On the Contrary

How does it feel to live in a nation that is controlled by a small radical, religious minority?  Welcome to California ladies and gentlemen.  We can’t govern in this state because a super majority is required to do anything important.  So a small radical conservative minority controls everything.  And now the same effect is occurring in our national government because a minority of Democrats (Republicans just vote no) demands their pound of flesh.  So every important piece of legislation has to accommodate this small minority and that legislation becomes so watered down, it loses its original purpose.

Look at health care.  Since the Republicans aren’t playing, this has to be carried on the backs of Democrats.  The real meat of health care reform is access to a public option.  All of the rest is certainly noble, but without real cost control of a public option, this bill will not be able to control the spiraling cost of private health care insurance and will ultimately fail.  So what does the small minority demand? Gut the public option.  Oh we will let you have it, but at such a small sliver it will be ineffective to control costs.  Did I forget the opt-out option?  You don’t have to play if you don’t want too.  Both of these pieces of the health care reform demanded by the minority are designed to gut health care reform and leave the private insurance companies in the drivers seat.

Oh but it gets better.  Evangelicals and Catholics in the House with behind the scenes help from Republicans in both Houses, decided that they could legislate their religious beliefs by crafting a “compromise” that prevents health insurance from covering abortion.  The effect of this language is to make abortion throughout the nation unreimburesable and therefore inaccessible to most even if it results from rape, incest, or is a medical necessity.  We already have the Hyde Amendment which is bad enough, that prohibits public funds from being used for abortions, but this goes way further to say if you receive any federal funds, you can’t perform them.  That is way different.  It basically says that no insurance company in this country can offer insurance for abortion.   This even applies to the public option which is totally funded by premiums.

Now think about this a minute.  Here truly is a religious belief, that life begins at conception, being codified into federal law.  Second it puts the government in the driver’s seat to decide what medical procedures are appropriate.    For those conservatives who are afraid of big government, apparently they only fear it if they don’t agree with it.  But if it is accordance with their religious beliefs, then government should force it on the rest of us.

So the state of the state is getting worse and worse.  The majority can see the way forward, but what they want is negated by a minority because we have instituted minority rule in our Congress.  Then of course we have the God syndrome best evidenced by Joe Lieberman when, this weekend on FOX noise, he explained that he would have to block (read filibuster) health care reform if it contains a public option.  He said he could not in good conscience allow a program to go forward that would bankrupt our children.  Two problems here with this thinking:  The Congressional Budget Office says it will save money and he is playing God.  Americans want a public option but he is so important he has decided to decide for us.  Another good American who has no understanding of Democracy and has let his ego grow to unbounded proportions.

I would be the first to protect minorities from the tyranny of the majority.  So we don’t legislate laws that say you must have an abortion.  That would be tyranny of the majority.  But when the minority forces its views on the rest of us, Democracy no longer works.

So what does all this bode?  No real reform for years to come.  If people were awake they would understand that if we want to really have change and move forward, the makeup of the House and Senate must change.  And in the next election that probably will happen, but if the jobless rate doesn’t get better, that makeup may shift to those who are holding us back.  I can’t wait to see what they do with the Climate Bill.  Have a nice day.

Monday afternoon I was out in my vineyard trying to do some erosion control before a big storm moved in.  I was in a particularly steep section and I slipped and caught my leg under me, tearing the patella tendons and dislocating the patella.  Needless to say I was immobilized.  I tried to move down to my ATV to get out of the vineyard, but the pain was excruciating.  So I was stuck in the vineyard till someone (my wife) came looking for me when I remembered I had my cell phone and, although reception is spotty down there, I got through to her and she called 911.

Within minutes there was a paramedic crew here from the El Dorado County Fire Station.  They managed to remove me from the vineyard with a minimum of pain and get me to the local hospital.  The local hospital (Marshall) did an excellent job of managing my care until I could be transferred to my primary health care provider, Kaiser Permanente, for surgery that evening and outstanding care. And when I got home my neighbors were there to help out.

