In politics as in Scrabble, whoever controls the language controls the game. The most powerful words and phrases in the health care reform debate right now are coming from those opposed to reform: “rationing,” “death panels,” “kill granny,” “big government,” “government takeover,” “socialism,” “socialized medicine.”
Fear words like these are related to a common human phenomenon psychologists call “loss aversion.” Human beings tend to worry about changes. No matter how bad things may be, no matter how inadequate our present condition, there's always a chance it could be worse. Change may mean loss.
People who have health insurance, even expensive, inadequate health insurance, are worried that they might lose it or the medical care itself. This fear is most visceral with the “death panels” and “kill granny” phrases. I hope the claims behind these phrases have been thoroughly debunked in recent weeks, and I hope that people are beginning to realize that we already have rationing by insurance companies. It’s the last four terms--“big government,” “government takeover,” “socialism,” and “socialized medicine”-- that seem to have the most staying power, turning up again and again over the decades.
All four phrases reflect a divide in political philosophy in the United States about the role government should play in our lives. However, powerful as they are, none of these phrases is being applied accurately to the health care reform debate.
“Socialized medicine” is a system where the hospitals, pharmaceutical manufacture, and equipment manufacture are owned and operated by the government and where providers such as doctors are employed by the government. The U.K. has some of these features. Veteran’s health care has some of these features.
“Socialism” is a system of governance in which everything is owned and operated by the government and everyone is an employee of the government—hardly descriptive of our capitalist system.
A “government takeover” of medicine would mean that “socialized medicine” would be put in place. That is absolutely not under discussion under any plan before Congress or the President. Nor is it being considered even by the most radical liberals in Congress.
“Big government” is perhaps the phrase with the most credibility in this discussion. Yet all it means is that whoever is using the term thinks government should not be regulating or funding whatever area of our lives is under consideration. Do we ever hear the term "big government" in connection with huge farm subsidies to corporate farmers? In connection with defense spending? In connection with regulating people's private lives? Curious, isn't it? Is it only "big government" when social programs are involved?
Repeated often enough and with enough volume, these phrases can be highly effective in prompting the fear of change.
Is there anything in any of the bills that remotely resembles “socialized medicine”? The short answer is no.
Some members of Congress would like a “single payer system.” That is not socialized medicine. The government would not own the hospitals or the drug companies or employ the doctors. It would simply be the insurer, as it is now in Medicare.
“Single payer” is not on the table. A “public option” is. This would make the government one among many insurers. If you don’t like your current insurer’s offering, you could choose the government as your insurer. If you don’t have an insurer, you still have the government’s plan. That’s in no way “socialized medicine” or a “government takeover.”
Whether it’s “Big Government” to set things up so that health care costs are contained and people are able to afford the care they need is a matter of perspective.
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Cartoon for the day
Wednesday, September 16, 2009
Monday, September 14, 2009
Of Blue Dogs and Dying Options
With 256 Democrats (257 probable by November) and only 178 Republicans in the U.S. House, why, you might ask, don’t Democrats just get HR 3200, “America's Affordable Health Choices Act of 2009” through the House and be done with it? The bill has already gone through three of the five committees it must navigate, so what’s the deal? Even if health care reform has rougher sailing in the Senate, where the Democratic majority is not filibuster-proof, at least it will have passed the House. Right?
Maybe. But maybe not in its current form. That’s because the Democrats are far from united. Though the President spoke last week of his preference for the public option, the way he did it signaled that he will be open to compromise—a compromise that will be pushed not only by Republicans but by a number of Democrats.
First, a bit of background. The House has more than 250 Congressional Member Organizations—caucuses or coalitions formed to discuss and strategize about member causes. Most of them are specialized issue groups like the Hydropower Caucus or the Composites Caucus. There are also identity CMOs like the Black Caucus, the Hispanic Caucus, the Native American Caucus, the Caucus for Women’s Issues. Most important, there are the major Democrat and Republican caucuses.
But most relevant to the Health Care Reform debate are those CMOs that divide up the two major parties by where the members place themselves on the political spectrum. Republicans have their Republican Study Committee (right-wing) and their Republican Liberty Caucus (libertarian). Democrats have three sizeable groups: the Progressive Caucus, the New Democratic Coalition, and the Blue Dogs.
The Progressive Caucus is made up of 83 House Democrats most in favor of strong health care reform, including a public option. The NDC is the group of 63 moderate Democrats. The 52-member Blue Dogs are conservatives, especially when it comes to fiscal matters.
