I watched the whole health care debate yesterday, and it was quite enlightening. And mostly concerning.
Republicans put up a decent show, trying to bring attention to all flaws and corruption around the current bill. Obama on the other hand, also did a good job to at least appear interested in some sort of back and forth. However, the one point Obama (and other democrats) were specially successful yesterday was to challenge Republicans to clearly state the ideological difference between their proposals. And Republicans failed to do so.
You see, trying to focus on cost or procedure here is what democrats want. They want to establish that, all things considered, health care is a right. That one point would justify their agenda, no matter what form it takes. At one point, a Democrat (can’t remember who) said something like “our goal here is to make sure that health care is provided equally. Sick people should not be forced to pay more than healthy people for care”.
That my friends is the crux of the matter. Not access, not price – but equality. Once you establish that a resource (in this case, health care) is not affected by market forces (which determine that sick people *should* pay more than health people, just like reckless drivers pay more for car insure than safe drivers) the battle is over. Health care becomes a non commercial good. That ultimately means the end of private health care.
Why Republicans shied away from this challenge? I think there are a few reasons at play here. First, the current system does allow insurance companies to abuse their power. Cancelling existing policies or adding loopholes on complicated contract language compromised the treatment of sick people who were responsible and were following the rules. So it becomes easier to convince the public that since insurance companies are not following the rules we should simply screw them back, instead of trying to fix the loopholes. Second, the Republican support for Medicaid/Medicare and especially the expansion done under Bush to cover prescription drugs (Medicare Part D) broke the public’s perception that government should not be handing out ‘free’ medical services to people. It became simply a matter of who should receive what, and that is exactly what Democrats want. So now that they simply want to change the variables at play, any kind of ideological rebuttal is almost impossible.
So my take on this whole thing is: Overall, the battle is lost. Republicans are still a positive force here (remember that one year ago we were discussing the public option, which now is dead) but some sort of reform will go through. Eventually, this reform will lead to higher taxes and the decline in quality of the medical system. It will most probably be a smaller change than initially feared, but a big one nonetheless.
Elections do have consequences.