In other words what could have been a very ugly experience was just a minor bump in the road because of the taxes we pay for our public services, the excellent medical coverage I have, which is a public plan (I am a retired federal employee), and a good community.  Public services and the taxes we pay for them may seem like they just weigh us down, but then like a parachute you have to drag around as dead weight, when you need it, it is critical.  Having health care is also critical and I am not special.  Everyone deserves it.  If this little episode doesn’t demonstrate how important our public services are, and how health care access for every one is critical, nothing will.

If you watched the debate yesterday in the Senate Finance Committee on the Health Care Bill, it became abundantly clear that some of our Senate leaders are not very bright.  When obvious flaws in their logic against a public option was pointed out, they just stammered that it was a government run program and would eventually, like the blob, eat Chicago.  Listening to Senator Grassley explain why it might be good now, but bad later and then having to say Medicare is good was like being Alice in Wonderland.  They were making no sense whatsoever.

Now conservative Democrats took one of two tacks.  The first one from our spineless and obviously bought chairman was that although he was for a public option, he had to be against it because he didn’t think it would get 60 votes.  Well, not if you are not going to vote for it.  This also made absolutely no sense.  Let me vote for a bill that I think is wrong because I think it will pass?

The other tack was that I have to be against this because a government program would force Medicare reimbursement rates on rural providers and these rates are too low for them to survive.  Now this one has a shred of truth, but strained at best.  If the rates are too low, then raise them in rural communities.  Ah, but therein lies the rub.  This program has to be revenue neutral so where does the additional money come from?  How about from the funding for the war in Iraq and Afghanistan?  One has to ask themselves, if the present system continues, what is the cost to the government as health care costs spiral upward out of control.  This is truly a head in the sand approach if one is to take it on face value.

So one has to wonder where is the Democratic anger?  We now know that 65% of the population wants a public plan and that includes those populations that these Conseradems represent.  After the hearing and the defeat twice of a public option, here were all the Democrats putting a happy face on the situation and saying stupid things like we never having gotten this far before.  Sort of like any bill, even a bad bill is a real step forward.  Harry Reid, the Democrats’ bumbling leader, has indicated that he is not sure whether the final bill will contain a public option.  And of course where the hell is the President, off to Copenhagen to fight for the Olympics in Chicago?

Maybe I am missing something and there is some grand strategy to all this, but I doubt it.  I think Democrats may be on the verge of committing political suicide as they destroy the best opportunity we have had for real reform.  Where is the discipline?  Why not say to Democrats that if you want to keep your chairmanships, and you want to stay in the Party then you will vote against a filibuster and then we will allow a real public option with teeth to be voted on?  Then majority rule will be reinstated in our government and maybe we can get something done.

I think there is a gathering anger out there that will only get worse if the Democrats fail to pass real heath reform.  It would be nice if we could see that anger now, because it might wakeup a few who are on the fence.  Remember the real, but totally irrational anger from a minority this summer that changed the course of the debate.  How about some real anger based upon real issues for a change?

“Senator Olympia Snowe, a member of the Senate Finance Committee, where the most-watched version of the health care bill is being written, said on CBS’s “Face the Nation” that the so-called public option is “universally opposed by all Republicans in the Senate” and “therefore, there’s no way to pass a plan that includes the public option.””  The New York Times article went on to say, “A new government insurance has been roundly opposed by the health care and insurance industries, and Republicans have argued that it would create an alternative to employer-sponsored private plans that will lure millions of insured workers away and lead to a dysfunctional single-payer plan.”

