By Steve Klinger
In a candid moment last week Barack Obama said what is evidently true about health care in the United States: The only way to cover everyone is through a single-payer system. In a press conference that may become more memorable for its blunders than its successes, the acknowledgment seemed unintentional.
Obama quickly returned to his agenda of promoting a much weaker alternative – private coverage with a public option – but the fact that he would even utter the term single payer in public gave some hope to the 86 Democrats backing HR 676 in the House and those who supported a successful amendment proposed by Dennis Kucinich to allow states to offer their own single-payer option.
What a study in contradictions: Seventy percent of Americans believe a single-payer system with the government as sole bill-payer would serve them best, but the lawmakers they sent to Washington to vote their interests are decisively opposed to it. The rhetoric has likened single payer to the scourge of socialism, and the bloviators won’t let facts get in the way of their hysteria:
• In health care outcomes, the United States trails numerous nations with universal care in such categories as life expectancy, teen pregnancies, even infant mortality rates.
• Fully one-third of our $2.4 trillion annual health care expense is siphoned off for non-medical expenditures, mostly lavished on the obscenely profitable insurance industry.
• The Medicare system now covering millions of older Americans and a rough model for what a single-payer system would look like, has been such an effective program for over 40 years that few can imagine life without it, despite spiraling costs that have less to do with government administration than the overall health care environment.
As Obama himself has correctly argued, the uncontrollable costs of continuing our current patchwork of private insurance and subsidized emergency and indigent care will surely bankrupt the United States, as they have helped bankrupt millions of individual Americans, even those who thought their insurance policies covered them. The expense of 50 million uninsured Americans plus another 50 million who are underinsured is higher in the long run than a program that can be regulated and cost-controlled. Obama hopes that introducing a public option will hold the insurance industry’s feet to the fire, but even this huge compromise on a plan that would work is in grave jeopardy with lawmakers.
So what is going on in our so-called democracy? Why won’t legislators work to enact the will of the people when an obvious solution is right in front of our collective noses? In a phrase, it’s the corruption of the political system. That system is rigged against the vast majority of Americans, held hostage to the unregulated greed of corporations, from the pharmaceutical industry to the insurance industry, and far beyond.
Republicans may parse the language of naysaying but they seem uniformly opposed to any comprehensive reform that involves the government. On top of that, hardliners see health care as an opportunity to bring down Obama and the current Democratic majorities, despite the damage their obstructionism would cause. It worked in 1993-94 against the Clinton health plan, so why not do it again? Sounding the clarion call for a wall of opposition, Republican South Carolina Sen. Jim DeMint said last week that health care will be Obama’s Waterloo: “It will break him.” And Weekly Standard Editor Bill Kristol said it’s time for Republicans to “go for the kill” on Obama health care reform.
Conservative Blue Dog Democrats and even some centrists, who could provide reform legislation with an insurmountable 60-vote majority in the Senate, instead have been opposed to a public option; needless to say, a national single payer system in this environment is about as likely as Dick Cheney wearing a peace T-shirt and Birks to the next American Legion function.
The elephant in the room of course is campaign financing. Senate Finance Committee Chairman Max Baucus (D-Montana) has taken millions from health care industry supporters, and (shockingly!) he is opposed to reform with a public option. Other key Democrats are similarly compromised; in fact virtually every member of Congress is dependent on significant corporate support to get re-elected.
The result is a political situation that can best be described medically: paralysis in the form of severe trauma to the Congressional spinal cord. Until meaningful campaign finance reform frees lawmakers from their indentured servitude to the health care industry, representational government in Washington figures to be at a standstill on issues like health care. (Substitute energy policy, gun control and immigration with the appropriate lobbying industries.)
One answer, probably the only feasible political answer, is grassroots organizing to elect a new generation of legislators from the ground up, who will reject corporate campaign financing and show the resolve to reform campaign financing laws once they get to Washington.
In the meantime we need to keep the pressure on Obama and the Democrats to pass the strongest bill their numbers allow. Republicans will obstruct in lockstep. Better that they suffer the consequences for no legislation at all than to allow them to manipulate a worthless, watered-down bill through Congress.