The Art of the Possible

After agreeing tentatively to jettison a key liberal priority — a full-blown government-run insurance option — Democrats say they are getting close to pushing President Barack Obama's health care bill through the Senate.
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As I have stated many times before, it is illogical for any society that cherishes freedom and human rights to allow any one of its citizens (much less thirty million) to be denied high quality health care. It is a grave moral wrong for any human being to not receive the medical treatment he or she needs to survive and/or maintain a decent quality of life; likewise, it is nothing short of an atrocity for any human being to have to undergo financial suffering simply because he or she became sick. That is why many countries - like Japan, France, Sweden, Greece, Switzerland, Canada, Great Britain, Germany, and Israel - have made a point of guaranteeing health care to all of their citizens. Although the systems of universal health care provided in these nations have their various imperfections, all of their citizens are united in consistently expressing preference for their current system over a privatized one (oh, and in the fact that each one outranks the United States both in the quality of health care provided and in overall cost efficiency).

However, because insurance and pharmaceutical companies are allowed to exploit the American public which depends on their services, the injustices that have been eliminated in other first world countries remain commonplace in our own: insurance premiums are made so costly that millions of Americans can't afford them, those who can afford insurance still often wind up being financially crippled through out-of-pocket expenses, millions of others who are covered by insurance companies are often dropped as soon as they become sick or a pre-existing condition is discovered, and the prices of prescription drugs continue to rise at exorbitant rates. In a world in which both sides of this debate were required to be honest about their motives, it is difficult to imagine the depraved reasoning of Big Medicine - that they have a right to cause human suffering as a means of earning money, that their God-given freedom includes becoming the medical world's equivalent of war profiteers - being greeted with anything but contempt. Unfortunately, well-placed political contributions, a brilliantly orchestrated lie-and-fear based propaganda campaign, and the mindless dogmatism of a veritable army of right-wing zealots have all combined to give their cause the facade of moral and intellectual legitimacy. Now, thanks to their efforts, a public option - the single most viable route through which America could have obtained universal health care - has been rendered impossible for the foreseeable future. It is easy to feel not only angry at the reactionaries who opposed necessary change, but betrayed by the Democratic politicians - the ones who were supposed to be fighting on our side - for allowing them to stand in the way.

And yet there is something we need to remember before condemning them...

Politics is the art of the possible.

This famous remark by Prussian Prime Minister Otto von Bismarck has become something of a mantra for practicioners of realpolitik. Defined by dictionary.com as "political realism or practical politics, esp. policy based on power rather than on ideals", realpolitik is frequently used to reflexively dismiss idealistic aspirations with a faux savvy sleight-of-hand that makes it a genuine threat to real progress. Indeed, the liberal movement has spent so long watching its objectives get watered down or utterly destroyed by the concessions inherent in realpolitik that it is easy to see why so many of us are infuriated at the prospect of having to do so again. The temptation begins to arise within many of us to say that - because we control the executive and legislative branches of government, have a vitally important issue at stake, and thus presumably shouldn't have to make concessions this time - we won't accept anything less than that which we know ought to be passed. It's a sentiment already being express among liberals in both the Senate (like Russ Feingold) and House of Representatives (like Dennis Kucinich, who voted against the House's health care reform bill last month).

The problem with this impulse, though, is that it ignores two stubbornly irrevocable facts:

1) Based on what we now know of the leanings of each Senator, it will be impossible to pass a public option.
a) Although the Republican Party makes a point to purge from its ranks those who do not mesh with its ideological hegemony, the Democrats are much more diverse in their ideas. Consequently, even though Republicans are easily capable of uniting as a bloc either in favor of or in opposition to any measure they please, Democrats are more likely to run into a wide diversity of opinions which they need to accomodate.
b) Because the Democratic Party contains members from all sides of the ideological spectrum, there are only fifty-six Senators (fifty-five registered Democrats and one independent who caucuses with the Democrats) who were willing to vote for a bill that included health care reform. The remaining four Senators (three registered Democrats and one independent) refused to get on board so long as a public option was in a bill - and while it would be possible to pass the bill with only 51 votes (meaing we already have five more than needed), it is impossible to block a legislation-killing filibuster by the Republicans (which they have already pledged to do) without at least 60 votes (of which we are four shy). Therefore, in order to guarantee the health care reform bill's passage, Senate Majority Leader Harry Reid had to make concessions to the four senators whose support he hadn't received.

2) The health care bill itself, though not addressing every problem within our system, nevertheless fixes quite a few of them. It would offer nonprofit insurance cooperatives strictly monitored by the government in order to guarantee affordable health care to all, make it illegal for insurance companies to drop you because of a pre-existing condition or after you become sick, and place price caps on how much patients can pay in out-of-pocket medical expenses or for prescription drugs.

Simply put, the chances are that - thanks to the opposition of four Democratic Senators (Mary Landrieu, Blanche Lincoln, Ben Nelson, and Joe Lieberman) - we never had a chance of getting a public option at all; our only choices were a health care reform bill without that public option or no health care reform bill at all. Although some liberals, due to either pride or ideological steadfastness (or both), believe that protesting the whole corrupt system by voting against the bill might make a strong statement, such an action is only conscionable when it doesn't interfere with actual good that could be done. Because good will be done if the health care bill is passed in its current form, opposing it would simply be another way of cutting off your nose to spite your face.

This is why - even though I am disappointed that liberals are getting much less than what is good for the country - I still strongly support this health care bill, and encourage all fellow left-wingers to do likewise. While for many of us it is far short of what we want, as true liberals the foremost question we must be asking ourselves is: Will it make the nation better or worse if it's passed? Assuming the answer to that question is "better", then we owe it to ourselves and to our cause to support the incremental changes we can get, rather than sulking over the ones we missed. In short, we must remember that:

Politics is the art of the possible.