Congress has begun delving into one of the key concerns of a vast majority of Americans: health-care reform. Vows have been made by the leadership of the House of Representatives to pass legislation before the August recess, an astonishing deadline if it can be met. What is decided will deeply affect tens of millions, both those who now have coverage for their health needs and those who do not. The impact of what the House and Senate do will be sharply felt by businesses and individuals, the profitable and the destitute.
Under such circumstances, one would think that, in a democracy, there would be an unstoppable desire to collect and talk about as much information on alternative reform proposals as can be found. So as to, you know, not skip over any thoughtful concept designed to profoundly transform the dysfunctional, money-sucking system we now have in place. After all, you only get a chance to make major reforms like this on rare occasions, and a half-baked reform now could actually put obstacles in the path of future fixes.
That being the case, why can't the advocates of single-payer health coverage even GET A DAMN HEARING on the subject?
Yes, that's a rhetorical question.
The powers-that-be are not even going to publicly discuss single-payer. Despite the immensity of the issue, there will be no three-day, televised hearing devoted to witnesses discussing single-payer's pros and cons in full public view. Instead, the whole single-payer idea is being treated as if it were a terrorist. They've shackled it, put a hood on it, renditioned it and disappeared it.
A single-payer health care system in the United States would obviously be a gigantic step, a major upending of the current system. If passed, some of the most powerful stakeholders in that current system would, let's face it, be left out in the nether reaches where 50 million uninsured Americans reside today. And those powerful folks have never had any intent of letting single-payer fly.
All but its most delusional fans have known since well before November 4 that single-payer's near-term chances are - short of some fracture in the space-time continuum - a sliver above absolute zero. The Democratic presidential nominee long ago backed off his 2003 stance when he had declared:
"I happen to be a proponent of a single payer universal health care program." (applause) "I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."
And even though lions like Representatives John Dingell and Henry Waxman had introduced single-payer legislation as far back as the George H.W. Bush administration, support for a single-payer plan is no stronger in Congress now than it was 17 years ago when they put forth their proposal. John Conyer's plan, H.R. 676, collected 78 co-sponsors when it was introduced in 2005, but it meandered into committee in 2006 and never came out. Rep. Jim McDermott introduced the single-payer H.R. 1200 in 2007, and it languished in committee. He introduced it again this February. It has seven co-sponsors. In the Senate, no Democrat would come forth, so it was left to Bernie Sanders, the socialist independent from Vermont, to follow in the late Paul Wellstone's footsteps, the last Senate Democrat to introduce a single-payer plan. Sanders's "American Health Security Act of 2009" was introduced in March. It has no co-sponsors.
Senate Finance Committee Chairman Max Baucus, who has begun hearings into the health care overhaul, says he respects the views of single-payer advocates. As my grandfather used to say: Don't tell me, show me. Baucus did just that when he said single-payer is off the table, didn't invite any single-payer advocates to testify and called the cops when a handful of single-payer protesters arrived at the hearings uninvited.
That is essentially the Democratic leadership's whole approach to single-payer now. It's a nuisance, get out the duct tape.
If single-payer is a non-starter, if it is so deeply flawed as to be unworkable, if the good things that its backers say of it are fantasies, if its adoption by our neighbors to the north has been such a disaster that there's talk of a Canadian civil war over the damage it has caused, why not expose this, humiliate single-payer advocates for their naivete and myopia and bring a proper end to the discussion once and for all, in full public view? Since the Democratic leadership has instead chosen to shut single-payer out of the discussion altogether, one can only ask, What the hell are you afraid of?
The answer to that in some cases is, of course, fear of losing the contribution bucks and friendships of convenience with various health-care stakeholders. But what of those heavyweight Democrats who aren't bound hand-and-vote to the corporate agenda? Even from a utilitarian point of view, giving single-payer a voice in the reform talks ought to be high on their list, especially those who are behind a ... uh... what's the buzzword, oh yeah, robust public option. Why not play it smart and let the single-payer advocates take the heat for presenting the "socialist" plan, allowing the tepid public option to avoid that epithet and be seen as moderate in comparison to what those radicals are proposing? Why not reduce opposition to the public option by letting it be seen as a compromise instead of an extremist proposal to be chipped or blasted away until the whole health-care reform is just another pay-out to the guys who've brought us where we've arrived?
But no. In place of this fundamental approach to negotiating a deal, we're seeing yet another example of how things work these days with the Democrats in control of Congress and the White House. Pre-compromise rules. Anybody who rejects that approach gets told to shut up.
If a majority of Democrats in Congress opposes single-payer, if they think it's bad or unworkable, let them get their leaders to order discussions on it and then vote it down. If they think it's impossible to pass given the make-up of Congress, which is no doubt an accurate assessment, then at least let them publicly lament the fact that health care reform this year will be half a loaf, if that. Otherwise, they might as well haul all of us away in handcuffs.