Tuesday, December 08, 2009

no public health insurance for you!

After days of secret talks, it looks as if the Democrats are giving in on a government-run public option. "In place of a government-run plan," Associated Press reports, "officials said the Democrats had tentatively settled on a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage. Additionally, the tentative deal calls for Medicare to be opened to uninsured Americans beginning at age 55..."

According to Reuters, "Democratic Senate sources said the substitute proposal would create a non-profit plan operated by private insurers but administered by the Office of Personnel Management, which supervises health coverage for federal workers."

Except that we've been down this road before. Non-profit cooperatives are to a "robust" public option as a handshake is to a passionate kiss. As McJoan at Daily Kos points out, (citing Politico) private emails among insurance company lobbysists are declaring victory based on this outcome. 
The bill without a public option is little more than a big ol' wet kiss to the insurance industry, a gift of some $600 billion and millions of new subscribers. Sure, they'll have a few more hoops to jump through to figure out how to dump people and deny their claims, but they'll still be able to do it. There are bits and pieces in the legislation that will help control costs, but without a program that expressly challenges the status quo of employer-based private insurance, it can't be called "reform."

If the insurance companies come out of this declaring victory, it's not reform.
60+ percent public support is not enough to overcome corporate opposition. We may have won a few table scraps, but it looks like we've lost the most significant part of the battle. This is a failure of democratic deliberation brought about by the intervention of corporate resources --nothing more and nothing less.

This outcome was made possible because Obama himself, and even many "liberal" democrats, fundamentally believe that a world where the rich get better care than the poor is an acceptable world--one not worth the effort and risk of a foundational attack.  Obama admitted such an outcome was inevitable long ago when he said the market culture of America rendered single payer inappropriate.  "Obama’s case against single-payer," writes Alan Nasser, "frames health-care priorities in the language of atomic individualism. Hence, the range of possible outcomes is determined for the worse before discussion begins." 


Russell Arben Fox said...

I can't disagree with anything you say here, Matt; Obama and the leadership of the Democratic party have announced themselves as rock-bottom believers in the individualistic ethos at the heart of finance capitalism again and again and again. And so of course they were going to build upon already-intrenched private insurance interests. But unlike you, I just can't get myself to blame them too much, because I find it hard to believe that a more direct attack upon the system would have worked. Perhaps it might have; perhaps there was some way to bring around dozens of Democrats whose campaign finances depend to a great extent on contributions from insurance companies to an embrace of single-payer, or something else. But if there was such a strategy, I can't imagine what it would have been. So again, perhaps I end up playing the patsy, but I'm putting my hope and faith right now a compromise which will leverage Medicare into doing something slightly more, for slightly more people. It's infuriating that it has come to this...but then again, it's infuriating that Reid, et al, have to deal with the Senate that we have.

Anonymous said...

Although totally unrelated to this post... I hope you enjoyed your time in Iraq. Sounds like it went quite well.

Here's to your safe return, and happy holidays!


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