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The End of "Nice" Health Care Reform

Of course I could be wrong. Congress could turn around and pass some cockamamie scheme to kick the issue of health care reform down the road, offering some kind of minimal insurance coverage to a few million more people, and cracking down on this or that particularly egregious health provider rip-off, and then staging a “mission accomplished” photo op.

But real health care reform of the kind that Democratic candidates were promising during last year’s presidential campaign is dead, killed by the timidity of the promiser-in-chief, President Barack Obama (and by the massive corruption of the Democrats in Congress, who hav e accepted the tainted coin of the health care industry).

Obama could have come to the American people as a newly elected leader and addressed us as adults, saying: “Look, we know what needs to be done. Plenty of countries in Canada, Europe and elsewhere have figured it out already. They set up the government as the single payer to health providers—doctors and hospitals, etc.—and the government bargains and sets the prices those private providers of health care can charge.  Of course that means you’ll all pay higher taxes to finance such a plan, but the record of all those countries shows that you’ll be saving money over all, because you won’t be paying for health insurance, your employer won’t be paying for health insurance, you won’t be paying co-pays and deductibles, and you won’t be getting gouged for drugs or hospital stays or doctors’ bills. You won’t be paying state taxes for Medicaid either, nor will your insurance and local property taxes have to subsidize the hospital care of indigents. On balance, you’ll all be saving money, and you’ll never have to worry about disease or injury bankrupting you. Nor will employers be able to hold you hostage any longer. The reality is that the countries that have a single-payer plan are spending half of what we spend per capita for health care, they have no uninsured citizens, and their health overall, as measured by such things as longevity, infant mortality, etc., is better than ours.”

The president could have said all this and rallied the tens of millions of Americans who desperately want a health care system modeled on the single-payer idea to his side, forcing Congress to go along or pay the price in 2010.

Instead, this president who, in years past as a senator, as a state representative and as an activist had praised the idea of single-payer, has taken to saying it’s important do keep the private health insurance industry in business. Instead of inviting Canadian administrators of that country’s successful system down to talk about how it works up there, he barred even American advocates of single payer from speaking at his talk-fests on health care reform at the White House. Instead of taking an axe to the US Medical-Industrial Complex, he has pretended he could reform the current profit-crazed system we have in the US without raising taxes. Instead of pointing out that we already have a well-functioning single-payer system for our elderly and disabled in the form of Medicare, he has spent his time badmouthing the single-payer idea, even claiming that it’s not part of our “American” tradition.

But let’s note that Obama’s sell-out on health care reform was aided and abetted by the progressives, the left groups and political organizations and the unions that failed to hold him to his earlier espousal of single-payer, that instead of calling him out on his cave-in, bought into his initial compromise of a so-called “public option” insurance alternative, and even into his subsequent backdown to an even more watered-down version of possibly state-run or “cooperative” plans.

Now his political cowardice and mendacity have caught up with him. His “plan,” if it can even be called that, of mandating employer health coverage and then adding a government-run alternative  “public option” to existing private insurance, has understandably failed to excite the public, while still arousing the passionate opposition of conservative Republicans and conservative  members of his own party, and meanwhile does nothing to limit soaring health costs, which already eat up a fifth of the entire gross domestic product of the nation,  requires an increase in taxes and reductions in Medicare,  will probably, if established, lead to more companies actually dropping their current benefit programs in favor of a cheaper, stripped-down government plan, and yet will still leave millions of people unable to get access to timely, quality, affordable medical care.

Furthermore, his apparent failure to deliver on this key initiative will deal a body blow to his political clout on other initiatives, such as tackling climate change and dealing with an acute economic crisis.

If I’m right that health reform is dead, so is Barack Obama’s presidency. President Bill Clinton’s new administration foundered early on following his shameless backdown on a pledge to guarantee the right of gays and lesbians to serve openly in the military. It never recovered. President Obama’s new administration is foundering on his equally shameless backdown on a promise to establish a system of quality affordable health care for all.

DAVE LINDORFF is a Philadelphia-based journalist and columnist. His latest book is “The Case for Impeachment” (St. Martin’s Press, 2006 and now available in paperback). He can be reached at dlindorff@mindspring.com