Health Care Train Wreck

Commentary By Ron Beasley

As John noted below our current health care system is a train wreck.  Well Josh Marshall has come to the same conclusion I have - the wreck is only going to get worse.

Am I the only one who thinks that if the Dems pass a bill with mandates and subsidies for poor and moderate income people to purchase it but no public option or competition with the insurers, that it will be pretty much a catastrophe for the Democrats in political terms?

You 'solve' the problem of the uninsured by passing a law forcing them to buy health insurance which, by definition, most a) cannot afford or b) are gambling they won't need because they're young and healthy. Either you end up with low subsidies which still leave it onerous to buy, thus creating a lot of disgruntled people, or you get generous subsidies, which cost a lot of money.

It's sort of like reform with all the cool political downsides but none of the reform.

So how did this happen?  As Matt Taibbi explained we not only have a dysfunctional heath care system we have a dysfunctional government as well.

Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises. What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers.

Over the course of this summer, those two failed systems have collided in a spectacular crossroads moment in American history. We have an urgent national emergency on the one hand, and on the other, a comfortable majority of ostensibly simpatico Democrats who were elected by an angry population, in large part, specifically to reform health care. When they all sat down in Washington to tackle the problem, it amounted to a referendum on whether or not we actually have a functioning government.

The health care crisis in this country is going to have to get even worse and it will before legislators are forced to reform it.  Taibbi concludes that it will take a revolution and we are to blame for it not occurring this time around.

Then again, some of the blame has to go to all of us. It's more than a little conspicuous that the same electorate that poured its heart out last year for the Hallmark-card story line of the Obama campaign has not been seen much in this health care debate. The handful of legislators — the Weiners, Kuciniches, Wydens and Sanderses — who are fighting for something real should be doing so with armies at their back. Instead, all the noise is being made on the other side. Not so stupid after all — they, at least, understand that politics is a fight that does not end with the wearing of a T-shirt in November.

So we would be better off with no health care bill at all now.  The train wreck will only get worse and at some point the legislators will be forced to act.

Update

Jamelle at the League of Ordinary Gentlemen picks up on Josh's point that a bad bill will also be a train wreck for the Democrats.

As I’ve said many – many – times, congressional Democrats need to realize that their electoral fortunes are tied directly to passing good legislation.  Not only will voters like and respect the party that passes effective health care reform, but Republicans will be completely discredited when health care reform passes and a year from now the United States hasn’t slipped into a commie/socialist/fascist totalitarian dictatorship. Rick Perlstein describes programs like Social Security and Medicare as efforts that created more Democrats, and if the party leadership really is interested in building a durable, long-term majority, it needs to remember that successful legislation leads to successful parties, and vice versa.

The Republicans know this which is why they have no interest in health care reform.