If the Republicans and the health care and insurance industries don’t like it, it must be a good idea.  So it is clear who is in charge of health care reform, and it is not the Democrats.  Senator Snowe is, of course, referring to the filibuster requirement of 60 votes.  But one has to remind the Democrats that our democracy as defined in our Constitution does not require 60 votes for a health care bill.  The Constitution is clear about what actions require a super majority, but lets each house set its own rules, thus the filibuster in the Senate. The Democrats have tied their own hands because they have failed to call the Republican’s bluff and stand firm for what they believe will work.  They seem to work under the impression that half a loaf is good enough when in fact it may just worsen the situation.  I wonder how the Republican Party would fare if the Democrats stood firm on a Public Option and forced the Republicans to actually conduct a filibuster, exposing their nihilist approach to our problems for all to see.

Senator Snowe went on to say scuttling the public option for good “could give real momentum to building a consensus on other issues.”  Read the words “real momentum to building a consensus on other issues” as meaning do it the Republican and health industry way so that the bill enrolls lots more people, but does nothing to really correct the massive cost growth problem. Building consensus with Republicans has really worked well for the Democrats in the past, hasn’t it?  If they are stupid enough to go down this road again they deserve to be out of power.

Republicans mean only one thing when they say bipartisan, and that is do it our way.  Real negotiations would have been insisting on a single payer system and then compromising to a public option.  As it is, President Obama and his band of weak-kneed advisors gave up the single payer system before the game began, have not stood firm for the public option, and then made side deals with the health care industry to try to defuse opposition.  It was a stupid play when they could have used the opposition to their advantage.  It is unlikely now that we will get any real health care reform that makes a difference or put in place the incentives to control costs, unless the Democrats decide to fight the filibuster.  Will they?  I don’t think they have the guts.  It has always been their fatal flaw that Republicans have turned to their advantage.

What we need is a strong public option and a real look at how unlimited health care incentivizes unlimited spending.  Probably a mix of public and private insurance such as France has is the optimum approach (See Roger Cohen op-ed, Get Real on Health Care),  with a look at how to make consumers more discerning about how they spend their health care dollars (How American Health Care Killed My Father).  If Congress brings anything forward without a public option, it should be killed because it doesn’t address the underlying problem of mushrooming costs and has no mechanism to control the private industry by competition.  We need to stand firm for what is right and will work, not half measures that may cover a few more but bankrupts all of us in the end.

The health care debate, if you can call it that, is reaching new lows with Sarah Palin entering the fray with a Facebook message that continues a fairy tale about the government deciding end of life decisions.  Sorry Sarah, that was the Republican Party in the Terry Schiavo debacle.  It is amazing to me that people could think this woman could be Presidential material when she doesn’t know the difference between fact, pseudoscience, and outright misinformation.  She could make decisions almost as well as George did.

But there are some good questions out there, some raised by our gray heads.  One is will the amount of coverage that seniors now have under Medicare be reduced in order to pay for universal coverage?  Another is will there be rationing (see Health Care, Rationing, and the Obvious)?  Can we afford it?  The problem with this whole debate is that we don’t have an Obama Health Care Plan to judge.  More importantly, I believe the whole issue of how it gets funded has missed the point, but let me back up.

Here is what we should all agree on.  The status quo is not sustainable.  So just saying no is not a way forward.  Any way you look at it, in ten years none of us will be able to afford health care.  If you are one of the 73% who likes their present health care, that is all well and good, but you won’t be able to afford it as businesses drop your coverage as the price gets too much to bear.  And that is only the tip of the iceberg.  Now the Republicans say they have good plans but you have to ask yourself when the Republicans had complete control of our government, and unlike the Democrats these guys have discipline, why did they do nothing?

The second thing that most of us can agree on is that it is unconscionable that we have so many people unable to afford health care.  The third thing most of us can agree on is that the data clearly shows that we do not have the “best health care system in the world.”  We may have some of the best doctors and best hospitals, but we do not have the best outcomes and we do have the most expensive system in the world. If you are sick and you get laid off or quit because you are terminal, you are uninsureable unless you qualify for Medicare.  It needs fixing.

