What If?
By Sam Stark
Reposted with permission - see links below.
What if this is 1935 and Congress is getting ready to vote on the Social Security Act?
As political progressives, union activists, or whatever, do you support the bill or oppose it?
No brainer, right?
So what if I told you that by supporting the 1935 Social Security Act you would be selling out the working-class and capitulating to right-wing interests who wrote half the bill?
Didn’t see that one coming didja?
To get Social Security passed, progressives had to agree to exclude nearly ½ of the working class, including 2/3 of African Americans and more than ½ of all women.
Yep, that’s the deal you had to agree to in 1935 to pass what we now know as one of the most successful and progressive government programs of all time. Bur in 1935, it didn’t look that way when progressives had to accept the deal racist, reactionary Southern democrats laid down in exchange for their votes.
These backward elements held power over key committees that could have scuttled Social Security and even prevented a vote. Their deal? Exclude al domestic workers, agricultural labor, state and local government employees, and many teachers, nurses, hospital workers, librarians, and social workers. Their special interest? Keeping power by keeping intact the American-styled apartheid system they presided over.
So what do we do? Kill the bill and try to come back later or take what you can get now?
Remember this deal was made during the Left’s Glory Days. That’s when we had one of the most progressive presidents ever in the White House, the most progressives ever in Congress and the biggest mass movement ever out in the streets. And progressives still had to cut a deal with the devil.
Protesting is easy. Governing is a b*tch.
So let’s bring this What If game to the present
What if you are a member of Congress in 2009, do you vote for the deal cun in the Senate or vote to kill the bill?
Not so easy anymore, is it?
We know the flawed Social Security bill was strengthened over the years, adding household workers in 1950 and agricultural, hotel, laundry, and state and local government workers in 1954. What we don’t know is the future of our flawed health care bill?
The nice thing we do know is that improving it will be a lot easier than passing the original bill. As New York Times columnist Paul Krugman pointed out, many of the future improvements can be through reconciliation with simple majority vote as opposed to the anti-democratic, super-majority 60-vote process that gave sociopath Joe Lieberman the power to kill the public option and prevent lowering the enrollment age for Medicare to 55.
So what do we do now?
We still have to figure that one out. But one thing we can’t afford to do is make single-payer a dogma. Such rigidity in strategy ties our hands and limits our options. Looking at the world we see that more nations have accomplished the goal of health care for all through a multi-payer system. Only Canada, Taiwan, and South Korea have chosen to go single-payer.
France is considered to be the world’s best health care system while Japan has the longest healthy life expectancy. Single payer systems? Hardly. French citizens are covered by 14 private insurance companies. The Japanese have about 3,500 private health insurance plans. These multi-payer systems succeed because private insurers there are not allowed to make a profit selling health insurance.
Every nation that has committed itself to providing health insurance for all its citizens has followed its own unique path to get there. It’s a sure bet that the United States will never adopt the socialized medicine system of Great Britain, even though the Veteran’s Administration is already a socialized system with government-owned, government-run hospitals and government-hired doctors.
We could build on this flawed health care bill by expanding Medicare to all Americans of all ages. That would be the most direct route to single-payer since the structure already exists, is quote popular (Even Tea Baggers love their Medicare) and operates way more efficiently than private insurance with it’s 3% administrative costs verses 20-30 percent for private insurers.
But it’s not certain most Americans are prepared to kill a whole industry even if many of the clerical workers are absorbed by Medicare to serve the new enrollees.
The private sector has always had a role in our government-run health care. Most of the Medicare workers who process sand pay claims are employees of private insurance companies. That was the result of deal struck in 1965 to help win support for passage of Medicare.
With the creation of health insurance exchanges under both the House and Senate bills and the Senate’s provision that private insurance companies must reduce their administrative costs to 10% could move us in the direction of a French-German-Japanese-Swiss model. In these and other multi-payer countries, private insurers collect premiums set by government regulation, pay all claims immediately under rates set by government negotiations with doctors and hospitals, and cannot deny coverage for any reason under strict government regulation.
So what if it turns out that most Americans decide they prefer a multi-payer over a single-payer health care system?
Protesting is easy. Governing is a b*tch.
Author: Sam Stark
http://michuhcanblog.org/index.php?blog=2&title=what_if&more=1&c=1&tb=1&pb=1
