First off, I am a health care reform supporter. I was always hoping we would do something along the line of single payer (Medicare for all). However, since single payer doesn't seem to be on the table any more I have been becoming more open to compromise with insurance exchanges and maybe a scaled back public option. I hate to say it but I have even been thinking a co-op might be fine.
Then today I was thinking about how this can all unfold and still work out for the best. I just read Paul Begala's article in the Washington Post Progress Over Perfection . Paul discusses how incrementalism can be the way to go. His point is not to go for all or nothing like they did in 1994. It made me feel pretty good with compromise.
I started to imagine what 2-3 years from now could look like and something scary occurred to me.
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It occurred to me that if we think we have problems now with the health industry’s influence on politicians including Pharma, insurance and doctors just wait until there is an exchange or "public option" that they have to compete against. Campaigns that would favor industry interest would obviously be overwhelming supported with cash from these industry groups.
There is no doubt this would likely favor Republicans. We could find that Democrats could quickly become a minority party again. Republicans would slowly chip away at the "public option" to discourage consumers from choosing it. Even the government controlling an exchange could result in lobbying to ultimately drive up prices of the exchange.
I am now of the mind that Begala is wrong. By compromising or going with an incremental approach we could be causing more political corruption and increase the influence of industry in politics. I have always been critical that Obama did not campaign on major political reforms. Without political reforms I am not sure we can trust government to manage the private health industry.
With single payer there is a direct relationship between politician’s actions and health care effects. Politicians can run on lowering costs, increasing services, etc.... But with this compromise and public option the cause and effect are more convoluted. We are going to pass new laws that may drive up costs or cut service and we will have politicians, health insurance companies and doctors all pointing the finger at the other.
I am going to have to think about it a little more but I am starting to think that incremental change could be very bad for us and the Democratic Party. It might be that liberals in congress have not gone far enough simply demanding a public option.
Is it possible to limit the influence of the industry being regulated? I don't think so. It is the forever struggle with government, free markets and corruption.