No, Rachel, No! This "Health Reform" Could Lose the Middle Class for Dems

I read with interest Mike Elk's assertion that "liberal elitism will make Sarah Palin President," as well as Oliver Willis' response that "some people are, sadly, stupid." But if Democrats and progressives are really concerned about middle-class votes - and they should be - it's statements like this one by Rachel Maddow that should concern them:

And this weekend, the House grabbed the brass ring that president after president and Congress after Congress have wanted to grab and failed: health reform at last -- the kind of once in more than a lifetime historic achievement that could brand the Democratic Party and inspire voter loyalty for a generation.

Now, as a conflict-of-interest disclosure, I love Rachel Maddow's show. And she gets better every week. But when I heard her say these words on Monday's show, I felt like an actor in one of those slow-motion disaster scenes, watching a friend make a tragic mistake and wanting to shout "No-o-o-o-o- ...." (Remember, it's in slow motion.)

I think that's what Rachel was doing, too, when she went on to rightly slam the Stupak Amendment. (For an idea of how that amendment might look to a visitor from another planet, go here.) But, Stupak Amendment aside, it's this sort of rhetoric that troubles me the most right now. This is not the time for people, especially progressives, to congratulate themselves over this deeply flawed bill. There's still time to fix its most egregious flaws, which are by no means limited to the highly objectionable (and politically foolish) Stupak Amendment. I hope Rachel will reconsider.

Any possible amalgam of the House and Senate bills, as they now stand, will look very much like the plan once called Romneycare in Massachusetts. It will be highly (if not entirely) dependent on private health insurance, will lack meaningful price controls, and will be forced of necessity to leave a great many people uninsured even after passage. It will do great things for the lower-income uninsured - which is to be celebrated - but it will do so by placing disproportionate financial burdens on the middle class.

When politicians and health policy experts were celebrating the Massachusetts bill, only a few of us sent out warnings. But the scenario has played out pretty much the way our minority reports predicted. Politically, the Massachusetts bill - which addresses a much smaller problem than the one we face nationally - is mildly popular overall (51% favorability), but markedly unpopular with those it has affected personally.

And who would that be? The middle class, mainly.(1) That scenario's likely to play out again on a national scale. Those who currently have health insurance will face a future of rising premiums, starting next year, which these reforms would do little or nothing to address. Most of them will not have a public option choice, and even those that do will find it lacks cost-containment "teeth." And, while there's some merit to Goldman Sachs' doomsaying, the insurance companies will have a guaranteed revenue stream that can be enhanced with further premium increases. (The Goldman forecasts address the trend-based scenarios which drive stock prices - e.g.,will margins tend to improve or narrow - rather than absolute revenue numbers, which will remain healthy.)

This hardly sounds like "a lifetime historic achievement that could brand the Democratic Party and inspire voter loyalty for a generation." It sounds more like a bill that will help some people, leave others where they are, and place new burdens on still others. It also sounds like a bill that can be used to make political capital for the GOP, which can paint Dems as "the party that doesn't understand the middle class." A little of that, plus some populist right-wing rhetoric about Wall Street's coziness with Washington, and you could have a winning formula for Republicans.

Why say this now? Because there is still a chance to make this bill significantly better. Democrats can strengthen the public option, reconsider price controls, and make sure not to pass that "Cadillac" tax. (David Leonhardt's defense of it in the New York Times is based in part on a decades-old RAND study that has now been seriously challenged methodologically - I hope to discuss that at more length soon).

Nobody's going to bother addressing some of this bill's more troublesome provisions if smart, engaged progressives like my hero Rachel engage in premature congratulation, rather than providing Democrats the tough criticism needed if we are to get a better result than the one we're likely to face today.

____________

UPDATE: I haven't been able to read all of the comments, and you're entitled to your opinions (if expressed according to site rules, of course.) But, please, guys - the hatin' on Rachel is upsetting to me. I think she's terrific.

Can't we disagree on one point without whipping out the switchblades on one another?

