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We all know about the critical negotiations going on now and how hard it is to discern what is really happening behind close doors. So what can we outside the doors be doing? Badgering Congresspeople and giving money, to be sure, but also contributing to the debate. Much as I love data and logic, we of the wonk-i-verse fail when we make normal people’s eyes glaze over. We need reason and logic, we need to work the machinery, we need bargaining, flattery, threats. We need soaring rhetoric. But we also need clear and compelling narrative about why people should care. Here is my small contribution, trying to make the point about why normal people should sweat the details of what happens with the public option. If you agree, please spread this meme (originally a letter to the Boston Globe):
The specifics of health care legislation being hammered out now in the House and Senate will determine whether we get real reform or something worse than nothing. In particular, if the final bill compels people to buy health insurance (the individual mandate) but does not create real competition for private insurers (a robust public option), it will impose a severe financial burden upon ordinary people struggling to afford health coverage. It will also be a huge windfall for the very corporations that have been a big part of the problem. It is important that we change a misleading analogy: This is not a case where we are arguing over whether to settle for half a loaf. Instead, the legislation is like a machine where if the parts do not balance, the end result will be ruinously expensive to operate, fail to do its job, and injure the very people who need to use it. The next few weeks are critical and the outcome still very uncertain. Now is the time for people to push back against the millions of dollars in lobbyist money trying desperately to stick us with a broken (but very profitable) machine. Everyone who cares about this -and that should be all of us- should contact their representatives and urge them to vote against any bill with a mandate but no effective public option.
Sincerely,
Robin Colgrove, MD
Attending Physician in Infectious Diseases, Mt. Auburn Hospital, Cambridge MA
Instructor in Microbiology and Molecular Genetics, Harvard Medical School, Boston MA
13 Comments
ONE THING YOU CAN BE SURE OF, WHAT YOU GET WON”T BE WHAT YOU EXPECT.
Like they say be careful what you wish for.
I can almost guaranty that it’s going to cost you more, well get alot less, and the insurance industry will make you pay for what they did.
Congress and Obama will pat themselves on the back, while they are grabbing for your wallet.
Public option is a distraction. We have never really debated a universal single payer system. The media won’t cover it. They misinform the people. The Sunday shows never have on Physicians for a National Health Plan. They don’t have a discussion about why there is a crisis in primary care. Why are there doctors making millions while others can hardly pay off their college bills? Why don’t they have somebody on from Switzerland, Taiwan, Denmark, Germany, Francce, or Canada? All they talk about is the politics and not what’s really wrong health care. It’s our system that is no longer a democracy. It is, as Sheldon Wolin writes, “Democracy Inc.” People in Congress work for the company not for the people.
I’d love to have the “option” of debating Single Payer, which I support, but that is not what we have in front of us. Not to jinx anything, but it does seem likely that a bill of some sort will pass. My point was that there is still a real danger of a worse-than-nothing bill that contains an individual mandate but a gutted public option (e.g. triggers). This argument is not directed at fellow progressive wonks, who get this already. Rather, I hoped that the analogy I gave about broken machines would be clear and compelling to the normal people [ ;^) ] we interact with, who might understand why we are making such a federal case (pun intended!) over this. There is still a defeat-snatched-from-the-jaws-of-victory risk here, so the more people we can get pestering their reps the better.
drrobin,
public option is a distraction if one thinks, as i do, that something like hr 3200 would probably not to be a victory in actual fact (even if everyone declares “victory” and has lots of parties to celebrate). if that is correct, the need for a debate does and will remain.
however, if we’re going to have the effing individual mandates shoved down our throats, i do support all efforts like your’s to prevent further weakening of an already tiny, limited and lame po.
if you are convinced that there is legislation on offer that represents a victory, then i understand why debate re single payer may not seem important to you. however, i do think it is incumbent on you to make the case for why you think that legislation will not “be ruinously expensive to operate, fail to do its job, and injure the very people who need to use it” — in other words, a broken machine also. (btw, i love your “broken machine” analogy)
Hi, Dr. Robin – good letter, probably works for the Globe, whose readers tend to be educated.
