With all the critical issues facing this Country these days, healthcare reform is the one everyone is looking at and talking about right now. Including here at Dkos. I don't have nearly the kind of personal stake in the reform as do many here. I have excellent insurance coverage through my husband's employer and we have no health problems. I've watched other family members struggle through various health issues without insurance and know it's had a major impact for them financially, but they haven't been forced into bankruptcy or died because of a lack of care. Even so, it's one I feel strongly about because I think it's an important one for the future of this Country. Not just for the physical health of the individuals who will be affected by it, each of whom is important, but also for the financial health of the Country as a whole. If costs aren't contained somehow, healthcare will end up eating such a large percentage of our incomes, the rest of the economy will be left unsupported.
In the beginning, it seemed like this was an easy issue for this community. But as time's gone on, it seems even it has developed camps and leads to bitter fights and arguments. I've greatly enjoyed a few of the diaries posted lately about how we need to put our disagreements aside and work together for the best plan we can get. But ultimately, even in those diaries, it seems the bickering continues in the comments.
I've been trying to figure out what it is everyone is actually arguing about and why. And I realized there are very few arguments about what healthcare reform should include, but a lot of arguing about how to get it. Well, not even arguing about how to get it, but criticizing how others are going about trying to get it. So maybe we need to think about what is most critical and see if we're really that far apart after all: What we want to see in the plan and how we can get what we want.
I see the issues constantly being debated here as essentially three: a. How important is a public option and what is meant by a "strong" public option; b. Is the Progressive Caucus being obstructionists and idealogues or doing the right thing by holding firm; and c. What is the best method of influencing the final version of the reform. I see these three issues being argued again and again and again, with people talking at, over, under, and around each other without talking to each other. So let's break them down and see whether we don't have more common ground than we seem to think we do. And maybe we can limit some of the bickering between ourselves and use that energy to start fighting where it matters.
a. Public option. I can't say for sure, but I suspect the majority of Kossacks would have been in favor of single payer. But that's off the table. We're down to fighting for a public option. I don't see many who believe we don't need a public option, that co-ops or triggers would be satisfactory. So what is it people are arguing about in this context? Truth is, I'm not really sure. It seems the arguments mostly devolve into criticisms and defenses of various politicians, and arguments about whether it should be our "line in the sand" or whether we should take what seems to be on the table now in anticipation that it can be improved later.
So why do we support a public option, what do we think it would accomplish? What is meant by a "strong" public option? How critical is it that it be included or can we reach a desirable result with incremental changes such as happened with social security?
To me, the definition of a strong public option is pretty simple. It provides every American with a choice between public and private insurance. End of description. My reasons for supporting it are 1. I think it's the only way to ultimately control healthcare expenses, create real competition for the insurance companies and provide them with an incentive to avoid gouging, 2. It's the only way to provide affordable coverage to the middle and working classes without costing the government massive amounts to reimburse them for the gouging insurance companies will otherwise do when mandates come into existence, and 3. I don't think incremental changes will happen like they did with Social Security. There's a critical difference between the two. Social Security was opposed by individuals; it did not have a specific powerful industry that stood to lose by changes to it. Whatever the insurance companies win in this battle will be it. We'll be fighting this hard again for every tiny concession in the future. So personally, I don't think we can dismiss flaws in the reform with the idea that we'll be able to go back and fix them later.
But you know what? It doesn't even matter whether I'm right or wrong in any of those three positions. Bottom line is, it's Always better to get as much as you can as early as you can. So even if you disagree with me on whether it will accomplish what I thing it will or whether we'll be able to improve it later - why not be fighting for the best we can do now? At the very least, it will reduce our need to fight harder later. So what are we arguing about? Nothing that's important right now.
Same thing for all the arguments about whether particular politicians are sufficiently supporting the PO and whether it should be our "line in the sand". If everyone could resist the comments like "I'm never voting for Obama again" or "Obama has sold us out" or "Pelosi has caved", it would be SO much better. Because you know what? It really doesn't matter right now - at this moment - whether those statements are true. Some of us will become disillusioned with Obama and with Pelosi and with Baucas etc. over many different issues from time to time. But arguing about individual politicians will do nothing to improve the final reform bill. The situation is as it is. They've said and done what they've said and done. Whether Obama is sending conflicting messages or has backtracked on campaign positions is not what we need to be focussing on right now. Swallow your disappointment, your disgust, whatever, and move on to "okay, who can we influence to get a better plan and how do we go about it".
