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Thursday, December 17, 2009

The Health Care Reform Debacle: Meandering from Persuaders to Kabuki to What Comes Next


Two thought-provoking posts about how we got to this dreadful place in terms of the Senate health insurance reform bill, and what might help get us out of here, if that's possible. I'm not sure I entirely agree with either of these analyses, but I definitely think they provide pieces of the puzzle.

I've been out and about among numerous Dems today and it was a stunning experience to learn that, almost to a person, they were devastated (more than angry) -- and almost speechless in an odd sort of way -- at the spectacle played out over the past couple weeks in Washington regarding the decades-old, signature issue of Democrats everywhere.

The people I chatted with ran the array - from chose authorities, to party individuals, to activists, from genuinely direct sorts to lefties. It didn't make a difference. It resembled somebody had kicked them in the stomach, or they had awoken from a fantasy, or somebody had passed on. It jumped out at me that what truly had kicked the bucket was confide in our administration, confide in our Democratic President, confide in the political procedure, confide in our foundations. This most recent disillusionment resembles the inconvenience that makes the whole situation too much to bear.

We feel lied to and spun and used and ignored. We feel disrespected and confused. We feel more than a little lost. At some level, we can't believe it's happening -- even if, at some level, a little voice kept whispering it was coming all the time. This betrayal. It's hard to gin up hope after a long string of defeats and disappointments, so when folks manage to do it, it's hard to give up on. It's hard to let go of. It's hard to admit the hope was mostly in vain. But we feel it in our bones.

There is so very much at stake, so much at risk, so many problems swirling around us like a perfect storm. The very lives of our friends and family, the very lives of the poor and the working poor, the very life of the planet -- all are hanging in the balance. We need boldness and paradigm-strength changes and creativity, compassion, unity.

But over the past few weeks it dawned on many of us that mostly we'll be getting more of the same, more of the way things are, more of the powers that be that are gaining in wealth and power on a national and global scale. More of the kissing up to the owners of the casino. More of the profit before humans. More of the very behavior that brought us to this dangerous place where human beings -- really, all living things -- are viewed as mere widgets, perfect for buying and selling, for using and discarding, for polluting and destroying, for manipulating and abusing.

All so a class of people at the very top can pile up so much capital there's no place to put it. So they invent derivatives and faux everything to keep their "investments" growing beyond any shred of intrinsic value. It's madness. It's sick. And now we fear there is no stopping it, not even with Mr. Change We Can Believe In in the driver's seat. No matter what we do.

It's very difficult to admit and accept that this President, while undoubtedly much better than Bush, is another corporatist at heart, in his mind, in his soul. At the very least he will give in to the demands of the corporate cabals. At the very worst he will fight on their behalf while having his messengers mock those who fight against the tide of greed and dishonesty. We are shocked. We are drifting. Even though we knew better. Even though we knew the score. It still hurts, regardless.

So, yes, we must regroup, find unity and purpose within ourselves, and carry on. Change our expectations and change our tactics. Change our givens and change our focus. He wasn't the one we were waiting for. We are the ones we were waiting for. And we have to start acting the part.

We have to push against this President just as hard as we pushed against the last. He is no longer one of us, if he ever really was. He's been absorbed, willingly or not, into the vortex of the very beasts he should be slaying. He is becoming one of them. Or, at least that's how it feels today to a great many of us. And to me.

I hope I'm wrong.

December 17, 2009 at 11:12 PM in Corporatism, Healthcare, Obama Health Care Reform | Permalink


Yes it does feel as you describe. I don't like to admit it like you said. This is a tragedy whether the bill passes or not.

Posted by: Jared | Dec 18, 2009 12:43:20 AM

I don't know what kind of health care reform will come out of this session, but I strongly suspect it won't be much. There is, however a silver lining behind this very dark cloud. I am reminded of the Civil Rights Act of 1957. Don't be embarrassed if you've never heard of it, there really isn't a hell of a lot to remember about it; a mere pittance, really - a scrap of leftovers tossed out to "American Negros" (in the parlance of the age) in order to appease them. But it made the passing of the Civil Rights Act of 1964 - the one we remember - all-the-more easier seven years later.

We'll live to fight another day.


Tom Degan

Posted by: Tom Degan | Dec 18, 2009 7:59:59 AM

I'm both devastated and angry about this. But the fact that Obama is a corporatist is no surprise. If anybody listened past the hope/change BS during the campaign, it was evident. I'm just surprised that he dropped that veneer as fast as he did and got to work for his corporate masters. I figured it would be at least a year, but that pharma secret deal happened pronto.

