ObamaCare Clusterfuck: RJ Eskow endorses Medicare for All (kinda)
I still feel the way I did in 2009 when I wrote that "progressive groupthink hindered health reform." The reflexive instinct to support a Democratic-proposed policy led to the mind-bending spectacle of liberals from Rachel Maddow to Paul Krugman cheering for an "individual mandate" policy which was designed in a conservative think tank as a boon to private corporations.
Well, that is a very charitable view. AFAIK, Hamsher is the only one in all that shameful crowd to have reflected, and changed her mind.
It's also worth noting that, whatever you think of Obamacare's merits, this story reinforces the perception that today's Democratic leaders are pretty terrible at messaging. John Boehner's spokesperson was understandably gleeful when he said "The speaker's objective is to spare the entire country from the ravages of the president's health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will."
It should've been pretty easy to see that coming, too.
The Washington Generals are fine at messaging, so fine. It's just that Eskow can't bring himself to see the kayfabe.
We argued then that it was ethically unacceptable and economically unwise to force people to buy a lousy private-sector insurance product.* The only way to mitigate that would be by offering them membership in a publicly-managed Medicare plan.** But the combination of high-pressure lobbying and presidential indifference*** made sure that didn't happen.
This doesn't mean that "Obamacare" should be repealed, although it now seems that nothing short of Medicare-For-All (or, at a minimum, all-payer) can save our broken healthcare system. But it does mean that the battle for decent health care in this country isn't over. In fact, it's only begun.
So, a couple of comments. First, it would be helpful if Eskow was just a leetle more clear-eyed about Obama, the nature of Democrats, and the truly destructive role played by career "progressives" four long years ago, when ObamaCare was passed.***** Second, it would be extremely helpful if Eskow wasn't preparing yet another pre-capitulation now that the public option, having done its bad work, is seemingly discarded. The tell is right here:
... Medicare-For-All (or, at a minimum, all-payer) ...
C'mon. Eskow's doing great, then he goes soft. All-payer is just another scam to leave the health insurance industry parasites intact while normalizing the damage they do to the host. (And I like the brand confusion of the two "____ payer" proposals. Wonderful what funding can do.) Uwe Reinhart is ON IT, so what does that tell you? PHNP:
Reinhardt discusses the effectiveness of all-payer for hospitals in the state of Maryland. In a previous response to the Maryland all-payer system, I stated, “If we can succeed in reestablishing a public service role for government, then wouldn’t it be reasonable to simply enact an all-payer system for hospitals? The problem is that it only makes one change in our fragmented, dysfunctional system of financing care, and not a complete change at that. Under all-payer, only the rates are controlled, but each service still must be accounted for and paid for independently, and the hospitals would still have multiple public and private payers with which they would have to interact.”
So what about Switzerland? Reinhardt mentions it as having successfully applied an all-payer system. In another previous message on the OECD/WHO report on Switzerland, I stated, “It is not clear why so many in the U.S. are enamored of the Swiss health insurance system when this OECD/WHO report confirms that it is highly inefficient and fragmented, with profound administrative waste, inequitably funded, with regressive financing and with wide variations in premiums, has the highest out-of-pocket costs, has an increasing prevalence of managed care intrusions, and is controlled by a private insurance industry that has learned how to game risk selection at significant cost to those on the losing end.”
Uwe Reinhardt is to be highly commended for moving us in the right direction, but…
We’ve said it before and we’ll say it again. If political feasibility is the barrier to enacting a single payer system, let’s not simply jettison single payer; let’s change the political feasibility instead! All-payer might be a modest incremental improvement (modest when compared to what needs to be done), but why settle for that when we can have it all through an improved and expanded Medicare for all?
Ya know, it's almost like "progressives" are inventing lines of defense for the health insurance industry. Weird! Or not, eh?
NOTE * I would this in a simpler and more pointed way: "ObamaCare forces people to buy a defective product."
NOTE ** That's the so-called public option, a bait and switch operation masterminded by career "progressives" running interference for Obama. That Eskow can't bring himself to name it gives me hope that somebody's finally put an axe to the Public Option Magic Zombie Sparkle Pony's head.
NOTE **** At this point, I sought, and was unable to find, posts from Ykleinias saying that ObamaCare took health care reform off the table for another thirty years or so. (Readers?) Obviously, I hope they're wrong, if only because, at the grossest possible level, somewhere between 20 and 30 million people are going to end up being denied health care for lack of insurance even after the creaky, complex, and extremely expensive Rube Goldberg device that is ObamaCare finally stumbles into motion.
NOTE ***** Let's remember that when LBJ got Medicare passed in 1965, it took one year out Medicare to the entire over-65 population, in the days before computers, too. That's because single payer is a simple and well-architected system for delivering heath care. ObamaCare has taken four years to get past the cherrypicking stage, and that's because it's a complex and confusing system designed to minimize the delivery of health care while maximizing the collection of rents. I realize that the "minimize" in "minimize the delivery of health care" is a political criterion, which is why Obama made sure that his constituencies got covered first.
NOTE "charitable organization" -> "charitable view." Not sure what's happening to my brain here...