Obama, Dems' create reign of confusion on their healthcare parade

President Barack Obama's drive for national healthcare reform has been hobbled for many reasons, including the role of major campaign contributions in distorting the debate.

From the start, the most popular option of the Amerian people--single-payer healthcare as in Canada and Taiwan--has been ruled "off the table,"  in the words of Max Baucus.

Numerous polls have tested public support for the concept, but perhaps the most precise and rigorously worded survey was reported in Business Week (5/16/05): "67% of all Americans think it's a good idea to guarantee healthcare for all US citizens, as Canada and Britain do, with just 27% dissenting," US doctors, too have come to support the "Medicare for All" model by an overwhelming 59%margin, as the Annals of Internal Medicine reported in 2008. Moreover, 70% of Democratic voters in the 2008 primaries favored single-payer.*

Flowing from this policy decision shared by top Democrats, the Democratic message has been contradictory and confused. If insurers are the heart of the problem, why include them at the bargaining table? Why include them in the new system when all they do is add a 31% administrative burden, costing some $400 billion annually?

The result among the public, understandably, is confusion. Paul Street, in his excellent piece in the current Z, spotlighted this example:

When Obama gave an uninspiring prime-time press conference in support of Democrat-led health reform last July, much of the public didn't follow his logic on why it should support his curiously corporate-captive version of "change." All too common was the reaction of Rowena Ventura, 44, an uninsured worker who had just moved her ailing mother into a house she shared with her disabled husband. "You see," she said, gesturing at the president on her television, "he's saying he wants to continue private insurance, but then he says they're part of the problem. Well, which is it? It's just ridiculous" (K. Sack, "For Public, Obama Didn't Fill in Health Blanks," New York Times, July 23, 2009)

Meanwhile, the Right has been actively and visibly mobilizing those hold distinctly marginal views against healthcare reform, creating the false impression of a popular uprising against a health plan that too ambitiously involves the federal government, according to the conventional wisdom.

But as with the Clintons' health plan in 1993-94, the effort to accomodate insurers--while imposing the minimal safeguard of a small-scale "public option" to contain costs, the Democrats' multiple plans lack a clear focus on dealing with the elephant in the room: the for-profit insurers.

While the insurers are among the very least popular industries in the US, the Democrats have chosen to keep them at the center of the healthcare universe, resulting in yet another complex, confusing set of plans.

Proposing a single-payer plan would have generated hysterical accusations of "socialism," but as linguist Geroge Lakoff told me in a recent interview, that happened anyway with the much weaker public option.

Clearly, the Democrats could have put together a more coherent campaign by targeting the much-despised insurers--a ripe target with their recent 428% increase in profits and astronomical CEO pay. They could have then offered a solution that corresponded clearly and directly to the problems posed by insurers, simple, understandable alternative of a singlepayer plan..

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*Paul Street cites a number of other surveys that confirm the general direction of the polls reported in Business Week and Annals of Internal Medicine:

• 64 percent would pay higher taxes to guarantee health care for all U.S. citizens (CNN Opinion Research Poll, May 2007)
• 69 percent think it is the responsibility of the federal government to provide health coverage to all U.S. citizens (Gallup Poll, 2006)  
• 59 percent support a single-payer health insurance system (CBS/New York Times poll, January 2009)
• 59 percent of doctors back a single-payer system (Annals of Internal Medicine, April 2008)
• 73 percent feel that health care is either in a "state of crisis" or has "major problems" (Gallup, November 2007)
• 71 percent feel that we need "fundamental changes" or to have the U.S. health system "completely re-built," compared to just 24 percent who wish only for "minor changes" (Pew Research Center, 2009)