Will we see a complete breakdown of the Obama Hopemobile (not to be mistaken for the Popemobile) by summers end? The collective anxiety of all who still retain a smidgen of faith in the Democratic Party is tangible. From the newspapers columnists, to the jabberwocky TV talking heads, to the windbag scribblers (like yours truly) producing unread (and unreadable?) blogs - everyone is watching and waiting. The whole idea that we can elect someone as our El Presidente and that one person will miraculously “fix things” is actually pretty naive. Barack Obama, the best of the litter, in terms or electable pols, had fashioned over time a political persona well to the right of any thinking person’s views - professional reactionaries (right wing talk show hosts, Fox TV performers and so-called "conservative pundits") excluded. If the truth were known on most issues I’m sure Obama would prefer a position well to the left of where he stands. But as his erstwhile minister, Reverend Wright, said as Obama skedaddled away from is former views, “what do you expect, he’s a politician.” He had to create an electable entity. A Ralph Nader or a Dennis Kucinich position on the issues would have doomed his enterprise from the start. We know that in order to be taken seriously by the managers of the hegemony, ‘acceptable positions’ on the issues must be assiduously taken.
We have grown weary of expecting much. We are so conditioned to seeing good ideas shrunk down and beaten into mush. And if anything requires courageous confrontation with the imposing and powerful corporate forces, forget it (read: a Single Payer plan was never even discussed in polite company.) If anything requires a breathtaking break with the past, a past that has failed us dismally, forget it. If anything requires exposure of the drooling, corrupt, reactionary, power hungry pack of hacks that hide behind the label Republican Party, forget it. Anyone with a grain of objectivity and the wits of an intelligent 12 year old knows that things are in a rapidly accelerating downward vortex – the US economy, global capitalism, the environment, the water supply, the weather. For christ’s sake we wont’ be able a get fish sandwich in couple of years if the world’s fisheries keep collapsing.
The US spends the most per-capita on health care of any country in the world and yet we are 32nd in infant mortality (UN statistics) well behind our long-time nemesis Cuba at 28th. As the recession grinds on and layoffs continue thousands lose their health insurance every day. 46 million of us wing it without any health insurance at all, knowing full well if we get seriously ill or get racked up bad in an accident, we are up Poop Creek big time. And yet it seems all heaven and hell is aligned against Obama getting even a modest and conservative plan intact through Congress.
And the plan that is being offered is indeed modest to a fault. The money machines, called health insurance companies, are being left intact - free to bamboozle and gouge again. The various others industries that make up the vast resource-gobbling medical-industrial complex that have morphed into virtual vampires are free to keep on sucking. The docs’ comfortable 6 and 7 figure incomes are not at risk. No, nobody as far as it now looks is going to take much of haircut on this. In fact that’s its key weakness - it’s going to cost a lot of money. In fact it's being deemed as “too expensive” especially for the right wing of Obama’s own Democratic Party, the Blue Dogs, who had no trouble voting for George W. Bush’s (a Prez from the opposition party no less) ‘supply side’ baloney tax cut for the rich, or for two wars - one totally unfounded and un-funded.
Only a small brave contingent of members of Congress were ever interested in discussing a real plan, a plan like every other industrialized country has – a Single Payer system. This would mean clearing the table of all the greed heads and parasites, and starting over. It would also mean doing what we are already doing for the senior citizens with Medicare, having the government take over the insurance side. We already have “medical socialism.” It’s called Medicare and Medicaid – for the old and for the (very) poor. With Single Payer the delivery would stay the same but all the payments would go through one big not-for-profit insurance company, the US government. I never hear the oldsters complaining about the “rationing of health care” under Medicare. But that said, some way to ‘de-incentivize’ gaming the system is crucial. Medicare works but costs way too much. And drives up the cost of the entire system. This is because Medicare t is based on fee-for-service not final outcomes. The more service rendered the more money collected. And forget Medicaid, it’s a loser because it relies half on the states. So it’s not uniform. Poor states provide poor coverage. The poor always get the feces dipped end of the stick. But Medicare is different. Everybody if they live long enough is entitled to it. It has been called the Cadillac of health care. But it costs us as taxpayer’s a fortune. It is not actuarially sound. It needs to be reworked, will have to be reworked even if Obama's initiative fails. When the baby boomers all become eligible, Medicare costs will knock us for a loop. The way Medicare is structured everybody has an incentive to maximize service, the suppliers, the providers, the users. And all of this is circumscribed in a law suite rich arena with malpractice lawyers waiting on the sidelines like vultures for the occasional (or not so occasional) error or adverse outcome that can be interpreted as an "error." So expensive tests and others services are maximized both for pecuniary reasons and to fend off potential malpractices suites. And then there is the expensive malpractice insurance that physicians must carry.
The Senate Majority Leader, Harry Reid has announced the Senate will fail to deliver a bill by their August recess. As I write this, the whole thing is tied up the Senate Finance Committee (see http://www.nytimes.com/2009/07/28/us/politics/28baucus.html?hp) chaired by one Sen. Max Baucus from a big but unimportant, conservative, under populated western state - Montana. Baucus is known as a Blue Dog Democrat, a term meaning he is essentially a Republican calling himself a Democrat. The lack of unity of Democrats on this centerpiece issue is pathetic. Letting a small contingent of center-right Democrats hold all that has been already hashed out hostage is beyond tragic. How does this shit happen? The Blue Dogs essentially buy the arguments of the Republicans most of who would like nothing better than the whole thing to collapse into a pile of broken pieces as did the Clinton plan of ’92. The Blue Dogs allied with the Republicans are opposing the fundamental cost control mechanism, a government run option, that would compete with and corral in the money machine health insurance plans. They, the Blue Dogs, good “Republicans” that are see it as is “too socialistic.” Furthermore the Blue Meanies think it should be funded by those who already have health insurance, by reducing existing tax deductions. They are opposed to increasing the tax on the upper income biggies ($250,000 per year and up) whose after-tax income has skyrocketed in the previous Bushian era.
At lot hangs in the balance but at this point it doesn’t look good. Any bill that emerges will be a target rich environment for the mob of Red Meanies (Repubs) that want it to fail (or even worse are afraid it might actually work.) It could fail in two other ways, too: either being too comprised and watered down to get support from those who have carefully championed this for so long, the progressive and majority wing of the Democratic Party or Obama, himself. Or it gets rammed through but it’s a stinker and fails to perform because of its own internal contradictions - another way the Repubs could win big.
The problem is the Democrats in general and Obama and Harry Reid specifically are not big on playing hardball. That’s the one thing the Republicans have going for them, they are absolutely ruthless - they love hardball, and could care less about collateral damage or the truth.
