When President Obama first took on health care, I actually sat down and wrote him a letter. As an American, I do stuff like that. I’m absolutely amazed that people looking like Tommy Lee Jones in Men in Black didn’t show up at my front door.
I urged him to look up Benjamin Disraeli’s famous political flanking maneuver in hopes that he might get an idea or two before taking on Entrenched Big Money. I’m betting he now wishes he had taken my advice.
Disraeli was a conservative and in the political minority in England in the mid-to-late 1800s. There was a movement afoot to expand the franchise—that is, to let more people have the vote than just the traditional rich white folks.
Disraeli’s arch-rival, William Gladstone, introduced a reform bill that would expand the voting franchise to include voting-class men who met certain property requirements. It was actually a rather modest proposal, but Gladstone’s party botched it (that sounds familiar), and it not only went down to defeat; it cost Gladstone’s party a parliamentary majority.
In swept Disraeli, and instead of celebrating the all-too-brief “success” of having defeated the measure, Disraeli looked long-term, for his party and his country. He drafted a measure that went far beyond Gladstone’s proposal, one that included lodgers who paid a certain amount of rent. It also extended representation to people in various small villages and increased representation to larger cities like Manchester and Liverpool, which had previously been under-represented in Parliament. In all, the measure almost doubled the number of eligible voters in the country. It was popular, and many of the new voters sided with Disraeli’s party.
To be sure, not everybody was happy with the bill. Far-right-wing members of Disraeli’s party were livid. One in particular, Lord Cranborne quit Parliament and spoke out against Disraeli’s move, calling it “a political betrayal which has no parallel in our Parliamentary annals.” Cranborne’s protests were largely swept away by the tide of history, while Disraeli and England prospered from the franchise expansion.
In my letter, I suggested that President Obama outflank his opposition, which basically had but one strategy available, that being to demonize Obama and whatever reform package he offered. That’s exactly what they did with their “death-panel” talks.
The flanking maneuver would have required Obama to throw tort reform on the table with everything else. This has always been a third-rail issue for the Democrats, because their big-money backers, the trial lawyers, would hate like hell to see that gusher of easy cash slowed to a reasonable flow. It has also long been a rallying cry for Republicans, who believe that limiting the damages one could collect on medical malpractice would have a huge effect on corralling out-of-control health-care costs. (It probably could, and combined with some of the measures that the Dems put forth, it would have made for real, long-term health-care reform.)
In this toxic political atmosphere, probably the only successful and meaningful measure that could be passed would be one that includes something for everyone to hate.
The president had his chance. It would have been a bold and risky move, but if he had done it at the right time (and explained it to the American people), it might just have been crazy enough to work. The Democratic members of Congress, many of whom had been swept into office on Obama’s coattails, would have been reluctant to oppose the measure, even with the lawyers putting up a squawk. And the Republicans, having had their biggest hot-button issue handed to them on a silver platter, would have been backed into a corner in permanent put-up-or-shut-up mode.
The Democrats, looking at the fall elections that are racing toward them with gathering dark clouds, almost certainly have to pass something now. Whatever it is will be, in words of Abraham Lincoln, “weaker than a soup made from the shadow of a pigeon that has starved to death.”
Entrenched Big Money has won; of course, it could be argued that it would have won no matter which way the vote went. Health-care reform, meaningful or otherwise, is dead for another 20 years, by which time most people will find it easier, cheaper and less painful to just die rather than trying to pay the bills. The unholy alliance of lawyers, medicine, and insurance has stuck it to us, and the sad fact is that many people willingly participated in their own beat-down.
The amount that my wife pays to insure herself and my son is five times what she paid just 10 years ago (and back then, the policy also covered my daughter, who now has her own insurance). Even the knuckleheads who are celebrating the defeat of health-care reform should realize that people can’t sustain that.
So, health-care-reform opponents: While you’re dancing in the street, I hope you sprain your ankle, and that your insurance company absolutely punishes you. Which they will, because they now know that Congress certainly won’t stop them.
This article appears in Feb 4-10, 2010.
