[lbo-talk] The possibilities of failing upwards with healthcare

Michael Pollak mpollak at panix.com
Sun Oct 25 23:34:45 PDT 2009


A couple of months ago I offered what I thought was the best liberal apologia for Obamacare:

http://mailman.lbo-talk.org/pipermail/lbo-talk/Week-of-Mon-20090817/011390.html

which is that it would fail financially, but that it had a decent chance of failing upwards, towards single payer, precisely because once people got used to thinking of health care as a right they'd never want to go back, and the only issue would be how to cut costs -- which would lead inexorably towards single payers as the only wholesale way to do that.

FWIW, in todays Krugman column is some polling data from Masscare, which is basically the same dog's breakfast kind of mess except that it's been operation a couple of years. It's serious financial problems are already becoming visible (and they ain't seen nothing yet). But the public attitude seems pretty much exactly what you'd hope for:

http://www.nytimes.com/2009/10/26/opinion/26krugman.html

Like the bill that will probably emerge from Congress, the

Massachusetts reform mainly relies on a combination of regulation and

subsidies to chivy a mostly private system into providing

near-universal coverage. It is, to be frank, a bit of a Rube Goldberg

device -- a complicated way of achieving something that could have been

done much more simply with a Medicare-type program. Yet it has gone a

long way toward achieving the goal of health insurance for all,

although it's not quite there: according to state estimates, only 2.6

percent of residents remain uninsured.

This expansion of coverage has tremendous significance in human terms.

The Kaiser Commission on Medicaid and the Uninsured recently did a

focus-group study of Massachusetts residents and reported that "Health

reform enabled many of these individuals to take care of their medical

needs, to start seeing a doctor, and in some cases to regain their

health and control over their lives." Even those who probably would

have been insured without reform felt "peace of mind knowing they could

obtain health coverage if they lost access to their employer-sponsored

coverage."

And reform remains popular. Earlier this year, many conservatives,

citing misleading poll results, claimed that public support for the

Massachusetts reform had plunged. Newer, more careful polling paints a

very different picture. The key finding: an overwhelming 79 percent of

the public think the reform should be continued, while only 11 percent

think it should be repealed.

Interestingly, another recent poll shows similar support among the

state's physicians: 75 percent want to continue the policies; only 7

percent want to see them reversed.

<end excerpt>

But both physicians and people are very cognicent of the cost problems and think it's very important to solve them while not giving up the gains. Which is pretty much exactly what you'd want.

So maybe the strategy of changing reality so you can change consciousness so you can change reality isn't totally stupid.

Although to avoid jinxes I feel the need de-mothball my old sigfile motto
:-)

"I'm an optimist because it's intellectually more challenging."

Michael



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