Friday, December 25, 2009

Ersatz Health Reform

There's been some celebratory self-congratulation on the imminent enactment of a health care reform. I find myself fearful and deeply ambivalent.

When I was a little kid, my mother once made an 'apple pie' out of Ritz Crackers. It was something she learned to do, during WWII shortages.

This reform is like that apple pie, but less tasty. It's an ersatz form of universal health insurance. Instead of the simplicity of single-payer and tax-financing, we have a Rube Goldberg contraption of taxes, subsidies, regulations without a regulator, and a mandate.

Telling us that this is the best our supposedly democratic system can produce is deeply discouraging.

This is a system that is designed to fail. Deliberately designed to fail: subsidies that will be cut, regulations that will never be enforced effectively, payoffs to insurance companies, pharma and providers that obviate any cost containment. And, a leisurely pace of implementation that puts two general elections between now and the program having full effect.

I'm not saying, 'Kill the Bill', but I am saying it may be political suicide for liberals to celebrate it as the greatest thing since Medicare.

Now, at what may well be the zenith of liberal power in the aftermath of the catastrophe of GWB, this is the best we can do? To fight the plutocracy to a standstill?

This bill puts us up on sharp ridge. The system this bill creates is even less sustainable that the system we had. It is hard to believe such a thing would be possible. Either that basic unworkability will be recognized and the Republicans will start taking it apart; or that unworkability will be recognized, and the Democrats will start repairing the defects. But, the unworkability will be recognized, and action taken on the basis of that recognition.

Every syllable uttered by Democrats concerning how great it will be, is undermining their credibility as repairmen.

The sclerosis of corruption and special-interest politics has the country's political process stalemated, at the very moment when radical change is acutely needed.

The shape and character of this reform is just more evidence.

Confidence in the democratic process is being severely undermined. I cannot celebrate that.

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