Saturday, February 6, 2010

How Democrats can benefit from ending HCR

The elimination of HCR, represented by the consensus of the House and Senate bills, is the very best thing that could have happened for many reasons. The bill was vastly unpopular, and it's no accident that Obama's popularity has gone up since this bill has been out of the news.

If further evidence is needed, the mandates for purchase of private insurance is about to be prohibited in the first of thirty some states who are passing amendments to prevent this integral part of HCR. There is also a strong possibility, especially since the aggressiveness of the SCOTUS conservative majority in the last decision, that this HCR would have been ruled unconstitutional based on the tenth amendment.
Let me speak for myself on this. If anyone is really interested in why I have been opposed to this bill there is a string of diaries on Dailykos in addition to other essays on this blog on the subject where I did extensive analysis of the shortfalls based on the Medicare Actuary's report that was generally brushed off by the Administration.

As recently as last week, even when the administration had tabled the bill after the Mass. election, they were still saying that the public opposed the bill because they didn't understand it. If there is a more egregious way of alienating an entire national electorate I don't know what it could be.

President Obama's Q&A at the Republican Representatives meeting was a turning point for me personally, and I believe the country. As long as the Health Care Bill was the lead story, what the public saw was a ruthless, unethical political party that was prepared to make any deal to get something passed. This party had the gall to vote down a bill, one proposed by their own Senator, Lautenberg, that would have resulted in pharmaceuticals being drastically reduced in price for all Americans.

And the Party was asking us not to notice this but to be thrilled that Democrats had negotiated a hand out from big pharmaceuticals to patch the donut hole of Medicare. As much as democrats opposed the Part D legislation that was pushed through by Republicans, there was never even a hint that this abomination of a giveaway to insurers and pharmaceutical companies would be restructured.

It is hard to design a bill that is not only hated by the right and the left, but even those with no insurance who are the ostensible winners, are evenly divided.

Sure, the Republicans were the "party of NO" but on the HCR they were speaking for the majority of Americans.

This is a turning point...and here's how it can be consolidated.

Within the HCR bill was an sizable appropriation for community medical centers. Like the VA, this can be a federal agency that cares for all who have been going to emergency wards. Actually some emergency wards can be combined with this. The advantage is that as a federal agency all state rules may be abrogated, licensing, standards, formularies etc.

As an example in the VA pharmacists do not need to have a license from the state where the facility resides. This would allow maximum use of para-professionals, evidence based medicine to be the rule rather than the exception, and tremendous economies of delivery of health care. Will it be the very latest state of the art? No, it will not.

But it will be constitutional, accepted....just as public colleges are accepted even though they don't get their share of Nobel prize winners, but still provide a good education.

Focusing on Financial Reforms among other areas

Once the 1900 page HCR is buried, the Democratic party can focus on the egregious behavior of the banking-government nexis. The best example I can think of is student loans. Here's how it has been working. Banks borrow money from the fed at 1-4% and loan it to students at about twice that rate. Now if the students default, first even if they go bankrupt under the new law (bipartisan, sadly) they are never relieved of this debt. But no matter what, if they die, or go to prison, even then the banks don't lose, you see then the taxpayers pay what is owed to the banks.

This is being fought by Bank Lobbyists, as described in this N.Y. Times article

This is only one item. There are so many more, and many of them Democrats have been complicit in passing.

But no more.

This is the time for Obama to actually start to lead the Democratic party out of the morass of corruption, of being so close to those corporations who have the power.

Obama trusted in the congress to come up with a workable health care reform that would be politically acceptable. The product he got, the one that is still pending, is not workable and is not politically acceptable. We joke about it being "sausage" but that's a poor metaphor. It is more like President Kennedy had relegated the task of designing a vehicle for sending a man to the moon to Congress in 1960. They would have come up with something, but nothing that would have conquered the force of gravity with the precision that was needed for a successful outcome.

But those rockets only had to go through space, while a health care reform has to go through a dense tangle of existing powerful forces that are not about to relinquish their hard won prerogatives.

No one likes our electoral college system for choosing a president, but it is what the deal was to form our federal government. We may not like our current health care system, but that too was part of the deal, the rights of states, the power of personal property including intellectual property, the first amendment right of groups to organize and influence the public.....all of these have formed our current private enterprise health care complex.

The attempt to graft on to this an egalitarian concept, something that worked in other countries, will not work here. Had the bill been passed it would have left a legacy of bitterness and contention that would have dragged down this party and further divided the country.

We have dodged a bullet, now the only question is whether the party, and our President will seize the opportunity to look at what can be changed.


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