I’ve been a little under the weather this month, and nothing gets a guy angrier at the American medical system than having to use it. And, right off, I’ll tell you, I have pretty good insurance. I didn’t used to, and I paid a high price for that mistake, so now I send off a hefty part of my monthly income for a private plan that comes very close to qualifying as a “Cadillac plan” under the merged Senate health care reform bill. Yet, even with this deluxe package—one that increased in price some 17% this year—I have paid a couple extra hundred bucks in co-pays and prescriptions in the last few weeks.
That is a quick recap of my personal ride on the cost curve—the cost curve President Obama and his health economists economist (singular) insist is going to get bent by the reform package we are now all supposed to get behind, pass, and cheer as if it is the magic inevitable we’d been working toward all along. But, of course, the things that have made my maladies so pricey—insurance and pharmaceuticals—are, by all accounts, going to be spared the rod of reform.
There is no drug re-importation, no direct drug price negotiation, no ban on “pay for delay,” and no way to accelerate generic competition for expensive classes of biologics. None of that is in the Senate bill that is now to be swallowed whole by the House, and it is all but certain that none of the PhRMA deal-busting provisions I just listed will make it into the reconciliation “fix” that is supposed to follow. The fact that a year’s worth of wrangling has been wasted trying to avoid upsetting Rahm and Barack’s BFFs in the Pharmaceutical lobby is now barely a blip on the radar.
Still at issue, though in a Kafkaesque way, is the other half of the equation: meaningful competition for the private insurance industry in the form of a viable public option. A majority of House members voted for it last year, Bernie Sanders claims he has a majority of votes for it in the Senate, and the President campaigned on its behalf throughout 2008, and yet, when all the votes are taken, who here is willing to bet that we will get a public option as part of comprehensive health care reform?
Assistant Majority Leader Dick Durbin claims he will whip for a public option in the Senate—if the House sends him one. Speaker Nancy Pelosi says she supports a public option, and would put it in the House sidecar if only the Senate had the votes to pass it. And, of course, President Obama says he would prefer a public option, but he doesn’t think it could get the votes.
But, behind the scenes, Durbin is actively whipping against a public option amendment coming to the floor; Pelosi will not allow the public option an up-or-down vote in the House; and, Obama has made a series of campaign-style appearances, and mobilized his minions, all to underscore that it is “time” (as opposed to year ago, when it was, I guess, not time) to pass a health care bill. . . and that would be the Senate bill. . . and, you know, whatever.
For some reason, a program that enjoys the support of overwhelming majorities of Democrats, independents, or Americans as a whole—slice it any way you like—has become synonymous with “hot potato.” No one wants to be the one who has to take the blame for killing it—but, bizarrely, absurdly, maddeningly, no one wants to be the one that gets the credit for passing it, either.
In fact, the whole issue of health care reform, what was expected to be and should have been the signal accomplishment of this Democratic majority, is now something everyone just wishes would be “done with already.” Every major vote has been buried—the House’s initial bill passed on a November Saturday near midnight, the Senate “got ‘er done” on Christmas Eve, and now, with a vote set for March 19 or 20, Congress and the president will get this dirty business out of the way during the first big weekend of the NCAA basketball tournament.
But, try as they might to hide it, many of us will notice.
Some will notice that, even though Democrats and the White House are calling it a “win” for Americans, their own lot—their insurance premiums, their out-of-pocket expenses, the barriers that keep them from getting quality care—is not improved, and, in fact, will continue to grow worse.
Some will notice when they first figure that it just isn’t worth buying junk private insurance in the state-based exchanges, and then—thanks to the bill’s “individual mandate”—find the IRS knocking at the door demanding enrollment or payment of a fine.
Some will notice this November, and several Novembers onward, when they are told by a variety of candidates and oracles that whatever it is they are experiencing when they deal with the US health system, they are experiencing it thanks to the Democrats. It may or may not be accurate in any given circumstance, but, no matter how much they try to bury it, no matter how much they try to run against “Republican obstructionism,” if this Congress and this president get their “W,” Democrats will indeed own health care for a long time to come.
So, it is time to own the hot potato, too. Nancy Pelosi, you have been, by most accounts, a very effective Speaker; you know how to move legislation. If you really want me to believe you ever wanted a public option, then put it in the House “fix.” Dick Durbin, if you really want me to believe you would whip for a public option (when I know that you are whipping against it), then publicly tell Pelosi you will guarantee a simple up-or-down vote on a bill with a PO or a public option amendment, should the House neglect to put it in the sidecar. Barack Obama, am I really supposed to believe that you couldn’t move a handful of Senate votes if you needed to? Well, I don’t. If you want to uphold a campaign promise, if you want to deliver this real cost-curve-bender, if you want me to believe any of your promises, then make a public pledge to get a public option into this bill, and then make a few damn phone calls.
And, you, you 60 representatives, you progressives that pledged to vote “no” on any health bill that did not contain the public option, I have not forgotten about you, either. Pledges on core issues are not sought for their theatrical value. Nor should pledges be broken or positions changed just because you want to, um, move on. Every flip, defection, or ham-handed backtrack now, renders your future promises and pledges meaningless, and makes organizing for real progressive change very much harder.
And, this goes for all the folks outside elected government, too. The struggle to keep the public option hot was a collective struggle; the effort now to drop the PO while trying to cool the potato, trying to pretend that it wasn’t really so very important, that it wasn’t once a make-or-break issue, also appears to be quite organized. I’m not interested in pie fights, and no one died and left me king of Lefty Valley, so I am not going to make a list of who does or does not get to call themselves Democrats, liberals, or progressives. However, if you argued that the Senate bill was unacceptable in December, but suddenly, now, are coming on like gangbusters for what is The Exact Same Bill—or are spitting mad at those that have maintained a consistent opposition to the lousy Senate language—then you are not much of a health care hero in my eyes, and, more importantly, you now own this counterproductive, miserable excuse for reform, too.
To recap, that goes for bloggers and pundits, unions and PIGs, Senate leaders and House progressives, and, most of all, it goes for Barack Obama, president. Pushing a bad bill when many quality options are not only available, but also possible and popular, is, as Chris Hayes says in his video above, a “maddening bit of political malfeasance on the part of the Democratic Party.” And it makes me especially mad tonight—not just because I’ve been sick, but because, well, it is madness.