Inevitably, every credible health care expansion put forward by Democrats will be attacked by insurance-backed Republicans as "socialized medicine." "Socialized medicine" the lore goes, lets government instead of your doctor decide whether you live or die or receive the procedure or device you so desperately need for a quality of life.
Fifty years after the death of McCarthyism and red-baiting, many Democratic elected officials still shy away from the dreaded label of "socialism" for anything they support. Scrambling to sell their "new idea" to a public they are sure is sceptical of government, they back away from the government part of their health care plan. They market whatever their health care expansion is in private sector terms, "putting doctors in the driver's seat," "leveling the playing field for business," or simply appealing to issues of basic fairness.
In doing so, Democrats flout the advice of Madison Avenue which has a long held tenet of marketing a product by its weakest feature, rather than its strongest. Karl Rove and the Republicans have perfected this tactic. Thus, George Bush was re-elected by re-characterizing his stubborn record of stupid bad decisions, as "a strong leader who stays the course." (Correspondingly, Kerry's greatest strength as a war hero was turned into a liability by swift-boating him)
Replacing the crazy quilt "system" of private health care financing with a simple government plan is the greatest single strength of the most obvious solution to our health care crisis. But it's also becomes our greatest weakness if we appear to be hiding the government part of it.
Similar to the debate on global warming, the debate over what to do about health care in this country is long since over. All experts who are not funded by people who stand to gain financially from the status quo in the highly-lucrative health care industry agree that removing the health insurance industry/HMOs from the equation is the way to go. Government-financed (so-called "single payer") health care similar to what they have some form of in every other developed nation in the world is the only way to save enough money to provide every man, woman and child with cradle to grave full portable high quality health care coverage, for the same amount we are paying now to cover only a fraction of the population.
SB 840 by Senator Sheila Kuehl is the only serious credible universal health care reform proposal before the California legislature. The Governor vetoed similar legislation last year while on the campaign trail.
The only arguments anyone can muster against SB 840 other than "it's socialized medicine therefore it's evil," are political. "It's too soon," "it costs too much," and "it requires a 2/3rds vote for a tax increase," all serve to distract from the basic fact: the entrenched interests, insurance, HMO and pharmaceutical and medical device companies, for-profit hospitals, medical groups as well as integrated health care systems like Kaiser Permanente and SEIU who carries its water in the legislature, all have a lot to gain from preserving the private financing structure of the current system--or at least the part of it that benefits them.
Given the entrenched nature of the current big health care players, AB 8, the compromise health care proposal put forward by the Democratic leadership, appears to be a worthy incremental step--expand coverage for children in the state who currently fall through the cracks in the system. How can we be against that? But there's no question that this type of expansion is fiscally irresponsible, a short-term non-solution to the problem and risks either over-stressing the public budget or under-funding the coverage in a time when inadequate health care coverage is perhaps an even bigger a problem than lack of coverage altogether.
I don't know what I'd do if I were a politician facing this conundrum in the California legislature. But I know what outside groups that care about health care reform should do. They should stop mistaking themselves for the politicians. They should push for what they know really works and not what doesn't work.
It's not up to us to make the tough choices. It's up to us to make the choices tough.
And to do that, Democrats and pro health care reform groups need to stop backing away from government. Government-financing is the solution and the reason it's the solution is the efficiency and accountability of government. Until we embrace that and lead with it, we'll keep losing.
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