by Jim Kavanagh, counterpunch.org and thepolemicist.net
Given that this is a crucial subject area, both socially and politically, I thought that while Jason and I figure out how to format his coming guest post diary series, I’d (ahem) borrow from it liberally, and hope he doesn’t mind.
He begins noting that it’s great to get single payer into the Overton window, and that it’s a potentially good bill, and that a third of the Senate Dems have signed up as co-sponsors, and lauds the Bern’s dedication to it, etc. It puts single payer up for legislative action and discussion, from Fox to PBS, and even Democratic Party will have to talk about it.
“But please, please, do not be fooled. It does not mean that most, or any, of those co-sponsoring Democratic senators actually support single-payer. Most of those Democrats have signed on because they felt politically forced to, because they knew they could not face their constituents if they didn’t. But many of them do not support single-payer, have no intention of actually working to make it happen, and will, in fact, do their best to undermine and prevent it.
In Homer’s Odyssey, both Helen of Troy and King Priam’s daughter, Cassandra, tried to warn the king that the elegant Horse, which was presented by the Greeks as an emblem of surrender, was actually an engine of attack that would destroy the city if allowed in. Call me Cassandra.
The New York Times article of September 15th, “Buried Inside Bernie Sanders’s Bill: A Fallback Plan,” makes the danger clear. Duplicitous, Trojan-horse Democrats like Al Franken and Kirsten Gillibrand are jumping into this bill to hollow it out from within, and divert the tide of single-payer into another disappointing dead-end.
Franken, who has always defined himself as “a DLC Democrat”* comes right out and says that he considers the bill only “aspirational,” a “marker,” and “a starting point for where we need to go.” In other words: This is not real legislation and a real policy that I’m really supporting, but a kind of thought-experiment that I’m going to use to lead you to something else.
And that “something else” is something less than single-payer. Gillibrand puts that lesser card on the table. Bernie’s bill, it seems, has sections that “help establish a road map for what some other strategies might look like.” Gillibrand herself wrote into the bill an option to buy Medicare-like government plans on the “already available” Obamacare exchanges.
This is the pernicious “public option” that the Times delicately and deceptively says “didn’t have enough support” to stay in the final ACA bill, (It didn’t have Obama’s support, and he killed it.) As Gillibrand describes it: “One part of the [Sanders] bill that I worked with my colleagues to put in was the ability for every American to buy into a nonprofit public option… This would create affordable, public health care that is available to any American to purchase in the already available exchanges.” This “public option” is going to be pitched by Gillibrand as another “transition to get to single-payer.” But it is no such thing; it is not a move toward, but a diversion away from, single-payer, and a damaging one.
The “public option” can be spun to sound like a reasonable and “realistic” progressive alternative, another Zeno step toward single payer, In fact, any “public option” with the real progressive intent Gillibrand claims would actually destroy the private health insurance industry and market rather quickly. But that is not what Gillibrand or any of these Democrats want. They want a public option that will preserve and stabilize the private insurance market.”
Then he lists several things the bill cannot do, then he gets to this brilliant take:
“It also reinforces the class divisions and resentments those parallel programs create. One might be excused for thinking it maintains those wasteful inefficiencies in order to maintain those divisions. It would keep a “poor people’s” tier of healthcare (Medicaid, etc.) distinct from what people with extra money in their pockets can purchase in the exchange. Because it’s very important (for the intra-class division on which capitalism depends) for everyone to know, and continually parse, who gets “welfare” and who’s “paying their way.” Let’s keep some extra layers of bureaucracy just so desperately poor people can be reminded that they’re not precariously “middle-class,” and vice-versa.”
It would be supremely foolish, for example, not to expect that “other strategies” coming from Gillibrand, Franken, and the neoliberal Democrats will be projects for “fixing”—more like resuscitating, at this point—Obamacare and its “exchanges” with a public option that, as DeMoro says: “becomes the ACA escape valve by welcoming in the sickest people selected out by the private insurers, in effect another bailout for a failed private insurance market.” What a waste of time.
