Sunday, May 3, 2009

Healthcare Reform--Death by a Thousand Cuts?

I have a recurring nightmare about Barack Obama's efforts to bring health care reform--finally--to the United States of America. 

The scenario is this: Faced with solid opposition from the GOP, Obama needs enough Democratic support in the Senate to enable use of the budget reconciliation process to get a health care reform bill passed. Via reconciliation, that means he needs 51 votes. Currently, the Democratic margin in the Senate is 58-40 (the Franken-Coleman race still being in legal limbo), the number of Democrats having increased by one last week with the addition of Arlen Spector of PA, who switched parties (as I'm sure you all remember). HOWEVAH, a number of Democrats are of the genus blue dog, which may put that necessary 51-vote total in jeopardy.

I was reminded today (again) of the potential for blue dogs to vote with the GOP by recent statements by Nebraska Senator Ben Nelson (D, allegedly) and Senator Spector (D, at least this week) in opposition to Obama's proposed health care plan, particularly its public option.

What is the public option & why is it important? Basically (and please bear in mind that no bill has yet been written, so the precise details of the plan have yet to be spelled out) the public option would provide medical coverage without private insurance to those who choose it. Instead of private insurance, the government would, in effect, be the insurer, a la Medicare. This would not eliminate current health care plans using private insurance; rather, the public plan would exist alongside medical coverage as currently constituted. However, given that the public option would operate without the private insurance middleman, it is expected to be less expensive than current privately insured coverage because it eliminates the extra layer of bureaucracy created by insurance companies for the purpose of minimizing their responsibility for paying insurance claims, and thus, maximizing their profits. 

Why the opposition to the public plan? Nelson specifically has stated outright that his opposition is due to the pressure on profits a public plan would represent to the insurance companies (if Spector has enunciated the reasons for his objections, I have not yet seen it). In other words, given a choice between the interests of the public and those of insurance companies, Senator Ben Nelson opts for the latter, unambiguously. It should be no surprise to learn, therefore, that insurance companies are the biggest single source of funding for Senator Nelson. They're certainly getting what they paid for. And who says there's corruption in Washington D.C.?

In any case, whatever the motivations of other blue dogs in re Obama's health care plan, it should be clear that if we want health care reform to occur this year--that is, if we want to finally seize the moment and remove the U.S. from that small list of industrialized countries without universal health care (leaving only South Africa), we need to organize to put the maximum amount of pressure on conservative Democrats who are caving in to the insurance lobby or thinking about doing so. And while we're at it, in states where there's a possibility of replacing someone like Spector with someone who'll actually vote in the interests of the public, we should do whatever we possibly can to make sure that such wolves in sheep's clothing are retired in the next election cycle. In PA, keep an eye on Joe Sestak--he seems to be edging in the direction of opposing Spector in the next election. If that's true, I think it incumbent on progressive voters and activists to support him.

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