Posted by: Kerrie | Dec 18, 2009 8:15:33 AM

I agree with Tom Degan. Making the perfect the enemy of the good is what has gotten us to this place. Can you imagine what we would be discussing if we had passed what was possible on healthcare in 1993?? No one ever gets all they want at once, this is a PROCESS.
It's very easy to stand on the sidelines and complain that enough isn't being done. Anyone who has been paying attention this year knows that people are working hard on getting some progress made. Expanding healthcare coverage to more than 30 million Americans who currently lack coverage, as the current bill would do, is progress.
Am I disappointed, yes, but I'm not angry or betrayed or upset. I'm a progressive who is looking forward to finally starting the path towards full coverage for all.

Posted by: old timer | Dec 18, 2009 8:39:12 AM

I'm aware of the slow beginnings of Social Security and civil rights laws and previously I've suggested that people keep those in mind when viewing this process. However, the last "compromises" have rendered the bill unacceptable, as is, in my view.

I think the difference with this bill is that it transfers billions of taxpayer dollars to the very forces the bill is supposed to be taming -- the for-profit insurers and Big Pharma. How can we expect to fix the system later when we're giving these corporate giants vastly more money, and thus vastly more power, to keep real change at bay even more effectively than they are now? They'll buy even more clout. And with the consolidation of insurers this bill promotes, we'll end up with "too big to fail" corps similar to AIG.

The early Social Security and civil rights bills did not transfer billions to those who were the enemies of the legislation. Big difference.

At least when there was even a weak public option or Medicare expansion provision, there was a keyhole that might be widened as we go forward and at least a bit of competition to hold down premium costs of the vultures. Now there is nothing.

I keep hearing that there are good parts of the bill. That's true enough. So why don't we pass those parts using reconciliation and jettison the fine print horrors that this omnibus version allows?

We now have a bill that requires everyone to buy a product, at virtually any price the insurers set, when it was the insurers that got us to this point of health system collapse. The much vaunted "subsidies" are too small, and they come AFTER already struggling folks have to pay the premiums up front. They come as tax rebates.

Sleazy provisions have been slipped in to continue to permit insurers to put annual and lifetime caps on coverage, to allow insurers to charge up to 300% of regular premiums to those with pre-existing conditions and to continue using "recission" to throw people out of coverage.

Even worse, there is not one thing to help people until 2014. The growing number of people without coverage can suffer until then while Obama calls the situation an emergency. If he believed that, many things would kick in immediately.

One of the reasons we have such a bad bill is that not enough people were demanding of Obama. If more had been critical and kept pressuring him, we might have a much better bill. We gave him the benefit of the doubt and he used that to undermine anything that resembles real change.

I haven't heard yet what value insurance companies add to the health system. Why are we keeping middle men in place that merely skim up to 30% off the top to feed their habit and try to squeeze every dollar? We keep them in place ... why? Bribes, that's why. Same reason Dems were pivotal in defeating the Dorgan amendment that would have permitted importation of pharmaceuticals -- something Obama promised. The President should be calling out and mocking those Dems who voted against the Dorgan amendment instead of having Robert Gibbs mock Howard Dean and anyone else who dares to point out the obvious with this bill.

Posted by: barb | Dec 18, 2009 9:19:31 AM

Shoveling money to corporations. Not the change I had hoped for.

Mandates to buy without any cost controls is not good.

I don't know what to do.

This is a real kick after Afghanistan and the Nobel speech.

How low can we go?

Posted by: bg | Dec 18, 2009 10:05:23 AM

I am extremely glad that so many people really understand what is happening right now to our healthcare bills. Please join me and get the current bills killed. We are better off going back to the states and setting up our own systems, in New Mexico that is the Health Security Act, AND IT IS GOOD!

It is not time to feel bad. It is time to act. If anything passes at this point we must insist that it include a provision that will allow individual states to set up their own healthcare reform plans, even single-payer plans, and to eliminate the requirement that they first waste money with market exchanges and the 2017 time frame. People are dying at the rate of 45,000 per year, that would mean that 360,000 people will have to die before we can begin to solve the problem. That is unacceptable.

Terry Riley

Posted by: Terry Riley | Dec 18, 2009 11:25:49 AM

"At least when there was even a weak public option or Medicare expansion provision, there was a keyhole that might be widened as we go forward and at least a bit of competition to hold down premium costs of the vultures. Now there is nothing."

Even worse than crippling costs of premiums, co-pays and deductibles, there is not a standard level of CARE set. The For profit health insurance industry means to loot our health care coffers further by lowering health care benefits as they raise premiums. Taxes so called "Cadillac" plans would surely have this effect. What is a "Cadillac" plan except to charge more for people who have pre-existing conditions or are women? The sick, injuredand fertile will pay more for less service.

Did anyone see Senator Bernie Sanders yesterday on C-Span? He brought our a chart that showed zero growth in the actual number of doctors while at the same time, the number of health insurance bureaucrats has exploded. There exists a for profit health insurance bureaucrat for every hospital bed in the country. That is where our health care dollars are going as well as the pockets of health insurance CEO's.

Posted by: qofdisks | Dec 18, 2009 3:08:04 PM

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