Wednesday, December 16, 2009


At this point in the development of legislation, legislators usually are too invested in the process itself to see the grand arc of a given policy's trajectory. If Senators Wyden, Brown, et al would step back a bit and think in terms that history teaches us, they would see that the current health care legislative proposal is not reform. It is a windfall for for-profit health insurance companies. The wellspring of this windfall is the mandate for individuals to feed insurance companies buy buying medical coverage from them.

History teaches us that there is no "improving" bad legislation. Social Security and Medicare have been successful and expandable because the legislation creating these programs advanced bold visions and put sturdy new frameworks in place. Groups were left out initially, social justice deferred -- but the framework that the legislation put into place was conceptually friendly to including excluded groups. Slowly,coverage broadened to include mostly all persons in the labor market. The current health care "reform" bills, especially the Senate bill, is conceptually friendly only to tightening the grasp of for-profit private insurance on our discriminatory, punitive, and arbitrary medical delivery system. Don't let Democrats desperate for a win in the roll-call column tell you that "we can make it better later." It won't happen. To make anything better, we would have to overturn the paradigm the Congress currently is poised to put in place. We never have overturned a social provision paradigm in the short term, and we have never overhauled such a paradigm to make it more progressive. In fact, only one social provision paradigm has been overturned: the New Deal income assistance program for poor single mothers. That change hardly advanced social justice.

If enacted in its current form, health care legislation will come back to bite all of us -- with uncontrolled, soaring premiums; new methods of excluding and punishing patients; unequal access; unequal services. Worse, all Americans will be compelled to prop up the unjust system through mandatory buy-ins to the private insurance system.

If the Democrats need to salvage something, they should split the bill into its component parts. One big part could pass right away -- Health Insurance Reform, prohibiting pre-existing condition exclusions; gender and other demographic rating; annual and lifetime caps on coverage; churning of expensive patients from insurance rolls. Pass that now.

The other big part of the bill should be scrapped, and we should start from scratch. That's the part that is farcically referred to as "universal coverage." End the farce and let's get to work on a truly universal system that covers everybody in the same way.

Progressives should join Howard Dean in standing up for what's right instead searching for a silver lining that tarnished long ago.

Kill the Bill.