How sad to see President Barack Obama's knees begin to buckle on the issue at the very heart of health care reform: providing a public alternative to a collusive corporate health care dictatorship -- a corporate health care regime that has made a deadly joke of the capitalist mantras of "markets" and "choice."
You tell me: how many true "choices" and "market options" do (non-wealthy) Americans have for affordable, comprehensive health care in a system where virtually every private insurer in the "market" has embraced the same draconian pursuits of claim denial and premium extortion? (Yes, "extortion" is the correct word; it's the act of unfairly threatening someone in order to get them to hand over something. As in, "Sure, you can turn down our 30% rate increase. Heh, heh. Just try and find coverage elsewhere with your health history.")
So let us not pretend that anything short of a public option will constitute "health reform worthy of the name," as I heard Howard Dean phrase it the other night when he discussed health care with Tavis Smiley (and also flacked his new book about health policy). "Reform" without a viable, practical alternative to compete with the corporate health care lockdown is a sham, a shell game. Health insurance co-ops -- despite being put forth as a quisling contender for Today's Health Care Cure while frightened politicians try to nudge the Public Option offstage -- miserably fail the viability and practicality test as a national solution. Yes, in limited regions such as parts of the Pacific Northwest, co-ops have seen some success as alternative insurers. But the overwhelming bulk of the nation doesn't know a co-op from a capybara. Dump responsibility for running and managing fledgling co-ops on already-financially-overwhelmed and -fritzed-out working Americans and call it, with a straight face, a fair way of forcing robust competition into the corporate health care fiefdom? I don't think so. Rant and rave about the risks of "unproven" publicly-supported programs (let's see: Medicare, Social Security, Canada, Great Britain, Germany, Japan, France, Holland, Australia, Sweden...) while trying to pawn off co-ops as a known and effective national solution? Give me a break.
This is what makes Obama's currently apparent preparations for assuming the position so galling. From the beginning, this issue has called for leadership. Not please-kick-me-again bipartisanship, not you-guys-go-talk-and-get-back-to-me spectatorship, but leadership capable of seizing a mandate (in June, 72% of Americans favored a public option) and passionately championing it as a must-do, not only in steadfast public campaigning for true reform but also in relentless political insistence that it be done. Talk is not enough. Obama's erudite passivity on vital issues is becoming hypnotically robotic. He is an action figure without the action. I know, I've said this before. But I write so often about Obama's failing to lead because he so often fails at it.
Yes, there is cause to blame Obama's current shakiness on the Republican Misinformation Militia coup that turned town meetings into screamfests that many honestly pro-reform or open-minded citizens studiously avoided. And there is plenty of blame to be heaped upon supine Democratic legislators who have undermined Obama's position. But the illegitimacy of so many of the town meetings -- at which constant shout-downs of speakers and wild disruptions were tolerated by authorities responsible for maintaining a public forum -- posed a big, fat target ready to be publicly skewered by the Democratic leadership and reform advocacy groups. In fact, I have felt and still feel that making a conspicuously public issue of boycotting these Swift Boat Attack Parties, and calling upon government to safeguard the right to speak without being shouted down at a town meeting just as they safeguard it in the U.S. Capitol (when was the last time you saw a yelling protester interrupt a senator at a Capitol hearing and not be dragged from the chamber?), might be the tactically smartest position for pro-reform forces.
And yes, it's true that on the issue of health care reform, many of Obama's fellow Democrats have proved as rock-ribbed as a roomful of tribbles. But this makes Obama's leadership even more critically necessary, not less. Is it any wonder, then, that a political party in the majority is now getting mauled by a minority that knows the smell of blood?
To their credit, some in Congress, particularly members of the Progressive Caucus, are threatening to hold Obama's bill hostage if he folds on the public option. After all, they argue, without a public option there is no meaningful bill anyway.
I don't know if the Caucus is bluffing or not, or what influence they will wield. But I think they are correct in their observation: Kill the public option, and you kill health care reform, at least for now. Without a public option, we are stuck with the same outrageously unjust and wasteful system, the same protected corporate players with their inflated premiums, and the same colossal imbalance of power in who sets health care policy. We get, at best, a health co-op band-aid slapped atop our national hemorrhage, and perhaps a few cosmetic regulatory changes to slow the patient's loss of blood.
If ever there were a time to write or call your congressperson or senator -- and to start talking about a Million Patient March -- it is now.
And we haven't even talked about Single Payer.
By the way, if you haven't seen one, this is a capybara:
(Photo: greenexpander.com)