Here is where I think the debate misses the point.  We are trying to craft a system that continues the employer based financing system.  Why?  Because it is what we have?  It is what we know?  By doing this, the financing system gets overly complex.  Requiring everyone to buy health insurance doesn’t solve the problem; it just leaves people wondering how they are going to do this.  None of us are required to buy Medicare insurance.  We pay a tax on our income that (barely) supports it.  Why, oh why can we not accept that universal health care is what a civilized country provides to its citizens and we pay for it through our tax base?  Those who say what would happen to my existing coverage?  Well the government could pay a standard rate for each citizen and  establish the minimum coverage.  Hospitals and doctors could negotiate with the government for those payments and coverage.  If you wanted more, then there is a place for the insurance companies.  Why is this so hard?

It is so hard because we are trying to keep the existing failed system in place.  We have no choice but to reform health care.  For profit medicine (insurance companies) don’t work and we are the only country in the civilized world that is still trying to hammer a round peg into a square hole.  Our businesses have been hampered by the cost of medical insurance and it is time to set them free.  We all deserve health care, and we all can’t have everything and expect someone else to pay for it.   That system is a single payer system that allows a reasonable transition period to phase it in and give the insurance companies a soft landing.  Anything else and we are wasting our time and money.

What the debate so far has been about is really protecting the health care industry and their immense profits.  It is time to gore their ox.  Yes there are unknowns and some of us may lose the coverage we have.  Change is hard and the unknown is scary.  The Republicans know this and they are counting on it to once again hobble any attempt to find a new way forward.  Climate change, energy policy, medical care, it is all the same.  We either take a chance on the future or we and are children are going to be trapped in the past as the rest of the world passes us by.

Do you get the feeling that we are drifting?  I think the Obama drop in the polls reflects that feeling.  We had high hopes to change the direction of the nation and yet we seem to be drifting along on the currents of left over Republican policies.  I will grant you that the devil is in the details of change, but real change has not happened.  Let’s look at a few of our failed attempts:

• First and foremost was the financial crisis.  So we bailed out the banks to save them from collapsing and they paid us back by raising the rates on credit cards, not lending, and there has been no real change in the way they do business.  We are swept along on the current of the status quo.

• We enacted a stimulus package which was not focused on real programs for a new America, but a collage of spending in too many directions that has not been effective at either stopping the loss of jobs or investing in a new direction.  We just invested in the same tired old projects that have gotten us nowhere.

• We had high hopes for turning our war policies around.  Yet we are simply ramping up to spend another decade in a very backward part of the Middle East with no real end game.  We continue to waste vast sums of money and American lives in a region of the world that has little strategic value and we need the money at home.

• The end of torture, hooray! But then the cover-up continues.  Secrecy under the guise of protecting national security becomes supreme again, and we consider indefinite detention.  This is not change; it is a kinder, gentler, supremacy of the Executive Branch.  When will we be grown up enough to deal directly with the facts our government seems so intent on protecting us from?

• With much fanfare the House passed a climate bill with cap and trade policies for controlling carbon dioxide emissions.  But it was so watered down to protect coal interests and to court conservative Democrats from the Midwest that the real change was wrung out of it.  The Senate, it would appear, can’t even stomach this anemic bill.  So we continue to buy subsidized gasoline and nothing changes.

• Health care reform is lost in the myriad details of trying to hold on to the old system.  The rest of the industrialized world has figured this out and yet here we sit trying to reinvent the wheel.  On this one, the whole enterprise begs for leadership.  It needs someone to standup and say simply a single payer system, reconfigured to incentivize savings, paid for with a surcharge on our taxes (we all share), and a role for private insurance as an extra to the basic coverage.  But instead it is left up to the lobbied Congress who thinks in the last century to devise a plan.

So we are adrift, falling back into old ways and falling further behind as a nation.  Unemployment grows, the middle class loses more ground, the mortgage crisis continues, but the market had a surge so we are saved, or so we are told.  I will give President Obama his due.  He has changed many things, but where we really need him, he has failed.  That need is a vision of the future and a detailed road map to get there.  His fatal flaw was thinking that Congress, that bastion of the status quo and easy money, could rend change from within.  So he gave them a rough road map and said go to it.  They changed the destination back to the same trip we have been on for all these years.

