I'm sorry but while both Ezra KLEIN and Jon COHN have done great work on this issue, they are talking here about a country and a political system that no longer exist. And their responses to Marcia Angell's CRI DE COEUR are largely political, and not really to the point of her piece, which is that no substantive reform of the system is possible until the control that the insurance industry exercises over the practice of medicine is broken forever. The now-familiar argument is that the House bill--even if it had a snowball's chance in hell of surviving the Senate intact, which it doesn't--represents a good first step. When exactly was the last time our political system--to say nothing of the Congress--did anything in "steps"? We don't progress. We move a step ahead, and then there's an election, and then we move another step in the opposite direction. The idea that the current debate will produce a system that will somehow be immune to our febrile and idiotic politics is naive to the point of translucence. For this to have worked at all, it had to be so huge and transformative as to immunize itself thoroughly in the event that Congress or the White House--or both--change hands. It had to be so immense as to be unmovable so that it would be permanent enough for enough people out in the country to become invested in it that the political danger would be to monkey with it at all. (Which is pretty much the way things are in Canada now. Their system, for all its flaws, is politically sacrosanct.) It also had to be a big enough change to overcome the fact that one of our two parties will be completely off its head for the foreseeable future. Whatever comes out of this process is going to be far too fragile to survive the kind of boneheaded thinking that produced this NONSENSE this week. And Social Security has a more solid constituency than whatever the new healthcare plan will have.My fear isn't that he is right; I know he is. My fear is that the industry foot now on the necks of the people who pay it will gain cleats from any bill putrid enough to become law, and that it will sink them into the economic jugular of the nation and bleed us out until nothing remains of the middle class but old re-runs of Leave It To Beaver.
Saturday, November 14, 2009
The Final Word on Health Care Reform
Charles Pierce at Altercation sums it up so perfectly it needs nothing more than a blockquote: