The Political Stakes in the Battle for Health Care

There is a great deal at stake in the upcoming battle over health care reform, in some respects more than we might think. Reforming our cumbersome and costly health care system and finding a way to ensure that all Americans have adequate health care has been a major goal of progressives for decades. If a good health care bill gets passed millions of Americans will see almost immediate and tangible improvements in their lives. The US will no longer stand out among advanced industrial countries for its failure to meet this basic need.

This, however, is only one reason why health care reform is so important. The outcome of the struggle for health care may not only determine future health care policy, but the success of the Obama presidency more generally. It will either breathe life into the movement that elected Obama in 2008 or be a devastating and discouraging blow to that movement.

Obama's presidency, after the first five months, is at an important moment. The initial adrenaline and excitement, while still present in some quarters, has begun to wear off in others. There are some concrete accomplishments, most notably the passage of the stimulus bill, the closing of Guantanamo and the passage of the Lilly Ledbetter Act, to which supporters of Obama can point. There is also, however, an undercurrent of frustration in progressive circles regarding President Obama that is increasingly difficult to ignore. Obama's confounding failure to aggressively fight for gay rights and to push back against the finance industry remains puzzling, while some of his foreign policy decisions reflect the complexity and difficulty of the challenges facing any president. All of this has raised the political need for a decisive progressive victory.

Health care is the natural place for this to occur. A victory on health care would reinvigorate the progressive movement that elected Obama, and secure the president's place as one of America's great presidents. Failure on health care would have an equally negative effect on President Obama as well as the progressive movement.

Obama's campaign, and indeed his presidency, has been premised on the notion of change. Critics have argued that the word "change" has never been defined sufficiently by Obama either as candidate or president, thus making it something of an empty slogan. Obama's supporters, on the other hand, have always understood what was meant by this promise of change. It refers not just to changing the policies away from those of the failed Bush administration, but also changing the way we do government and politics, not just in Washington, but in the country more broadly.

This is why a defeat on health care would have such a big impact. The forces lining up against health care reform including the insurance companies, the AMA, right-wing ideologues and other conservative interest groups are an almost perfect symbolic collection of the past against which Obama's message of change has been positioned. If the president, and all of us who support health care reform, triumph over these forces of reaction it will be a critical victory for the future over the past. If, however, due to the lobbying, ad campaigns and scare tactics, of the opposition, health care reform fails, it will be very hard to argue that there has been any meaningful change, of any kind, at the core of politics in America. A defeat of health care will be a strong argument that nothing has changed and we are back to the nasty partisan and inefficient politics which has characterized our system for at least the last two decades. It should be remembered that the defeat of health care in 1993 was the beginning of the end for any progressive hopes that had been placed in the Clinton presidency.

Obama's campaign involved many people in politics for the first time. Some were young people experiencing their first presidential election, others were older people who had been angry and disillusioned with politics in the US. It is not at all difficult to imagine some of these people who were brought into politics by the excitement and hope for change generated by the Obama campaign and the early days of his presidency, walking away from politics again if the health care reform battle ends in defeat.

Passage of meaningful health care reform will be the most important piece of domestic legislation in a generation and the most important piece of progressive legislation in two generations. It will all but guarantee Obama reelection and generate more supporters for progressive change. If, however, opponents of health care reform prevail, they will have scored the first major victory for conservative forces since before 2006. It will then be possible to argue that the energy has run out of the progressive Obama movement and that conservatives are coming back.

Comments

[gfulmore]

One of the "strongest" arguments against a public option seems to be that it would be unfair to the private companies. But there are many areas where public vs. private entities work side by side:
Do public universities put private universities out of business?
Do public schools put private schools out of business?
Does the Post Office put Fed EX out of business?
Do public hospitals put private hospitals out of business?
Do public libraries put private bookstores out of business?
Do computers available at public libraries put computer stores out of business?
Can you think of other public vs. private options that compete successfully?
We must counter this false argument that the private sector cannot compete with the public sector, when, in fact, the two can complement each other to the benefit of both.

[mssisyphus]

Affordable health coverage for ALL Americans is too important to get bogged down in Politics.

It is pitifull to listen to Republicans who just choose to disagree with ANYTHING proposed by Dems.

I have already been ruined by two surgerys in two months, because I have a CO-OP Insurance Policy that has never raised it's payment to a Doctor in the thirteen years that I have had it. Ofcourse, once I used it and found out how useless it was, I was branded as having a "pre-existing" illness and could not get another policy.

I was pushed out of the Hospital on the second surgery too early because they found out just how little my policy paid on the first surgery, and I was denied rehab., causing distorted healing.

Now, not only am I ruined financially, but physically. Those of us in the "real" world have known for years that our Health Care system is in "critical" condition!!!

This is far beyond a Political matter, it is a moral and humanitarian matter.

