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Edited on Tue Mar-23-10 02:17 PM by JackRiddler
First, to the mandate criticizers:
Please be fair to the proponents' arguments. This law abolishes two abominations of the insurance companies: rejection due to "pre-existing conditions" and lifetime coverage caps. The mandate is therefore considered necessary because otherwise people wouldn't pay into the system at all until they actually needed it, and the insurers - or a public system, for that matter - would go bankrupt. The majority who have insurance are not directly affected by the mandate, though it remains to be seen how it will change the market for everyone. The majority of those who will now be "forced" into the system will receive not penalties but subsidies, because the problem the new system is supposed to solve is that so many people can't afford insurance under the present order. Most of them presumably will be happy finally to get any kind of health coverage. Only a small proportion might be subject to the penalty, and we'll see if anyone ever actually pays it. I'm dismayed to see some people uncritically adopting the right-wing scare propaganda.
Second, to all:
The real problem of course is that it was done this way to preserve the private insurance system. The only way to have won the fight for a true reform would have been for Obama to rally the people behind a variant of single-payer universal coverage explicitly modeled on the systems in place in all other industrial countries. In all cases, these are much cheaper than the US system. In all cases these have much lower administrative costs, sometimes just a fraction of the costs here. In all cases these cover a higher proportion of the people, and in most cases these provide more effective care, as the statistics on longevity and other health indicators show. A simple proposal could have won the popular support necessary to overcome the right-wing attack and the insurance, pharma and health care lobbies, but only if the Democrats had been unembarrassed to say, "look at Germany (not single-payer but effectively the same), look at Canada and France." they have it better. (Good luck with that in the land where "American exceptionalism" may not be a majority view, but remains religious dogma.)
But even simpler than that would have been to say, "look at US citizens over the age of 65." With Medicare, as a group (not always as individuals), they have it better cumulatively than any other age group. The crazy part is that a popular "socialized medicine" program already exists in this country, and all that was necessary was to open it to everyone else. That would have both improved and universalized the health care system, and also put Medicare on a more solid financial basis.
Of course this was never going to happen, because the Democrats are a corporate party and the US is more of a corporate dictatorship than any other large democracy. Of course the new law is corporate welfare - like every other major legislation. If they passed a resolution in praise of sunshine and leafy trees, they'd include a rider to enrich termites.
Since the option of mobilizing the people on behalf of an idea with majority support was not even considered, the only way to get anything against the foregone resistance of the rabid right was to let the insurance companies dictate most of the terms. The great offense is not the mandate in itself, but as many of you point out, the mandate to choose among the predatory private insurers, without a Medicare buy-in option or any other "public option."
It's pathetic that they didn't want to fight for something as simple as that, and yet - call me a patsy - I think it's now more likely to happen than if the bill had been defeated.
David Swanson's long list of critiques is true. I've said a lot of these things on DU, where I wrote a year ago that it would be best if Lieberman could sink the original proposal. (I'm a lonely guy on the Web because I tend to take up a dissenting position to the majority wherever I find myself.) Is the new system however worse than the old? On balance, I'd have to say it's better - an unimaginative, compromised set of improvements and tweaks, bought at the cost of continuing to pay the predatory insurance companies too much for an inferior system, and passed off as revolutionary social legislation by the one corporate-owned party and as the devil's dark triumph by the other.
In one recent job I had occasion to interview a number of people who have been screwed horribly by insurance companies claiming their very real injuries were actually the result of "pre-existing conditions." They stand for millions of people, and for them this change is urgent and good.
Now excuse me if I'm going to put on the realist's hat, but once the debate developed as it did - with a rambunctious mobilization of an explicitly racist right wing equating this small-thinking reform with "socialism," and claiming it represents the "death of America" - we're much better off with its passage than with a triumph of the know-nothings.
It's the fashion among many here to say the two parties are the same, and there's too much truth in that, but paradoxically it makes a difference who wins.
A win for the Democrats sends the message that the people are foolish enough to believe the Democrats stand for the protection of workers, women and minorities, maybe even solidarity, social justice and peace.
Then they get screwed.
A win for the Republicans sends the message that the people explicitly support ignorance, theocracy, hatred of the other and, at the drop of a hat, war on the world. This is an invitation to even worse screwings.
If the Democrats had won every federal election in a landslide since 1984, and the Republicans had been reduced to the 20 percent whose views and interests they may actually represent, by now the plurality of people would have shifted to new social democratic and other parties on the left. If the Republicans had done the same, by now the US would be a fundamentalist theocracy run by a narco-junta issuing declarations of war every six months. Sort of like it was under Bush during the first six years after 9/11, but ten times worse.
There is a reason that the corporate media give a free pass to the right-wing pablum and personalized bullshit attacks a la "Obama is a socialist Muslim/Clinton has a hungry dick" under Democratic administrations, but generally sing in unison with whatever hysteria is given as the propaganda line when the Republicans are in control, even though a Bush or a Reagan makes for an even easier target of personal ridicule: The duopoly of the corporate parties lives from the artificial propping-up of right wing stupidity in what is actually a center-left nation. That's why nowadays when election results are faked outright - something that requires overwhelming media complicity - it's done to the benefit of a Bush, and not a Gore or a Kerry.
The parties, like all complex social phenomena, carry a number of different and conflicting meanings. Sooner or later I'll do a long post (um, an even longer post) on this, but I'll outline what I mean here.
These meanings break up roughly into four types:
1) The ascribed meaning, which is always contested but has a hegemonically imposed consensus most evident in the corporate media and in what passes for popular "Joe Sixpack" understanding. The ascribed meaning usually does not correspond to reality, and yet has a huge impact on what happens in reality. The hegemonically ascribed meanings of the Democrats are that they are "liberal," protective of their voting clientele among workers, women and minorities, supportive of "government" limits on capital, and in foreign policy prefer diplomacy and coalitions to unilateral shows of strength. Again, this is remote from the party's nominal and real meanings (see below).
The hegemonically ascribed meaning of the Republicans is that they are "conservative," which in the modern-day language means they want to remove all limits on anything described as "private business," even if like the military-industrial complex it's actually part of the state; completely defund the social welfare state and privatize Social Security; implement theocratic measures; impose a total surveillance state with "hang'em high" justice; and pursue unbridled aggression against any and all designated enemies - the whole world if necessary.
In this case, the dominant ascribed meanings are actually a fairly accurate description of what national Republicans actually do (it doesn't apply as much among state-level Republicans in the Northeast and West Coast, who are more straight-up Party of Business). Ironically, minus the theocratic measures, these are also closer than not to the globalizing DLC types who dominate Democratic policymaking at the federal level.
2) The self-ascribed or nominal meaning, or what the parties and politicians running for office actually say they stand for.
3) The real meaning, or what they actually do, consciously, when in office. This one is closest to the model of "corporate duopoly."
4) The shadow meaning, unspoken, sometimes unconscious, however not in the sense of "secret." This is the embedded or ambient politics the politicians themselves may not even be aware they are supporting: first of all, bending always to the "laws," the logics and developmental dynamics of advanced capitalism. (I wanted to reform health care, but now crisis compels me to cut "entitlements" instead.)
5) The secret or covert meanings, in the sense these are usually understood by students of the "deep state": the "hidden agenda" of the elite policy apparati, the permanent agency bureaucracies, the spook world and other "PTB." Again, these may not be clear to many of the politicians themselves, who, you should remember, are largely the popular people, jocks and cheerleaders (the ones with decent grades) from your high school.
I plead for acknowledging this complexity first, and THEN putting your foot in your mouth.
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