Any way you configure it, a ““public option” integrated into a private market paradigm offers no discrete improvements they can point to that wouldn’t be better achieved with a full public single-payer program. The only reason Clintonite Democrats want to divert the Medicare-for-all momentum into the “public option” cul-de-sac is to save the for-profit private health insurance industry. (I’ll address the other ostensible reason below.) They oppose single-payer and are now presenting themselves as supporters of it in order to make sure no plan gets through that will actually break the for-profit market system.” [snip]
“The fundamental character of these RepubliDem proposals is signaled in the language of “affordable” healthcare. The “public option” does not make healthcare a right; it maintains it as a commodity that you have to buy and “afford.” It’s more of the “Go shopping!”” mandate. As if people shopped for health insurance like they do for tomatoes. Maybe I’ll make some spaghetti sauce get some health insurance today. I’ll just buzz by Whole Foods and Trader Joe’s Aetna and Humana to see what’s on sale which policies are most “affordable.” Isn’t it great that they’re selling that store brand, too!” [snip]
“In this regard, we might refer to André Gorz’s distinction between “reformist reforms” that stabilize the status quo and “non-reformist reforms” that advance real change. In the U.S. healthcare context, “reformist reforms” are those that seek to stabilize and protect the capitalist market healthcare system as well as the wealth and power of the class that controls it. “Non-reformist reforms” are those that establish new possibilities for a system that’s controlled by and for the public, and governed by “human needs and demands” rather than profitability.
Similarly, there are positive and negative compromises. The way to get a radical reform like single-payer is to fight for it, to work to bring people around to it, not to pre-emptively offer something else that you think will be more palatable to those who are resistant.” [snip]
“The duplicity is inscribed within his carefully crafted Schrödinger’s bill, which is tamely “reformist” and/or radically “non-reformist reformist,” depending on who’s looking at it. And Bernie’s invited a lot of neo-liberal Democratic Senators to cast their defining gaze. That’s raised considerable suspicion about why he didn’t coordinate his proposal with the Conyers bill in the House, which has been “considered the gold standard” by the single-payer movement.” [very long snip]
“Let’s not be diverted from single-payer again, for another scheme whose only purpose is to keep the private health insurance industry sucking profits and life out of people for another ten or fifteen years—after which it will again be obvious that single-payer is the only reasonable alternative. How many groundhog days will we wake up saying: “We’re getting there. It’s going to happen.”? What a waste.
Let’s instead, right now, have a left-led movement, independent of any party or personality, that delivers something of material benefit to the entire working population of the country, irrespective of any half-assed ideas any of them have in their heads.
Class solidarity based on material interest. Imagine that.”
Here’s the Executive Summary of the bill; the NY Slimes must have studied the long bill. (pdf) I’d added the Summary at the end of my ‘Many thousands wait with baited breath, etc.’ diary and had wondered: “…but it’s hard not to wonder if it won’t prove to be a wedge issue leading to another round of ‘oh, dismal left! we must elect democrats, there is no alternative! plan, accident, who can say?
And from TRNN Sept. 21: ‘Bernie Sanders Presents his Foreign Policy Platform’; Sen. Bernie Sanders (I-Vt.) delivered the Green Foundation Lecture at Westminster College in Fulton, Missouri, where he laid out his vision for a progressive U.S. foreign policy ?????? (No transcript, but an hour and 24 minutes, arrrrgggh. Is he…er…running, or just grand-standing?)
davidly
Greyson Smythe
LeMoyne
juliania2
ohiobarbarian
stephenadavis1
wendyedavis
café babylon 
Margaret Flowers, et.al.’s Health Over Profit is here.
dueling comments under the bern’s FP speech, of course. from “He will never mention how Israel involves us in wars in the middle east and wants us to attack Iran. Bernie is nothing but a cover up artist for the Zionist and Israel. He bent over backwards in ingratiating himself to the two stooges who own the DNC. Bernie is with the empire. This empty speech is to corral us for the DNC. This is like a $million speech for the kick back this old b8&^ch will receive. “F” you Bernie!” to “Bernie delivers. He has started the conversation, which is more than I can say for the rest of Congress.”…to aprecoup (sometimes ‘fuckno’; remember him from FDL?) “Stunning in the number of stark contradictions strewn throughout this rhetorically gilded neocon turd of a speech.”
What time’s teh Guillotine DR0P on the 3 DEM $T00GE$?
freda’s a treat, ain’t he? i did search for a smaller version, but didn’t locate one. you’d shown us obomba ‘it may take a long time’, (but he never put on his walkin’ shoes, either). hillary is funneee. but yes: beware the D trojan horses…wake up!
…Hi wd
…It is a real HeeHaw to now see the Dumbshit D’s and Repugnant R’s having another R vs. D Junk Politics USian Healthcare Barn Dance where all the square dances are still being called by AHIP. The rotation villain R vs. D Junk $$$ Politics shakedown flimflam of the WashDC R’s now being unable / not wanting to repeal or dismantle Barack Obama The Big Liar’s and his DLC flavored D’s 2009-2010 AHIP spawned ObamaAbominationCare is some more genuine R vs. D junk politics mockery of USian’s ( duped or not so duped ) desires for actual accessible affordable common sense based national USian healthcare and not AHIP’s LasVegas themed healthcare forced to pay diceplay $$$ casino gaming skim-a-thons.