[gfulmore]

In an ideal world, there would be no politics in the debate over a national health care system. But we do not live in an ideal world. Politics are real. At times, forced compromises are the best we can get and the only way to apease the majority. I think that most who voted for Obama did so to encourage progress and equality in opportunities. Availability and affordability of health care services has to be a big part of this. But we will not eliminate politics in this debate.
In his excellent book, "Hot, Flat and Crowded," Thomas Friedman suggests that climate-change deniers come in three varieties: 1) Those who are paid by fossel fuel companies to deny that there is a problem, 2) A small group who really do not believe that there is a global warming problem, and 3) those who hate the proposed solution because it involves more government regulation and intervention. I think these three factors are relevant to the opposition to health care reform, as well, and, for the most part, this is pure politics.

[zrants]

The political ramifications of the public health solutions are enormous and can't be over-looked by those getting ready to run for re-election soon. The end game is a single payer health care system. How we get there is another matter. We should start with the goal of providing basic health care for all American citizens in 2010. Speed should be a top priority and expanding on existing programs is the fastest solution. We are still waiting for the bank bailouts to improve the job market.

Not unlike the insurance industry, most programs run by social services are set up to deny benefits. It would not take an act of Congress to change that culture. The policy of denying benefits just needs to change to one of acceptance. Hire a few more people to process applicants into the system to speed up the process and you have an expanded health care system that covers more Americans without expending a lot of energy, creating a new agency. All that energy can be put into fixing the old system. Once it is up and running, hopefully within a few months, Americans who don't qualify for the free plan, should be allowed to buy into the public health plan, based on a sliding income scale and their needs.

[jmpurser]

I think you've really put the cart before the horse here. Personally, I have nothing invested in making the Obama Administration a success. I have a great deal invested (my life, my fortune, my sacred honor) in making my nation a success. So far President Obama has shown precious little interest in making my nation a success. As our interests diverge my concern for his "success" wains.

[tedbashley]

Now is the time for American citizens to make their voices heard on health care. If Americans came out on the street like the Iranians did I believe our leaders would listen this time. The Republican Party is at its weakest ever. If the American citizen spoke out loud and clear, the nae-sayers will be to weak to keep it from happening this time.

[LewisWalsh]

In France, Italy, the UK and other advanced countries the public will take to the streets for a lot less than what has and is being done to US citizens by the consortium of a bribed congress and corporate power. Does this corporate-­government­al relationship, illicit as it may be, feel a bit like fascism? And, please tell us, Mr. Mitchell, why our citizens do not behave as the Europeans do when they have been maltreated? Is it that on some level they believe that we are not as free as has been supposed?

[lthuedk 1]

General strikes for a specific purpose may be the only way we can get the ear of the bribed legislators.

Get Single Payer back on the table. Demand it. We no longer have representative government so there's nothing to lose but our Republic.

Don't ask. Demand! Organize early and broadly. Let's take government back and be very clear to criminal lobbyists that we are determined to cleanse their kind from _our_ government. If our legislators refuse Single Payer within a specific time frame, strike. This is my land. This is your land. Let's act like it.

Bring it to a stop until we get full representation.

[jmpurser]

In countries where the government fears the people they have EXCELLENT health care. In countries where the people fear the government they have poor health care.

Which do you think we are?

[LewisWalsh]

Law enforcement and investigative agencies of the US include: FBI, DEA, AT F, Secret Service, NSA (National Security Agency, CIA, National Reconnaissance Office, Local Police, State Police, Federal Marshal's, Defense Human Intelligence Agency, Office of Foreign Assets Control, Customs, Securities and Exchange Commission, Federal Protection Service (GSA), Department of Justice Police, Diplomatic Security Service, Internet Fraud Complaint Center, National White Collar Crime Center, Postal Police, Federal Protection (Homeland Security) and Air Marshall's. There are more that I haven't discovered yet. Government is capable of misusing any of these agencies. Obviously, the public, perhaps only on a subconscious level, understands the need to be fearful.

[Willywags]

In one way this misses the point. Passing health care is important to the success of the Obama Administration but it is even more important to the Dems keeping Congress. Dems lost in 94 because R's were motivated by gun control and taxes and Dems were demoralized over failure to pass health care reform. The result a very low Dem turn out. The Dem base could see little reason to turn out for a party that couldn't deliver on something so fundamental. History is at risk of repeating itself because of the "moderate" dems who take huge contributions from health care insurers and drug companies. The focus must be on these folks.

[LinkSync]

WE need to get our Government to Negotiate prescription drug prices and set them nationwide.
The same way Canada does.
This would help an awful lot of people right away.
It would even help the for profit insurance companies.

We can do this one thing regardless of what all else we do.
It could be a seperate bill even. (dream on)
We need to get rid of the donut hole in medicare too.
Doing the price negotiation would help there as well.

