Overhaul, schmoverhaul

Whether or not the effort to fix the nation’s broken healthcare system is ultimately successful will depend on what each assessor thinks the goal was. Those who think the system needs only minor adjustments will likely be thrilled with the result. But those who agreed with then-candidate Barack Obama that major reform is long-overdue, it’s looking more and more like we’re in store for an epic failure.

If that’s the case, Obama will be to blame.

The way things are playing in Congress, six senators—three Democrats and three Republicans—led by Democrat Max Baucus of Montana—have become responsible for shaping the reform. News reports of their progress say that the product of their efforts will include some necessary insurance-industry reform (such as a ban on denying coverage for pre-existing conditions), some kind of help for low-income citizens to buy insurance and some measures aimed at reducing costs. But this is the proverbial doomed-ocean-liner-deck-chair-rearrangement.

When all is said and done, businesses big and small will still be nonsensically saddled with the burden of making sure their employees have access to healthcare. There will be no government-run health plan to compete with profit-driven private insurance companies. And, as we understand it, concerns about the cost of the legislation will reduce subsidies to the point where insurance will remain unaffordable for millions of people—and yet they’ll likely be required by law to buy it anyway, which guarantees more customers for the insurance companies. The only other option for people without insurance will be to enroll in a nonprofit insurance co-op. We cynically await news of who will occupy the seats on the co-ops’ boards of directors and what the salaries of the top executives will be.

Given the trajectory of the effort, claims that we’re being led down the path toward socialized medicine—exemplified by Union-Tribune cartoonist Steve Breen’s absurd and misleading portrayal this week of Nancy Pelosi as the evil Nurse Ratched presenting a tray of pill bottles spelling out the word “Socialism”—are laughable. We wish!
We had such high hopes that the time and circumstances were right for real liberal-populist reform: A president with unbelievable oratorical skills, widespread disenchantment with Republicans and a financial meltdown that exposed serious capitalistic greed.

We praised Obama’s post-partisan rhetoric during last year’s presidential campaign, but now we see the pitfalls of playing it down the middle. We’d have preferred to hear him talking about public health as an individual right, on par with public education and public safety—why is it OK for those services to be provided by the government but not healthcare? Obama could have at least begun to lay the groundwork for that argument. He could have begun to make the case that what would benefit the economy in the long run is for government to relieve private businesses of the burden of looking out for their employees’ well-being, allowing them to focus solely on developing software or making mousetraps or publishing newspapers or whatever it is they do. Hell, we haven’t even heard nearly enough talk of preventative healthcare as a way of reducing costs over the long haul, and that’s the easiest case to make of them all.
Instead, Obama, faced with wearing a Clinton-esque albatross around his neck for the remainder of his presidency, appears to be preparing to declare victory with whatever bill makes it to his desk, calling it genuine reform. He and the Democrats will pat themselves on the back for a job well done and move on to energy “reform.” Healthcare-industry lobbyists and shareholders will breathe a sigh of relief, business as usual will continue and very little will have actually changed for the better.

No one will want to open this can of worms for, say, another two decades, and a grand opportunity will have been wasted.

What do you think? Write to editor@sdcitybeat.com.