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Archive for August, 2009

Teddy, Healthcare, and the Nature of Reform

Friday, August 28th, 2009

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by Brien Jackson

Well, I wasn’t going to write anything about Kennedy and healthcare and all that today, but this Yglesias post strikes me as pretty strongly on point:

There’s a tendency to get extremely wound up with optimism about the imminent dawn of sudden and radical change for the better, and then intensely bitter, cynical, and depressed when that fails to materialize. The reality, however, is that change is hard. That’s not an excuse for the people who stand in its way, it’s the reality. But if you respond to the difficulty of making things better by giving up or getting frustrated, then it only gets harder.Building a better country and a world is work—hard work—and it’s work that goes on. And on. And on.

We were having this argument in the forum the other day, and this is generally the side of the question I come down on. The American political system just doesn’t lend itself to comprehensive progressive reforms, and most of the things we regard as great progressive achievements have really been accomplished in multiple acts. Social Security seems to have become the cliched example, but that’s because it’s also a very good example. The original Social Security bill may have established the general framework of the current program, but substantively it wasn’t nearly the thing we know today, and was downright meager (and racist). But it was a significant improvement over the status quo, and was able to morph into a legitimately good program. Similarly, via Yglesias, Ed Kilgore makes the much needed point that, for as proud of them as progressives (rightly) are, Medicare and Medicaid were substantial compromises, at the time, from the goal of universal healthcare:

As for Medicare and Medicaid, the idea that LBJ came up with a bold set of proposals and ram-rodded them through Congress is wrong by all sorts of measurements. It’s important to understand that however important these health care entitlements became, they were at the time clearly major compromises from the progressive commitment, first articulated by Harry Truman, to enact national health insurance. Medicare, obviously, was offered only to retirees, not all Americans–a distinction that is cherished as a matter of principle by those Medicare beneficiaries who today oppose universal health coverage. Medicaid was even more of a compromise, eschewing national health coverage for a crazy quilt system in which the states would largely determine eligibility and benefit levels, with coverage generally limited to low-income families with children.

I really could go on at length about The Myth of LBJ, but that’s best left for another time. Instead I’ll just say that Kilgore is right, especially about Medicaid, which was a very big compromise from the universal healthcare goal, and also point out that neither Medicare nor Medicaid has really helped us move towards universality in the past half century. But that doesn’t make them bad programs. Indeed, they’ve been very good programs. And, again, progressives are quite rightly very proud of them.

This works with something that, to me, is the great paradox of Ted Kennedy’s legacy. He was simultaneously the Liberal Lion and also arguably the great negotiator of this era. To progressives, he was the great champion of liberalism. To John McCain, he was a guy who knew when and how to make concessions. And yet, both of these visions were accurate. Because one thing Kennedy always understood was the notion of taking what you could get, and always seeking to move the ball forward. Kennedy was instrumental in constructing and implementing SCHIP. But SCHIP wasn’t universal healthcare. What it was was an improvement over the status quo, and attainable. And nobody questions the progressive bona fides of Ted Kennedy, or anyone else, for not refusing to support SCHIP because it didn’t achieve universal coverage or establish a single-payer plan.

This shouldn’t be taken as an argument for or against anything in particular in the current circumstance, other than as advocacy for taking, and accepting, the best package that can be attained now. It’s one thing to get mad at the Democrats in the Senate making a better package unattainable (seriously Max Baucus, fuck you), it’s quite another to outright refuse a reform bill that improves on the status quo because it’s not perfect. There has never been a perfect piece of progressive reform passed by the United States Congress. Every major accomplishment progressives have achieved has started as an incremental action and been added to and improved upon later. Healthcare reform probably isn’t going to be any different. The sooner you get the foot in the door, the sooner the improvements will come.

Sen. Edward Kennedy (1932-2009)

Wednesday, August 26th, 2009

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by Brien Jackson

I’m certainly not of the generation of Americans who are usually considered to be enamored with the Kennedy brothers, but it was, and still is, impossible not to be awed and moved by Ted Kennedy. Teddy doesn’t get nearly the credit he deserves, and is obviously not thought of nearly so fondly as his older brothers, yes, in part because his life was not artificially cut short. People can imagine what Jack and Bobby might have done, and impute their own vision of their better angels to them, but with Teddy, we actually have a full life and body of work to look at, warts and all.

