. . . in the health care reform debate, the Obama administration pursued legislation that utilized regulated and subsidized private for-profit health insurers to achieve universal health coverage. This approach was inherently flawed to "single-payer" advocates on the left, who strongly believe that private for-profit health insurers are the main problem in the U.S. health care system. The difference was for a long time papered over by the cleverly devised "public option," which was acceptable to many New Democrat types as a way of ensuring robust competition among private insurers, and which became crucial to single-payer advocates who viewed it as a way to gradually introduce a superior, publicly-operated form of health insurance to those not covered by existing public programs like Medicare and Medicaid. (That's why the effort to substitute a Medicare buy-in for the public option, which Joe Lieberman killed this week, received such a strong positive response from many progressives whose ultimate goal is an expansion of Medicare-style coverage to all Americans).
Now that the public option compromise is apparently no longer on the table, and there's no Medicare buy-in to offer single-payer advocates an alternative path to the kind of system they favor, it's hardly surprising that some progressives have gone into open opposition, and are using the kind of outraged and categorical language deployed by Marcy Wheeler of Firedoglake yesterday. As with the financial issue, there's now a tactical alliance between conservative critics of "ObamaCare," who view the regulation and subsidization of private health insurers as "socialism," and progressive critics of the legislation who view the same features as representing "neo-feudalism."
To put it more bluntly, on a widening range of issues, Obama's critics to the right say he's engineering a government takeover of the private sector, while his critics to the left accuse him of promoting a corporate takeover of the public sector. Ed Kilgore
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Even if one grants the arguments made by proponents of the health care bill about increased coverage, what the bill does is reinforces and bolsters a radically corrupt and flawed insurance model and and an even more corrupt and destructive model of "governing." It is a major step forward for the corporatist model, even a new innovation in propping it up. How one weighs those benefits and costs — both in the health care debate and with regard to many of Obama's other policies — depends largely upon how devoted one is to undermining and weakening this corporatist framework (as opposed to exploiting it for political gain and some policy aims). (Glenn Greenwald discussing Ed Kilgore's article)
Both Kilgore's and Greenwald's articles are important and clarifying. Read them. They explain why you are either ok with the healthcare bill as it stands now or hate it. It all depends on your attitude toward the corporatist model or not. If you accept that as reality, then you're mostly ok with the bill. If you resist corporatism and want to do whatever you can to oppose it, then you're mostly not ok with the bill.
And if nothing else, Kilgore and Greenwald explain why progressives lose on every critical issue–they don't have the votes, not even close. The alliance between corporatist Democrats and Republicans in the Beltway system is much stronger than the alliance between corporatist Democrats and progressives. That's why single payer was never on the table. That's why Lieberman's withholding his vote has clout and Sanders' withholding his does not. The corporations win if a Liebermanesque bill gets passed, and the Republicans win if the bill is killed either because Lieberman or Sanders kills it. There is simply no leverage to get a non-corporatist, progressive bill passed. We were told that all summer, and those of us who refused to believe it were just wrong.
If the Progressives kill the bill, it weakens Obama, and makes gains for a frighteningly right-wing-dominated Republican Party more likely in in the next two cycles. If they support the bill, they reinforce movement toward a form of corporatist governing that is fundamentally repugnant to them. Those are the choices currently available given the current power alignments–Dem/GOP corporatism (which passes now for reasonable centrism) or Beck/Palin wingnuttery.
Choose your poison. There is no short-term solution. The long-term solution lies in primary challenges to rid the congress of incumbent corporatist Democrats. In the short run, we have to choose the lesser of two evils, the greater evil being a resurgent Rightist GOP.
What does that mean with regard to healthcare? I would recommend doing what you can to support stripping out the individual mandate, but failing that I think we have to support the best bill they come up with, no matter how corporatist it is. At least some people without coverage now will get it. The problem isn't primarily with the bill but with the underlying power alignments that insured from the beginning that this corporatist giveaway was the best possible outcome.
What does it mean for Obama's presidency? Well it's clear now, for those of us who still hope otherwise, that Obama is a DLC/New Democrat, closer to Evan Bayh and Joe Lieberman than he is to Russ Feingold and Anthony Weiner. I don't think he started out that way; I think he was pushed there by the political realities. The Bayhs and Liebermans have the support of Beltway power, the Feingolds and Weiners do not; they are tolerated, but not taken seriously.
Obama has simply made the calculation that he could not govern to the left of Bayh/Lieberman, and that's why Lieberman doesn't get taken to the woodshed. Whether or not he wants to take him there is irrelevant. He can't because Lieberman's vision of healthcare reform is closer to what's possible than Dean's and Weiner's. And that would be his, or any Dem president's, calculation until the composition of the congress, especially the Senate, changes so that the Weiners define a sane center and the Liebermans are pushed out of the center and far to the right.
If progressives don't like it, they should stop whining and start organizing. I point the finger at myself as much as anyone.
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