Tuesday, January 19, 2010

Health care reform: Abandon Hope

One of the most annoying themes of the Obama campaign was the slogan of "Hope", which also played a minor role in the Clinton campaigns, playing off Clinton's birthplace: The man from Hope (Arkansas). Clinton, however, proved to be a pragmatic executive over eight years which showed that the "hope" language was not his modus operandi.

President Obama is at a crucial juncture in his embattled tenure. Sure he has had more than a president's fair share of detritus to clean up, but now we see his signature legislation in danger of failure due to the Senatorial election in Massachusetts today. The Ted Kennedy seat may go to a Republican for the first time in a couple generations, and to a candidate campaigning primarily against the current health care reform.

Chuck Todd today on MSNBC said the Democrats are "still hoping" that the seat won't be lost and thus the bill will be salvaged. Hope? There is a sage Buddhist sermon from the first part of the eightfold path that calls for us to "abandon hope" and thereby "abandon fear."

The Democratic health care reform bill is replete with hope and fear. Fear of public options, universal coverage, hope of bending cost curves, etc. Instead of doing the right thing, the bill has lost its purpose and has become a sell-out to business interests and tea partiers. To be frank, we're better off without it. And i've been of the mind that we are just one small step closer to the proper solution: single payer.

If a public option is preferable, then put it in. If you want to bend the cost curve down, then spell it out explicitly. If universal health care is better than the patchwork bullshit we have now, then mandate it. The problem with the Democratic authors of this bill is that they not only sold out to their lobbyists' interests, they sold out the basic principles of governance. Pussies.

Massachusetts has state-run universal health care, so why the hell do they need to support national health care reform? They got theirs. What do they need Coakley for?

The main thesis is that preventive and proactive health care is cost-effective. Poor people would be less of a burden if they had regular access to the medical complex. Republicans don’t believe this; and that’s costing a lot of money in the long run. A 24 y/o woman with two kids might be able to avoid another pregnancy if she has access to a doctor for birth control, or better, a sterilization. Instead, we pay for her prenatal care and her kid’s Medicaid, and her kid’s kids’ Medicaid since she will likely get pregnant at age 16, too. All because you didn’t want to give her $100 worth of birth control or provide a tubal ligation for a few hundred dollars. Now that's stupid.

But this is what is happening. We fear calling it like it is, and we hope it will all work out in the end. The result is a costly, unworkable system that spirals out of control. The current health care reform has no stalwart backers from either side. On one side are the Medicare recipients and people with insurance who see no problem. On the other side are people who understand that this bill doesn't solve the problem of poor access and runaway costs. Anybody paying attention to the crisis in health care knows that these half measures are often worse than doing nothing at all.

Can we afford 17% of our GDP in health care costs? The answer lies not in hope or fear. And the voters will choose to shuffle the deck (again). Abandon hope, abandon fear, get health care reform done.

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