My wife and I talk about getting divorced, so we can marrying Canadians. They would have to agree not to consummate the marriages and arrange for my wife and me to live together on Vancouver Island. That way we could have better health insurance coverage than we can afford now. Sadly Canada is cracking down on such arrangements, so we’re unlikely to accomplish an end run around Entrenched Big Money’s defensive line in the States.
What can American’s do? Must we acquiesce to shitty, expensive coverage that profiteers on the backs of sick people? Apparently so.
President Obama’s lack of success in passing meaningful health insurance reform is a major disappointment. The present system of medical coverage will continue costing many Americans their lives.
Mr Obama bit off way more that he could chew, as do most first term presidents. If he would have addressed the most glaring problems with our system, explained it to the american public, and went with that, he could have passed a bill. It’s not too late of he backs off of the two thousand page plan and the deals he made and just fixes what needs to be fixed and covers those with no insurance. The rest can come later.
What gall you have, Tom! You actually have the NERVE to suggest that Obama compromise? If you were advising Jesus on how to attract admirers, you’d suggest he do a little sinning each day…
That aside, you and Obama miss the real point: Health Insurance coverage is not health care; in fact, if Republicans managed to kill this bill they (we) have done the country a huge favor. The republican proposals for tort reform, removing anti-trust exemption, forcing competition across state lines among insurers are great first steps, and would likely pass.
Personally, I think the word ‘comprehensive’ when applied to legislation never works. ‘Comprehensive’ immigration reform, ‘comprehensive’ tax reform, ‘comprehensive’ health reform are all equally bad ideas when translated into legislation.
Robert Frost said it well: “I advocate a semi-revolution. The difficulty with a total revolution is that the same class always ends up on top…”
America has the best health care in the world – bar none. Even a Canadian Minister is coming here for his surgery and I would assume knows a lot about Canadian Health Care. Here in America, Health Care is available to everyone by just walking into the nearest Emergency Department. Of course, they do take wheezy kids and immediate Emergencies over the folks who have not attended to their chronic illness over the last 4 years, as they are mandated to do in Triage. Forget the Obama Health Plan – its dead in the water and increase funding to state programs. Lower the cap on Medicaid.
“Health Insurance coverage is not health care..” What an incredible nonsequitor. Of course health insurance isn’t health care. But health insurance assures access to health care and that’s the problem with the current system. Your ideas, while pretty good IMO, only addresses the escalating costs of health care-not access. Even if health care cost inflation was halved it would still be over 5%-over twice the current inflation rate. So health insurance would still be incredibly expensive unless subsidized by employers. So how do we get access to health care for the over 30,000,000 americans who don’t have it? Saying “go to an emergency room” is ridiculously simplistic. If the Democratic plan is so bad then how do we increase ACCESS to health care? Lowering the cap on Medicaid is actually a pretty good idea and so is allowing the public to buy into the federal employee health insurance system but there needs to be some response to this problem. Both times Democratic presidents proposed solutions the GOP killed them but offered zero alternatives.
Tom, thanks for writing a column on the need for Tort reform in this country, vis-a-vis health care & insurance costs. That said, you left out other reasons as to why health insurance costs have risen so dramatically. First off, insurance companies have conspired to not allow interstate competition amongst insurance firms (ie. a health insurance firm in Massachusetts ought to compete against an insurance firm in Arizona) . By not allowing interstate competition, oligopolies of insurance firms has been created in many states. If Dems wanted to, they could change that overnight. The second huge cost problem is the many, many federally regulations that tell insurance firms what they must pay for, which draws in huge “moral hazard” costs. Imagine what we would pay for car insurance if all car insurance firms HAD to pay for all repairs, all consumables (gas, oil, filters, tires, brakes, car washes, etc.) and scheduled & unscheduled maintenance. Imagine the cost of house insurance if these firms HAD to pay for new carpeting, tiling, new bathroom upgrades, maid service and furniture repairs or upgrades. The moral hazard in these theoretical federal regs would be that most people would treat their cars worse than a rented mule and their house worse than a rock star in a hotel room.. Why not write a column stating that a majority of Dems and a Majority of Repubs should get together to pass legislation correcting just these two issues, plus the issue of tort reform, regarding health care insurance?