If we have any hope of a future, one that our children are better off than we are, then we don’t need just leadership, but bold leadership.  Instead of allowing the give and take of Congress to gang rape an idea into submission, the policy and its details must be laid out in stone.  What works is no longer debatable.  Where is the line in the sand where doing any less will not only be unacceptable, but seen as counterproductive?  Where is the courage to say no if the plan is not enough?  Where is the courage to tell people what they don’t want to hear and push for policies that while not popular, will work for our future? He promised he would ask for sacrifice and then we are asked for none.   If you want alternate energy and get off our addiction to oil, then price gasoline like the rest of the world and use the tax to move us on.  It isn’t popular, but it will save us.

President Obama could take a lesson from Abraham Lincoln.  He was never very popular during his presidency and he had to make hard decisions that did not endear him with the electorate.  He did what he had to do, in his mind, to save a nation.  And he was one of our greatest Presidents.  President Obama faces that dilemma.  Does he want to be a popular president who just scratches the surface of change, and in effect leaves us no better off than we are?  Or does he want to risk his popularity by standing firm for what will take this nation in a new direction; to lead us, to educate us, to convince us?  To date it would seem that he is pursuing the former and tricking himself that it will make a difference.  In the meantime, we are just drifting.

We got a wakeup call from of all people, conservative columnist David Brooks.  In his column yesterday in the New York Times, Vince Lombardi Politics, Mr. Brooks made the point that maybe winning isn’t everything, and compromising on legislation to get a win or to achieve what is politically possible may, in fact, pass legislation that is at best ineffective.   That would seem to be the modus operandi of the Obama Administration and the Democrats these days and it is so sad that even the conservatives see the obvious.

Take health care.  On Meet the Press Sunday, Senior White House Advisor David Axelrod, when pressed on whether the Obama administration would get health care reform passed with a government option, Mr. Axelrod kept repeating that we would get health care reform passed.  In other words they were willing to compromise away a government option if that is what it took to get a health care reform package through Congress.  As I have written before, what’s the point?  Without a robust government option there is no reform.  The fear of many of us is that if you compromise away real reform now in order to get a bill under your belt, you may also waste a crisis to force real change.  One might ask when are we ever going to draw a line in the sand and say no more back sliding?  When will we be willing to wait in order to get what is really need instead of the quick fix to say we won?

Take energy and climate change.  Because the Republicans are brain dead and deny both our energy problem (addiction to oil) and climate change, there will be little support from these morons, so quit trying.  But then there are the Democrats from coal states with the same myopia.  In order to bring them along, the bill got watered down to the point where it is a very timid approach to our problems.  Even with all amendments to make the plan almost ineffective, most pundits were urging passage in the Senate because at least it is a beginning ( See Tom Friedman’s column,  Just Do It).  The fear is that the Senate will water it down even further.  Again what is the point if in order to appease all the little self-serving people in the Congress, we finally pass a bill that is at best neutral?  Are we once again compromising away our future?

I listened to a discussion of the impact of finally seating Al Franken in the Senate, bringing the 60th vote for the Democrats.  Because the Democrats are anything but in lock step like the Republicans have been and are, there is little chance this would guarantee anything.  But what I found most interesting is that they felt there would be a power shift away from the moderate Republicans (Snow and Collins) to “moderate” Democrats like Ben Nelson.  What I found interesting was calling Nelson and his ilk moderate.  The nation has moved center left and Nelson and other conservative Democrats are center right and yet the Press still refers to them as moderate Democrats.  The Republicans have become the far right with no viable solutions for our future, the conservative Democrats have become moderate Republicans, and the mainstream Democrats are the center today and nobody gets it.  Worse we keep watering down our agenda to keep these “moderate” Democrats happy and what we are really doing is legislating a moderate Republican agenda while the nation cries out for a Progressive way forward.