There’s a lot of things that deserve to be said, both about the life he lived and what this means for the rest of us going forward, but for now, at least for me, the passing is too sad for words. Thank you Teddy. That’s really all that needs to be said today.

What Happens if the Uninsured Pick Up a Gun?

Sunday, August 16th, 2009

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By Writeside

Watching MTP today I was struck by how Dick Armey and Tom Coburn avoided any responsibility for the right wink kooks who are gathering weapons and ammunition, joining militias, buying gold and stockpiling cans of beef stew. Certainly it should be as obvious to those two gentleman as it is to everyone else that these nuts are being riled up because they are being told – by the Republicans – that the Obama administration is doing everything from wanting to kill grandma to destroying the American way of life. The right needs responsible leaders who will stand up and loudly repudiate the violent threats.

But after all, what the right wing wants is to preserve the status quo. They want those who “have” now staying that way, and as for those who “have not?” Well, the Republican party is pretty sure that those who have not are illegal aliens, lazy African Americans, Marxists, just plain evil or a combination of all of those things, and not deserving of having anything like health care in the first place. Certainly they are people who made “poor choices” in their lives and thus deserve to die young and leave nothing behind for their children.

Yes, the people like the idiot who brought a gun and threatening signs to the Portsmouth town hall, and the nutbag who held up the “Death to Obama and Family” signs in Maryland are a small percentage of even the right wing nuts, but all of them want to preserve the status quo. What about those who don’t?

What if the 46 million people without health care decided to form their own militias? It seems to me that the “have nots” in this country should be more motivated to change the way things are than the “haves.” Latest estimates are that 37 million people live in poverty in the United States. If only 1% of those who either live in poverty or who do not also have health care coverage decided that our system – despite overwhelming Democratic majorities – was not going to respond to them in general, and to the health care crisis in general, that would be an army of between 370,000 and 460,000 people. What percentage might it be if we see the moneyed interests come away with a “win” here? 3%? 5%? 10%?

And none of their anger would be based upon lies.

This is why I am anxious to see some leadership from those on the right. They threaten us with military coups to “restore” the GOP to power, and the Republican leadership winks and says that they know nothing about that. Then they turn around and say that they “understand” the anger that infuses the radical right.

They miss those with grievances on the left, those who worked last year to put huge Democratic majorities in place to effect change, those who worked within the system to try to make this a better country.

They Republicans play the “we know how to use a gun” schtick a bit too loosely, and they forget that they’re not the only ones who do…

The Myopia of the Public Option

Friday, August 14th, 2009

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by Brien Jackson

There’s much to appreciate in Howard Dean’s comments on healthcare reform at Netroots Nation, both on the policy and politics fronts, but at the same time, I keep coming away with this nagging feeling about the continued obsession progressive activists and activist styled bloggers have with the public option. It’s not that the public option isn’t important or worthwhile, it very much is, it’s just that it’s not the center of the bill, by any stretch. And it’s not that Dean’s 2004 plan didn’t contain any sort of public insurance plan, (or many of the other meaningful regulations the current proposal seeks to implement), it’s that I can’t shake this fear that while progressives focus on the public option, reform opponents will go after the more central regulations like community rating. And I do have to wonder whether or not the fact that the public option is easy to understand while the other things are a bit more complex, and numerous, doesn’t play into this as well.

But as far as advocacy goes more generally, I think the public option is one of the places its needed least. The White House has already thrown down a marker on it, before there was even a House bill drafted I believe, and most of the Congressional Democrats have already come to something of a compromise; progressives will get some form of public insurance option, while conservative Dems will get concessions weakening it in the market place, from limiting who is eligible to purchase it to prohibiting it from using Medicare style rate bargaining. Which is sub-optimal, but nothing that can’t be changed later. And putting something in place is much more important than making sure it’s absolutely perfect, over even “good enough.” It’s much, much easier to expand a popular program than it is to construct and implement that program in the first place. See Social Security.

But that said, it does seem like the debate over the public option is pretty much over with, and that there’s going to be some sort of public insurance program. Progressive activists would do better to keep their guns trained on the central aspects of the bill reforming the health insurance industry. That’s where most people are going to be affected at, and that’s where the bill is going to do the most immediate good. It’s also what the insurance industry has the most incentive to try to derail.

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