In this unbreakably conservative country of ours, the endless search for ""middle ground"" is deemed to be among the noblest of political pursuits. Mixing your opponents' ideas with your own to create a recipe of consensus is rewarded with accolades from the media and, by extension, the opinion polls. Yes, the American political system has an almost irresistible tendency toward bipartisanship.
Unsurprisingly, President Barack Obama–builder of bridges, mediator par excellence and so forth–has found his perfect niche as leader of this system, at least up until this point in his administration.
The interminable search for consensus, or ""reaching across the aisle,"" has a supremely undialectical method of operating. It may satisfy the government's need for stability and the human desire for reconciliation, but it also results in mediocrity and unhealthy compromise. Politics is meant to be divisive; truth and excellence are reached through a clash of ideas, not an interminable avoidance of conflict. Great reforms can only be achieved through an unbreakable will, buttressed by sound logic and verifiable facts. One must expose the intellectual and moral degeneracy of the other side, not adopt some of its program.
Tendencies toward this unhealthy bipartisanship are precisely what threatens meaningful health-care overhaul, probably the most important effort Obama will undertake during his presidency. Reform will not be murdered by an aggressive right-wing backlash–the conservatives have neither the power nor the arguments to do that anymore. Instead, the murder will come through the countless seemingly small gestures of acquiescence to the insurance companies, the American Medical Association and the like, the sum of which will leave tens of millions still uninsured and medical costs outrageously inflationary.
In the United States, 50 million people have no medical insurance while at least twice that number have grossly inadequate care. Meanwhile, medical cost increases continue to resemble a third-world economic crisis. American life expectancy is 50th in the world, while chronically ill patients are regularly turned out onto the streets for lack of hospital payments. Other countries labeled ""civilized"" look with horror upon the American medical crisis.
But with a recent change in the political wind, might we finally have the opportunity to substantively improve this ghastly situation? Naturally, a single-payer system is still unfathomable (remember, this is America). But with Democratic control of the executive and legislative branches for the first time since 1995, coupled with definitively vociferous popular demand for change, a rationalization of the medical system is suddenly possible.
In absence of European-style socialized medicine, creating a public insurance option is the next best thing, and probably the best of all politically realistic proposals. The public option, strongly supported by the White House, would offer Americans real choice (a much harped on, if abused, talking point in this debate) and tame the carnivorous, rabid private insurance industry. President Obama has also expressed strong support for state subsidies for the poor and meaningful measures to slow the increases in medical costs. All in all, the Obama outline, if not ideal, would still be a monumental progressive achievement, revolutionizing the health-care industry in a way that American executives have tried to do for 60 years.
And yet, even with Democratic filibuster-proof majorities and unprecedented popular support for government-sponsored change, the Obama outline is in serious jeopardy. The Senate Finance Committee appears poised to dump the public option in favor of a so-called cooperative system, an empirically unproven alternative whereby patients would have limited control over the local medical industry. This option would do almost nothing to challenge the dominance of the insurance companies, and create a whole new set of bureaucratic problems. For its cost, it's probably not worth it, which is why many congressional progressives have already vowed to vote against it. In short, it's bullshit.
At the root of the impending collapse of meaningful reform are the Blue Dog Democrats, a group of business-friendly politicians who mask their astronomical corporate donations with a supposed adherence to fiscal conservatism. Max Baucus, D-Mont., chair of the Senate Finance Committee, has voiced a determination to work with Senate Republicans (only 40 percent of the chamber) in creating a new plan, which seemingly means dropping the public option. As anyone familiar with the sordid history of our supposedly left-wing party knows, it is the Democrats, not the Republicans, who are on the verge of murdering health-care overhaul.
And it's not just the Blue Dogs.
The progressive wing of the party should be on every news show, asking for space in every newspaper and booking events at every local town hall condemning those, especially members of their own party, who would compromise Americans' health for political considerations. President Obama should start naming names of Senate Democrats opposed to the public option and point out that Baucus has received $3 million from the health-care industry over the course of his career. The insurance companies have been preparing for this fight for years; they have the funds and resources to gnaw away at meaningful proposals until we are left with a mangled, meatless option that leaves Americans hardly better off than they already were–unless their opponents stand up and fight back.
Standing up and fighting back requires conviction, which requires an explicit acknowledgement of reality: The right has no alternatives to clean up the health-care mess. So why compromise with them? The goal of reform proponents should be to deal the insurance companies as crushing a defeat as possible in order to deal the American health system its greatest possible victory.
Finally, proponents need to remember that if improvement doesn't happen soon, it will be postponed indefinitely. The moment is now. A repeat of the Hillarycare debacle would be just as big of a defeat for Americans' health as it would be for the Obama presidency and the progressive movement in general.