I think it is time to quit compromising or looking for bipartisan support.  All one has to do is read the polls to know the nation is far ahead of our Congress.  That is when we expect our President to lead, and instead what we are getting is compromise to nowhere.  The future is no longer clouded and if President Obama continues to give up the ship in order to get a legislative win, then he will lose both the American public’s support, and he will have lost one of the greatest opportunities given to a President.  If he fails to start challenging the system, then he will be seen as just one more political hack that sounded good and did nothing.  He himself has said that we are at a turning point.  So just when does he rise to the crisis and start leading?

The no-boys never cease to amaze me.  They are against everything.  But in the Iran thing they are for more aggressive language.  It is like they have learned nothing from the last eight years of bellicose behavior.  But what made me laugh until my sides hurt was to hear them call for a U.N. resolution.  These are the boys who think the U.N. is a wimp institution and now they want the United States railing at Iran from the podium.  Thankfully we did not elect John McCain who would be playing right into the Supreme Leader’s hands with these ham handed tactics.  The focus would be on the United States interfering with Iran internal politics instead of on Iran’s government stealing power from the people.  But then why change our tremendously successful bellicose war strategy on display in Iraq removing Al-Qaeda.  Oh, I forgot.  They weren’t there to begin with and neither were the WMD.

Okay, okay, but they are going to protect us from big brother.  Did it ever occur to them that they are big brother?  Weren’t these the guys leading the charge on denying habeas corpus and warrantless wiretapping?  Oh, but I digress.  This time they are going to protect us from big government’s involvement in health care.  I guess they are against Medicare, the VA, and Medicaid too.  Oh did I mention that big brother actually pays for their health care?  But the free market will save us from these horrible catastrophes caused by government intervention and according to Republican Senator Chuck Grassley, ranking Republican member of the Finance Committee, there will be no public option.

Now unless I am confused, there is no public option now, and the market place has made a muddle of health care.  But with a few rules from Congress and the magic of the market place, SHAZAM, the market place will prevail.  Actually what he is proposing is government welfare for the insurance companies, but that is a post for another day.  These guys are so out of touch with most Americans, but they have close relationships with health industry lobbyists.  I actually thought President Obama made the most eloquent argument asking if government makes such a muddle of everything, why are they afraid to compete with it.  But logic is not having its day with these folks, and fear tactics are everywhere.  Be afraid of the cost.  Be afraid of deficits (brought to us by these very folks).  Be afraid of losing benefits.  If we follow their lead, just where do you think this train wreck is headed.  All of the above.

But I save the best for last and that is hapless Governor Sanford of South Carolina.  According to him, he wanted to be off and alone in Argentina.  It turns out he wanted to be off and “alone” for the same reason a 15-year old boy wants to be off and alone in the bathroom.  In this case he had a lover other than his hand.  Now the talking heads/spin machine are at it telling us what a good man he is to stand up and take his punishment.  If he were such a good man would he have cheated on his wife?  If he really found his life’s love, would there not be a more honorable way to deal with it?  The story is made large by the largeness of his hypocrisy, he the railing protector of the sanctity of marriage.  But now he wants forgiveness though he wasn’t willing to give Bill Clinton forgiveness.  And that is the central theme of all Republican thought.  They can’t imagine they would ever have been in such a situation so they have no empathy for others until it happens to them, and then they are a special case.

And here I want to make a point that is so important to understanding Republicans.  They really do think that the world is just and they are special.  Those that are poor, or ignorant, or disadvantaged are that way because they deserve it.  The market place is the final arbitrator and it rewards those that are just.  Except it didn’t in the last bubble burst and the playing field is clearly not level.  Okay, but what is their fear of government funded (note not run, but funded) health care?  It is the fear that all they believe is wrong.  Just as fundamentalist Christians want to believe the Bible is literal and ignore the thousands of conflicts, Republicans cling to the status quo with all their might.

