Friday, January 22, 2010

A Final Thought on Health Care Reform

In his regular op-ed column, Paul Krugman implored House Democrats to not allow ideological dogmatism or petty pride to interfere with America's need for health care reform:

A message to House Democrats: This is your moment of truth. You can do the right thing and pass the Senate health care bill. Or you can look for an easy way out, make excuses and fail the test of history.

Tuesday’s Republican victory in the Massachusetts special election means that Democrats can’t send a modified health care bill back to the Senate. That’s a shame because the bill that would have emerged from House-Senate negotiations would have been better than the bill the Senate has already passed. But the Senate bill is much, much better than nothing. And all that has to happen to make it law is for the House to pass the same bill, and send it to President Obama’s desk.

Right now, Nancy Pelosi, the speaker of the House, says that she doesn’t have the votes to pass the Senate bill. But there is no good alternative...

Bear in mind that the horrors of health insurance — outrageous premiums, coverage denied to those who need it most and dropped when you actually get sick — will get only worse if reform fails, and insurance companies know that they’re off the hook. And voters will blame politicians who, when they had a chance to do something, made excuses instead.

Ladies and gentlemen, the nation is waiting. Stop whining, and do what needs to be done.

Krugman is right. The health care bill passed by the Senate is better than nothing, and despite the protestations of liberals who (understandably) wished for it do even more, the America in which that legislation is enacted will still be a far better one than an America in which it isn't. All the House of Representatives would need to do to fulfill President Obama's promise on health care reform would be to agree on the Senate version of the bill, letter-for-letter, and send it directly to the president's desk to be signed.

The sad truth, though, is that they probably won't do this. Far too many liberals in the House of Representatives feel disenchanted with the whole debacle of this health care debate - how the plan America needs was perpetually watered down by the Obama administration, how the media allowed control of the national dialogue to fall into the hands of those who intentionally lied about the content of liberal health care reform and the intentions of those who supported it, and how insurance companies managed to pull the strings of far too many politicians and duped far too many average citizens into implicitly supporting their cause. Many of these liberals, like Dennis Kucinich, would rather support no bill at all than one that falls short of the ideal. This toxic combination of ideological rigidity and personal pride makes it highly unlikely that they will ever accede to simply signing off on the bill offered them by the Senate last December.

This isn't to say that Nancy Pelosi and the Obama administration shouldn't make a valiant effort to persuade the intransigents to do the right thing. Quite to the contrary, every ounce of political skill possessed by the Democratic leadership should be concentrated, over the next two weeks, to the sole effort of getting the House to sign off on the Senate bill so that it can be made into law as soon as possible. Not only would this allow the Obama administration to turn a political embarassment into a significant victory, but it would dramatically improve the lives of millions of Americans as the decade progresses.

If the effort to move the House of Representatives fails, however, it is critical that the Obama Administration cut its losses. No one wants to hear that advice; after spending the last three decades making concession after concession to right-wingers and so-called centrists, liberals are understandably sick to death of losing battles. Yet the reality is that there are great problems which need to be addressed, and the more time that is spent engaging in a futile crusade for health care reform, the worse those problems will become, to the detriment of the Democratic party's political fortunes and the welfare of average Americans. Should early February roll around without any meaningful progress on health care reform, the smart move - indeed, the morally and politically responsible move - of the Democratic party will be to spend the next six months aggressively pushing for legislation to deal with the three pressing problems in America today:

1) Unemployment
2) Unemployment
3) Unemployment

In an irony that few have noticed, Saw VI - a horror film that offered surprisingly powerful and intelligent commentary on the health care crisis in America today - is being released on DVD next week, at what will most likely be the same time that health care reform in this decade dies. I am reminded of the review I wrote for that film when I saw it in theaters, which I have copied below:

On October 23, 2009, I saw Saw VI in theaters. Without spoiling the plot for those who wish to view it for themselves, it lived up to my expectations - and then some. While the flaws that mark virtually every installment in the series were still present here (a convoluted plot that requires the audience to have intimate familiarity with every preceding film, logical holes in both the design of the traps and the rationale used to select its victims, gore so copious that it somewhat dilutes the franchise's stronger narrative and philosophical qualities), the movie brilliantly (and yes, I do mean brilliantly) illustrates the moral monstrosity that is modern American health insurance. The formula that insurance companies use to decide who lives and who dies is broken down in layman's terms in great detail; the argument they use to legitimize their decisions (it's just an effective business plan) is given air time and then promptly shot down for the morally and logically devoid baloney it has always been; and half of the film winds up being devoted to vicious traps that, in a slyly allegorical fashion, turn the institution of American health insurance on its head, to great satirical as well as horror effect. The main social theme of the film is precisely what I hoped/suspected it would be - that the only thing which separates insurance companies from anyone else who takes human life for profit is that they are never viscerally confronted with the consequences of their actions. The genius of Saw VI's central conceit is that, in its cruel and brutally poetic way, it gives one such corporate mercenary no other choice but to do precisely that. Even as President Obama defends the motives of insurance executives by saying that they "don't do this because they are bad people, they do it because it's profitable", Saw VI has a rebuttal that is impossible to refute - that the very fact that they take human life in the name of profit is what makes them bad people.

Thinking back on that film, I recall a particularly poignant scene that I wish could be replicated in the halls of Congress. A man whose life is about to be denied him by an insurance executive (in circumstances that I will not divulge here, in case you wish to see the movie) realizes, for a few torturous moments, what is about to happen to him. After spewing profanity at his impending executioner, he notices that the executive is turning his eyes away from him in shame. "Look at me!" he angrily demands. "Look at me when you're killing me!"

A few years ago, an insurance executive named Wendell Potter did precisely that. Wandering through a farm where human beings were receiving cheap medical assistance in rooms normally reserved for animals, he was forced to look at the faces of the people who his policies sentenced to degradation, physical and mental suffering, financial hardship, and even death. The experience caused him to become one of our country's greatest crusaders for health care reform, a crusade that our own Senators and Representatives - men and women supposedly referred to as "public servants" - have by and large refused to take up. The death of health care reform means the killing of innocent people. In moments when my sense of justice feels inclined toward poetry, I wish that at the very least, they could look at their victims as they were killing them.

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