I'm a constituent. I live in Polk County and have lived here for 12 years since 1990. I'm a lifelong Dem and very much one who is willing to accept a government that is more conservative than I am so long as I believe it is principled, competent and draws from progressive values as readily as it does from so-called traditional values.
I've only rarely cast single-issue votes. I can really only think of one, and it is symbolic: The day after Marvin Gaye was shot and killed, I reminded myself I had promised never to vote for a gun-control opponent and voted for Jesse Jackson rather than Gary Hart. I've since voted for anti-g.c. candidates.
If things don't change quickly, I expect to support any primary opponent you get in 2012, and can't imagine a viable one won't surface.
I made a mental note the day you cast two committee votes on the public option and tightly parsed your support to a "yes" vote on one and a "no" on a second. Don't judge on this, I thought, but do judge based on its result. If you were simply positioning yourself to be fore the option before you were against it, well, it won't work with me. If you were participating in some kind of strategy to bring the senate around to a public option, then great. I'd congratulate all of you.
Is this a worthy single issue? Of course it is. The public option is, itself, a compromise. A lot of us think a single-payer system would work better for people, better for small businesses, better for the country as a participant in a global economy where our employers compete against similar systems. Additionally, the public option is the only check or balance I can believe in. For most of my adult life, the federal government has refused to enforce its laws when they apply to any area of the private sector with much lobbying clout. I don't trust enforcement of any of your reforms, but I did trust that if the system didn't improve, people could take the public option. School choice is at the heart of the checks and balances of so-called education reform. How is this any different?
You cannot mandate coverage and then trust that coverage to work when you have given its industry an excemption from anti-trust protection. You cannot mandate coverage and then make participants seek redress for being wronged from someone who takes money from their paychecks to use - far too often - for lobbying and lawyering and accounting shenanigans.
So, here is the deal. No public option? You had better successfully support two amendments to this bill:
- No mandated coverage.
- Repeal of anti-trust excemption.
No one but me seems to care about limiting what the insurance companies can do with payroll-deduction money, but if it was just my druthers there would be a 3).
The same conditions for use of payroll deduction money as are exercised against labor unions. This includes money going to medical savings account companies, money which financed the infamous "Swift Boat Veterans for Truth" ad campaign against John Kerry.
I don't think you're evil, but you have to understand that if you support what is becoming a giant giveaway to the insurance industry, you are helping to prop evil up. My favorite example of this is that Anthem Blue Cross, whose CEO is on record saying that health insurance shouldn't have to cover pregnancy and childbirth, uses a complicated enough system of OB-GYN codes as to initially deny coverage for pre-natal blood tests because the doctor's practice didn't submit the corrrect code to include a clean needle. Hanging on to money for an extra mnth or so seems to be a more important value than avoiding pumping additional stress into the home of expectant parents. You have been in government long enough that you know how premiums increased and shifted toward an employee rather than employer burden during the years following the derailment of the 1994 Clinton reform proposals. I don't really think this is an employer function as it currently plays out. But that is the social contract we were left with in 1994, and it is a social contract that has been compromised.
You can tinker with it, but as long as you continue to include an anti-trust exemption for these companies, as long as you prevent serious negotiation with the drug companies, as long as the only competition in healthcare is between the insurance company and its subscribers, nothing will improve.
If our party has losses in 2010, this will be why and it will be at least partly your fault. Do not assume that the losses won't extend to your own reelection in 2012. I'm not alone on this. Either get back the option, strip the mandate and the exemption, or face a primary challenge.