This morning I watched the senators arriving at the Capitol before dawn, emerging from their black sedans, breath steaming in frigid air. Within minutes Senator Harry Reid was presiding over the final vote on the hotly contested health care reform bill. He ceremonially praised all the many staffers who had helped bring us to this glorious day. For it was, after all, an historic day. It was first health care reform since whenever. Thirty million more people get health care...or did I say that right? Perhaps I should have said, thirty million people get commercial health insurance crammed down their throats whether they want it or not. And perhaps this isn’t the greatest victory since WW II. Perhaps instead this is a shocking sordid tale of just how thoroughly undemocratic America has become over the past 30 years, how utterly under the thumb of private business our government and especially our legislature has come to be.. But instead of shocking our conscience, we are numbed into submission by the constant assurance by those we respect most, such as the president himself, that this is a very very good bill.
They are calling the roll now – Mr. McConnell, no. Mr. Menendez, Mr. Menenedez, aye. How many of these senators have taken a million or more from the insurance industry this year? A lot of them. The industry has been showering money on Congress. Oh, but wait – the insurance industry is against the bill, right? Aren’t they against the bill? Didn’t I hear something about that? Aren’t they running ads against the bill? All I can say is, study the final passage of the Federal Reserve Act. It failed the first year, then the next year, the banks came out against it and it passed.
The roll call reached Senator Reid. Mr. Reid. Senator Reid said: "No." With perfect aplomb, the lady who was calling the roll, gave him another chance. Suddenly everyone realized what had just happened on the Senate floor. The leader himself, after all his heroic efforts, had finally faltered. At the last moment, he himself had actually voted "no" on the very bill he was shepherding to victory. Suddenly he came back into focus. He realized what he had just said. He said loudly: "Aye," throwing his hands up in wonderment at what he had just done.
That is exactly what I felt like this cold morning – saying no, and throwing up my hands in wonderment and even disgust at a legislative body that just passed the most important legislation in a generation without even putting on they table the reform that two-thirds of the American people and three-fifths of American doctors believe is the best approach. The legislature has passed a tremendously complicated bill forcing a great extension of private health care, when all astute critics observe that privatizing health care without socializing payment is oxymoronic, because private businesses are NOT INTERESTED IN MORAL GOODS. Private companies aren’t interested in your health. In fact, they don’t care whether you live or die. Even if you die from using their products. Trusting our health care to private industry is like believing tobacco company executives who say nicotine is not addictive. It’s childish bullshit, but it’s what passes for glorious legislation in America.
Just before the vote, I came across a magnificent Frontline documentary on Google Video called "Sick Around the World." Watching it again this morning – it really almost makes you gasp at just how bad our health care system is, and just what a bad idea privatized health care is. In the piece on the English system we hear, "Britain’s National Health Care Service is dedicated to the proposition that you should never have to pay a medical bill." Then on Japan: "Japan is ferociously capitalistic," yet "they cover everybody and spend half of what we do." In Germany, Otto von Bismarck himself introduced the principle that "a government has to provide mechanisms so all its people can get medical care when they need it." "Thanks to the Bismarck model, everybody in Germany is offered health care." The piece on Taiwan really shocks you. It shows you what a rational legislature does when it tries to design the best national health care system for its people. In late 1980s half the people had no health care at all. They knew they had to reform. They were becoming a rich country and they wanted a rich-country health care system. They consulted experts from around the world. Why repeat the mistakes others make, they said? Pick what people have done well and move beyond that, they said. "They wanted a system that gave everybody equal access to health care, free choice of doctors with no waiting time, and a system that encouraged lots of competition among medical providers." They looked at 10 – 15 countries systems, the Swiss, Dutch, English. "The American system is not really a system that you can copy," they said. "It’s a market. So if you let things happen, it will be like the United States. In the end we said, no, this is not the way we want to go." In the end they produced a magnificent sleek system with universal care at half the cost of ours.
Even in ultra conservative Switzerland everybody is mandated to pay for health insurance and everyone is guaranteed a basic package of care. Doctors and companies are not allowed to profit from basic care. There is a memorable exchange in the Frontline piece between Reid and the president of Switzerland, that shows both the excellence of the documentary and the horror of our new health reform
The right-wing president of Switzerland declared: "Everybody has the right to health care."
T.R. Reid replied: "See, that’s striking for an American . Because we would say certainly everyone is entitled to an education."
The president of Switzerland said: "Yes."
T.R. Reid said: "Everyone is entitled to legal protection if you get in trouble with the law. But we don’t say that everyone is entitled to health care."
The President of Switzerland said: "Why? It is a profound need for people to be sure that if they are struck by destiny, by a stroke of destiny," he raised his fist and smiled, "They can have a good health system."
This morning after the historic reform passed, the Senators presented themselves in a thick scrum around the microphone.
Senator Baucus said: this is a day we’ll look back on and be very proud of as senators. This is what we hired on for.
Senator Dodd said he felt real good about lifting the burden of fear from the backs of the poor. "Probably the most important vote that every sitting member will cast in their tenure here." Merry Christmas.
Senator Durbin gave plaudits to Senator Reid for his marvelous leadership, tenacity, strength, blah blah. "Lit a candle of hope for 50 million Americans who went to sleep last night without health insurance."
Senator Schumer said: At the same time it cuts costs, the waste, the fraud, the duplication, at the same time, it covers 31 million. Who would have thought we could do both in the same bill? Real triumph for the Democrats, he said. He said he watched with awe as leader Reid wove the legislative fabric. Schumer complimented Senator Dodd for keeping alive Senator Kennedy’s legacy of doing the right thing.
It was a huge pep talk, happy happy day, they said, for America, great great day for the Democrats. But as usual, it was the duck hunting dudes that won, the corporations won. THEY LIT THE CANDLE OF HOPE FOR 50 MILLION AMERICANS BY REQUIRING THEM TO BUY HEALTH INSURANCE. The 31 million people that Senator Schumer said the bill "covers", it covers them by forcing the poor schmucks to buy insurance. You can’t afford it? Hey, try a high deductible policy! Also, we’ve got subsidies, tax breaks, et cetera. Just give us a little bit more of your money.
In truth the legislative struggle over health care reform this past year has been an historic watershed. We see quite clearly now perhaps for the first time that private business can force the American Congress to make truly tragic compromises with our collective destiny. The problem with business controlling Congress is simple: business doesn’t care about people. Business is not a moral force. Business is business. If business kills you, it says: we were not doing anything illegal, and we are sorry for your loss. Nicotine is not addictive. If you get sick and you had an undisclosed pre-existing condition, they are very sorry but contractually you are not entitled to coverage. However, you might want to lodge a lawsuit during your late stage breast cancer to see if you can force us to pay.
The idea of forcing the American people to buy a shitty product and calling it a triumphant giant leap toward universal coverage – excuse me while I barf.