Better Than Nothing?


One of my professors years ago was a round little man who liked to warn us, with a twinkle in his eye, “Making predictions is very difficult, especially predictions about the future.” Will a bill pass, in what form, and then what will the long term implications be? It’s hard to predict.

Dr. John Geyman, former president of Physicians for a National Health Plan, makes a case in Tikkun “The Affordable Health Care for America Act (HR 3962): Enough Reform to Succeed?” He argues that whatever bill this Congress is able to pass will likely set the cause of Single Payer health care back because it “would leave in place an inefficient, exploitive insurance industry that is dying by its own hand, even as [the bill] props [the industry] up with enormous future profits through subsidized mandates.” His argument backs up Dr. Marcia Angell on the Huffington Post who asked “Is the House Health Care Bill Better than Nothing?”.

Not everyone on the Left agrees. Look at Sam Stein’s piece in the Huffington Post , “Goldman To Private Insurers: No Health Care Reform At All Is Best.” Goldman Sach’s analysis for the health insurance industry is that no reform would benefit them the most, and if we end up with a version close to the House bill, that would cause the industry the most financial difficulty. The Senate bill would fall in between from their perspective. Jonathan Cohn in The New Republic asks “The House Bill Is ‘Worse Than Nothing’? Really?” to further argue from a progressive perspective that we still could get reform worth supporting.

Sorting all this out is tough and can be frustrating because there is so much wishful, non-reality-based thinking going on. It is clear that many of the supporters and opponents of the bills, both in Congress and the general public, are clearly deluded, and Single Payer is what has them flummoxed.

On the Left I keep talking to supporters of the public option who claim to be “Single Payer at heart”, and they believe whatever passes will be the camel’s nose under the tent, the slippery slope to Single Payer. Seems delusional. If only they are right….

Speaking of the Right, many of them also believe any bill this Democratic Congress will pass will become the same camel’s nose, the same slippery slope to socialism. Could they be right, too?

There is still work to do. The handwriting was on the wall Saturday 10/31 when anti-abortion Democrats had enough political oomph to get their Stupid Amendment debated and passed while the Progressive Caucus couldn’t muster enough support to bring either the Kucinich or Weiner Amendments to the floor (for more discussion of these amendments in particular, and Single Payer in general, see the HCHP website and blog).

No matter what happens, one prediction is certain: we have to continue to build our movement. Next time around we have to get everyone in Congress who plans to vote for reform this time, to vote for real single payer reform, to push for Medicare Part E – E is for Everyone. And that would prove the delusional ones were right after all.

ROB STONE, MD is an emergency physician and Director of Hoosiers for a Commonsense Health Plan in Indiana. He is on the board of directors of Physicians for a National Health Plan.


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