a citizen’s journal by Thomas Nephew

Death of the public option on the Orient Express

Posted by Thomas Nephew on March 15th, 2010

Hercule Poirot: If all these people are not implicated in the crime, then why have they all told me, under interrogation, stupid and often unnecessary lies? Why? Why? Why? Why?
Dr. Constantine: Doubtless, Monsieur Poirot, because they did not expect you to be on the train. They had no time to concert their cover story.
Hercule Poirot: I was hoping someone other than myself would say that.
Murder on the Orient Express, 1974 film version

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The “public option” — a health insurance option run by the federal government, for those mandated to obtain new health insurance– seems likely to be dropped from the final health insurance reform legislation apparently on the agenda sometime towards the end of this week.

Last week, Rachel Maddow pointed out the sizeable number of Senators who’ve either co-signed the Bennet letter or otherwise claimed they would support a reconciliation bill with a public option.  Guest Chris Hayes (The Nation) said he thought that support was soft — some Senators were counting on never having to vote for or against a public option.

When Maddow replied that Durbin had just pledged to whip whatever came to the Senate from the House, Hayes continued,

“…except for the fact that what is going to come out of the House is being negotiated between three parties … the House leadership, the Senate leadership, and the White House […] …it’s become this kind of like murder mystery game of “Clue,” it’s this whodunit, you know, who killed the public option: was it Senator Reid with procedural obfuscation in the Senate chamber, was it Rahm Emanuel with the insurance industry in the Roosevelt Room, everyone is pointing fingers at everyone else and it really is hard to figure out who actually put the knife in.”

And that, of course, is the point.  As in Agatha Christie’s famous mystery, the right way to read the evidence is that they *all* put the knife in, spreading and blurring responsibility for the deed.

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Since it can’t quite happen under complete cover of darkness on a train bound to Istanbul, one or the other Democrat has to step up from time to time and be the public face of the double cross.  Right now it’s Nancy Pelosi, whose woeful interview with Rachel Maddow showed just how nonsensical throwing the public option under the bus would be.  But before that, as Glenn Greenwald noted late last month in “The Democrat’s Deceitful Game” and again last week in “The Democrats’ scam becomes more transparent,” it was Jay Rockefeller, Dianne Feinstein, Chuck Schumer, etc., etc.  Greenwald, who calls it “Villain Rotation,” reminds readers how the liberal/progressive base Democrats count on for votes, donations, and work have seen the same kind of thing before:

One minute, it’s Jay Rockefeller as the Prime Villain leading the way in protecting Bush surveillance programs and demanding telecom immunity; the next minute, it’s Dianne Feinstein and Chuck Schumer joining hands and “breaking with their party” to ensure Michael Mukasey’s confirmation as Attorney General; then it’s Big Bad Joe Lieberman single-handedly blocking Medicare expansion; then it’s Blanche Lincoln and Jim Webb joining with Lindsey Graham to support the de-funding of civilian trials for Terrorists; and now that they can’t blame Lieberman or Ben Nelson any longer on health care (since they don’t need 60 votes), Jay Rockefeller voluntarily returns to the Villain Role, stepping up to put an end to the pretend-movement among Senate Democrats to enact the public option via reconciliation.

It can’t all be inside the Beltway, of course, and the Democratic Villain Rotation Committee ought to have a few attaboys to spare for fellow travellers in the media and blogosphere.  Without getting into who all exactly is pushing the narrative, a significant part the blogosphere appears convinced, and eager to convince others, that health care reform is mainly imperiled by evil public option activists like Jane Hamsher — whose “firedoglake” web site is one of the very few remnants of the leftish blogosphere to distinguish itself with independent thought and a commitment to tactical, political action.  Criticism from the left seems rarer yet in the more established media — even media on the left such as Mother Jones or The American Prospect.

In part, this is good faith calculation that the health bill is good enough, even progressive enough, to merit passage.  Writers like Ezra Klein, Art Levine, Chris Bowers, and Paul Starr point to millions of newly insured Americans, and tout regulations that may prevent the worst insurance company abuses.

