Tim wrote:
My opinion is that the electorate is more sophisticated and independent than professional politicians give them credit for.And I responded:
Lets be honest I have not even heard the Vice-Chair of Democrats abroad say that the voters made the wrong choice in MA.
I have heard much about how inconvenient the results are.
Here is a crazy idea... spend less time in defending the "Status Quo" and more time recruiting candidates that can lead and inspire the country. And damn it... why are the lawyers taking over politics and business there must be other options.
Tim, you haven't heard me defend Martha Coakley as a candidate because I can't. She ran a terrible campaign, she said things on the campaign trail that offended me and annoyed me. I think I understand why MA voters chose the way they did, and I don't blame them for it. iBut for the record, yes. I think the voters of Massachusetts made the wrong choice. I think they made a choice that is going to directly lead to a lot more people dying in America, cause the government's budget to explode (remember that health care reform is deficit REDUCING), and continue the unacceptable insecurity for American families. If you lose your job you should still be able to get health care. If you have a pre-existing condition, you should be able to get health care. You should be able to afford health care even if you don't have a lot of money.Tim responds:
The status quo in America is the opposite of that, and I hate it with a fiery passion that only groes every day. The status quo is that America is a country that pays more PUBLIC health insurance alone than most other countries, but doesn't cover more than 46 Million people, and has higher infant mortality and lower life expectancy than most countries in Europe. The status quo is that everyone lives with this as if it were somehow normal, whereas to me it's a national emergency or 9/11 scale happening a few times a year. I'm not defending the status quo, I was hoping and working, and trying very hard to change it. That may not be possible now, and I will never accept that as anything other than a terrible, terrible outcome.
Amen Sister!And finally, here's me again:
If the legislation under consideration was going to do all those things America would vote for it. I can guarantee it. If you can assure me that the compromise health care bill that was being jammed through the legislature was going to do those things I would fight for it.
The one concrete benefit of the bill is (was?), the elimination of selective underwriting. There is very little else I can point to as a concrete benefit. The cost benefit was not a strong case as the best anyone could hope for was to minimize the increasing costs of coverage. I am not sure even the strongest supporters of the bill want to hang their hat on those projections.
Apparently the citizens of MA do not believe that we must spend Trillions and create a huge government program to accomplish those goals.
If you want to get a proper Universal Health Care system in the United State then it should be a system that is good enough to get implemented without the level of compromise and strong handed tactics that we have seen in this process. "Super Majority or bust" is a tough way to illustrate the value of any legislation.
What is difficult to understand, or at least difficult to remember, is that those with coverage in the US are content with it. Coverage for those that have it (voters) is state of the art and it is paid by the employer (generally). That contented group is your starting point for any discussion of National Health Care. What Clinton missed and Obama has tried to circumvent is that Americans that vote... are OK with their health care coverage.
The people who do not like health coverage are business owners, the uninsured/uninsureable and to a large extent the health care system itself.
We must prove legislation can fix the major issues with health care before we trust a legislatively mandated paradigm shift. (1) Stop premium from growing at an unsustainable rate and (2) provide coverage to every American that wants to buy it. If you can show some positive results on those concerns, that would put a more comprehensive Health Care overhaul within reach. I can even offer pragmatic solutions to affect this change.
It took other countries years to get a system they are comfortable with. Why should it be any different here?
NO MORE ALL OR NOTHING HEALTH CARE PLANS!
Just thinking out loud.
Thanks Tim - really useful and interesting thoughts.One further thought - to Tim's question about "no more all or nothing" health care plans...
I think you and I are largely on the same page on all the key points. The bottom line lesson for me here is that the country's problems will ALWAYS be un-solvable if we need a 60 vote Senate majority to pass anything. It's time we all (not just Democrats) start getting serious about insisting that a majority is a majority - and if that means that in a few years time a small Republican majority can push through legislation that I don't like, then you know what? Fair enough. Democracy only works if voters can see whether the policies that their politicians advocate actually work or not. THe current situation where voters can express a clear preference for one set of policies and those policies can never be delivered just leads to stagnation and a total lack of accoutnability. In any other national parliament in the world, this process would already have resulted in a law. And frankly, a better law than the one we have.
Now, to the current health care bill. This bill (even the watered down Senate version) would have covered, by CBO estimates, over 30 million uninsured Americans. It would have put strict regulations on insurance companies that means no one can be denied insurance for a pre-existing condition (that the simple answer, by the way, to "what does this bill do for me" - the day after it passed you would instantly be protected against the common sceniaro of getting sick and then having to desperately hope that you don't lose your job or insurance lest you face bankrupcy), it would create a national health care exchange that would for the first time create real competition in the industry - right now there's 90% consolidation within each state. And finally, by adding an individual mandate and carefully offsetting that with tiered subsidies based on income, it established for teh first time the principle that every American must be covered. The Senate bill isn't perfect, but I was genuinely excited about it. It would have been a major and irreversible step forward. I still hope we might take that step. We've come so far, falling at this hurdle... well, it would be pathetic.
The reality is that this plan WOULD be an incremental plan - it definitely wouldn't solve every aspect of the crisis in one go, it would just establish a framework for future tweaks and innovation. The New Yorker had a really good article recently about how health care in this sense may be like agriculture in that it will always need hands on management and constant adjustment to keep it working.
But, to begin solving this problem there is no way to avoid bold action, because the types of small improvments that would be superficially easy to make can cause the whole of the existing system to collapse. Most crucially, simply making it law that insurers can't deny people for pre-existing conditions - which would be the simple and fair thing to do - would massively increase costs for everyone because the incentive then would be to not buy health insurance at all until you get sick. The system only works if healthy people are paying into the system too so that it will be there for them when they get sick. That's why the individual mandate is important.
It's confusing and complicated and difficult. But it's vital, and I'm not prepared to give up. Ever.
