December 06, 2009

How Bad Is The Fuck You Act?

You may well conclude that by calling it The Fuck You Act, I've already indicated that the monstrosity that will finally emerge from Congress in the name of "health care reform" is very, very bad indeed. You're correct!

But it's worth setting forth some further particulars concerning how and why this legislation will be so incomprehensibly godawful. The exercise has value in itself, and I also do this as background to some upcoming articles. Two general principles are helpful with regard to what follows; I discussed both of them in a recent article about global warming and what I termed "The Fatal Corporatist Problem."

First, and this merits strong emphasis, the "health care reform" legislation will fatally undercut all the goals set forth by Democrats and progressives themselves. To restate the point: if the Democrats and progressives are sincere and genuinely committed to what they say their goals are, they should be working day and night to defeat this abomination. That most of them are doing the opposite is deeply revealing. And they are doing the opposite for the most transparent and pathetic of reasons: they are desperate for something they can call a "win" as an alleged demonstration of perceived "political power."

Note the qualifiers I have italicized in the preceding sentence. This is the Horror Hall of Mirrors of the fatally corrupted world now inhabited by the "leading" progressives: reality is endlessly reflected and distorted, until all that remains is a nightmare depiction offering no connection at even a single point to something that constitutes a positive achievement in terms of their own stated purposes. Virtually nothing in the final bill will offer genuine assistance to those the progressives claim to be so eager to help. You may think I exaggerate. Keep in mind that what is called the "public option" has been so eviscerated that it is worse than nothing; see this article for the details of how this "bait and switch" operation occurred.

But I don't exaggerate in the least:
Ezra [Klein] believes that if the votes aren't there for a decent public option then the horse trading should be around getting something good in return for giving up the public option rather than negotiating the terms of the public option. That would make sense if the public option were just another feature of the health care bill. But it is not. It is the central demand of the liberal base of the Democratic Party in this rube goldberg health care plan and has long since gone way beyond a policy to become a symbol.

Perhaps that is wrong on policy grounds.
People will argue about that forever. But that doesn't change the fact that it is no longer a matter of policy but rather a matter of political power. And to that extent it cannot be "bargained away" for something like better subsidies, even if it made sense. "Bargaining away" the Public Option is also the bargaining away of liberal influence and strength.

Indeed, since the political establishment and the media have been declaring it dead for the past six months, the fact that it is still in the bill is a testament to liberal strength. And that is why Republicans and corporate centrists are so desperate to destroy anything that's called a "Public Option" no matter how many compromises are made to accomodate them. And it's why the liberals are so adamant about keeping it alive.

Again, as a matter of policy I don't know that the public option actually means much anymore. But as a matter of politics, it's very important. Powerful people, from outside and inside the Party are desperate that the liberals are not seen to win this battle. It changes the balance of power in ways that extend far beyond the health care debate and they know it.
I've read this several times since I first saw it a few days ago. Each time I go back to it, I first have this thought: "It can't be as bad as I think it is. It just can't. I must have misunderstood it." And every time I read it again, I conclude: "No, it's not as bad as I had thought. It's worse."

The "public option" is no longer a question of policy, but "a symbol." To whatever extent it may somehow reflect policy, it may be "wrong on policy grounds." The fact that it may be "wrong on policy grounds" doesn't matter: "it is no longer a matter of policy but rather a matter of political power." The identical point is restated to emphasize that this is truly what the writer believes: "as a matter of policy I don't know that the public option actually means much anymore." One further critical point must be kept in mind: in very significant part, the fact that the public option doesn't "actually mean[] much anymore" is the result of the progressives themselves determinedly making genuine reform impossible, in the name of political "feasibility": see here and here for many details concerning how the Democrats and progressives worked toward this end. I also recommend consulting this post for an overview of what transpired, including some very recent developments; more on those recent developments will be found here (and read the comments).

So it is the progressives themselves who were in significant part responsible for a result that may be "wrong on policy grounds" and a public option that doesn't "actually mean[] much anymore." And that's not all: the same progressives now maintain that this worse than meaningless public option must be kept in the bill as "a matter of political power," but not even actual political power, merely its symbol -- and they further argue that the public option must be kept in the bill and "cannot be 'bargained away' for something like better subsidies, even if it made sense."

In other words: even though those people who will not be able to pay for insurance -- and who thus may be subject to penalties for failing to comply with the mandate -- may desperately need those "better subsidies," they won't get them "even if" those "better subsidies" "made sense." In still other words: too bad you won't be able to pay for insurance, too bad you might be fined (and won't be able to pay the fines, either), too bad you might even go to jail. We could help you, but we won't. And we won't help you because it's more important for us to have our symbol of political power.

And the people who won't be helped are precisely those people these same Democrats and progressives endlessly told us they so desperately wanted to help when this wretched, abysmal process began.

This is the very definition of moral and intellectual bankruptcy. In certain respects, it is not possible to go any lower. If you're willing to give up this much -- and as far as "health care reform" is concerned, they've given up everything that matters -- is there anything at all you won't give up? This is the inevitable result of engaging in this manner with a fundamentally corrupt system:
Thus, the lesson: when you choose to be a critical part of a system that has become this corrupt -- and the endless corruptions of our corporatist-authoritarian-militarist system have been documented at great length here and in other places -- you will not ameliorate or "save" it. The system will necessarily and inevitably corrupt you.
For much more on this general theme, see Chris Floyd's superb recent article.

