Wednesday, August 19, 2009

How the Democrats sold out health care reform

Lance Selfa at has the story. Here's an excerpt:

And while taking this look behind the curtain, let's dismiss the idea that the Obama administration's and the Democrats' good intentions are simply falling victim to a multimillion-dollar campaign by medical industry lobbyists.

For one thing, as the New York Times reported on August 13, Obama himself has been intimately involved in behind-the-scenes negotiations with lobbyists. For months, the administration has pursued a strategy of trying to neutralize industry opposition by encouraging industry help in drafting the bills.

The poison fruit of one of those deals, according to a secret memo the Huffington Post obtained, was a commitment from the White House to the main pharmaceutical industry lobby that it wouldn't press for any more than the $80 billion in savings that the industry pledged to implement over 10 years. Off the table, therefore, was Obama's oft-made promise (usually a sure applause-getter during his campaign) to end the Bush administration's stupid policy of preventing Medicare from negotiating for lower drug prices with the pharmaceutical manufacturers.

I don't think we should underestimate the significance of the fact that the Administration's strategy, from the beginning, entailed attempting to pre-empt, or "to neutralize industry opposition by encouraging industry help in drafting the bills". Or at the very least, Obama made the terrible mistake of thinking that the inevitable onslaught from the Insurance Industry could be forestalled by attempting to play ball by their rules.

Seriously, even if we accept for the sake of argument that Obama's health plan is the best we can do, is it possible to handle a reform effort more ineptly? Even the most cursory glance at the history of reform belies, in every case, an unremitting ruthlessness on the part of Insurers, right-wing front groups and the always-reactionary AMA. You have to know what you're up against, no matter how tepid your reform aspirations may be. These people will fight to the death against the most miniscule change to the status quo that doesn't sufficiently accord with their interests. And they've succeeded at just about every turn, even where reform was pushed through, in fighting a tough fight and ensuring that their interests are maximally represented in any changes that occur.

The creation of Medicare and Medicaid is probably the only example of a reform effort that was more or less rammed down their throats, although we must recall that even those efforts were diluted by right-wing opposition, and that the Insurance Industry was less wealthy, entrenched and powerful than it is today.

How could Obama be so naive? The records of the Max Baucuses and Kent Conrads of the world hardly belie a stalwart willingness to enact comprehensive reform. The AMA and Industry lobbyists have, as always, enormous influence. What made Obama think that they wouldn't do what they do best when the possibility of reform became palpable? It seems to me that reform to political institutions has got to be a serious precursor to any serious health care reform effort. Liberal activists aren't the only ones who've noticed that the Democrats have a 60-vote Filibuster-proof majority in the Senate. Industry interests have been, as always, hedging their bets by funnelling contributions to both parties and now they are simply doing their best to influence the people in a position to make decisions. And their doing an incredible job. In mobilizing Blue Dogs and other right-wing hacks in the Democratic Party, they seem to have a better grasp of the way Congressional power plays work than Obama does. And, as Selfa points out, by also funding and abetting the lunatic shock-troops descending on health-care 'town hall meetings' they've found creative ways to play both sides of the coin.

All of this feel-good language about consensus, bipartisanship, and faux open-mindedness were merely rhetorical precusors to Obama's calamitous strategy for health care reform. The result is that all Left critiques of the Public Option are proscribed, the tireless advocates of single-payer are shut out of public forums, the long-time Democratic politicians famous for their advocacy of health care reform are given the cold shoulder. Meanwhile, all of the forces who've historically been successful in destryong reform efforts were given a comfortable seat at the negotiation table, as though to sanction (rather than challenge) their deep-seated authority from the onset. The result is unsurprising.

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