When the health care debate began lo these many (many, many, many) moons ago, I felt sure of some things based on my experience with the health care reform battle in the Clinton White House. I was certain that it would take far longer than was being projected; that the bill would have lots of compromises that would make me unhappy; that the process would be messy, ugly, convoluted, bitter and highly partisan; and that every single step of the way would be wrenchingly hard.
It turns out that I was an optimist.
All of my assumptions came true in spades, but in every single case it's been worse than I feared. We are now finally - finally - coming to the end game. Over the next couple of weeks we will finally know whether having gone this far, Democrats can drag this wounded beast of health care reform across the finish line.
There are so many things about this process and this bill that I am unhappy about. The Obama White House made way too many tactical mistakes, compromised too early and too often, gratuitously insulted their base multiple times, and failed to show the leadership they should have on some of the biggest issues. The final package, while improved in some very significant ways from what the Senate passed, will be deeply flawed both policy-wise and politically. At this final moment of decision, though, I think progressives need to say yes to getting the bill passed.
Over 40,000 Americans a year are dying from not having insurance, and that number will go up if this bill isn't passed. People who don't have any way of getting insurance currently will get insurance with this bill, and subsidies to help pay for it - subsidies that progressives have succeeded at increasing from the inadequate Senate bill. A right to health insurance would finally be established in this country, crossing a rubicon that we have worked to cross for over a century. Insurers will no longer be able to screw people who have pre-existing conditions. Insurers will finally be subject to federal rate regulation. National exchanges will improve competition for insurance companies.
For all the disappointments, for all the flaws, this legislation does some critically important things, and I believe it sets the stage for doing better things down the road. If Democrats can't get this passed now, the lesson that Democrats will learn is to never try anything big or difficult again. If we get this legislation passed, it begins to change the psychology of Democrats just a little: that they can succeed at being ambitious and that they can make big changes if they persevere in the face of big money and political challenges.
So I'm all in. As painful as the process has been, as disappointed as I am by the flaws in the bill, I'm all in. I'm not consulting with anyone anymore on this issue (HCAN has had me as a consultant for a while, but that's been done for some time). I'm in this fight because I think it's the right thing to do. Which brings me to the rather painful decision I had to make late yesterday: that cruise trip I won a few months ago in the Air American contest (many thanks to all of you who voted for me) leaves from San Diego tomorrow, and I've decided not to go. My wife and I were really looking forward to it, having never been on a cruise, and we were very excited to be able to spend some time with Rachel Maddow, who is the featured guest on the cruise. (Seriously, Rachel, you are my all-time favorite cable show host, and getting to hang with you was the main reason I wanted to go on this trip. Maybe we can do lunch sometime.) But with the fate of this bill hanging in the balance, with the Speaker still facing a tough hill to get the necessary votes, and next week being the time to finally pin people down and get this done, I could not in good conscience go on the trip. I started working for universal health care 30 years ago, I fought the good fight with the Clintons the last time around, and I am not going to leave the battlefield for a week now. I am going to fight tooth and nail to get it done this time.
Plus I have one other big reason to stay: the insurance industry is coming to town. As I wrote yesterday, thousands of people will be marching to the Ritz-Carlton, where the insurance executives are meeting, and we're going to shut the meeting down. I want to be there with my friends and allies to hold these insurance execs accountable for the people who have died because of the way they do business. I hope you will join me.
To all my progressive friends who have been fighting this long, hard fight on health care: I know not all of you agree with me that this bill should be passed. But I think on balance that this is the right thing to do, not only in terms of health care but in terms of our broader progressive agenda. Because of you, not even the fight for the public option is over (although it's way uphill). Let's stay on the field, keep fighting, get this bill done, and then keep fighting for better things in the future.
What I don't understand is why there wasn't a huge push for people to come to Washington for the march. I belong to several progressive sites. I expected to be deluged with emails encouraging me to come to Washington. But I wasn't. Instead, I had to search all over the Internet to see whether any group in my area was organizing a bus ride to Washington. Turns out there are none in my area, but there are bus rides planned in other areas. For anyone in these areas, here are organizations planning a bus ride to Washington for Tuesday's protest.