But a bill that fails to challenge the central, unusual premise of the American health care system — that health insurance is and by right ought to be primarily handled by the private sector — may well be inadequate to correcting the failings of our system: unusually high costs, and unpredictable and inadequate coverage. Critics like Marcia Angell warn that the Obama/Democrat bill will unravel almost as quickly as the status quo will, and will only serve to delay and complicate a switch to a public health insurance, single payer system.

At “A Tiny Revolution,” Seth Ackerman goes further:

But it gets worse. The decentralized private payment system will inevitably start crowding out the public insurance we already have, especially Medicare. With continued double-digit medical inflation, the slow-motion dismantling of Medicare isn’t a possibility, it seems like an eventual certainty. (Just look at the current deficit hysteria, which is now being propitiated by the White House and its independent commission.) We are on a moving train going in the wrong direction; instead of turning the train around, this bill tries to solve the problem by having us all run towards the caboose.

While Ackerman doesn’t appear to consider the public option a significant fix in this respect, I largely agree with the picture he paints of the situation before us:

Obama came into office with every whim of history leaning in his direction: a discredited Republican predecessor, a crisis of deregulated finance that reached a crescendo literally weeks before the election (what luck!); the largest Democratic majorities in decades […] Such a clear shot will not return for decades. And the result: The Democrats shot their historical wad on health care by re-introducing Bob Dole’s bill from 1994 and justifying it as a free-market solution. How is that a “huge progressive victory”?

“That’s why any plan I sign must include an insurance exchange: a one-stop shopping
marketplace where you can compare the benefits, costs, and track records of a
variety of plans – including a public option to increase competition and keep
insurance companies honest
– and choose what’s best for your family.”
President Barack Obama weekly radio address, July 18, 2009
(at ~4:30; transcript here)

It isn’t.

Much of the responsibility for that belongs squarely with the current occupant of the Oval Office.  Now, of course, this needn’t surprise us; Obama has generally been at pains not to be seen as “progressive.”

But he has put a great deal of emphasis on being seen as different, as unconventional — and he has squandered that reputation with backroom deals with Big Pharma, and Big Insurance. As Lawrence Lessig — an early Obama fan — writes unhappily in The Nation:

The bill the Fundraising Congress has produced is miles from the reform that Obama promised (“Any plan I sign must include an insurance exchange…including a public option,” July 19, 2009). Like the stimulus package, like the bank bailouts, it is larded with gifts to the most powerful fundraising interests–including a promise to drug companies to pay retail prices for wholesale purchases and a promise to the insurance companies to leave their effectively collusive (since exempt from anti-trust limitations) and extraordinarily inefficient system of insurance intact–and provides (relative to the promises) little to the supposed intended beneficiaries of the law: the uninsured. In this, it is the perfect complement to the only significant social legislation enacted by Bush, the prescription drug benefit: a small benefit to those who can’t afford drugs, a big gift to those who make drugs and an astonishingly expensive price tag for the nation.

So how did Obama get to this sorry bill? The first step, we are told, was to sit down with representatives from the insurance and pharmaceutical industries to work out a deal. But why, the student of Obama’s campaign might ask, were they the entities with whom to strike a deal? How many of the 69,498,516 votes received by Obama did they actually cast? “We have to change our politics,” Obama said. Where is the change in this?

Nowhere that I can see.

Lessig rightly sees a major challenge facing America today to be reforming Congress; he calls for a Constitutional Convention to insure that laws for citizen funded campaigns and blocking the revolving door between Congress and the lobbyists can endure, and restore a government answerable to the people, not the corporations.

But it can’t be just Congress; it’s also something a little less towering — and a little less amenable to a political fix, even as far-reaching a fix as a constitutional convention.  It’s a return to integrity — that of our leaders, and that of ourselves.

