The Great "Debate"

As the healthcare “debate” unfolds this summer, we’ll have a test of just how stifling corporate control over the legislative process is. Everyone, including relevant elites, knows that the present system is unsustainable – never mind, unjust and inefficient – and must be reformed. And no one who is not a beneficiary of the status quo cares much for health care profiteers, private insurance corporations especially. Thus reform is in the air.

At the same time, many Democrats and all Republicans have seen to it that the obvious solution, single-payer health insurance, is “off the table.” Nevertheless, there is an effort, at least for now, spearheaded by Ted Kennedy and other liberals and supported by President Obama to come up with a pale approximation of the solution – by instituting public alongside private health insurance. Should something like that finally become law, there are two possibilities: either the public plan will not impinge, except superficially, on the interests of healthcare profiteers; or it will. If it does not, then we’ll know that, at least in this domain, corporate control swamps common sense, public opinion, and even enlightened self-interest. But if we do get a public plan worth having, then, as I argued recently, it will be evidence for a different hypothesis: that the main reason why liberal Democrats have taken single-payer off the table is some combination of cowardice and incompetent, murky thinking, not campaign contributions or promises of future riches. We’ll know soon enough.

But the great “debate” now underway is not about that, at least not according to the liberal media (for example, NPR this morning). It’s about whether the government should be in the insurance business. I suppose a principled libertarian could produce a coherent, though flawed, argument on the No side, but that’s not what we’re hearing. Instead, “moderate” and right-wing Democrats, marching in tandem with the Greater Evil Party, seem oblivious to incoherencies, as if their intent is just to lower the level of public discourse (not that it isn’t already low enough!). That they could get away with such blatantly mindless drivel speaks to the failure of American schools (and colleges and universities) and media to educate the public up to the point where they can meaningfully participate as citizens. To cite just one much in the news and especially egregious example: listen to anything Iowa Republican Senator Charles Grassley says – and weep.

It’s not rocket science; it’s not even basic civics. Either health care is a right (like education or legal representation for persons charged with crimes or any of a variety of other “services” even “bipartisans” and “moderates” support) or it’s a commodity (like Plymouths or Pontiacs). Again, a principled libertarian might opt for commodification. But that’s not what most naysayers think. If pushed or even just forced to think about it, most of them. I am confident, would agree that health care ought to be a right. But if health care is a right, then obviously there’s no principled reason to keep the government out. The only plausible grounds there could be is that governments are somehow inefficient. But then the naysayers are in plain defiance of overwhelming evidence to the contrary: from a patient’s point of view, Medicare, for example, is remarkably efficient; private health insurers are not. QED.

But, of course, the “debate” NPR reports on is oblivious to the obvious. The point of it is not to address genuine concerns, but to help Republicans and “moderate” Democrats pull off what their corporate masters are paying for them to do. That’s why, no matter what it looks like, defenders of positions even worse than Obama’s are not dumbing down for dumbing down’s sake or even, in many cases, because they don’t know better. They’re dumbing down public discourse the better to shift our impending national “conversation” onto a course that will ease the way for a “solution” healthcare profiteers can welcome.

Given public opinion nowadays, liberal Democrats, properly mobilized, could almost certainly defeat the insurance, drug and for-profit healthcare industries – and their legislative flunkies -- handily. But that would take standing up to powerful economic interests; and that, in turn, would require liberal Democrats to have backbones – an anatomical feature they conspicuously lack. But maybe, just maybe, this time around, enough of them will be able to find just enough courage not to set the cause back, Clinton-style, for another generation. If Obama can see past the folly of bipartisanship, even if only long enough to get reform through, there is a chance. Then, to be sure, we won’t have a very good solution for what ails us -- that’s “off the table” -- but at least we won’t have to deal with anything too plainly awful. And we’ll know that not all Democrats are bought and paid for all the time; that if they seem to be, it’s only because they’re muddled and, by nature, cowardly instead.