____________

(1)This point applies specifically to families who will be mandated to purchase coverage, but will be eligible for little or no assistance paying their insurance premiums (which, as a reminder, neither the House or Senate bills would do much to contain). This will most strongly affect those who make roughly $66,000/year income and upward for a family of four, and who do not receive insurance through their employer.

RJ Eskow blogs when he can at:

A Night Light
The Sentinel Effect: Healthcare Blog

Website: Eskow and Associates

 

Follow RJ Eskow on Twitter: www.twitter.com/rjeskow

Comments

[uglygnome]

Yes, it could. What appears to be certain is this: any reform, even the watered down crap coming out of the house and senate - will only give insurance companies an excuse to raise premiums and blame it on congress (despite the fact that they are being handed 35 million new paying customers compliments of the US government.) And when they do raise the premiums, freelance, self-employed workers like myself, already struggling to make premiums, will have to drop our insurance because we simply cannot afford it. I will have no choice but to hope and pray the my kids, my wife and I stay healthy.

[PennP]

I was alarmed when I heard her gushy superlatives on the historic passage of the bill, until I heard her ask, of its glory and wonder, "....or IS IT?" Unfortunately, her second-guessing in that show seemed to focus exclusively on the Stupak Amendment. I am hoping and praying that in future shows she will elegantly disembowel the thing, piece by piece. She's been so right on so much that I believe this will happen. But I certainly understand your qualms.

[JayEsbe]

I fully EXPECT, the health insurance industry to raise premiums on the false assertion that the Dems health care bill was responsible, with the specific, premeditated intent of creating a political backlash by the middle class, in hopes of returning Republicans to power. The rotten bastards.

[RTIII]

Unfortunately, you're probably right.

How's that for cynical?
.

[RTIII]

From the better late than never department:

Good post, RJ. I hope this post has a positive effect!
.

[Coinyer101]

They should have given single-payer advocates a seat at the table back in february when there was 59% support for it. When they failed to allow them a seat at the table, they gave up all the best ideas for reform.....,

[jumperpin]

It's sad watching all this back-door support (from progressives, mind you) for big insurance to kill health/insurance reform.

There's a WHOLE LOT MORE in the House bill besides restricted fed funding for abortion ; and yes, a lame public option:

- CBO estimates 96% of us will enjoy some form of coverage

- Far greater consumer protections from onerous caps, cherry-picking, dropped coverage, and many other insurance industry abuses. Finally, even the chronically will have access to affordable coverage.

- Eliminates copays from preventative care and prohibits noncoverage for needed testing.

- Dramatically improves affordability of coverage with progressive subsidies (yep, includes Medicare D style corporate welfare). BTW, it also shrinks the Part D "donut hole" and provides for gov't negotiated drug prices.

- Substantial incentives­/investmen­ts for more primary care professionals. (we'll need 'em).

Of course there's lots more:

http://edlabor.house.gov/blog/2009/10/affordable-health-care.shtml

Scroll down for the readable summaries, endorsements from non-profits/unions, etc. Unlike Hannity and Ed Schultz, many have studied the bill(s) in considerable detail.

...or line up with the insurance companies. They're counting on a robust "single-payer or bust" crowd.

[cybexg]

I've tried many, many times to comment that the current version of the health care bill is far from perfect but much better than what is in place now (our current health care). I've tried warning that only accepting great (or perfect) will end any chance at health care reform. I've tried to explain that health care reform will have to start like this (like the current bill) and take years of improvements through various processes.

Sadly, too few will listen. I believe health care reform will be killed by the progressives, not the fright wing

[Indon]

This is assuming that we end up passing 100% the House bill - the Senate version, I presume, is inferior in each and every one of those ways?

[UkrainianPrince]

I have done essentially the same thing as to donations to the DCCC and the DNC... I will support my Congressman, Rep. Alan Grayson and I have some reservations about Sen. Bill Nelson's willingness to fight for Dem policy and principle, but I refuse as a life-long, card-carrying, voting, donating Democrat to give money to the Dem party to use to stab women, the middle class, gays and minorities in the back!

