The healthcare bill that will likely come out of the Senate makes our atrocious healthcare system worse, not better, and those who wish to salvage some kind of actual reform — not to mention a shred of social democracy — need to oppose this bill tooth and nail and demand something better.

The "compromise," a brazen pander to the health insurance lobby, makes it illegal for you not to purchase healthcare from private insurance and drug companies who, notes Sen Bernie Sanders, "will be laughing all the way to the bank the day after this is passed.”

"We WIN,” one health insurance insider wrote in an internal memo.“Administered by private insurance companies. No government funding. No government insurance competitor.” Soon after it became clear Senate Majority Leader Harry Reid would cave to the demands of Sen Joe Lieberman, insurance stocks when through the roof.

The last 36 hours or so have been facinating and infuriating all at once. The left is split. While Markos, Howard Dean, Glenn Greenwald, Jane Hamsher and others are, rightly, deciding to fight for decent policy, the likes of Ezra Klein (who has been begging for this capitulation with his outright refusal to stand for a public option), Matt Yglesias, Paul Krugman and Josh Marshall are saying it should pass, arguing it represents a major progessive victory and will help around 30 million people who are uninsured.

At various liberal blogs, Obama’s remaining apologists are wagging their fingers at the "purity trolls" who are making the "perfect the enemy of the good." I truly believe most of these progressive supporters of the bill are well-meaning but they are wrong. The bill, and the rationale of its supporters, is complete and utter folly. The bill is bad. It is worse than the status quo. If passed, it will seal the fate of health insurance for decades. As we wait for the bill to go into effect, and Democratic majorities decline, as expected, the power of private insurers — whose profits and administrative waste represent the root cause of the healthcare problem — will be further entrenched.

While Ezra Klein and co will say this bill will help sick people, in truth, it will hurt. Here is why. While the new legislation does prevent companies from denying care for those with pre-existing conditions, it does not forbid them from charging more to these people. Further, the companies are allowed to deny care once a annual limit –totally unregulated — is met. And, because there is a mandate, one must buy these policies by law. In essence, a sick person will have to, by law, buy a bad insurance product from an evil company, but will have no protections on how much they have to pay, and can be denied care. Imagine this conversation.

"Hey Steve – We already paid for $100,000 of healthcare, since your car accident. We have an annual limit, so now you are on your own. Welcome to financial ruin, or maybe death. Oh, and by the way, it is illegal not to buy this product from us."

As Obama (the candidate) said, these mandates are roughly akin to trying to solve homelessness by making it illegal for the homeless not to buy a house. Insurance and drug companies, who gave Obama more money than any other candidate in history, have won the battle.

There is plenty of blame to go around. Obama, for one, is chiefly responsible. He was bought off by the health insurance companies and he bought off the drug companies. He caved in September on the public option and refused to fight for what his supporters — and most of the country – want. Also to blame is Joe Lieberman (I-Connecticut) who is a weak man, lacking any principle or compassion. And, between his hatred of any social safety net for healthcare — and his notorious support for endless, illegal wars — he seems to chiefly play the role of making people suffer as much as possible.

But also to blame are liberal apologists. Mr. Capitulation himself, Ezra Klein, who despite claiming to support a public option, has signaled for months he would not fight for one. He essentially signaled to Congress and the White House that they could go and ahead and support whatever, because he and others like him would support him no matter what "reform" looked like. . Ezra has plenty of company as well. This is not to say that Klein (who, despite the fact that I am obviously annoyed and disappointed with his analysis during this battle, is a bright policy wonk) and others are not right that politicians must compromise. But let them compromise, don’t do it for them. Make Obama and Congress make compromises with the full pressure from advocates of a public health system — not a blank check to screw us over. Progressives, all too often, let themselves get walked over so they can claim to be "realist," "pragmatic" and living in the real world. Us naive idealists are crazy lefties at the kids table — how dare we demand a decent bill with some kind of public program not designed to yield profits to corporate shareholders? And while it has drawn some controversy, there is an interesting trend where liberal supporters of the War in Iraq (Klein, Yglesias, Marshall among them) are the ones who are telling progressives to fall in line with establishment thinking yet again. While those who opposed the War in Iraq (kos, Dean, me) are again screaming for Congress to show some courage and oppose a bad policy.
Writes the always sharp Glenn Greenwald:

Shared contempt for the Bush administration (at least once Bush and the Iraq War became discredited) largely obscured these differences when Bush was in office. The desire to undermine the Bush GOP and dislodge that movement from power subsumed all other objectives and united people with vastly different political outlooks and agendas. There is still a shared revulsion towards the Palin/Limbaugh Right, but that faction is too marginalized and impotent to serve the same function. With the unifying force of Bush/Cheney gone, the divisions Kilgore describes are now vibrant and increasingly potent. In addition to health care and Iraq, roughly the same progressive fault lines are seen over the bank bailout, escalation in Afghanistan, Obama’s economic team, tolerance for Obama’s embrace of Bush/Cheney civil liberties polices, and even the reaction to Matt Taibbi’s recent Rolling Stone article on Obama’s subservience to Wall Street.

