How the Anti-Health Republicans Can Still Derail Health Care

As Congress reconciles the House and Senate versions of Health Care, there will be much "give and take" to come up with a bill to send to the President that provides meaningful reform. While neither bill goes far enough, any compromise must be a good start toward real reform.

From what I have read, it seems that the final bill is moving in a direction whereby the individual states have much control over the parameters of coverage and benefits. It would be a mistake to let this happen. For real reform, the bill must be a mandate, not a set of minimum guidelines. Despite the millions of dollars of lobbying and the intransigence of the anti-health Republicans, Congress has started to move in the right direction. By putting the critical decisions in the hands of the individual states, the lobbyists will simply transfer their tremendous bribes to the state legislatures which are even more dysfunctional than Congress. Even in a "blue" state such as New Jersey, I fear that the incoming Republican governor along with a bribe-prone legislature will undo to the good work that Congress has started.

What the Detroit Terrorism Attempt Means for Us

There are a number of lessons and observations from the recent Detroit airliner terrorist attempt:

Apparently, the alleged hijacker has ties to Nigeria, not Afghanistan or Iraq. I’m sure that if Dubya were still President, we would be invading Cameroon – following the precedent of invading countries adjacent to those where the attackers originated. Oh wait – the 9/11 hijackers were Saudis, not Iraqis – but I digress. Nevertheless, the lesson here is that brute military force is the wrong solution. Police work, detective work, and human intelligence are the only ways to mitigate this threat. Wars embolden the terrorists, police work captures them.

Passenger screening will always be imperfect. If we assume that the TSA has instituted a solid six-sigma process, with 3.4 “defects” per million, given that there are 30,000 domestic commercial airline flights per day, this works out to one defect every 33 days. So roughly once a month, some item that is not allowed past screening gets on board an airplane. Even if these assumptions are correct, this does not mean that we should expect one attack per month. All it means is that someone (perhaps inadvertently) got a bottle of shampoo or even a "legal" gun through security. Increased screening may marginally make these numbers better, but there will never be a perfect screening process.

After 9/11, the entire country became unified, supporting the President in his quest for justice. Only after the President used 9/11 to further his political agenda did that feeling go away. If, God forbid, there were another attack of the same magnitude, I can guarantee that a Democratic president will not receive the same support. Indeed, even now, with this failed attempt, the Republicans (see Representative Peter Hoekstra and Senator Jim DeMint) are using it to further their political agenda.

Are Republican Elected Officials Patriotic?

The Merriam-Webster dictionary defines patriot as one who loves his or her country and supports its authority and interests. Do our elected Republican officials fit this definition of patriotism?
Let me make it clear that I am referring to elected Republican officials, not everyday people who vote for them. Some of my best friends are Republicans, and I have no doubt about their patriotism. But there seems to be a difference between the ideals and actions of run-of-the mill Republicans (at least the ones I know) and the elected officials on the state and national level.

This is not a new phenomenon. Thinking back a dozen years to the impeachment of President Clinton, the goal of the “vast right-wing conspiracy” was simply to act on their visceral hatred for the President and First Lady. Using impeachment to bring down a President for transgressions that had nothing to do with his conduct of the presidency was far from supporting the “authority and interests” of the country. One wonders if all of this nonsense had not happened whether President Clinton would have been more of a risk-taker in dealing with Al Qaida when he had the opportunity to take out Osama Bin Laden. Could it be that if the impeachment had not happened, more attention could have been paid to Al Qaida and 9/11 would not have happened?

Over the past nine years, the Party of Lincoln has evolved from the “vast right-wing conspiracy” and has morphed into the GOP/tea bag/C-Street/evangelicals whose attitude is far from patriotic. The prime example here is their attitude toward health care. The anti-health Republicans have openly stated that their goal is to bring down President Obama by not allowing him any legislative successes. There can be honest differences of opinion on how health care is to be conducted, but the anti-health Republicans have only represented the interests of the insurance and pharmaceutical companies, and have not even bothered to present an alternative plan to insure more Americans. Is this “love for country” or only self-interest and greed? The Republicans have openly opposed the equal rights clause of Section 1 of the 14th Amendment by opposing gay marriage. Is this “supporting the interests” of all citizens? The Republicans have openly opposed the separation of church and state clause of the First Amendment to the Constitution by finding clever ways to circumvent it and conflate church and state issues. Is this patriotic?