The second general principle to be remembered was also discussed in my recent piece about the corporatist problem. It is stated with wonderful conciseness by Gabriel Kolko, who wrote this about the actual nature of the Progressives' achievements in the early part of the twentieth century. The same remains true today, as the corporatist system has become the inescapable foundation upon which all policy decisions and all legislation are based: "It was not a coincidence that the results of progressivism were precisely what many major business interests desired." Much more about this and about the earlier Progressive Era will be found in the previous article.

With these issues in mind, consider some excerpts from Helen Redmond's recent article, "Health Care's Historic Flop":
I get weekly emails from Levana Layendecker of Health Care for America Now (HCAN) and Mitch Stewart from Organizing for America. In increasingly shrill prose, the two try to convince me to support whatever legislation emerges from Congress. They warn, “IF THE INSURANCE COMPANIES WIN, YOU LOSE.” I agree completely. That is why I won’t support any legislation Congress passes because the insurance companies have already won and we have lost.

We need only look at the check lists of two of the most powerful people in health care reform to see who is benefiting most from the proposed legislation in Congress.


AHIP [America's Health Insurance Plans] uses lobbyists and campaign contributions to shape legislation, not to kill or oppose it as HCAN and Organizing for America constantly claim. That’s what the 3000 lobbyists are doing every day in Congress - inserting industry friendly, arcane language and loopholes into unfathomable (except to industry lawyers and actuaries) 2000 page bills which the Democrats support. To be sure, insurers don’t like the public option but it’s so not robust, so eviscerated, so devoid of honesty keeping mechanisms it poses no competition or threat to profits as most political commentators now admit. Similarly, Ignagni wants tougher financial penalties for those who don’t purchase health insurance but it’s not a deal breaker, nor is accepting all patients regardless of health status. The industry has already announced premium increases and the added revenue will underwrite health care for those with “pre-existing” conditions.

It’s obvious. THE INSURANCE INDUSTRY IS WINNING AND WE ARE LOSING. There is an inconvenient contradiction that both HCAN and Organizing for America attempt to obscure: President Obama and Congressional leaders are working hand in glove with the very corporate criminals both organizations excoriate. AHIP and PhRMA have unfettered access to politicians and a massive influence on health care legislation. Why? Because the Democratic Party, despite its populist image, is a party of big business, of capitalism, not a party of the people. Notwithstanding the occasional howl about “insurance industry abuses” (to hoodwink us into thinking they are curbing those abuses) current legislation entrenches the industry even further into the core of the health care system and is on the brink of handing them unprecedented billions in taxpayer money and a mandate. This is dangerous not only to our health, but to democracy. Once the spigot to billions in public money is open, the industry will oppose attempts to shut it off. The money will flow back into American politics as campaign donations and kickbacks to happy-to-help, pro-industry politicians of which there are no shortage on either side of the aisle.


Here’s an inconvenient, honest-to-god truth: the legislation does nothing to solve the health care crisis. It’s estimated up to twenty million people will still be uninsured. There are no effective cost containment mechanisms in either bill because that would reduce profits. There are no controls on the price of premiums and the House bill permits charging twice as much for older people as for younger ones. More profits. Insurers can continue to deny physician recommended medical care and patient claims. Medical-loss ratio in favor of insurers, million dollar salaries for CEO’s and Wall Street investors untouched. The caps on out-of-pocket expenses are $5000 for individuals and $10,000 for families. These amounts result in medical bankruptcy now. Employers must pay 72.5 percent of premiums for individuals and 65 percent for families. That gives companies who currently pay a higher percentage an incentive to shift costs onto employees then dump them into the insurance exchange because it will be cheaper. The plans in the exchange will be high deductible, stripped down, tiered plans much like the ones available through the Commonwealth Connecter in Massachusetts. There will be an expansion of Medicaid but the history of the program reveals that just as it expands, it contracts. Eligibility criteria and reimbursement rates for Medicaid change with the fiscal fortunes of the states and federal government. It is truly stunning that health care reform will be paid for with billions in “savings” from the health care program for the elderly; Medicare. Why not use “savings” from the bloated 700 billion dollar military budget? The talk about fraud and waste in the Medicare program is a cover to cut benefits and seniors are right to be angry and mistrustful.
As I've written:
I point you again to Chris Floyd's wonderfully brief and entirely accurate summary of what is going on in the health care reform debate. It's no debate at all: whatever happens, certain already immensely powerful and wealthy corporations closely allied with the State will become still more powerful and wealthy. Given the nature of the corporatist system that now throttles every aspect of life in the U.S., that is how the system works. That's how it's set up, and that's its purpose. The fact that insurance companies will reap huge rewards on the backs of "ordinary" taxpaying Americans is not a regrettable byproduct of an allegedly good but imperfect effort at reform, or a flaw that will be fixed at some unspecified future date. And as already powerful and wealthy interests become more powerful and wealthy, the State will also increase its already massive power over all our lives still more. None of that is incidental: it's the point.
But I think I must now revise the name I gave to this legislation. Let us try to capture more completely the hideous, monstrous nature of what Congress is doing. Henceforth:
The Fuck You to Death Act
I suggest you lie back and breathe it in. Breathe deeply.

It won't hurt as much that way. And you'll die faster.