Obama to Ben Nelson: “I Will Bury You”
ADRIAN BLEIFUSS PRADOS
Since last year’s Democratic primaries, the most obvious weakness in Obama’s liberalism has been its reliance on consensus and good-faith dialogue with political adversaries. Indeed, it is a liberalism that knows no enemies and sees only potential allies.
Unfortunately, the basic progressive platform (health care for all, strong unions, access to quality housing, education and public transportation, etc.) faces stiff opposition from irreconcilable interests that benefit greatly from the status quo. It is no accident or administrative oversight that millions of Americans have no health insurance, a just and equitable universal health insurance system would spell the end of the health insurance industry, and so the industry and its allies in Congress quite rationally oppose any such reforms.
Once upon a time, before government-run fire departments, private fire brigades would put out fires in those buildings covered by fire insurance companies. This policy of selective, for-profit firefighting was inefficient, inegalitarian and unsafe for dense urban communities, nevertheless it was profitable for the fire companies of the 19th century, whose owners were probably quite happy with the system as it was.
The analogies to health care are obvious; the for-profit health insurance model is inefficient, prohibitively costly for those most at risk, and epidemiologically unsafe for the public at large. Some people make big money in this unhappy arrangement. Those people, the major insurance companies and their lobbies, are not potential allies because their interests are antithetical to meaningful reform. They cannot be “brought to the table” because any real solution to the health care problem would necessarily involve their demise, like the for-profit private fire companies of yesteryear.
Sadly, the Obama administration seems determined to pretend that these intractable antagonisms do not exist. This willful naivete is having a disastrous effect on contours the health care debate. The idea that the insurance industry will retain some important role in a future regime is giving political cover to right-wing Democrats like Ben Nelson of Nebraska as they undermine the more progressive proposals floating around Washington.
Nelson correctly observes that if for-profit insurance companies were forced to compete with a low-cost public plan, they would ultimately lose “the game” and disappear, effectively resulting in a single-payer system. This is exactly what progressive advocates of the Edwards ‘08-style health care plan hope will happen. But since Beltway liberals have refused to commit themselves to the single-payer concept (preferring the sneaky, backdoor approach to a single payer endgame while pretending the insurance companies are our friends) they have exposed themselves to corporate hacks like Ben Nelson, who are now calling them out on their contradictory approach.
What Obama should do is abandon the big tent strategy, name his enemies and rally his supporters. In my haziest opium dreams, I imagine him saying this:
My friend Ben Nelson is absolutely right. My goal is the total dismemberment of the private insurance model and I make no bones about it.
The current regime is morally untenable and economically disastrous, with employer-based coverage becoming an increasingly heavy burden for our struggling manufacturing sector.
Private insurance companies perform no function or service that cannot be provided more efficiently and inexpensively by a non-profit, single-payer system.
It is time for members of Congress to choose between the interests of their constituents and the interests of the powerful corporations that oppose reform. I’m on the war path for single payer and I will be victorious.
May God have mercy on my enemies.
(Or something along those lines.)
The Congressional Progressive Caucus met with Obama this week; they focused on critiquing his Afghanistan policy and, most important in my opinion, on the need to have a public option in the health care reform bill. They claim they will not support it otherwise.
Hahahaha, “I will bury you.”
In all seriousness, I like this piece. The public option needs to be on the table, and it’s pathetic that so-called Democrats are not willing to fight for it.
I actually think some degree of dialogue is a good thing, but I do think Obama (and many of his rather naive followers) don’t realize the nature of their oppoisition (if, as you point out, they even acknowledge that they have true adversaries). Bipartisanship IS needed, but Republicans aren’t even willing to play the game.
I will say, though, that I’m not sure the debate is only being shaped by narrow self-interest. A good number of Americans hate and fear “big government” and anything that smacks of it. Even I, an ardent advocate of universal healthcare, have to admit that it’s not perfect. One thing I always struggle with is when opponents of my preferred policy say something like: “But in France and England (etc.), you need to wait for months to have a heart operation….” From what I have heard from friends in countries like those (and Canada), this IS actually the case.
Personally, I prefer a system where everyone is covered by the same insurance, and thousands are not dying needlessly or going bankrupt because of costs spiraling out of control. Yet, critics DO have a point that seeing a specialist is harder under some single-payer systems.
What is the talking point on this one?
Well the waiting lists and doctor shortages aren’t necessarily because of the system. This country had shortages in the 70s and 80s.
It’s immoral to say, “I like our system, because the wait is shorter”, because 1 in 6 Americans aren’t allowed to wait in line. The wait lines might have been shorter in segregated restaurants in the Jim Crow south too.
Secondly, Americans need to get these serious, complicated procedures more often than our European and Canadian peers because we don’t pursue the preventative health that’s needed. Checkups, regular doctor’s visits, availability of cheap rX drugs, etc., in the long run lower the need for serious surgeries and procedures.
Government isn’t getting bigger; by having the government as the single insurer we are streamlining the system, cutting through layers of paperwork and bureaucracy and saving time, money and lives. We are replacing a system built upon profit with one built upon solidarity.
And we do need more general practitioners and fewer specialists.
Even the best designed single payer insurance model doesn’t guarantee a good health care system, it merely ensures that the costs of the treatment are shared fairly by young and old, the healthy and the sick so that nobody is catastrophically burdened by the cost of care.
That being said, my limited experiences with actual socialized medicine have been excellent and I do believe we need government-owned health care providers, a public pediatric clinic in every public school district, etc. But that’s a separate issue from how we change the insurance system.
Bhaskar and Adrian wrote good responses to “the waits are longer.” The only thing I’ll add is that few of those people who wait longer want to exchange their system for ours. My friend’s fiance is originally from Cuba. He needed serious tooth work when he came here. All he could say was that he missed his dentist that he could see for free in his home country.