…It is very knowable as to how Obama WH and the CapHill D’s sabotaged any Single Payer ideas back in 2009 – 2010 both overtly and covertly. Black Jesus Obama The Closet NeoCon R who sold himself as being a D to get into the WH during 2007- 2008 along with the CapHill Votes For Sale Big D deal makers / breakers basically went with AHIP approved and some old R think tank BS healthcare reform ideas that were given a slapped together Bondo politics body and paint job and rebranded as D/ACA/Obamacare. Of course the D’s passed the ACA without any R votes cuz it was required to do some rotation villain R vs. D junk politics to sell Obamacare as being ” must be really good D idea and reform cuz the R’s hate it ” …Suckers.
…ObamaDidn’tCare was so ” good ” USians had to wait until AFTER the 2012 WH election and Obama The Liar’s and D’s gaming of that election before ObamaDon’tCare was forcibly injected onto/into common USians daily life and healthcare $$$ add/subtract realities. That was so very clever of Black Jesus Obama and his DLC D’s.
…Well golly gee KillerObama barely got out of the WH before his namesake ObamaNo$$$NoCare convoluted and unsustainable AHIP spawn went awry in several wide and deep ways. Gosh golly gee imagine that. Color me so not surprised to read above that the WashDC D’s now fix’in to ” fix ” ObamaNoCare. But that must be a good thing cuz the WashDC R’s won’t repeal / junk Obamacare tho for years that was The Big R Plan but not now when CapHill is under R control. Amazing how AHIP’s $$$ payouts and payoffs slide both ways in WashDC ain’t it? Single Payer? MedicareForAll?
Common USians ain’t gonna get it even tho we now paying out over $10,000 per USian per year for HC and USA now spending around $$4 trillion a year on HC cuz AHIP/WallSt. want the $$$ skim and pay out winnings just like any LasVegas casino would.
…sta🏹
yow! that was one high-octane rant even 4 U, sta! $10 grand a year, srsly? and 29,000 die each year due to no health care. nope, even the Bad Team wouldn’t repeal ODontCare/romney care in blue, but now it’s down to a new scheme or three, including cassidy-graham. kee-rist. but hero john mcCrankpants will vote no on that one, too!
but oy, i could kiss ya for ‘hee-haw barn dance’ and not the tired kibuki. swing yer partners, do-si-do; now, allemande left, then swing that old apple tree. and allemande right! yee haw!
i loved kavanaugh’s polemics altogether, but this was my absolute fave:
“Because it’s very important (for the intra-class division on which capitalism depends) for everyone to know, and continually parse, who gets “welfare” and who’s “paying their way.” Let’s keep some extra layers of bureaucracy just so desperately poor people can be reminded that they’re not precariously “middle-class,” and vice-versa.”
ooof, you remember the electoral history shuffle; i didn’t, and good on you.
we’re kinda lucky: no insurance, but we don’t do docs…then we die. ‘life: they say it’ll kill ya but…they won’t say when!’ (nor do they™ care when the rabble die.)
…Hi wd
…The touchscreen on this Jobs device was smoking from the heat being given off as my digits pecked and poked out that Rant-A-Rama wd…I kinda miss my old Dell and Tohiba Gates running MicroPuff devices archaic old fashioned keypad layouts as I do know how to plant my digits on the home keys and type two fisted 😉
…Anyhoo glad you liked the square dance descriptor wd and I had a good chuckle seeing your take on that as it brought back fond memories from my vintage 1960’s grade school days where we had square dancing activities and indeed did the dosey does, swing your partner and allemande left then right…😉
…Those icons you been commenting and asking about are from this IPad and show up / appear on these Rant-A-Ramas I tend to launch ever now and then quite easily / repeatedly…don’t know the black magic being conjured by this Jobs device to do so wd…🐿
…Been pay’in well over $700 a month for AHIP styled bogus health insurance as it is for sometime and believe me ObamaCare has not been and ain’t no help no how but only because of companion am I able to keep doing so…I am so very sorry for all USians who duped or not duped thought ACA / ObamaCare was going to actually be real world affordable or make USian HC access and outcomes better…
…best wishes always wd
…sta 🏹
i shouldd ended with ‘allemande right, straight on to wall street’, but i was too pressed for time to edit it. man, i bet that apple thang was smokin’ really? those aren’t alt-codes graphics then. but…you have smiley icons which i’d disabled ‘auto-convert punctuation’ or what ever it is. glad you can afford the dollahs for now. irs wanted to fine me for no o-plan, i did a cover letter: fook me, w/ my addle-pated brain, would you please fine me? that shit is waaaaay beyond comprehensible. hmmm, they musta had pity on me, and never did.
hope you grabbed my email on the last thread you were on…er which one? i have no earthly idea. best to you and your partner always, arrow.