[skeptical1]

No bill will pass that does not ultimately benefit the investor class to a greater extent than anyone else. They are the ones footing the compaign costs of the decisionmakers. And, the will get what they pay for in the end. It must be remembered that the definition of a poltician is one who takes votes from the poor and money from the rich on the pretext of defending one from the other.

[nana4g]

I received a phone call yesterday from the Democratic Campaign Finance Organization "to promote the election of Dem candidates to US Congress" inquiring why I had not sent in the pledge I made. After they told me how great it was that the House passed the Healthcare Reform Bill, I asked, "You mean that bill with the Stupak Amendment?" The one that will go to the Senate whose bill does not support, but waters down, the Public Option?" I asked them why on earth should I send more money and work as I did for the election of a majority in Nov, if these are the results we get with a majority in Congress now? I told them I would not be sending any more monies to achieve or maintain a majority until the majority performs on behalf of the people who elected them, instead of on behalf of special interest groups who send more money to them individually than I could ever send. Apparently, my vote, my money is insignificant compared to what the insurance industry and the Catholic Church can do for them.

I told them I would deter my political contributions to Planned Parenthood for the funding of elective abortions to those women who could not afford to pay for them out of pocket and for those women who could not afford or who were ideological opposed to mandates to purchase insurance coverage from the insurance industry, such as myself.

[RandVictims]

The Middle Class doesn't have a coherent voice OR coherent leadership. We lack the resolve to fight plutocratic tyranny.

This isn't a "class war", this is a class *slaughter*. We don't fight back.

[MicheleCA]

Is the status quo actually better than what lobbyists have written?

I suppose we have no say one way or the other.

I hate what this country has become.

[textynn]

For some reason the whole AirAmerica Bunch jumped right out and thought the bill was great initially. I was really surprised at their lack of insight and promptly realized these people are really not affected and quite financially insulated. It has caused me to listen to AirAmerica with much more skepticism . It is obvious that many AirAmerica hosts are a little bit too removed to report with insight on the pitfalls of real world wages and health care at the pleasure of small tyrants called supervisors. Because of their reaction to this abusive poverty-upon-entry health care bill, I have stopped listening to Stephani Miller, Rachael Maddow, and Richard Green. I have always liked them, but listening to them defend this health care bill that does nothing to stop the shift of wealth out of the hands of average Americans makes me feel, they too, are somewhat Elitist if they can go with this hand out to the Health Care Industry that has been callously choosing between lives and their bottom line for decades. This debate is no longer just about health care, it is about who is running this country and who should live like kings while others die so they can do it.

[mymatrix]

I don't understand. Are you saying that we CAN have a health reform bill PASSED that us progressives would like a whole lot more?
If not, then what is your point?

[MicheleCA]

How would that happen?

[Muruga]

Great article, thanks.

[THISTLE]

This bill is an insult to every thinking person in this country. Obama caved before any debate
began, when Single Payer was taken off the table. He was on his knees to the Republicans
from day one. The discussions on healthcare reform were never framed the way, they should have
been. Questions that should have been asked include the following:
How can the richest country on the planet NOT provide healthcare to all the people?
How can the members of Congress, fight to stop people from getting healthcare - the
people who PAY for THEIR HEALTH INSURANCE?
Recently, on Larry King, Michael Moore said, "the American people are given so little."
How right he is. In Demark, there are NO medical bills paid for by the patient. No
hospital or Drs. bills. Countries all over the world, including some very poor ones,
provide free health insurance for ALL.
And this bill wants to FINE people for not buying health insurance, - that's ABSURD!
Billions are found over night for wars - literally over night. No outrage about costs,
not any at all.
And there is no real outrage from the Democrats - we are so used to being disappointed,
we just take it. Obama and the Democrats are losing - because they are seen as weak,
spine less. They have the House, the Senate and the White House
and they still act like the Republicans are in power and control. The Democrats will lose because
given how weak they are