Check this out. As Henwood points out, the already tepid public option was more or less taken off the table because the "stakeholders" (i.e. the for-profit insurance industry, hospital industry, etc.) were virulently opposed to it.
So when you hear liberal apologists for Obama asking that you forget recent events and join in endorsing empty propaganda about how successful Obama's presidency has been for progressives, recall who was calling the shots when health "reform" was being decided. Recall that nothing substantial changed at all, and that the "weak sauce" Public Option was proscribed because Obama cares more about placating powerful capitalists than about the well-being of the American people. And we should be clear not to place all of the blame on him as a person, of course: the entire Washington political system, and especially the Democratic Party, represent Wall Street, not the majority.
Monday, October 18, 2010
More on Obama's Legislative (Non) Accomplishments
Wednesday, August 19, 2009
Raymond Geuss on the discourse of "soaring prices"
Much of the terrain of recent health care 'debates' has been fought over how to hold down 'soaring' or 'excessive' costs. As this helpful interactive history of health reform makes clear, this is not new. Today the issue is again framed as one of 'excessive' costs. Yet in any reasonably comprehensive discussion of health care reform talk of costs should be marginal, at best.
What about, for instance, the justifiability of subjecting access to health care to market forces at all? What about the status of access to health care: is it a 'human right', as a matter of social justice should everyone have access to basic medical care? Should the institutions responsible for financing people's access to health care be run by profiteers who ration care according to the dictates of profit-maximizing calculations? Should access to health care be thought of in the same way that we think of any other commodity? All of these crucial questions are totally lost in the fray of the technocratic quibbling over 'soaring costs'. As Geuss presciently explained in his most recent book published last December:
"Diverting attention from the way in which certain beliefs, desires, attitudes, or values are the result of particular power relations, can be a sophisticated way of contributing to the maintenance of an ideology, and one that will be relatively immune to the normal forms of empirical refutation. If I claim (falsely) that all human societies, or all human societies at a certain level of economic development, have a 'free market' in health services, that is a claim that can be demonstrated to be false. On the other hand, if I focus your attention in a very intense way on the various different tariffs and pricing schema that doctors or hospitals or drug companies impose for their products and services, and if I become morally outraged by "excessive" costs some drug companies charge, discussing at great length the relative rates of profit in different sectors of the economy, and pressing the moral claims of patients, it is not at all obvious that anything I say may be straightforwardly "false"; after all, who knows what "excessive" means? However, by proceeding in just this way I might well focus your attention on narrow issues of "just" pricing, turning it away from more pressing issues about the acceptance in some societies of the very existence of a "free market" for drugs and medical services. One can even argue that the more outraged I become about the excessive price the more I obscure the underlying issue.... relatively marginal issues come to be presented as though they were central and essential."- From his Philosophy and Real Politics (Princeton UP, 2009).As Geuss makes clear, the more intensely we are encouraged to focus in on issues of pricing, the more the underlying issues are obscured. The debates over HMO's in the late 60s and early 70s were fought over issues of 'soaring prices', which makes painfully clear how easily the uproar over 'unjust pricing' can be appropriated by the Right. Its not a far reach from the language of 'soaring costs' to move quickly into a fiscally austere, cost-cutting and belt-tightening orientation toward social spending as such. We have already seen some of this right-wing appropriation latent in complaints about 'greedy doctors', which as a friend pointed out to me recently, threatens to become the new 'welfare queen'.
This is not to say that thinking of large, aggregate social costs is not important when devising how the reform of health insurance institutions must proceed. But talking about large, macro issues is a qualitatively different activity from the depoliticized rabble rousing about costs lighting up the 24-hour cable news circuit. The quibbling about costs to individuals says nothing of how much of GDP is spent on health care, how much tax revenue is available to be spent on health care and how best to collect it, how much per capita is spent at present compared to other rich capitalist nations, how much private health insurers set aside for their own enrichment, for advertising, for needless bureaucracy and overhead.
To passively adopt the language of costs is already to accept an entirely unjust set of institutional arrangements. It is to accept the idea that access to health care is a commodity floating amidst a fray of market forces.
Friday, August 7, 2009
GritTV: Rep. Weiner puts Single Payer on the Table
I'm not sure I understand the logic of getting a vote on Single-Payer. I think I'm sympathetic to the argument that Single-Payer should be part of the discussion to give the Left leverage over the conversation, in effect, pushing the entire debate to the Left. But what will an up or down vote do? I'm not sure I see the point. I suppose any publicity is better than none, and perhaps forcing a discussion by any means necessary is what's going here, but I'm not clear if this is the motivation or not.
I must say, as disgusted as I was with the modesty of Obama's plan and the way in which Single-Payer was locked out of forums purporting to 'put all options on the table', I am ready to start struggling just to get Obama's plan passed. Faced with the prospect of yet another right-wing foot-dragging assault on reform, I think I am ready to table medicare-for-all demands for the moment and start struggling against these kooks who watch Glen Beck or whatever. Perhaps the best way to participate is to air the medicare-for-all argument in order to balance out the complete morons who are whining about 'stalinism', etc.
Thoughts?
Tuesday, July 21, 2009
The Public Option Bait and Switch
(Via PNHP):
"The people who brought us the “public option” began their campaign promising one thing but now promote something entirely different. To make matters worse, they have not told the public they have backpedalled. The campaign for the “public option” resembles the classic bait-and-switch scam: tell your customers you’ve got one thing for sale when in fact you’re selling something very different.
When the “public option” campaign began, its leaders promoted a huge “Medicare-like” program that would enroll about 130 million people. Such a program would dwarf even Medicare, which, with its 45 million enrollees, is the nation’s largest health insurer, public or private. But today “public option” advocates sing the praises of tiny “public options” contained in congressional legislation sponsored by leading Democrats that bear no resemblance to the original model."
Read the rest here.