Two Points Related To The Chicano Movement…
First, is in that I have been watching the television news cast regarding the earthquakes in Mexico, and the “nuance and subtlety” of America’s influence in Mexico. During one of the rescued persons, and after she was located and extracted from the rubble, the first responders called for quiet, and it’s at this point that the rescuers and the attendant audience, broke into a cheer and where “Si Se Puede” was the three-time cheer. And after hearing these cheers, made my heart do a quiet flip relative to my pride for being both a Chicano and Native American military vet. And the history of the Chicano Movement commenced back in the end of world war two. And in these long and intervening years, Si Se Puede continues to this day. And yet,20,000 credentialed journalists still haven’t come to realize that politics that originated in the Sonoran Desert, continues to prevail, practice and carry forward for this stellar “nuance and subtlety.”
The second point I want to make is that the “perceived” Progressives in the Senate, such as Sanders, Clinton and even Obama, never crafted a Progressive Caucus when they served in the Senate. As such, anyone serving in the Senate and attaches himself or herself to a label of a“progressive” should be seen as a political scam=-artiste of the first order. So, when Senator Sanders announces his “foreign policy” attributes, he is incapable of recognizing that we, the actualized Progressives, know that Sanders is just another in a long line of scam-artistes.
Now, don’t get me started on the “foreign policy” issues that he–Sanders, conveniently fails to address.
Jaango
similarly in cuba:
but you’ love to think that if any of those three Big Ds had attempted to form a progressive caucus, the world would have erupted in guffaws. but sadly, the world wouldn’t have; esp. obomba and clinton are still being treated on blogsites as though they’re still in power.
i never watched the speech, but i have read a few articles lauding it highly, lol. “war as a last resort” was mentioned. yanno, r2p scenarios as he’d mentioned earlier, and tra la la. but srsly, i can’t imagine that obomba would have failed to readicalize you, jaango. sure did me. as well as anti-capitalize, anti-imperialize me.
Here’s the comment I made at NC in response to a link to the Kavanagh article:
“Thanks for the link. That article does go on and on….. but the reemergence of the public option scam, and the perpetuation of a multi-tiered “market” for health insurance are among the real danger points in the Sanders bill compared to the Conyers bill in the House.”
PNHP says it still needs work:
http://www.pnhp.org/news/2017/september/doctors’-group-welcomes-sen-sanders’-medicare-for-all-bill
“In 2016, PNHP released its Physicians’ Proposal for Single-Payer Health Care Reform, a proposal based on decades of careful analysis and research. PNHP recommends several improvements to the Medicare for All Act that would save money and improve patient care, including global budgeting of hospitals and other health care institutions; the separation of capital and operating payments to hospitals and other health care institutions; full coverage of all medications, without copayment; the exclusion of investor-owned, for-profit health care providers; and the establishment of a national long-term care program.”
I’m still working out my thoughts on this a bit…on some of the points of comparison Dr. Flowers makes, there are 2 related issues – whether something in the Sanders bill is less good, neoliberal, etc. in itself; and also, even if something is ok enough though not great, represents a potential point of failure which would make the whole thing go wrong. For example, the Conyers bill calls for a 1 year implementation, Sanders 4 years. Well, a lot can go wrong if you stretch it out. Or leaving long-term care up to the states through Medicaid, already a problem for a number of reasons, with the Sanders bill not addressing existing issues.
thanks, marym. i know that you’ve kept your finger on the pulse of this issue for a long, long time. glad to hear that pnhp says it needs work. zeese and flowers sent out this in the popular resistance newsletter: ‘Is health care a commodity or a right?’, zeese and flowers…with a page on the ‘transition period’
and a page on the comparisons, as per their tweetie somewhere up yonder.
they say that conyers’ bill would start immediately, so i dunno. the public options included as fallbacks seem destined to make it, keep it, healthy to capital. i guess i’m with kavanaugh and flowers: this is the time to fight for health care as a (natural) right, and not for something w/ phase-ins and fallback positions.
glad to hear that yves or lambert must have put it up at NC. but ‘getting it out on the table’ for the npr crowds ain’t enough for me, as in: this is the time. ;-)
and i say that as an old crone living on SS and a bit of mr. wd’s sometimes-wages for mebbe another year or two, not going to docs, etc.