Tuesday, February 19, 2008

Why universal health care won't result from this year's election...

... even if Barack or Hillary wins.

Checking on the live blogging of the Dem debate over at DelawareLiberal, I picked up this from donviti:

I’m telling u all right now, If I get burned by this guy when he becomes president, I’m going to be a pissed mother fucker for falling for his kool aid.

I buy what he is selling man…but I still have to remember that he is a politician.

Prepare to be pissed, dv.

First there's this from Foreign Policy Blog: 10 Things That Won't Change (no matter who gets elected):

1. America's relationship with China: Next time a candidate promises to get tough with Beijing, you may want to remind them of the trillion or so dollars that we owe them.

2. The partisan divide: Politicians have been promising to bridge the divisions in Washington ever since Aaron Burr shot Alexander Hamilton. It's a lot harder than it looks.

3. Dependence on foreign oil: Promising energy independence is the easiest way for a candidate to seem both environmentally responsible and security-conscious. In the real world, unfortunately, it's not happening any time soon.

4. The decline in manufacturing jobs: All the pandering in the world can't reverse the march of history.

5. The flow of illegal drugs: This has been a perennial empty promise since Nixon launched the "War on Drugs" in 1971. Obama has hinted that he might be open to liberalizing marijuana laws, but it seems doubtful that he would devote much political capital to it.

6. Military spending: By one analyst's estimate, the U.S. military budget has reached a staggering $713.1 billion. Yet, for all the talk of fiscal responsibility and soft power, no president will risk appearing soft on defense by proposing even minor budget cuts.

7. The influence of lobbyists: Lobbying reform only faces one minor stumbling block: the U.S. Congress. The much-maligned "special interests" are very creative, and they're here to stay.

8. U.S. support for Israel: Despite the dire warnings that may be clogging up your in box, the United States will remain Israel's staunchest ally.

9. Ethanol subsidies: Despite mounting evidence of the damage corn-based ethanol does to the environment as well as economies great and small, this monumentally dumb subsidy is probably safe as long as candidates need to fight for votes in Iowa. Former subsidy opponents McCain and Clinton have both learned to stop worrying and love biofuels during this election.

10. The primary system: Sure, the early primaries give a handful of white, rural voters disproportionate influence over the election and state caucuses make Tammany Hall look like a golden age of democratic participation, but they're an entrenched part of party politics at this point and it's not wise to mess with them. Just ask the Democrats in Michigan or Florida.

To which I want to add item eleven:

There won't be universal health care.

This is a prediction, not a statement of preference or non-preference. Why?

Here are my reasons:

1) No mandate. This is going to be a closer election that most people think right now, swept up in Obama-mania. John McCain has no intention of losing, and he will make a tough fight of it. When he does lose to Obama (he won't lose to Hillary), the Democrats still won't be any better off in the Senate than 55 or 56 votes. They're going to need more than that to do universal health care, and they're not going to get too many Republican defectors.

2) No money. We're closing on flat broke and in hock to the Chinese. This incredibly stupid stimulus package is only one part of the proof. No matter how you slice it, universal health care is going to require massive new taxes, and it's not going to happen.

3) Captive constituency. Like the Republicans after 1994, who tried to pass term limits to keep their Contract with America, or Bill Clinton after 1992 who tried to keep his campaign promises on a middle-class tax cut and gays in the military, the brutal fact is that America's un-insured and under-insured are by and large poor. And as my own university president said in one of his less sensitive moments (at his previous university): "Poor people don't vote." At least they don't vote in numbers enough to offset those who don't want to pay for national health care.

4) The insurance companies. They're buying the politicians right now, and they have billions of dollars to throw at propaganda. Some people have compared them to the tobacco companies, pointing out that even giants corporations can be brought low. But the tobacco companies were not in a life or death situation. The percentage of their profits coming from the American market have long been declining. They're out hooking kids to smoke in China, India, Pakistan, and Brazil. They paid the settlements as protection to keep the US Government from ever going after their overseas operations. For the big health insurance companies, this is the whole enchilada--it's kill universal health care or go out of business. They will spend every penny they have.

5) It will be too easy to cop out. The insurance companies, the Democrats, and even the Republicans will all eventually vote for something that is called Health Care for All Americans, but won't be. Just like No Child Left Behind or the Clean Skies Initiative, we'll get a bill that purports to be a form of universal health care, but will really be something like Extended emergency room and public clinic availability with limited prescription drug coverage for a lot of people, but nothing that covers cancer, or Parkinson's Disease, or even advanced neonatal care.

6) We don't have the right plan available yet. (With apologies to Dana and Floyd McDowell and everyone else who thinks single-payer is it.) The US will NOT adopt a plan that is similar to those employed in Canada, Europe, Japan, and Australia, because (a) the scale and diversity of this country creates a completely different challenge than for individual nations in Europe, and (b) we are culturally averse to such overt borrowing. We'll have to think up our own new approach, or nobody is going to buy it. Sorry, but there it is.

My point (and I do have one, even if I try to keep my hair securely combed over it): Governments have incredible inertia. The next administration is going to inherit that inertia the way Bill Clinton inherited US troops in the Sudan just in time for Blackhawk Down. The Demopublican system is too well entrenched to turn on a dime.

Barack, if elected, may bring some new transparency to Washington, and he may bring some momentum to make modest changes to what's happening.

Unfortunately, he's not going to prove even as systemically able to make major changes as Ronald Reagan was.

1 comment:

Anonymous said...

"Captive constituency"

With all the new security laws should read "enslaved constituency" Thanks for the correction.