Comments on: The End of Healthcare History? Let’s Hope Not

By: Chris Maisano

Chris Maisano — Tue, 15 Sep 2009 14:45:31 +0000

I don’t think any single-payer advocates expected Obama to come out for Medicare for all. It’s been years since he publicly endorsed the idea of a single-payer system. What’s more frustrating is the fact that so many people who actually want a single-payer system, or at least a real public option, aren’t fighting for it and are accepting a terrible “reform” that will basically boil down to this: buy bad private health insurance or be fined upward of $4000 (and you’d be forced to accept whatever health plan your employer offers you, even if it’s terrible). That’s not even a small victory in my book.

There’s a very good chance there’s not going to be any public option in any final legislation either. Pelosi, Reid, and other leadership Democrats are backing away from it: http://politicalticker.blogs.cnn.com/2009/09/10/democratic-leaders-in-congress-soften-on-public-option/. There could be “trigger option,” but if this is the case the bill would probably be structured in such a way that this public option trigger will never be pulled.

This might not be happening if people like you (I don’t mean this in a negative way, I just mean people on the center-left who generally support what the Obama administration is doing) were out there fighting for better reform rather than just “taking what you can get.”

By: Nick Rossi

Nick Rossi — Tue, 15 Sep 2009 09:23:31 +0000

Sorry, Hutch. Didn’t mean to reply directly to you.

By: Nick Rossi

Nick Rossi — Tue, 15 Sep 2009 09:22:39 +0000

Did anyone really expect Obama to push for single-payer? If you think things are ugly now, think about the shitstorm the Right would’ve kicked up over THAT. I’m just counting my lucky stars he didn’t pussy out on the public option like we all thought he would. With so many ill-informed, brainwashed assholes driving this country into the ground, you kinda gotta take what you can get. Small victories, folks.

By: Bhaskar Sunkara

Bhaskar Sunkara — Sat, 12 Sep 2009 00:53:46 +0000

Doug Henwood made basically the same point as Chris in the latest Left Business Observer. I tend to be an optimist, but I agree with both of them.

I see a shred of hope in the Kucinich amendment that would allow states to pilot program a single-payer system.

By: Chris Maisano

Chris Maisano — Fri, 11 Sep 2009 22:41:05 +0000

The reason why Obama keeps talking (increasingly weakly) about the public option is to protect his left flank and prevent liberals from rebelling against him. That’s it. The “public option” would not to what its supporters think it’s going to do – expand coverage and lower costs – because it will not be tax-funded, and it will not be big enough to allow it to effectively compete with the private insurance industry (as Obama himself said in the speech, it would only be available to about 5% of the population). Besides, there’s a very good chance it won’t even be in the final bill because the votes are probably not there in the Senate. As for mandates, people will most certainly be forced to buy bad health insurance coverage that they cannot afford. The experience in Massachusetts proves it: http://www.pnhp.org/news/2006/april/massachusetts_health.php.

My biggest fear is that this doomed legislative boondoggle is going to discredit the entire concept of government funded/guaranteed insurance coverage in many people’s eyes. We could very well have a system that’s even worse than the one we have now by the time all this is over. That wouldn’t be progress at all.

By: John Hutchinson

John Hutchinson — Fri, 11 Sep 2009 21:02:17 +0000

Great article, but I hope you don’t mind a small rebuttal from someone who, by and large, agrees with you and wants the same things. Mostly I believe that progress is always going to be more gradual than we’d like or hope. If this is a step in the right direction, which I think for the most part it is, then it’s progress. It’s not perfect, certainly, but then there’s a political element in this country that elected officials have to contend with.

With the mandates, obviously this is something the insurance companies will push for. It means more payers and more money for them. But with a cheap (or free, based on income) public option, mandates could effectively lower the cost of healthcare as a whole by making sure everyone is covered. It’s a tightrope they have to walk, though, to make sure no one ends up getting screwed by being forced into healthcare they can’t afford.

As for the employer mandates, I think it’s nothing more than a shot straight at Walmart. And good on them. Maybe in a decade or so, we can lower that $500,000 limit (or let inflation catch up).

But the public option really is key and, honestly, I was surprised he still put it on the table at all. From everything I’d heard before the speech, it was expected to be removed. So that it’s out there at all shows some sack on Obama’s part. I just wish he could get those traitorous blue dogs on his side to force the issue. Cause without a public option, there can be no mandates. And without mandates, there’s no end to pre-existing condition clauses, as you said. And without that… well… what’s the point?

I don’t think the battle’s lost quite yet, though. There is still a chance for progress.

By: Bhaskar Sunkara

Bhaskar Sunkara — Fri, 11 Sep 2009 01:55:58 +0000

An excellent post. At least a portion of the left is finding some sort of voice in this debate. Someone who has been around for longer can tell me how this compares to the response to Clinton’s gutting of welfare.