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?)