I think there’s no way for a good faith observer to watch Obama give the speech he gave on July 18 and not feel at least disappointed and at worst betrayed.  Obama eloquently and succinctly made the case for a key policy initiative — and then abandoned it within a year, later going so far as to claim he never campaigned on it, which he most assuredly did. (As Ezra Klein noted at the time, “It was, in fact, their answer to a lot of the other flaws in their proposal.“)

Far too many of us are willing to let him do it, for reasons that do us little credit either: misguided loyalty to a man, to a party, to expected winnings down the road.

In so doing, we, too, are like the conspiracy aboard the Orient Express; we, too, add our own hesitant little knife stabs to the tally and turn away, not quite responsible, yet uncomfortably co-responsible — and not for the death of an unlamented tyrant, but of the very possibility of governing ourselves with leaders fairly elected, who say what they mean, and mean what they say, or suffer the consequences.

5 Responses to “Death of the public option on the Orient Express”

  1. Nell Says:

    I came home from the local Dems’ elated election-night party and made the fatal mistake of turning on the television, where I heard that Obama had chosen Rahm Emanuel for chief of staff. I picked up a kitchen chair and threw it across the room, knowing right then just how bad it was going to get.

  2. Thomas Nephew Says:

    Yes, that was (*(*Not A Good Sign*)*), in flashing neon.

  3. ballgame Says:

    EXCELLENT post, Tom.

    A couple of months ago, I wrote something similar in guest post over at Ian Welsh’s. (Don’t know if you’re familiar with Ian; he used to be managing editor at FireDogLake.) I got raked over the coals a bit by Sir Charles and some commenters at Cogitamus (where I was briefly co-blogger a while back). Perhaps I could have benefited from your more temperate wording; the fact is I was disgusted at the chasm separating the president that candidate Obama promised he would be and the one he actually has become. I’m very sorry to see the vitriol being directed at genuine progressives like Jane Hamsher and Dennis Kucinich. (I never really knew that much about Kucinich before but my respect for him has grown tremendously during the HCR debate.)

    I don’t have much hope for Constitutional Convention, although we clearly have a need. It seems altogether too fraught with opportunity for right wingers and teabaggers to put in genuinely noxious provisions (like California’s requirement for super majorities to increase taxes, or marriage must be between a man and a woman, or any of a number of potentially more egregious provisions that might seem superficially reasonable to some people).

    But with the Supreme Court bent on defending corporate dominance of our political economy, it’s clear that our Ship of State is headed for turbulent waters.

  4. Thomas Nephew Says:

    Thanks for dropping in! and for the links back to Ian Welsh and Cogitamus. — I often don’t know how (and closely related, how often) to best raise Obama’s disappointing actions either. On Facebook, I try not to overdo it, but as one person told me, I keep coming back to it like massaging a bruise that hurts or picking at a scab that bugs me.

    I actually worked fairly hard for Obama (just weekend warrior type stuff, to be clear, not full time volunteer like some). I thought I had my eyes open about his centrism, but hoped my work and that of others like me might somehow earn me and those like me a figurative seat at the table. Hasn’t seemed to so far.

    And to tell the truth, there were strong indications during the campaign that Obama wasn’t reliable about his word — FISA telecom reversal, public financing reversal (IMO, others see that differently), the Goolsbee/Canada/NAFTA thing. So I gave Obama a pass on stuff too, because… well, I wanted to get the GOP out of there, and thought surely Obama would be a huge improvement and a perceptible left turn/course correction. Hasn’t seemed that way so far.

    I worry about a constitutional convention going off the rails, too, but things are so badly wrong that major changes seem necessary — breakaway party, constitutional amendments, something. I need to give “Balkinization” co-blogger Sanford Levinson’s “Our Undemocratic Constitution” another chance; I used to be impatient with L. because it seemed to me he wasn’t willing to use the Constitution we had — i.e., impeachment — and wanted to go straight to revising it. Now I’m more sympathetic.

    Thanks again for your visit and comment; I look forward to checking out your blog posts.

  5. » Blog Archive » Health care reform: an activist-annotated scorecard Says:

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