I have conservative friends who are facing a health care crisis and see the problem, but that does not bleed over into so many of their other faulty held beliefs.  It only does when they have personal experience with the reality most of our citizens actually live.  Then and only then do they get it.  Governor Sanford wants compassion, but he was having none of it when the shoe was on the other foot. The Republican Party justifies very, very selfish behavior.  It does not empathize with less fortunate because to be less fortunate is to be unworthly.   We are going to have to live with conservatives for a long, long time, but isn’t it time Democrats started to ignore them instead of a bipartisan fool’s errands to accommodate false logic?  I would hope so.  They are very little people with no vision of the future, except on looking in the rear view mirror and protecting their own.

I have been trying to understand the Republican objections to government run health care (single payer system).  They run something like this:  “Don’t let the government get between you and your doctor; all government systems in other countries are a disaster; competition between the government and the private sector is not really competition; government run anything is a train wreck.”  The bottom line here is that anything government will be a disaster.    Of course the only insurance available to any of them that are over 65 is Medicare and I don’t see them turning it down.

I have a personal story here.  I have a friend (and a conservative) who is a principal in his law firm who has just turned 60 and his plan was to work till 65, retire and then get Medicare since an earlier bout of cancer made him uninsurable in this wonderful free enterprise system we have.  But shit happens and his cancer has returned with vengeance.    His firm, like many businesses, will not cover his medical care if he retires so he must work 30 hours a week to keep his medical coverage.  He will keep that up until he can’t drag himself in anymore and only has a few weeks to live.  It is the only way he can keep his coverage and not bankrupt his family.  Isn’t this the greatest system on earth?  This is the best free enterprise can offer?

Now looking back at the Republican objections to a government payer system let’s see how it would affect my friend Mike.  First, there is no government between him and his doctor, just an insurance executive that would rather maximize profits for his company than let my friend Mike have some peace and some time with his family before he is no longer with us.  If he were in any other system in the industrialized world, he would get the same care and not lose his coverage when he retired to live out his last few months in peace with his family.  Just as an aside:  Note that the first face transplant took place in France.  Their facilities and doctors are quite capable.  If he could have the option of selecting a government system, then he would now be fully covered even if he did retire.  And what part of the government run Medicaid which has administration costs running 20-30% less than the insurance companies don’t you understand Mr. Republican?  Same doctors and hospitals, just a government payer.

Of course none of these objections make any sense.  What does make sense is that Republicans and conservatives really believe that government run anything is a disaster.  I listened to them lament a government run GM and Chrysler.   Here would be my question:  What is your alternative?  Private enterprise has run the banking system, auto industry, and our health care system in the ground while their executives have made off with a bundle of money.  It is the government that keeps them honest.  So what is wrong with government competition?  Why isn’t that real competition?  Why are jobs created by government spending not real jobs?  Why is government run anything a disaster?  Does it have to be?

The military is the largest government bureaucracy there is and yet most of us turn to them when things break down to re-establish order (think Katrina).  There are tons and tons of successful government programs.   Most of us take them for granted.  Airplanes don’t crash (FAA), highways are reliable, we all get a free high school education, criminals aren’t roaming the streets, our drugs and food are relatively safe, your air and water are clean, and most workplaces are safe.  You could think of hundreds more so where does this irrational hate of government run programs come from?  Another aside:  Most farmers are Republicans and you don’t see them complaining about their subsidy.

I know where this irrational belief comes from.  Many have some bad experience with government where the government has a rule or regulation that impacts them and seems mindless.  Actually many are mindless because the same people who hate government made it mindless.  In order to make rules fair we pass or make comprehensive rules that someone abuses, and then instead of punishing the abuser, we demand more regulations to further limit the flexibility that led to the abuse.  But in pushing for these tighter and tighter rules, we are tying the hands of the administrator of these rules so that the outcome is no longer rational.  He no longer has the discretion to apply the rule where it makes sense.

