Democrats has always been that they can't support any “robust public option,” let alone single payer because their districts are sooooo conservative. But this doesn't hold water. Many blue dog districts are among the highest in proportions of the uninsured, and rife with bankruptcies, caused in large part by unpayable medical bills. These blue dogs have been shielded from progressive challengers in primary elections by none other than Rahm Emanuel for two or three terms now, and they expect that protection again for standing with private insurers against the voters of their districts.
2010 is beginning to look a lot more like Clinton's first mid-term election, in which Democrats lost dozens of seats and the political initiative passed to Republicans for the next 14 years.
If Democrats refuse to pass a health care bill that is very close to Medicare For All, they are storing up trouble for the near future. They only thing, increasingly, that congressional Democrats have to recommend them is that they aren't Republicans. Whether that will be enough to re-elect them in 2010 is anybody's guess.
Private insurance companies have a business model to protect. They are making a killing. 120 killings a day, in fact, and 45,000 a year. Single payer activists, whose aim is to take private insurance companies out of the health care equation, aim to raise the price of doing business for private insurers to unacceptable levels with tactics that have begun to include nonviolent civil disobedience in and around the offices of insurers, who are the only real death panels.
Congress and the White House are continually bombarded with letters, phone calls, faxes and emails demanding the consideration of Medicare For All, HR 676, simple and effective single payer legislation introduced by Congressmen Conyers and Kucinich, and sponsored by 90 of their colleagues in this congress. The initiative in the struggle for universal health care remains where it always has been, in the streets and in the public and private meetings of single payer advocates. The harder they press, the more divided congressional Democrats become, between those who adamantly oppose single payer AND the imaginary public option, and the faction that keeps telling us their “robust public option” is so much like single payer that we'll hardly know the difference.
If you want to become involved in the fight for universal, everybody in, nobody out health care, go to www.mobilizeforhealthcare.org and sign up to be included in the flow of information and connected with like minded activists in your city or town. It's time to demand what most people voted for last year. Health care for everybody. Now.