Republicans aside, the Blue Dogs are the House members most reluctant to vote for HR 3200. The public option—a budget insurance plan managed by the government, like Medicare—is a major sticking point for the Blue Dogs. While Progressives say that the public option is a very important feature that will help keep insurance and hospital prices down, Blue Dogs claim that such a plan would cost too much and would be unfair competition for insurance companies. The opposition of the Blue Dogs, coupled with that of some of the moderates, managed to postpone the vote on HR 3200 until after the August recess.
Interestingly, Blue Dogs are the biggest recipients these days of fundraising largesse from the health care industry. That’s not to say that members of the other Democratic caucuses aren’t also getting money from the industry; you can bet that whoever is currently in a power position, like House Speaker Nancy Pelosi—a Progressive—is going to be pulling down big contributions even from unlikely sources. Money doesn’t buy votes exactly; it’s not as simple as that. What it buys is a chance to rub shoulders with the powerbrokers. Nevertheless, the health care industry apparently figures its bucks are best spent with the Blue Dogs.
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For instance, click the Congress tab under Politicians & Elections. In the second gray box on the right, put in the name of a Congressperson and then check out who their big contributors were during what year.
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So in the end, what will the Blue Dogs do about HR 3200? That depends on the deals that can be made across party lines and across caucus lines. Will the public option survive the pressure from the Blue Dogs and their allies? Even now the Progressive Caucus is lobbying Democrats to find out who will declare the public option a must. If the count is not high enough, the public option will die in the House. Even if the public option gets through the House, and Democrats for a moment appear to be speaking with one voice, the Blue Dogs may yet prevail when the Senate and House have to work out a compromise bill. Whether there is anything in the final bill that will actually provide the competition and cost containment we need remains to be seen.
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Cartoon for the day
Maybe. But maybe not in its current form. That’s because the Democrats are far from united. Though the President spoke last week of his preference for the public option, the way he did it signaled that he will be open to compromise—a compromise that will be pushed not only by Republicans but by a number of Democrats.
First, a bit of background. The House has more than 250 Congressional Member Organizations—caucuses or coalitions formed to discuss and strategize about member causes. Most of them are specialized issue groups like the Hydropower Caucus or the Composites Caucus. There are also identity CMOs like the Black Caucus, the Hispanic Caucus, the Native American Caucus, the Caucus for Women’s Issues. Most important, there are the major Democrat and Republican caucuses.
But most relevant to the Health Care Reform debate are those CMOs that divide up the two major parties by where the members place themselves on the political spectrum. Republicans have their Republican Study Committee (right-wing) and their Republican Liberty Caucus (libertarian). Democrats have three sizeable groups: the Progressive Caucus, the New Democratic Coalition, and the Blue Dogs.
The Progressive Caucus is made up of 83 House Democrats most in favor of strong health care reform, including a public option. The NDC is the group of 63 moderate Democrats. The 52-member Blue Dogs are conservatives, especially when it comes to fiscal matters.
Republicans aside, the Blue Dogs are the House members most reluctant to vote for HR 3200. The public option—a budget insurance plan managed by the government, like Medicare—is a major sticking point for the Blue Dogs. While Progressives say that the public option is a very important feature that will help keep insurance and hospital prices down, Blue Dogs claim that such a plan would cost too much and would be unfair competition for insurance companies. The opposition of the Blue Dogs, coupled with that of some of the moderates, managed to postpone the vote on HR 3200 until after the August recess.
Interestingly, Blue Dogs are the biggest recipients these days of fundraising largesse from the health care industry. That’s not to say that members of the other Democratic caucuses aren’t also getting money from the industry; you can bet that whoever is currently in a power position, like House Speaker Nancy Pelosi—a Progressive—is going to be pulling down big contributions even from unlikely sources. Money doesn’t buy votes exactly; it’s not as simple as that. What it buys is a chance to rub shoulders with the powerbrokers. Nevertheless, the health care industry apparently figures its bucks are best spent with the Blue Dogs.
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Who Gets Whose $$$
If you ever have a free hour to spend investigating what lawmakers get what money from what sources, take a look at Open Secrets, a website that tracks contributions and even allows you to plug in individual lawmakers to see what they are getting from whom. For instance, click the Congress tab under Politicians & Elections. In the second gray box on the right, put in the name of a Congressperson and then check out who their big contributors were during what year.
=========================================================
So in the end, what will the Blue Dogs do about HR 3200? That depends on the deals that can be made across party lines and across caucus lines. Will the public option survive the pressure from the Blue Dogs and their allies? Even now the Progressive Caucus is lobbying Democrats to find out who will declare the public option a must. If the count is not high enough, the public option will die in the House. Even if the public option gets through the House, and Democrats for a moment appear to be speaking with one voice, the Blue Dogs may yet prevail when the Senate and House have to work out a compromise bill. Whether there is anything in the final bill that will actually provide the competition and cost containment we need remains to be seen.
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Cartoon for the day
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