Look at mandatory sentencing.  The injustices that followed are astounding.  The unintentional consequences of this desire to punish the few, end up punishing all of us.  Yes governments do stupid things sometimes, but we can change that.  Private enterprise doesn’t do stupid things, just things that only reflect their bottom line which in many cases is for their best interest, not ours.  Note that whenever these business fail us, we always want to know why government let them do it.  Well in things like health care or regulation, the profit motive should never be part of the equation.

So the debate becomes more and more irrational because conservatives really have no alternative but to return to the status quo.  I heard a commentator the other day state that the best tactic for an opposition party was to criticize the party in power, but don’t take the risk of offering your own alternative.  I think the Republicans are following his advice, but they have badly misread the nation.  The nation knows the status quo got us into this mess and the new guy is trying new things.  If you haven’t got an alternative, we may not be totally in love with the new guy’s ideas, but we know letting you return us to the status quo will be a disaster.  Better start offering some alternatives besides your old solutions that didn’t work.

I could recite to you all of the failing marks our health care is getting, but it really doesn’t register until you personally face a medical crisis and you find your health care is gone.  Sadly many Americans are facing that reality as they lose their jobs.  Others are finding out just exactly what their insurance aren’t covering.  Many of my friends have come to the reality that there will be no retirement of any kind until they hit 65 because they will lose their coverage until Medicare kicks in.  Businesses saddled with health care benefits are losing their competitive edge in the world market place.  So the ball is teed up for real change in our health care system, how we pay for it, and who is covered.  Enter the Republicans with their never ending scare tactics.

The current line of scare tactics is that you don’t want the government between you and your doctor.  This is, of course, is their strategy to prevent any form of a single payer system, the single payer being the federal government, you know, like Medicare.  What is so hysterically funny about this is that right now the guy between most of us and our doctor is the insurance companies the Republicans (and some Democrats) are working so hard to protect.  So we would rather have someone whose primary task is not your health, but profit for the stockholders, than the government whose elected representatives are answerable to their citizens?

The other scare tactic is that people in Europe and Canada have horrible care and patients have to wait forever for their care.  This is not true of course and their waiting times are comparable to ours, and oh by the way, they have better outcomes than we do.  Oh did I mention that all their citizens get care?  No they are not perfect and each system, and there are many as opposed to some monolithic government health care system the Republicans try to portray them as, have their own problems.  But if they were so bad, what are the Republicans so afraid of by allowing a single payer system along side the usual suspects of private insurers?

Well one argument is that the competition won’t be fair because the government system is so large that it can negotiate unfairly and have lower rates.  This is a bogus argument because they could just put in the law that the rates for services/drugs the government system enjoys has to be available to everyone.  The reality is that the private insurers will never be competitive because of their overhead costs to do what they do best, deny claims and cherry pick members.  It is a for-profit business after all and the business model is lots of enrollees and few payouts.

Remember that like Medicare, doctors and hospitals are still private enterprises that compete with each other for patients and the only difference is who pays the claims. The free enterprise system for medicine did not go away, it would just simplify the paper work and get rid of the middleman.  But I actually am in a single payer system that I am very satisfied with.  I am retired from the federal government and my health care is provided by Kaiser Permanente, an HMO.  So the federal government pays for some of my health care and I pay for the rest.  And there is the model for the future.

If you are afraid that the federal government will limit services or limit payments so that there is a waiting line, or certain procedures are not available, think about this model.  Providers (private companies) would provide a certain level of services based upon a basic single payer system (the federal government), and if you wanted more, you could contribute to the plan.  Each plan or provider would then be in competition for providing the most services under the government system, and making their extras more cost effective than their competitors to attract enrollees.  Would this not be the best of both worlds?

I am sure there are holes in my plan, but at least it is an idea outside the box of the status quo the Republicans seem so dedicated to protect.  Just what are the Republican’s offering as an alternative?  My point exactly. The real question is whether Washington will represent what the majority of people now see as the way forward, or like banking reform, they are owned by the insurance companies.