Universal Health Care Run by Psychotics
by Matt Stoller
I'm glad there's widespread liberal discussion about the health care system and the need to fix it. Paul Krugman made a forceful argument about it today in his Op-Ed, but it's really the same argument that heroic blogger nyceve makes on a regular basis on Dailykos - the policy questions aren't the problem, the insurance companies themselves are the issue at hand. There are two pieces of the puzzle in health care - the policy and the politics. Clinton's failures in 1993-1994 were the result of a lack of willingness to handle the politics appropriately - read this timeline from Digby and you'll see that we could have won the fight - public support for a different health care system was extremely high, even after Clinton's plan had been defeated.
From what I can see, what happened in 1993 is that a wonky Clinton team tried to preemptively compromise with the insurance companies, and did zero organizing to deal with a backlash they didn't foresee. The right-wing innovated to the defeat his plan, using a new combination of genuinely poisonous Congressional politics, direct mail, and cable news punditry. Instead of understanding that they had been outmaneuvered, Clinton Democrats took the lesson that any policy challenging corporate power had low public support, whereas the business community took the lesson from this fight that bad faith poisonous aggression can pass any policy they want. It was a nice little partnership that worked through the 1990s, though it fell apart with George Bush as corporate elites used the opportunity Bush presented to rape America, and Democrats sat helpless on the sidelines. The K-Street project and the cronyism we are dealing with today are a direct legacy of this fight, but so is the new and pugnacious generation of Democratic politicians who grew up watching us get bloodied with corporate money.
Now I've done a fair amount of blogging on Chamber of Commerce and its President Thomas Donahue, who has built the Chamber into the $100 million a year institutional manifestation of this sickness. Donahue has been on the board of both Union Pacific and Sunrise Senior Living when they were found to have serious safety concerns that end up killing or hurting people, and Donahue never loses an opportunity to lobby for relaxed regulations to allow his companies to kill more efficiently. He's going to fight tooth and nail to kill any attempt to change the system for the worse, and he has $100 million to do it. And with the new Democratic Congress undominated by Dixiecrats for the first time in a hundred years, the fight for universal health care is going to mirror a whole series of clashes with corporate power that include the Employee Free Choice Act, negotiations with Medicare, net neutrality, media consolidation, war profiteering, corruption in the food industry, shareholder abuses, etc. It's that bad. And these are not problems that can be solved this cycle - they are going to require big fights and then one or multiple elections during which the public must ratify our anti-corporate populist message.
The problem with health care in other words is not passing technically interesting policy, which is why the Wyden plan should be seen only as a somewhat besides-the-point rhetoric gambit. The problem is convincing the public that the Republicans and their corporate backers are bent on attacking the American way of life, and that Republicans simply need to be voted out of office. Only then, when Republicans are sufficiently convinced that they cannot survive in office by bucking the public, can we reign in corporate power and implement good health care for all and other nice economic goodies that reduce risk for most of us. To get to this place, we need to present a series of obviously good proposals and let the Mitch McConnell-led Republican Congress filibuster them, and then make 2008 about the national question of who controls the economy. that creates the space for 2008 contenders to be progressive and build a movement around them. Let's not be afraid to take this to the voters, as they are with us.
As part of this, ">Atrios thinks, and rightly so, that getting politicians behind universal health care needs to happen. That's true. I'd like to think a little bit about framing, though. It's been clear for some time that America already has a universal health care system, it just works through pushing costs to states and localities and shunting people to emergency rooms where they die faster and their care costs more. Once we accept the framework that American taxpayers already pay for health care coverage for everyone, we just do it in the worst way possible, the argument changes from 'should the government pay for health care' to 'who's ripping us off'. And the answer is the health insurance industry.
These companies render our health care system bloated and inefficient, but let's be honest, that's somewhat dry language to describe what they are really doing. Through their immoral decisions to deny care and coverage based on excessive bureaucracy, the executives of these companies are simply killers. Their wealth is literally built with blood money. And their chief lobbyist, Tom Donahue, probably believes that there should be a special tax exemption for equipment to clean the blood off their hands. You might think I'm being rhetorically hot or irresponsible, but dealing with horrible customer service designed to deny you care when you have, say, cancer, demands a certain level of honest outrage. It isn't wrong to disdain these people, though I suppose that Very Serious People like to pretend that decisions made by a corporate elite denying millions medical care isn't actually murder by spreadsheet. But it is.
As progressives, we are going to be fighting these terrible people who use poisonous political tactics for a long time. They are well-funded, they are smart, and they have a lot of institutional allies. I don't know what it's going to take to convince Democratic wonks that this is a very aggressive time in politics, and we ought to change our strategies to emphasize public persuasion. But we ought to.
So anyway, to recap, we already have universal health care, it's just run by psychos. These psychos happen to wear nice suits and drive fancy cars and have titles like 'CEO' and credentials like 'Harvard Business School' graduate. These psychos will resist any attempt to take away their power. Taking away their power is a necessary part of any solution.
You do the math.
