“The health care debate isn't a
question of Left vs. Right, it is a question of Forward vs Backward,
or Up vs. Down.
----from The
Quotations of Chairman Joe
The
New York Times featured an essay
today written by Peter Suderman, the features editor at Reason,
a libertarian rag trafficking in the fevered fictions of Aynn Rand
and company. Suderman is here lamenting the G.O.P's foggy response
to Obamacare and the recent Democratic shift toward universal health
care, usually put in the form of Medicare for all.
From
the mantra repeal and replace used
in 2016 to mislead the public to today's patient centered
and preserving
the doctor-patient relationship, today's
slogans ring as hollow and separated from the real world as defeated
senatorial candidate Susan Lowden's suggestion, in the 2010 Nevada
Senate Republican Primary that patients bring chickens to the
doctor's office and barter them for medical attention. Of course, no
one asked her what would happen if the patient's doctor were already
stuffed with feathers and the poor soul had nothing left with which
to barter. Carrying the argument to these extremes is to plumb
libertarian fictions to the depths at which one encounters the likes
of Suderman and his unhinged Reason. It's
at these depths, according to these lights, where real freedom lies.
But
the fact is, in this post-medieval society, that one cannot achieve
real freedom by
chaining the health of your very being to the rapacious caprice of
the marketplace, any more than you can purchase medical care with
chickens. It simply doesn't work.
It
isn't simply that the Republicans have given us fluff in place of
substance; slogans instead of policy, vacuous platitudes instead of
relief. It's that they had no intention of replacing Obamacare in
the first place. They had no intention of doing anything.
Oh,
but Suderman would have us believe otherwise. “It's not
a shortage of ideas: Conservative think tanks have health policy
white papers to spare, and have for years.” (1)
Suderman assures us with a straight face. “All the way
back in 2012, for example, you could find the right-of-center health
policy scholars James Capretta and Robert E. Moffit outling
principles for an Obamacare replacement in the journal National
Affairs. Their plan called for limiting the tax break employers
would get for offering health coverage, converting existing public
coverage programs to premium support (essentially a subsidy) while
promoting competittion among private plans, protecting people who
maintain continuous coverage from spikes in premiums, and allowing
states more flexibility to opt in or out of national health care
initiatives”. (2)
Alright, lets analyze this word salad. First, let's
begin with our nomenclature. This is not “right-of-center”, it
is wrong-of-center. Obamacare, let us never forget, was first
forged in the conservative stink tank Heritage Foundation, and
has served as the most salient form of “let's never keep our
corporate paymasters out of the mix”, initiative. First put in
place of Mitt Romney in Massachusetts, Obamacare was written and
implemented by the very same architects of Romneycare. And,
accordingly, corporate America has its fingerprints all over it.
Yes, Obamacare leaves too many people without coverage and is proving
too expensive. It's failures are not that it has gone too far, but
that it hasn't gone far enough—corporate profit-making is still an
egregious feature and one look no further than big Pharma as an
illustration of the problem. We remain with the developed world's
most expensive system which in too many places delivers third world
service.
But let's continue. Secondly, limiting tax breaks for
employers, does not alleviate the problem; it would only
exacerbate it. Under the all-too-transparent figleaf of
'principles', this 'reform' would only give corporate America yet
another exit from the stage and, since most would still be depending
on employer-sponsored health care, this further erodes security.
Over time, as sure as the morning sun rise, the trend toward
corporate shedding of this responsibility on to the backs of it's
labor force would accelerate. The goal here, disguised as
“priniciple” is to render the laborer at the mercy of the
market-place, armed only with inadequate subsidy in the face of
rapacious greed. Imagine, if you will, taking your health token to
the drug store to get medications for a serious or rare disease. Of
course, conservatives will bolt, as they do with the minimum wage, at
any suggestion that these subsidies be annually adjusted for
inflation. In a very short time, the public will be left not with
health care, but health coupons.
And, point number two, this is the problem with
converting existing public coverage to premium support. Government
subsidy as used here is long on underwriting corporate profitability
and short on health care delivery. Can we say campaign contributions
here?
Third, Suderman assures us that the conservatives are
all about promoting competition. This is pure balderdash. If that
were true, conservatives would be pounding the drums—as Teddy
Roosevelt did—to enforce anti-trust legislation and break up the
medical, insurance and pharmaceutical cartels. Again, one must
always take the conservative use of the word principle with a
grain of salt, for it is always a fig leaf designed to mask greed.
Fourth, the idea that they would protect people who
maintain continuous coverage, as opposed to others whose coverage is
interrupted, favors those who have steady, long-term employment. It
also favors those who still have employer-based health insurance.
Market trends, in case the conservatives haven't noticed—and by
god, being the architects of these trends they know—are running in
the opposite direction as corporations have been shedding these
responsibilities long before Obamacare was crafted. Indeed, even
during the best of times, employer-based health insurance never
covered half the work force. This, 'protection' is yet another
disingenuous overture designed to cover greed with yet another
fig leaf; another principle masking greed.
Fifth, Suderman presents us with the old canard that
allowing states more 'flexibility' to participate or not in whatever
hodge-podge they would gag up is yet another attempt to sabotage any
meaningful improvement of our health system under the age-old
stratagem of giving the problem to the states. Again, like the
Clinton-era welfare reforms which made welfare not needs but budget
based, over time inflation will reduce the value of these 'block
grants', further reducing the delivery of services to mere coupons.
At some point, the public will grow disgusted with the delivery for
the dollars spent and move to reject the whole enterprise as
unworkable. This is entirely the point. At some point the public
will lose confidence and want to dismantle it. That's the reality
lurking behind the mask of these high-fallutin libertarian
'principles'.
Then, of course, there are always the shopworn
suggestions that we adopt some kind of Health Savings Accounts, so
dear to conservatives. Besides the fact that those living on the
margins, those who, while working at Walmart, have no money with
which to put into these accounts,--and there are tens of
millions—those that do will have the opportunity to put that money
into investments. Investments which, incidentally, will go into the
pockets of stock jobbers and other financial parasites well before
they make their way back into the emergency or the delivery room.
It's strange how every conservative idea somehow benefits first, and
perhaps foremost, the capitalist benefactor.
There are reasons these dog-eared proposals, taking
short-lived flight in the 2016 campaign of Marco Rubio, and in the
proposals of Lindsay Graham and Bill Cassidy in 2017, as the GOP
struggled to come up with something—anything--to counter Democratic
calls for universal health care. The reasons are that they have not
worked and are now universally known to be-- unworkable.
And that is the criterion that conservatives, blinded by
the ideological imperatives laid down by a writers of pulp fiction,
(3) cannot wrap their arms around. This is not, from an ideological
point of view a question of 'left-of-center' vs 'wrong-of-center'
debate; and it would be a mistake to make it one. It is a question
of what works and what doesn't .
The verdict is in. The game is up. But conservatives,
whom experience is powerless to instruct, cling to their greed armed
only with their all-too-transparent principles, and billions
of dollars of Cartel money. It is with fig leaves and money that
they cover their aging backsides and cling to power.
“An
Br'er Putin, he jus' laugh and laugh'
Impeach and Imprison
__________- Suderman, Peter. “The G.O.P.'s Health Care Confusion.” The New York Times. Monday, February 11, 2019. Page A19.
- Ibid.
- I'm referring here to Aynn Rand and her accolytes.
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