Should a strong PO be our "line in the sand"? Doesn't really matter right now. That's a decision to be made when a vote is taken. Right now we're pretty much all in agreement that a PO is desirable. So let's work together toward that objective. We'll have plenty of time to argue later whether it's preferable to have something rather than nothing, whether incremental changes can be made later, whether mandates without a PO will make it worse than now. The time to fight about that is when there's actually a bill on the table. Right now, we're essentially in agreement that a strong PO would be better than a weak one or none at all. So let's concentrate on working together on getting as close to that as possible.
b. The Progressive Caucus (and certain progressives on this site whom others sometimes refer to as "you progressives"): Are they acting as obstructions and idealogues? Once again I say- right now, it doesn't really matter.
I believe one thing we could all agree on right now is that everything and everyone in life takes the path of least resistance. Water flows around obstructions. If there's more than one, it will go over the smaller one, around the larger one. The same thing will be true of concessions in the health reform bill. Those offering the strongest "obstructionist" position right now are the ones that will be successful in getting what they want in the bill. The Republicans and Blue Dogs have played the game as obstructionists for a long time now. As a result, they've gotten much of what they've wanted even though they didn't have the numbers to justify it. They take a stand and refuse to back down. And what happens? The Whitehouse and Congress takes the path of least resistance and negotiates with them. They might not end up with everything they wanted that way, but they get a hell of a lot more than their numbers justify.
Now, having the CPC begin to act in the same way has been a shock to the system of all of us, including Obama, and no one is sure how to handle it. It puts the administration in a much tougher position. It's like a parent with two kids. It no longer has to decide how much of the piece of cake to give one kid, it now has to figure out how to divide the piece of cake between the two kids without one of them running away. But the issue right now is not how to make the administration's job easier. It's how to get the best health care reform passed. So the question is: Will their standing firm help or hinder that? Once again, we can argue whether their refusing to vote for whatever bill finally comes out is a good or bad thing when one comes out. Right now the question is will their actions influence the final bill that does come out in a good or bad way.
What would happen if they were not acting as they now are? If they were not saying a PO was not negotiable. Does anyone here think there's the remotest possibility we'd end up with a bill with any PO at all included? Even one with triggers? Or one that covers only a few now, but that we can hope will be improved in the future?
What is their option? To say "we'd really like a PO, but if the rest of you don't, we'll go along with you"? While the Republicans and Blue Dogs are there insisting they will not support anything that does have a PO? We would be guaranteed no PO then. So they have absolutely no choice but to be standing firm right now. I don't think anyone that supports a PO can argue with that. So let's give them all our support now, let up on our harping about what obstructionist they're being, and save those attacks and arguements for when there's an actual bill to be voted on.
c. The best methods for influencing the legislation. We have a number of people posting here that have been working long and hard on this issue. Slinkerwink, NYCeve, etc. Their chosen method of trying to affect the final bill has been very defined - get as many Reps to commit to standing firm with the CPC and insisting on the inclusion of a PO and then providing as much support as possible to those who do, to encourage them not to back down. Lately, I've seen more and more criticism of their method being voiced. "Why aren't you spending your efforts getting Senators to switch sides?" "Why aren't you targeting fencesitters?" "Why aren't you rasing money to contribute to those on the other side in the hope of getting them to switch to our side?"
Could we not at least agree that everyone gets to make their own choices about how to fight and that unless we're taking the actions ourselves that we think they should be taking, we have no right to critcize them for what they are doing? If you're taking action different than them and you're seeing positive results from it, by all means, write about it. I'd be willing to bet if something else was working, they'd be thrilled to join those efforts. But when you're sitting back doing nothing, it seems quite counterproductive to be criticizing those who are doing something. I'm not sure whether it gives those offering the criticisms a feeling of superiority to think they'd be doing it better - if they were doing it. Or if it's just so much more fun and easy to criticize than to do. But I think the alternative "suggestions" are being terribly late in the game and in pretty unconstructive ways. So what's the point of them - unless you're just trying to discourage people from actively working for better reform. I don't think that's the goal of many people on this site. On this one, I think people maybe just need to stop and think a bit before actually posting their "constructive criticisms" and ask themselves why they're doing it - what do they really hope to accomplish by it?
Bottom line is, it seems the best route is for all of us to think about which of the arguments we're having right now are beneficial to shaping the healthcare reform bill and which should be saved for when there is a bill to be voted on. None of us will get everything we want in the bill, all of us will have to accept some things we don't want. But let's work together right now to get as much of what we do all want and as little as we all don't want into whatever bill does come up for a vote. Let's be the path of most resistance. I guarantee you, we'll all have more than enough chance to pick the arguments up later.