(On a side note, is it not amazing that all the ones who favored the War have plum gigs at establishment papers and think tanks? Of course, they all admit they were wrong; Must be nice to be moving in the same direction as conventional wisdom and never fight against the current.)

This whole scenario is maddeningly depressing. I am losing faith in the democratic process and have never felt more dejected and isolated. Our president has failed us, Congress has failed us, entrenched corporate interests continue to yield far more power than people — and worse, progressives are cheering it on and blaming advocates of public health — who have already made concession, after concession, after concession, after concession — for the whole mess. By supporting this bill progressives are assuring they will cease to be a viable entity in Washington DC.

To give an example of my disappointment, I will note an exchange I had with my colleague. He asked me who I would support for US senate race in Massachusetts, a special election to replace the late Ted Kennedy. The race is between a typical Massachusetts Democrat, a Republican and a third-party libertarian type. Obviously, the Democrat is the east choice to replace Ted Kennedy. But then I remembered: it doesn’t matter. Progressives already won a super majority in Congress and we still can’t penetrate the debate enough to get a public option that will cover a tiny fraction of the population, or that doesn’t hammer at a woman’s right to choose. I am having trouble even imagining myself getting off the couch on Election Day. What good will it do? Corporate interests will win again, the Democrats will represent them more so than its supporters — who merely want something resembling a sane healthcare system — and so many well-meaning people will swallow it and praise their own realism. Is this democracy? Is this social justice?

The public wants single-payer healthcare. The private system is a joke; we spend more than every other country — 17 percent of GDP – and leave 30-45 million uninsured. We have woeful statistics on infant mortality, life span and so on. And after all this fighting — and after two mammoth electoral victories for progressives in 2006 and 2008 — things are not getting much better. Insurance companies are writing healthcare legislation. We are engaging in more wars, sending more troops and killing more innocent civilians. The same darlings of Wall Street who ruined the economy, now run it under Obama. Indeed, 2009 is a very dark year for American democracy and the hopes and dreams of the Obama election have proven to be, for the most part, empty rhetoric.

In any case, there is never a good excuse to stop trying. Here are my suggestions for ways to move forward:

1.) Let Joe Filibuster: leave the public option and Medicare expansion in the bill and let Lieberman obstruct it. Then …

2) Use Reconciliation: Do what Bush did with his Tax Cuts and ram through whatever you can with reconciliation. It can be done. Most of the Senators that say otherwise, it is worth noting, are banking on donations from the health insurance lobby. Why some progressives will not even consider this is beyond me. I can only guess they don’t want to irritate His Hopiness.

3.) Primary opponents for real reform. Those who said they supported a public option and didn’t suport it? Do what Firedog lake has suggested and challenge them. We cannot let them get away with this. This includes Obama. I repeat: the threat of a 2012 progressive challenger to Obama needs to be considered.

4.) Election Reform: The system is broken. Progressives will never have such a mandate for change again and still nothing is done. Stop donating to Obama and the DCCC and so on and start donating to groups demanding election reform: publicly financed elections, serious ethics legislation, instant run-off voting. Do not give a dime to candidates who voted for a bill with no public option. They must learn there are consequences to snubbing the base.

5.) Single-payer: The fight continues. As I noted in the Christian Science Monitor in September, single-payer may be dead in Washington, but it is alive in the states. Pennsylvania, Vermont and California, among others, are getting serious on this issue. Get involved in your state. Donate to these movements. Also, ask congress to remove the legal "ERISA" impediments to single-payer.

6.) Media Reform The public debate on this issue is so very weak. Single-payer advocates are virtually absent from the media.Notes a report from Fairness and Accuracy in Reporting:

Over the past week, hundreds of stories in major newspapers and on NBC News, ABC News, CBS News, Fox News,CNN, MSNBC, NPR and PBS’s NewsHour With Jim Lehrer mentioned healthcare reform, according to a search of the Nexis database (2/25/09-3/4/09). Yet all but 18 of these stories made no mention of "single-payer" (or synonyms commonly used by its proponents, such as "Medicare for all," or the proposed single-payer bill, H.R. 676), and only five included the views of advocates of single-payer–none of which appeared on television.
Of a total of 10 newspaper columns FAIR found that mentioned single-payer, Krauthammer’s syndicated column critical of the concept, published in the Washington Post (2/27/09) and reprinted in four other daily newspapers, accounted for five instances. Only three columns in the study period advocated for a single-payer system (San Diego Union-Tribune, 2/26/09; Boston Globe, 3/1/09; St. Petersburg Times, 3/3/09).

The FAIR study turned up only three mentions of single-payer on the TV outlets surveyed, and two of those references were by TV guests who expressed strong disapproval of it: conservative New York Times columnist David Brooks (NewsHour, 2/27/09) and Republican congressman Darrell Issa (MSNBC’s Hardball, 2/26/09).

Support groups like Freepress.net and Fair.org, and fight for independent media, so private companies don’t control our health and all our information — which, as of now, is sadly the case.

As I said, this is a dark day in American democracy, but the fight must continue; the struggle for social justice never stops.