It's easier to fight against something you hate than for something you feel ambivalently about, and that's the problem with Dems' healthcare program. It's such an ambiguous mishmash of compromises that's it's hard to get enthusiastic about it or even to develop a coherent argument to defend it--not that coherent arguments would make much difference at this point. What would we defend, anyway, when we don't even know if the final bill will have a robust public option in it or not.
We don't know squat, really, about which committee's bill is going to be closest to the one that finally comes out of reconciliation. I think we have good reason to fear that we are going to get a bill that will be for healthcare very similar to what the FISA bill was for civil liberties. If Obama was OK with the FISA bill, why shouldn't he be OK with some watered down healthcare reform that doesn't really reform at a level that matters, and quite possibly will make things worse in the long run. I think the Dems ineptitude and their proclivity to get played by shrewder, more aggressive opponents might very well make things worse when some so-called reform bill finally gets passed.
I've been worried all along that Obama was taking this on prematurely before he really knew what he was doing and before he had secure control of the Beltway process. It's clear to me that, so far anyway, Obama and the Dems are being outmaneuvered by tactics that they should have been prepared to deal with, but which apparently have surprised them. Did they really expect that they could just work it out in a bi-partisan way? Are they that naive? Am I wrong to have expected that Obama would be shrewder and more creatively strategic? Was I wrong to have expected anything, really, from him besides more of the same? I think he's better than he's shown, but something has got to get his Irish, so to speak, up.
At the very least Obama needed to be clear about what he wanted, aggressive in making his case to the American people, and have just drawn a line in the sand about what he simply will not accept. He's got to frame the debate and define what's centrist, not Max Baucus. Centrist should be defined by what a majority of the American people want, not Republicans and Dems in the pockets of special healthcare interests. The Dems' and Obama's ineptness lie in once again having allowed the debate be defined by those interests.
In the long run healthcare has to be taken out of the for-profit sector. It's immoral that such huge profits are being made on people's illnesses. The economics of healthcare should be structured more along the lines of the non-profit economics of education, whether public or private. The idea that profit drives progress and innovation is nonsense, and a case could be made that in critical areas it quashes innovation (e.g., energy and transportation). And in the case of pharmaceuticals, it's been well established that most of the creative work is done at the universities financed by grants, not in the R&D departments of corporations.
I will not fight for a plan that doesn't at least start us down a road will eventually move healthcare out of a model where decisions are made primarily to produce returns for stockholders. And I don't know if this already is over, as many close to the process are saying, but if it is, and if the insurance companies have already won in shaping the essentials of whatever bill will get voted on, I'd be inclined to encourage my reps to vote it down. Better to start over again. Make it an issue for the midterms and hold incumbents' feet to the fire. I'd like to see a massive progressive organizational effort to dump any incumbent who is beholden to insurance and the pharmaceutical companies. That's something I'd fight for.
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UPDATE: Apparently Rahm Emmanuel would think the above post was pretty stupid. Probably because I don't understand how real politics works as an insider. Maybe he should look for ways to make people like me allies rather than enemies. Rahm isn't afraid of a fight, he just wants to fight the wrong people. Wouldn't it be interesting if he'd see these people he's shouting at as people who will fight for him if he gives them something to fight for. No economic progressive is going to fight for an agenda dominated by obstructionist Blue Dogs. And what popular constituency do the Blue Dogs represent anyway? For Emmanuel it's all about the technical win, no matter that what he wins isn't worth much.