If I were editing for my local Texas paper, I would simplify and shorten drastically – no latinate words, for example. My local paper’s audience is not particularly educated, and is (to judge from its letters column) depressingly right-wing. The city isn’t RW overall, but the less-educated Dem/liberal population doesn’t buy papers much, or sticks to the sports pages. Sad.
This is the fracture point of real, honest disagreement among progressives (as you can see from the postings to liberal blogs like FDL): at what point do compromises in the various aspects of the bill take it from being half-a-loaf (better than nothing) to a broken machine (worse than nothing)? I have nothing to add to the arguments on all sides of this question, most of which I think have real merit, and I can’t claim any certainly that my final position is the right one. I think, on balance that the current, weakened plans (containing a public option with an opt out) are probably the maximum we can get and are enough of a camel’s nose under the tent (to throw in yet another metaphor) to make them worth going for it -but I might be wrong. If I thought we would get another shot at this next year, I would probably favor bagging this one and trying to get it right next time. In reality, though, I think if we miss this moment, it could be a long time till we get another shot, with a lot of sick people under the bridge till then (metaphor overload, I know ;^). I think the White House and Congressional leadership bungled this big time by not letting progressives lead off, coming out swinging hard for Medicare-for-All, with a really strong public plan as the fallback. Right now, though, we have to work with what we have. I respect the arguments of my fellow lefties who disagree, but then again tolerating honest disagreement is part of why we are not wingnuts.
“I think if we miss this moment, it could be a long time till we get another shot”
Whereas if we get a clunker now the issue will be re-visited next spring? I seriously doubt that. More likely whatever we get now we will have to live with for many years.
What we get now won’t start for many years, say like 2013.
Thanks, Tejanarusa. Overly dense prose is a well-known failing of failing of mine that I do try to keep in check. The basic analogy, though, is simple and vivid, which is why I have been trying to get it into the meme-stream:
People pushing hard for the public option are not doing so because they won’t take half-a-loaf.
Instead, in bribing legislators to break a critical piece, the insurance companies are trying hard to stick us with an unbalanced machine that will make them richer, us poorer, not work, and blow up in our faces.
We all need to call our representatives, tell them we are paying attention, and will vote against them if they give us a broken machine.
************
Short enough? ;^)
What’s up Doc.
We all know what You do with a brokem machine. Fix it, scrap it, or make a lawn orament out of it.
THE AMERICAN PEOPLE AREN”T WILLING TO DO ANY OF THE THREE options.
You see their to busy calling each other liberals or conservatives, and blaming the other persuation for the problems. It’s just easier to bitch and think the other guys are the problem. We will continue for years to come voting and changing parties while the Country and our lifestyle falls down around our ears. Thinking each time we vote things will get better, when the new guys take over. Yes and being completely surprized when things are getting worse.
OH WELL! Next election we’ll vote for the other guys, and things will get better.
My purpose for this post was not to argue among ourselves, but to offer an analogy that I thought might be useful when talking to normal people. That said, of course you are right and point out the breakpoints within the progressive movement on this issue: where, exactly, does hold-your-nose-and-live-with-it compromise transition over into worse-than-nothing-which-should-be-fought-against? Clearly, we disagree among ourselves here, but thinking for oneself is part of what it means to be a progressive. For me, the bills shaping up in the house and Senate are on the side of worth fighting for, if not by much. YMMV but you’re right, whatever happens now is likely to be with us for years and years, so let’s all get out there and fight.
I’m thinking that if nothing passes now they can try again almost immediately, certainly as soon as the next Congress. If, however, they pass a piece of crap we’ll be stuck with it for God knows how long.
It’s hard to say which side of the breakpoint the current Bills are on since they haven’t been finalized yet. What really worries me is that there are folks on both sides who don’t care: lefties who will support anything just to satisfy their “do something!” urge, and righties who will oppose anything due to partisan bickering.
To bad they aren’t like kids. when bad we could send them to their room or make them stand in the corner. I guess now days take away their vidio games.
With the congress we have a hard time even telling them anything, and they make us stand in the corner and shake our heads.
Next Congress the Republicans will be back in, and all will be lost. We’ll be happy if they pass healthcare, and when they pass cap and tax we’ll want kill them all when it hits us.
Like always they will even make their stanchest supporters pissed off, and get their asses again thrown out, for the other guy’s.