Please people FIGHT FOR SINGLE PAYER and GOVERNMENT NEGOTIATED DRUG PRICES !!

[ChelseaC]

Mr. Mtichell,
When Al Gore lost the election in 2000 ( stolen), I was devastated.
After Gore's defeat, I thought never again will I get involved--I didn't want my heart broken again.
2004 camebut I didn't vote.
I was excited in 2007. I liked Hillary as she is intelligent has moxy and style, however, because of her support of the war, that killed it.
Then comes along this handsome guy who was against the war before it became popular to do so, I heard him speak--he moved me to tears. That was it.
He has done the good things as you have listed--BUT his taking money from the insurance companies--I'm loosing hope.
I want Obama to turn this thing around and stand out from the status quo--that would mean putting the American people BEFORE the insurance industry.
I don't buy the "disruption" argument--I know better.
Indeed, he would be the best President ever if he fixed health care--not throwing money at the mess we have now--but starting over from scratch. Single payer with allowing private supplemental insurance. That's the way to fix this--single payer is the answer to get the economy going and to save lives.
If not single payer, Medicare for all who want it with no triggers or firewalls. If the insurance companies can't keep up-- sell other types of insurance or change paths.

[eciaccio]

Only single-payer health care would be a truly meaningful reform of our current mess of a for-profit health industry which results in the deaths of 22,000 Americans each year due to lack of health care.

If Obama and Congress sell out to the insurance industry, they must be thrown out of office in 2010 1nd 2012.

[jmpurser]

Well said. They've already sold out though. Right now they're haggling about the price. We're really going to have to fight to get meaningful health care reform and not a "public option" plan.

[bighat]

Does anyone here know when medicare and medicaid started? I know they are extremely popular and will not be eliminated. I would just like to know when the price of healthcare escalated out of reach and if it coincided And if so does anyone know why?. Was it because of govt payments. Or was it the govt chose not to buy in bulk or whatever.

As a child my doctor make housecalls. Did not want us with the flu to spread it to everyone else.

Now short of being a billionaire or a bigtime celebrity no one gets a house call.

[kevinw]

If we do not get a public option WITHOUT triggers, the Democratic Party will have failed us. And the Co-op plan is just that a plan to co-opt health care reform. Conrad and some of the others are hoping that will be the fig leaf to pacify the progressives.

There is a trigger on the medicare part D plan. Even with its uneveness of coverage and the doughnut hole, we have never hit the magic metric to turn on the public option. It will be the same for the public plan. The trigger is created so that it will be impossible to actually activate. The party needs to know that if they can not pass this with 59 Senators, then there is no value in fighting for more. It only means that they will get the lion's share of the lobbyist booty. There will no need for netroots. No need for contributions or get out the vote. They need to know that there will be a price for failing.

[jmpurser]

Getting a "public option" plan means health care reform has failed.

[Spectator99]

I don't think there can be such a thing as non-partisan when it comes to the major issues and this is the biggest of the issues. The president seeks input from the GOP, the hearings are awash in GOP amendments and the Republicans still vote as a block against the major issues. The president will have to do what G.W.B. did when he wanted his tax breaks for the rich, go for a majority vote in the Senate. It's a sad state of affairs but the GOP has chosen to appeal to their ever shrinking base instead of being statesmen and maybe re-gaining some respect as a political party that wants to represent everyone in the country.

[DaveCarroll4]

The status of our health care is that it's a mess derived from those whose pockets are lined by the gaps and holes that have evolved since the HMO concept succeeded. Whatever the process, reform needs to be gigantic. Only that way will "EVERYONE" have care. Everything proposed so far does not go all the way and leaves millions uninsured. Though I voted for him, Obama is not doing what he said; HEALTH CARE FOR "EVERYONE"! Congress is doing even less. Believe me, there will be no health care reform that transforms us into a CIVILIZED nation. Money... money... money... just like in everything else, money talks and BS walks. Don't count on change in the financial sector either, that already a "no deal". I'll take bets... we're screwed!!! CounselorDave

[jmpurser]

The only system that actually addresses all of our issues with health care reform is Single Payer. Everything else costs more and does less.

[vanmungo]

No MAINSTREAM Democrat is proposing any real reform. One dissenting democrat--John Conyers--is pushing for Medicare for all in the form of House bill HR676; it already has 76 cosponsors. In the Senate, the independent Bernie Sanders has submitted another single-payer bill, S703. Telephone/fax/write your member of Congress and Senator and demand that they support these bills. For more information on the only proven, workable plan to control costs and guarantee high-quality universal health care--nonprofit, single-payer Medicare for all--see the following:

www.pnhp.org

www.singlepayeraction.org

http://www.healthcare-now.org

http://www­.1payer.ne­t/

http://www.guaranteedhealthcare.org/

[ChelseaC]

Bernie Sanders is a wonderful Senator. He cares about Country and the People.
God Bless him.