Connecticut Citizen Action Group - http://ccag.net/civicrm/event/info?id=34
Progressive Maryland - http://progressivemaryland.org/page.php?id=268
bus flyer - http://progressivemaryland.org/public/documents/2010/health/2010hcan-ahip-protestflier.pdf
NJ For Health Care - http://njforhealthcare.org/national.html
bus flyer - http://njcitizenaction.org/hcan2010dc.pdf
Citizen Action of New York - http://action.citizenactionny.org/p/salsa/event/common/public/?event_KEY=15844
Metro New York Health Care for All - http://www.metrohealthcare.org/html/special_events.html
Pennsylvania HCAN - http://blog.hcanpa.org/?p=420
WV Citizen Action Group - http://www.wvcaef.org/cag/elist/cag_current.htm#five
With that the "health care fight" was over. What was left was a struggle over how big and how pure a corporate welfare bill to pass if we pass anything at all.
Our choices today are whether or not to make the current hideously expensive system even more expensive and slightly less cruel or to get nothing at all.
Epic fail for the Left, the Democratic party, and the American form of government.
It's not a perfect bill (soon law), but it will allow further discussions concerning healthcare instead of closing the gate for many people for many years.
This will be an epic success for all involved.
The only epic success I see in the whole health care reform debate, is that it has shown the average citizen just how corrupt the entire process has become.
"No man can serve two masters". Simple statement, absolutely accurate.
Our elected officials only serve OUR best interests when they don't conflict with the interest of those who provide the money that keeps them in office, the corporate lobbies.
When given the choice between serving the electorate, or serving those that gave them over 6 million dollars each (just last year), human nature prevails, the good of the public becomes secondary to personal gain and corporate needs. Profit has become America's religion.
Until there is campaign finance reform, all other reform bills are lip service.
This bill has ONE purpose -- trading a mandate that forces people to buy private insurance, at whatever extortion level rates the insurance industry colludes to charge, with no choice of any form of public option alternative, under tax penalty if we don't, in exchange for an ocean of corporate campaign cash from the insurance, pharmaceutical and hospital industries.
History will record that a President who was elected with a historical mandate and tremendous good will sold his political capital and mandate to the highest corporate campaign contributor, and that tens of millions of people saw their standards of living lowered even further.
Most countries, most of the time, are badly governed. The USA is not an exception.
The question of governing a country (US for example) is a separate issue. It's true that govts tend to be conservative (to stay in power), but that has nothing to do with quality.
The charge of "govt takeover" would have rung truer had Reid decided to go with reconciliation early on.
Perhaps this will lead to a change in the rule (ala Harkin)
For those who say to scrap it and start over I can only say, the GOP welcomes your help. Nothing would please the GOP more than for the 2 most popular Democratic presidents of the last 40 years to have tried to get healthcare passed, and failed (if that occurs).
There's no way for the bill to become perfect within the next several weeks. But it''s still good, esp to those millions that will be newly insured, and because it'll be the first step in our (US) thinking that we should have a healthcare system instead of the hodgepodge make up we currently have.
You're absolutely correct, if it doesn't pass now, it'll be many years before this is again taken up. If it fails, it'll become the third rail of politics.
Failure: Insurance cos will continue to profit at Americans' expense, they won't lower costs. People will get poorer, and the country will suffer.
However, it appears Obama, Reid and Pelosi will be able to have this passed.
Everyone choosing Private Option could have it free with no restrictions.
All 300 million people in the US could receive free public option health care, delivered from government VA system styled hospitals, paid for with sales tax revenues instead of insurance premiums, and it would save $1trillion dollars every year from the $2.6trillion spent last year.
Of course not everyone in the US would choose to use public care and those wanting to purchase private insurance and care could do so.
All government funded care would go through the Public Option to control costs and outcomes.
Veterans Government Health Care is producing better outcomes for Vets than civilian patients are receiving anywhere else in the country including Mayo, Cleveland Clinic, Medicare, anywhere and for a fraction of anyone else’s costs.