Abraham Lincoln must be spinning in his grave.

Eliminating the Tyranny of the Minority

There has been a lot of buzz recently on whether the Senate should modify its rules about the filibuster. Despite the fact that nearly every poll indicates that the American people overwhelmingly are “pro-health” in that they support the Medicare for All option, the Senate has been held hostage by a vocal and virulent minority. Doing the math from the 2008 state-by-state population estimates as listed in Wikipedia, in the worst case, if senators from the 20 least-populous states decide to filibuster a bill, they would represent 18% of the total population. This hardly seems fair or even reasonable.

Of course, the make up of the Senate is inherently non-democratic. Wyoming, the least populous state has the same number of Senators as California, the most populous. Each Wyoming voter has 69 times more clout in the Senate than her counterpart from California. In the 1790 Census (the first census after the ratification of the Constitution), this ratio between the most and least populous states was 13:1, albeit using the “3/5” rule when counting slaves. I wonder if the Founding Fathers would have established such an unfair and undemocratic system if they could foresee such a disparity.

If the Senate feels it needs to retain the filibuster (and there are reasonable grounds to argue that some sort of filibuster is necessary), they should change the rules for cloture as follows: Cloture may be invoked if Senators representing 60% of the Electoral Vote are in favor of cloture. Each Senator’s vote would be weighted by ½ the number of Electoral Votes in his or her state. This would still skew the power toward those states with smaller population (because each state has a minimum of 3 Electoral Votes, regardless of its population), but would help eliminate the “tyranny of the minority” that we see today.

Senator Nelson - we know what you are.

Senator Ben Nelson's "deal" to vote for cloture on the Health bill in exchange for having the Federal government subsidize his home state's Medicaid cost reminds me of the punch line of an old joke. "We've established what you are. Now we're just haggling over the price."

Taking Control of the Language of the Debate

Over the past decades, the Republicans have been very effective in taking control of the language of the debates. They coined the term “pro-life”, implying that those people who support keeping the government from interfering with a woman’s medical decisions are “pro-death.” Another term that they use is “death tax”, and since each of us must die eventually, who can support that? They conveniently ignore the fact that this tax applies only to the very wealthy. They gave us the “Patriot Act” which eviscerates Constitutional rights.

So for those of us who support health care reform, let’s call ourselves “pro-health.” Of course this would imply that the Republicans and Blue Dog Democrats are “anti-health.” Given that they have not presented any viable alternative approach to the health care crisis, this has the added distinction of being accurate.

The Progressive's Dilemma on Health Care

Progressives are in a quandary about the dismal state of the Senate’s proposed health care bill. Some, such as Paul Krugman in today’s NY Times column (here) urge passage under the premise that there are some good aspects in the bill, and even though it is flawed, we should take what we can get and use that as a basis for further reform and cost-cutting. Others, such as Senator Sanders and Keith Olbermann advocate defeat of the bill because it puts even more money in the pockets of the private insurance companies at the expense of the health of Americans.

We should pass this flawed bill and then resolve this dilemma by taking two additional actions. First, repeal the anti-trust exemption for the insurance companies that has created virtual monopolies in each state. As far as I know, the only two industries that have anti-trust exemptions are the health insurance companies and Major League Baseball. Why either of them needs this exemption is beyond understanding. While the now-dead “Medicare for All” approach would have been the best way to achieve competition, repeal of the anti-trust exemption will enable some competition and would tend to bring down premium prices.

The second action would be more difficult to get through Congress. If we must have “for-profit” insurance companies, let’s pass legislation limiting those profits. This is not unprecedented – we have had price controls in the past, and today certain segments of our economy (e.g. defense) have profit caps that are legislatively mandated. This will be a difficult sell, given that members of both parties in Congress receive significant contributions (i.e. “bribes”) from the insurance and pharmaceutical companies. But it would be worthwhile to bring such a proposal to a vote to see which members prefer to line their pockets, and which members vote for the health of their constituents.