The Democrats may pass a bill, and it may contain a watered down public option, but the Democrats have mostly blown it on health care reform. Were it not for the massive numbers of the uninsured, the large majorities in Congress, the swelling health care costs, and the distaste Democrats have on the Hill for failing to pass health care reform again, as they did in the 1990's, the chances of passing a bill at this point would be nil. When Bill Clinton's health reform proposal dipped to just 47% approval, Democrats on the Hill called it DOA, so with Obama's proposal at just 37% demonstrates the other factors at play. Democrats know, politically, they have to do something on health care, or risk looking like complete incompetents. Here's where the Democrats went wrong...
They needed to pick a side and argue for it. I'm talking about you, Hillary, Obama, Edwards. And, I'm talking about us for letting them get away with it in the primary when we could have used momentum for health care reform to build a movement for a truly transformative policy(yes, I know many of us felt after the election, we'd be able to push a campaign for Medicare for All, and I know some of you said all along we should be pushing for Medicare for All, but lots of us let it slide). Anthony Weiner has been sporting the best rhetoric on Medicare for All I've heard from a Democratic politician in a long time. Here's how. He doesn't argue it primarily from the moral sense. He has said, yes, in a sort of academic way we have a moral obligation to provide everyone with health care. But the gist of his argument is practicality, that fiscally, the most pragmatic policy is to expand Medicare to All. The policy saves money and gives peace of mind to the middle class. And, Medicare for All doesn't give taxpayers the sense that their leaders in government are looking out for Wall Street over Main Street.
Here's Weiner's bottom line on the politics of Single Payer:
I have no delusions about the muscle needed to overcome resistance from the insurance and pharmaceutical industries. But I believe that for every American we may lose to a slash-and-burn TV ad funded by these businesses, we will gain five among those who are looking for a clear rationale for what we are trying to accomplish and an example for what it may look like.
We also achieve something else: realignment of the political universe. Democrats understand the role of government and are proud of our signature achievement: Medicare. The Republicans care most about big business.
That Weiner is building the case for Medicare for All should tell you that the paltry public option being in crafted in Congress is not the end of the debate. We will be back to expanding Medicare at some point. It's the 800 pound gorilla in the room, and it will remain so.
Now here is what is wrong with trying to find a position in the middle of the choices in health care policy. Democrats confuse people when they do this. It's unclear what they are proposing and where their principles lie. Now, of course, we know what Republicans are proposing and where their principles lie, and it's unappealing to most Americans, but that doesn't change the fact that Democrats are not offering a distinct policy that people can easily envision and understand the principles behind.
Here's Sebelius on the Public Option sounding absolutely befuddling:
Ironically, you know, the public plan is a compromise position. There are many members of Congress, and certainly many members of the American public, who are anxious to have a single-payer plan — get rid of all the private insurance companies, and move to a system where you cut out the middle guy altogether. The president has not supported that. I have not supported that.
So the public option is really a competitive market strategy for a new marketplace that really only applies to people who either don’t have affordable coverage right now, because they’re in the private insurance market buying individual coverage, or small business owners who, frankly, are paying the highest coverage of anyone in America.
Huh? Get rid of the private insurers. Sounds good. Cut the middle man. Makes sense. She and the President don't support it. Ok, why? This sounds like an actual solution. Why wouldn't you support it? Then she goes through hoops making public health care sound like a free market solution. That's frankly, confusing. What's the principle behind the policy? And, most of the Democrats do this or worse. Their rhetoric is just awful. They say things like "I support single payer, but Americans are not ready for it." Says who? "I support Medicare for All, but it doesn't have the votes." Why doesn't it? "If we were starting from scratch?" But we are starting from crisis.
Democrats should have been arguing to expand Medicare for the last 40 years. It's our signature domestic policy initiative outside of social security. It's very popular. And you know what, I think the conservatives are laughing at us for not advocating for it this go-round. It makes Democrats look...weak. Sorry, it does.
Here's Frum positively smirking at the Democrats for missing the Medicare for All moment:
The single strongest advocate I know of a single-payer, government-run health-care plan is a small-business-owner friend. She runs a company in a knowledge industry, and her employees are her greatest asset. She must provide health-insurance coverage, or they will quit. But the cost of her coverage has more than doubled since 2001. If she were offered an escape from this crushing burden, she'd gladly pay a tax of 6 percent, even 8 percent, of payroll. And she's a Republican.
But who is listening to her? Henry Waxman's overly ideological opening bid in the House, the Republican senators' eagerness to inflict a "Waterloo" on a powerful president, and the accident that the most powerful Democrat on the issue represents a red state—all have combined to produce a gigantic and expensive whiffle.
And from a Democratic point of view—yikes!—what a crushing disappointment. As the punch line of the old Soviet joke posed: "For this you made a revolution?"
Indeed. This is our transformative moment on health care? A market based solution with a paltry public option.
Here's David Brooks also slightly mocking Democrats in their safe-based health care approach:
Over the long term, I’ve become more and more convinced that we have to make a choice. We either have to go down the road to single payer, as you’d like, or we have to go down the road to a consumer-driven system, as I’d prefer. I like the latter because I think the health care economy is simply too dynamic and complicated to be regulated and driven from the center. Nonetheless, I’ve lived in Europe and I don’t regard single-payer as a civilization-ending disaster.
Both of these options are better than the status quo. And I’m afraid the status quo (in obese form) is where we are headed.
Democrats need to offer a choice. A distinctive policy with clear Democratic principles behind it would be best.