It’s been a pet peeve of my mine for quite some time now that the pseudo-conservative movement in this country has embraced, with relish, a rhetorical style that is almost Leninist in character. The aim, pure and simple, is to destroy the opposition. At the far end of the scale, you find the bizarre rumors and conspiracy theories that pass for everyday discourse. Witness the lunacy of the debate over Obama’s birth certificate. Some claim racism, noting that this ever-dwindling echo chamber – with a base in the old confederacy – simply cannot accept a black president and will do whatever they can to paint him as a usurper. This may well part part of it, but it cannot be the main reason. Why? Because I’ve seen this all before, during the presidency of Bill Clinton. Wasn’t he supposed to have murdered Vince Foster? Didn’t he run drugs from Latin America into Arkansas? Didn’t be assassinate a stream of political enemies? As they would say in Battlestar Galactica, this has all happened before, this will all happen again. Now, I’m sure many will immediately think: a-ha, but the left does the same thing. And sure, if you comb the blogs you will find some nasty stuff out there. But it’s not the same. The conspiratorial approach to politics is far closer to the center of power on the right than on the left. Not only do you have the whole noise machine in the media (essentially radio and TV, less so blogs), but you have Republican members of Congress engaging in this kind of apocalyptic rhetoric. Remember, the crazy attacks on Clinton culminated in a frenzied impeachment.
This is a style of politics that elevates the will over the intellect, and sees facts as malleable. It is warped and cynical version of post-modernism. Ultimately, it is relativism. Let’s talk healthcare.
When it comes to policy, especially healthcare policy, it boils down to either avoiding or distorting the actual issues, and instead sounding the war cry. You know the story. Obama is on the verge of nationalizing healthcare. It’s part of his dream to turn America into a socialist paradise. Never are these terms defined or is it explained why the person believes these things to be true. But that is not the point. The point is rhetorical total war. The point is to destroy the enemy. And they will marshal any arguments that they think will disgust people. Hence socialism. Sadly, there are many Catholics who play that game too. And here, the pressure points are a bit different, but the tactics are the same. You see, this healthcare reform is going to lead to a huge increase in abortion. And the latest – the plan involves euthanasia, cutting costs by killing old people. The latter point exposes the true intentions of many of these people, which is simply to destroy the reform attempt. Sadly, there is some semblance of a point on abortion, but the fact that they lump it together with all the other garbage tells me they are not serious. It’s rare to find somebody on the right claiming that they are totally behind healthcare reform, but will not support if government subsidies can be used to fund abortions in either private or public plans. No, in nearly all cases, they oppose it on some laissez faire free market grounds. They rally the unborn to serve their own political ends.
But let’s get into it. For when you actually spend some time studying this plan, you will see it is quite modest. If you actually looked at the proposals, you would see the public option is limited to those who can participate in health insurance exchanges, which in turn is limited to the unemployed, the self-employed and small businesses. The CBO thinks that only 27 million would be in the exchange by 2019, and only a small portion of these would be in the public option. For everybody else, it’s old-style employer insurance. This is already a huge compromise. So much for socialism.
And then there is the widely held belief that somehow costs are more out on control in public than private insurance, which is used to denounce the public option. In fact, costs are rising substantially more slowly in medicare and medicaid than in private insurance (7.3 percent versus 4.6 percent for the average annual increase in premiums over the past decade or so). Here’s another fact: if insurance premiums had risen “only” as much as medicare spending since 1970, they would be a third lower today. Ignorance on this issue is staggering. I’m thinking of the recent anecdote in wide circulation concerning the guy at a town hall meeting who told the politician holding court to “keep your government hands off my Medicare”! This is only slightly hyperbolic.
Remember, the aim of reform is two-fold. First, we must treat healthcare as a the basic human right it is. It is a scandal that 47 million are uninsured and a further 25 million are underinsured. It is a scandal that medical costs is probably the leading cost of bankruptcy in the United States. It is a scandal that the poor end up in emergency rooms, where the treatment hey get is too littletoo late, because they have no access to affordable primary care. It is a scandal that insurance companies prey on suffering by denying coverage, dropping coverage, and denying claims — something that again disproportionately affects the poor.
The second aim to to curb costs. It is absolutely insane that the average person in the United States pays more than twice as much as the average person in comparator countries for healthcare, with little to show for it. Rising healthcare costs at this rate are simply unsustainable. Again, people tend to focus only on the government balance sheet, whereas the true and hidden burden is being borne by workers in the form of stagnant real wages. Remember, private costs are rising faster. There are many culprits behind the escalating cost of healthcare — the profit-seeking motives of insurance companies, the inefficiencies from the proliferation of insurance schemes, the inability of medicare to bargain with suppliers, the over-reliance on the emergency room… Let us also not forget the problem of information asymmetry whereby doctors and healthcare providers get paid based on treatments ordered rather than being paid a salary or pooling income. There is a great deal of overtreatment that goes hand in hand with great neglect — we must own up to this. It is just another aspect of the gaping inequalities in our society.
Will the proposed reforms fix these problems? As I said, I think they are too timid. They will certainly cut costs relative to status quo, but perhaps not as much as they could. They will certainly move toward universal coverage. I believe this is probably the best we can do at this point in time. It is incredibly difficult, if not impossible, to dismantle and entire healthcare system and build a new one from scratch, however desirable that might seem. This reform is prudent and incremental. It is also a moral imperative.
Let me conclude by pointing the finger yet again. (Surprise!) I’ve already criticized the Republicans for their fact-free sloganeering. But I must also criticize the media for being too bloody lazy to cover this debate, for giving equal time to wonks and bomb throwers, and for deeming Michael Jackson’s death a vastly more important topic. I also blame Obama. Quite frankly, what is he thinking? Why is be standing back and allowing so much obfuscation to envelop the reform process? People in the know are claiming he wants to allow congress to take ownership of this agenda, but this is a lousy excuse. It plays right into the hands of those praying for failure.
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