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Fri

25

Dec

2009

Obamacare: a Mortal Threat to the Democrats, and What We Need Instead
Friday, 25 December 2009 11:16
by Richard W. Behan

To get a health reform bill passed—some bill, any bill—the Obama Administration has caved in completely to the health insurance and pharmaceutical lobbies. Doing so guarantees Barack Obama will be a one-term president, and poses a grave political threat to the Democrats in 2010.

The House bill is a façade, a joke. The bill mandates the purchase of insurance by all Americans, but provides no effective constraint on premiums: a stupefying windfall for the industry. The bill’s “public option” is available to just a tiny fraction of the American people, so it generates only a hint of price-competition. Meanwhile in the upper chamber, Mr. Joseph Lieberman has eliminated competition altogether in the Senate bill: a public option of any sort and the Medicare buy-in proposal have been dropped. And so has any hope of reimporting less expensive prescription drugs from other countries—a deal worked out in the White House with PhRMA’s Billy Tauzin and confirmed by a Senate vote.

Yes, both bills feature innovative measures to reduce costs—basing payments not on quantity, for example, but on successful outcomes. That’s laudable, but the cost-savings accrue to the insurance companies who pay the bills, not the American people who buy insurance. Few expect the companies subsequently to lower their premiums.

Suppose a Conference Committee dilutes the House bill even more, to match the insipid Senate bill. Suppose the committee’s work survives and is enacted into law.

The Republicans will continue screeching about “socialism” and use the insurance-purchase mandate to display how “government-run healthcare” tyrannizes and victimizes American society. This will be a powerful stimulus for the lunatic right fringe to gain strength in the GOP, to promise repeal after the election in 2010, and to serve up a Palin/Beck ticket, say, in 2012.

Such a ticket might win: there are frightening precedents for demagogues playing to the anger of victimized people, by demonizing plausible culprits. Hitler focused on Jews, racial impurity, and the communists. The far right today spouts hatred of Muslims, immigrants, and liberals.

President Obama’s flaccid health reform legislation will attract no Republican support in 2010 or in 2012 for his reelection, and it is driving away hordes of Democratic voters.


Disaffected Democrats, notably including Howard Dean, are seeing yet another corporate giveaway, and insufficient benefit to American people to justify supporting the legislation. The Obama Administration sent billions to Goldman-Sachs, Citigroup, Bank of America, AIG, JPMorgan-Chase and Wells Fargo; billions to Chrysler and General Motors; and with its newly expanded warmongering, billions to General Dynamics, Boeing, Lockheed Martin, Northrup Grumman, and Raytheon. Now it’s the turn of the health insurance and pharmaceutical corporations.

So Mr. Obama is facing not only bloodthirsty Republicans but also disenchanted Democrats. How can he save his majority in Congress and expect to be reelected?

President Obama must scrap the ludicrous legislation he has engineered and start over. There is a chance, anyway, he might succeed.

What the country needs is lower, stable, and controlled healthcare costs. This is the fundamental, absolute imperative. But Obamacare, relying on “free market” forces to control costs, utterly fails here, because the healthcare markets are light-years distant from “free.” They are rigged and manipulated at every turn, and policy-driven as well. (President Obama enacted a de facto policy in prohibiting the reimporting of prescription drugs: how free is that market?)

We need some new and drastically different policy-drivers, but to put them in place President Obama must confront and call out the insurance, pharmaceutical, and hospital corporations, not cater to them. With his gifts of intelligence and eloquence, the President can take his case directly to the people—how about a weekly, hour-long telecast?—and win great support, enough to make the necessary changes and conceivably enough to survive politically as well.

What might real healthcare reform look like? There are simple and effective healthcare systems vastly superior to ours in every other industrialized nation on the planet; the one most palatable and easily replicated in the U.S. is probably Germany’s.

The German system has no public option. There is nothing comparable to the Medicare buy-in. Senator Lieberman, the “moderate” Democrats, and perhaps a few Republicans come on board soon. The purchase of insurance is mandated: that’s already on the table here. There is not a hint of “socialism,” which should appeal to America’s conservatives. The insurance companies, the hospitals, the doctors, the pharmaceutical companies and the drug stores all operate in the private sector. Sarah and Glen should now be applauding. Citizens are free to choose their doctors and, if necessary, their hospitals, and if there is any waiting at all it is a matter of a few days, not weeks or months. There is no rationing, and there are no death squads. Per capita costs are a fraction of those in the U.S., health outcomes are far superior, health-cost bankruptcy is unimaginable, and German citizens are understandably delighted.

The German insurance companies, the German hospitals, and the German manufacturers of pharmaceuticals are less so, because they are prohibited by law from extorting obscene profits from the people at large. Healthcare premiums and prices in Germany are handsome but reasonable, because they are capped--negotiated, standardized, and enforced by public policy—as they are in every other advanced nation in the world.

Our healthcare system is outrageously expensive and tragically ineffective because we haven’t done this. But we could, easily, with a freshly minted bill and a simple one, establishing a federal agency to set and administer health care prices. Not much else needs to be changed.

Congressional Democrats? Are you ready to deny the lobbyists, to give priority instead to the well being of the American people?

President Obama claimed to be, last February, when he said,

The system we have now might work for the powerful and well connected interests that have run Washington for far too long, but I don’t. I work for the American people. I didn’t come here to do the same thing we’ve been doing or to take small steps forward, I came to provide the sweeping change that this country demanded when it went to the polls in November.



Mr. President, Godspeed.

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