Wednesday, March 10, 2010

You get what you get and you don't get upset

A very good friend recently sent me a link to the transcript of a set of health insurance reform interviews Bill Moyers did last week. The whole thing is interesting and worth a read, but for me, this commentary, from Marcia Angell, positively leapt off the screen:

I think the problem is this, Bill. If this plan is passed, and I think there's real doubt as to whether it will be, and there's even more doubt as to whether it would ever be fully implemented, but let's say that it's passed. It will begin to unravel almost immediately. And then what will people do? Well, they'll say, "We tried health reform, and it didn't work. Better not try that anymore."

It'll be like what happened after the Clinton plan failed. There'll be another 16 years before anybody comes up with the courage to try that again. People say, "Too expensive. Just can't have universal care. Tried that, did that, didn't work, good-bye." Whereas if the bill dies now, people can say, "This bill died because it was a bad bill." And the problem is still on the front burner. And then one can hope that we get some version of Medicare for all. And that we don't have to wait 16 years.

Moyers asks exactly what I would have asked: "What makes you think it would come back in 16 years or more? What makes you think it will ever be back on the table?" To which Angell responds:

Oh, I think it has to be. I mean, I think that this system is unraveling so fast, doing nothing or doing the Obama plan, so fast, that something will have to be done. Unless we want to, you know, explicitly be a third world country. So I don't think it's going to wait. But if we pass this plan, it's going to delay.

This whole exchange strikes me as absurd.

Maybe folks like Dennis Kucinich are right, and "the bill" as it currently stands won't address the underlying problems in our health care system. But if the thing goes down, know this. Health insurance reform will not stay on the "front burner" -- at least not by any conceivable definition of "front burner" that I can imagine.

Can I extend the kitchen metaphor? Okay, how's this: like a cooking experiment gone horribly awry, health insurance reform will promptly go into the trash. And we will all need to adjust to the fact that we'll be having something else for dinner. (Sorry, I think I took that too far.)

Note how Angell compares the hypothetical success of the Obama bill to the failure of the Clinton plan. Get it? Since Clinton failed, and since that failure prevented us from revisiting the issue for nearly two decades... the success of Obama will produce the same result.

Call me crazy, but that seems to betray a fundamental misunderstanding of political behavior. "Failure," especially when bombastically proclaimed as such by the media, will lead not to more action but to inertia. I mean, consider the headache it has been to keep the issue on the front burner this year alone -- even though, by some estimations, we are already well on the way to third world status.

"Success" of the bill may not exactly bring "success" as Angell would define it (or, hell, as I would define it), but it will bring momentum. Some people will get a glimpse of a better life. Again, the fixes may not address the underlying problem, but a certain amount of desperation will be removed from the equation. All this birther, deather, Obama-as-Hitler bullshit we've had to put up with over the last year, and which has prevented any sort of reasonable dialogue on the subject at hand? That is mostly derived from desperation. You can't think rationally when you are treading water.

Look, I like Marcia Angell. I think she's very smart. But I wish she (and others like her) understood that, at the moment, we're in a triage ward. Brain surgery will have to wait.

[Photo credits: Redvers (top); Anyaka (bottom).]


godoggo said...

See, my worry is that it's going to hurt people on medicare because of the failure to control costs. I'm not inclined to try and go through it in detail and figure out how bad a problem it's going to be, but this is what I've been hearing, and if it's bad enough, that will be its downfall politically. In other words, I'm not merely dissatisfied with the reform, I'm not convinced it's going to be a net positive. I guess we'll see..

godoggo said... some voters will undoubtedly be angry to be forced to purchase insurance that they don't want.

godoggo said...

However, (hope you don't mind me doing what I'm doing here), This Steve Bennen post (responding to Kucinich) makes me feel a bit more optimistic about the possibility that this could lead to something better:

Andrew Durkin... said...

Thanks for the link to that Benen piece. My feelings exactly.

And no, I don't mind what you're doing here! This is a complicated issue, it's helpful to chew it over a bit...