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Generation of Thugs
By: Jane Hamsher
In response to Paul Krugman's op-ed piece in the NYT on our busted health care system, Matt Stoller has a compelling post entitled "Universal Health Care Run By Psychotics," (see above, Noonan) which I would retitle "Universal Health Care Run by Hoodlums." He outlines that we in fact do have a perverse sort of universal health care, in the form of outrageously expensive and inefficient emergency wards — "it just works through pushing costs to states and localities and shunting people to emergency rooms where they die faster and their care costs more," says Matt.
I'd like to add a sidebar to that. Yes this is the only form of health care available to most Americans, but with the passage of the Bankruptcy Bill last year that left no exception for those with catastrophic medical expenses, the government became a de facto enforcer for a bunch of medical loan sharks. Now there is no relief for those who still have means, no matter how meager, to pay those debts — nothing to help them escape working in a form of indentured servitude to their medical creditors for the rest of their lives. The whole system conspires against them — collection agencies, credit reporting agencies and the courts stand at the ready to destroy their credit and redouble their original debts with outrageous interest and collection fees and force them into payment by seizing their assets and their wages with no regard for their medical condition or other mitigating factors in their lives.
Said Ryan Spear writing at TPM:
It is a system both draconian and obscene.
Matt's post is also worth reading for a rundown of the players who will conspire to kill any move toward universal health care, most notably Tom Donahue, the Chamber of Whores and the insurance industry. It's also a good recounting of the missteps made by the Clinton Administration as they tried to please everyone with HillaryCare and ended up pleasing no one.
Says Krugman:
He's right. Appeasement only sowed the seeds that the lobbyists used to destroy universal health care in the first place. Let's not make the same mistake twice.
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By: Jane Hamsher
In response to Paul Krugman's op-ed piece in the NYT on our busted health care system, Matt Stoller has a compelling post entitled "Universal Health Care Run By Psychotics," (see above, Noonan) which I would retitle "Universal Health Care Run by Hoodlums." He outlines that we in fact do have a perverse sort of universal health care, in the form of outrageously expensive and inefficient emergency wards — "it just works through pushing costs to states and localities and shunting people to emergency rooms where they die faster and their care costs more," says Matt.
I'd like to add a sidebar to that. Yes this is the only form of health care available to most Americans, but with the passage of the Bankruptcy Bill last year that left no exception for those with catastrophic medical expenses, the government became a de facto enforcer for a bunch of medical loan sharks. Now there is no relief for those who still have means, no matter how meager, to pay those debts — nothing to help them escape working in a form of indentured servitude to their medical creditors for the rest of their lives. The whole system conspires against them — collection agencies, credit reporting agencies and the courts stand at the ready to destroy their credit and redouble their original debts with outrageous interest and collection fees and force them into payment by seizing their assets and their wages with no regard for their medical condition or other mitigating factors in their lives.
Said Ryan Spear writing at TPM:
QUOTE
The infamous “millionaire’s loopholes”—which allow rich filers to hide their wealth by buying mansions or special trust funds—were carefully preserved. At the same time, the bill raises the price of filing even for the lowest income earners and eliminates a judge’s discretion to discharge debts if people go bankrupt due to medical emergencies, job loss, or divorce.
It is a system both draconian and obscene.
Matt's post is also worth reading for a rundown of the players who will conspire to kill any move toward universal health care, most notably Tom Donahue, the Chamber of Whores and the insurance industry. It's also a good recounting of the missteps made by the Clinton Administration as they tried to please everyone with HillaryCare and ended up pleasing no one.
Says Krugman:
QUOTE
But now is the time to warn against plans that try to cover the uninsured without taking on the fundamental sources of our health system’s inefficiency. What’s wrong with both the Massachusetts plan and Senator Wyden’s plan is that they don’t operate like Medicare; instead, they funnel the money through private insurance companies.
Everyone knows why: would-be reformers are trying to avoid too strong a backlash from the insurance industry and other players who profit from our current system’s irrationality.
But look at what happened to Bill Clinton. He rejected a single-payer approach, even though he understood its merits, in favor of a complex plan that was supposed to co-opt private insurance companies by giving them a largely gratuitous role. And the reward for this “pragmatism” was that insurance companies went all-out against his plan anyway, with the notorious “Harry and Louise” ads that, yes, mocked the plan’s complexity.
Now we have another chance for fundamental health care reform. Let’s not blow that chance with a pre-emptive surrender to the special interests.
Everyone knows why: would-be reformers are trying to avoid too strong a backlash from the insurance industry and other players who profit from our current system’s irrationality.
But look at what happened to Bill Clinton. He rejected a single-payer approach, even though he understood its merits, in favor of a complex plan that was supposed to co-opt private insurance companies by giving them a largely gratuitous role. And the reward for this “pragmatism” was that insurance companies went all-out against his plan anyway, with the notorious “Harry and Louise” ads that, yes, mocked the plan’s complexity.
Now we have another chance for fundamental health care reform. Let’s not blow that chance with a pre-emptive surrender to the special interests.
He's right. Appeasement only sowed the seeds that the lobbyists used to destroy universal health care in the first place. Let's not make the same mistake twice.
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