Americas Veterans Administration is now the largest, lowest cost, best outcome producing at any cost, health care delivery system in the US, it developed and uses the world’s best medical software VistaA.
The VA’s successes can be used to create a Public Option government health care system now.
See Phillip Longmans book Best Care Anywhere: Why VA Health Care is Better Than Yours.
http://www.washingtonmonthly.com/features/2005/0501.longman.html
The Public Option could be jump started by acquiring health delivery systems around the country that would choose to sell to and be integrated into the Public Option.
The entire country could be served by year end 2010.
We have another party so grotesquely lacking in courage, conviction, strength and integrity, a party afraid of its own philosophy, its own vision, its own campaign promises, a party of cowards and killjoys, a party willing to accommodate its opponents to the point at which -they- might as well be the majority, for all the influence they and their ideas have had on the legislation everyone knows they will -never- vote for.
Then there's the President.
The GOP has a lot of money and influence, yet its strategy of opposing anything suggested by the Democrats, its reliance on fear as a political device - Cheney(x2), terrorism, etc - and its maniacal representatives, Steele, Bachmann, Palin, etc - show desparation. The GOP has never been good at governing (it doesn't care about Americans), but it used to be good at winning elections; now it's not good at winning elections. There will always be exceptions ("Brown") but the trend is away from the GOP. (Notice that Brown Never used "Republican" in his campaign).
After a few more cycles, there will be another major party, though it's still not shown. Existing parties have an opening, esp w/all this "corporation" talk, but they're not entering the fray. Nader would be the natural, but he's waiting for 2012 to say, "Unfair, I'm not on all 50 ballots!" Guiliani showed in 2008 that waiting for clearance to stratigecally(sp) enter a race doesn't work. There's nothing that will pull the fractious TeaParty together.
The GOP will remain (a southern, regional party?) but not as a major party.
That's why we're seeing extreme actions on
I wish I knew what it was about the Republican party that makes people feel safe, comfortable, normal, where the Democrats feel like a risky and dangerous aberration by comparison. We all know the anti-government and militia types tend to keep quiet when the GOP is in power, even as the GOP grows government, drives up the national debt, and spies on American citizens. What I don't understand is why the public at large is so patient and forgiving to Republicans in ways they have never been, in my lifetime, with Democrats.
Whatever President Obama wants to accomplish, he'd better do it this year. Once the GOP takes over Congress, he's done.
Example: Under Obama, we're concentrating on Afghanistan, as he said we would, while getting Pakistan to be more involved. BTW, We're scheduled to start leaving in 2011 - he's being responsible.
Tackling 2 wars, the economy, jobs, healthcare, immigration, and soon more [watch] is more than any president has done. Nothing's completely done (it never is) yet nothing will ever be perfect for everybody. A "wuss" would be someone that doesn't let these issues come to the table, not someone that brings up these issues. Call Obama and the Democrats whatever you will, yet if a wuss would lead us away from the perils of the previous 8 years, then I'll take "wuss."
http://www .huffingto npost.com/ ann-imse/h ow-to-fix- health-car e_b_475916 .html
Authorities who need "more studies" are not interested in solving the problem and are spinning. These dinosaurs need to be removed. Exposing and monitoring practice-patterns and comparing statistics with local and national peers, will reduce over-utilization by 30% in the first year, before any corrective action. Healthcare planners and administrators in 'high cost states' like those in the Northeast should read the above article.
After studies of various treatment parameters and comparative analysis are made, the data (physician- and hospital-specific) should be on-line. Local print and TV should publicize the data; and start a dialog in the community about families and community helping medical providers be more efficient in delivering care. This can be facilitated by Chamber of Commerce and AARP. Important aspect of good care is patients having effective family and social support during illness and at end-of-life.
A stick for cost-effective healthcare - lack of reimbursement for unnecessary treatment as defined by best practice patterns.
And I admire your skipping the cruise to stay on the field. Ms. Maddow, if you're reading this, perhaps you could spare an hour to have coffee with Mike--he deserves it for the sacrifice (I like to think I'd've done the same, but really, not many would, and I'm not sure I would, either).