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Few people would predict that I would agree with Howard Dean as often as I do, fewer still should be at all surprised that I agree with him when he says of the Health Care Bill:
This is essentially the collapse of health care reform in the United States Senate. Honestly, the best thing to do right now is kill the Senate bill.
Then again, I also agree with President Obama when he said:
the federal government “will go bankrupt” if Congress does not pass a health care bill
Of course we begin to disagree from there because I’m confident that we will go bankrupt at least as fast with his health care bill (any version of it) as we will if we do nothing. We need reform, but we don’t need this reform. Once again I agree with Howard Dean’s take on the cost issue:
He said he also doesn’t see cost-control measures but, rather “a whole bunch of bureaucracies and a lot of promises.”
While we disagree with what health care reform this nation needs I was dismayed by the truth pointed out by Chris Cillizza as he explained why he feels confident that despite all the wrangling, Congress will pass a health reform bill:
The broad strategy adopted by the White House toward health care is based on a single fundamental belief: coming out of this extended fight with nothing to show for it amounts to a political disaster not just for the President but for congressional Democrats as well.
“It’s a huge problem if nothing gets passed,” said one senior Democratic strategist. “Huge.”
Howard Dean is right about the dangers of that strategy:
We’ve gotten to this stage … in Washington where passing any bill is a victory, and that’s the problem. Decisions are being about the long-term future of this country for short-term political reasons, and that’s never a good sign.
I even agree with Howard Dean that there are some good elements in the current Health Care Reform bill. At least, I agree with him if Section 9002 is still in the bill. (As an aside, when did they return to the term “health care reform” from the more accurate “health insurance reform” that they had begun using earlier this year?)
I still contend that the only proper way forward on health care reform (and the only possible way forward when debate over this bill finally ends – regardless of the outcome) is to stop trying for some sweeping omnibus overhaul bill and pass individual pieces of legislation to take baby steps forward. If this bill passes the very first baby step forward will have to be the repeal of the individual mandate.
5 replies on “Howard Dean is Right”
Glenn Greenwald in Salon this morning makes the point that this massive giveaway to the insurance and pharma industries was what Obama wanted all along, and I agree. The only rational course of action for a conservative is to vote against this bill. The only rational course of action for a progressive is to vote against this bill. The only way to have money to get re-elected is to vote for this bill, so obviously it (or something like it) will pass.
The problem with this legislation is that removing the tax exemption for employer coverage will induce some (many?) employers to drop their coverage, raising costs for workers. Healthy young people who might otherwise forego the expense of health insurance will be forced to buy it (a “feature” I consider worse than taxation). The minor mandated reforms in insurance provisions will probably end up being vague and lack enforcement anyway.
This is exactly where the corporate Democrats wanted to be: “forced” to pass a worthless piece of legislation by those ornery Republicans. Actually the Obama White House and the conservative Democrats (+ Joe Lieberman of course) were working for exactly this outcome from the start. It was only the voters who wanted something different.
Actually after all our discussions, I think the best way to go if we are serious about universal coverage and cost reduction is probably to empower the states to experiment. If Vermont wants single-payer and Utah wants a free-market approach, then let them try it without federal interference and may the best plan win. At this point, the ERISA act apparently prevents states from enacting single-payer systems, and there are myriad complexities with other approaches as well. Of course, the big industry players can probably have even more influence in a state legislature than in Washington, but perhaps voters will be close enough to the situation to punish those whose vote is for sale.
Score one victory for the idea of federalism and laboratories of democracy. I’m not familiar enough with the ERISA act to know what side effects would come from repealing it, but I have no problem with allowing states to enact single payer plans if they want. Like you said, let the best plan win in open competition between the states. I think if the approach in one state proves superior other states will gravitate toward similar systems, whatever system that is.
Personally I still don’t believe that Obama actually wanted this. I believe that he was caught up in his own aura of inevitability that he honestly (and mistakenly) believed that he could get something passed that was better than this (according to his personal definition of better). I do believe that corporate Democrats and possibly Joe Lieberman (I can’t pin him down on this) wanted to be forced to pass a monstrosity like this – they think they’ll come out smelling like roses simply for getting it past the Republicans.
I do think that your assertion that the only way to have money to get re-elected is to pass this bill is inaccurate. Certainly passing this bill is the way to secure campaign contributions from insurance companies, but even if corporate money is the only viable method of financing a campaign there are other industries whose donations would not be tied to this legislation. Whether you are right or not, neither of us will be surprised to get more proof that there are more corporate money grubbers than actual conservatives or liberal in Congress. And I freely admit that the bulk of the Republicans who will be opposing this are doing so for anything but pure motives. (That is unless you can accept the notion that “purly opposed to the Democats” qualifies as a pure motive. ;-))
If a Democrat was purely opposed to Republicans, he/she would be trashed as a hopelessly partisan lefty kook – which I suppose is not that dissimilar from the language some are using for the good Senators from Maine.
Obama and particularly his chief of staff are not naive. When they needed to pass a stimulus bill, they did the necessary arm-twisting and got it through even though there was tough opposition from the same quarters. This time they made a back-room deal with the insurance companies and pharmaceutical industry before the debate got underway and when it came time for arm-twisting, it was the progressive members who were targeted, not the conservative ones. Greenwald makes an excellent case. Democratic voters aren’t fooled. The innocent young people and hopeful minorities who came out in droves to vote for Obama aren’t going to get too excited about voting for the bozos that passed this mess. They’ll just stay home which is good news for the Republicans. Obama had better hope that this episode (along with the Af-Pak and Iraq wars and the economic collapse) are over by 2012. I don’t think that same dog will hunt again.
I’ll have to go read Greenwald’s take because I certainly can’t claim any special insight into what the President was thinking or expecting.
And I think that Republican’s who have no principle beyond purely opposing the Democrats are worthless (at best).
Kucinich had a post somewhat similar to this back in September.
The Private Mandate Sausage Machine
The only difference maybe that his prediction that it would pass will likely end up being wrong.