Monday, June 08, 2009

Weighing in on health care

This is my response to Bernie Horn's post on health care at Campaign for America's Future:
"This is Negotiating 101," David Sirota said at AFN last Tuesday. You don't start negotiating from where you expect to end up.

The Big Money Boys will work to beat us down from whatever we start out asking for. If we begin the process asking for some kind of public option, we may not even get that. In fact, you can see from some of the proposals floating around that Frank Luntz still has some influence - "trigger" provisions are meant to give the illusion of some kind of public plan without actually delivering one, just what Luntz suggests.

As you said, "even if a single-payer proposal starts out with a majority of Americans in support, it won’t hold majority support after the insurance industry clobbers it with ads." Maybe. Maybe. But that's my point, and Sirota's. That's where we have to start. We have to aim high if we expect to get in the end what we'd accept as a minimum. That's why pushing single-payer makes good strategic sense, not just good public policy sense.

Those who remember ClintonCare being shot down by the “Harry and Louise” ads are understandably gun-shy this time around. ClintonCare was an all-or-nothing proposition and we ended up with nothing. By pushing the public option, the gun-shy (the pragmatic, if you prefer) hope not to provoke the massive retaliation we all know is coming against real reform anyway. (A neighbor describes the coming health care battle as another Gettysburg.) But we don't have an all-or-nothing situation this time. There are various proposal floating around, and this time a public option allows people the comfort of keeping what they have. It's sellable. I get that.

But single-payer isn't politically viable? I'm not so sure. As I recall, Obama was unelectable. But he somehow managed to dispel preconceptions and stereotypes in winning the presidency. Politicians, they say, are always looking for a parade to run to the head of. That's what Obama seems to be doing behind the scenes with Organizing for America (OFA), trying to organize that parade. If a single-payer parade materializes, and if it is massive, just watch the pols run to get in front of it. If it doesn't materialize, single-payer won't either.

We're dealing with corporate entities happy to deny care to the sick and dying to save a nickel. Don't think they won't neuter any public option before implementation if it means extra shareholder value. We have to push hard for more than a public option if we hope to preserve a viable public option by the time the dust has settled and the bill is ready for signing.

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