'Intelligent discontent is the mainspring of civilization.' -- Eugene V. Debs

Wednesday, January 18, 2012

Who Killed the Public Option? 

I'm feeling a little nostalgic today, so much so that I found myself interested in a post over at firedoglake about Richard Kirsch, Health Care for America Now and the abandonment of the public option during the passage of health care reform. For those of you with any remaining doubt that over the lack of Democratic support for the public option, Talking Points Memo dispels it during the course of a review of Kirsch's recently released book about his experience:

The book is Fighting For Our Health, by Richard Kirsch, who directed the advocacy group Health Care for America Now during the push for reform. HCAN is a well financed umbrella group backed by scores of liberal groups, unions, and other reformers — making Kirsch a close witness to the entire saga. He confirms that the White House treated the public option like a bargaining chip with powerful industry players, and believes that when his group became most critical of the bill mid-way through the fight, that top White House aides sought to have him canned.

The White House had negotiated a number of deals with the health industry, designed to win their support for reform, including agreeing to oppose a robust public option, which would have the greatest clout to control how much providers got paid, writes Kirsch, largely confirming what has become an open secret in Washington.

Kirsch’s book is replete with similar stories. Thematically, it centers on contradictions within the Democratic party, and Obama himself, that gave rise to the infighting that marked the debate. To keep factions from spinning apart, Kirsch suggests, the administration was averse from the outset to the idea that progressives and sympathetic stakeholders should play an outside game, pressuring the President and problem Democrats in Congress to pass robust reforms.

By way of background, it is important to note that the public option was a watered down version of single payer, designed to provide an acceptable alternative for a Democratic President and a Democratic Congress. Perhaps, you recall that the passage of health care reform with a public option and the availability of generic drugs, also voted down in Congress, was mentioned by progressives as one of the reasons that it was essential for to vote for Obama and the Democrats in 2008.The public option, it seems, was more about creating a transfer station for those health care reform supporters traveling from single payer to the individual mandate than it was about an actual policy that could be effectively implemented.

Upon reading the Talking Points Memo review, one is immediately struck by the fact that the White House could not even tolerate the mild advocacy of an Obama friendly organization like HCAN. In the end, Kirsch got back in line, as HCAN urged its supporters to call Congress to get the final version of the bill passed, warts and all, as a visit to the HCAN homepage demonstrates. HCAN is therefore a cautionary story about how a progressive organization created for a particular, socially beneficial purpose ended up as an advocate for what it purportedly loathed, a neoliberal health care reform that places much of the costs on the middle class, although one can plausible argue that this was the true objective of those who created HCAN from the inception.

Not surprisingly, if the Talking Points Memo review of his book gives us an accurate impression of the scope of his book, Kirsch evades these unpleasant truths. Even today, it seems, Kirsch just can't be forthcoming with those who would support his objectives. Kirsch and HCAN refused, during the legislative process, to inform the public about what had already been done to the public option, and, in fact, continued to lead people to believe that, through public pressure, legislators could be induced to pass it. It was all just one big Kabuki show, where Kirsch and HCAN, with the support of labor unions like AFSCME and SEIU, and progressive groups like MoveON.org, mislead progressives and workers because they felt it was more important to dissemble and maintain an illusory influence with the White House than it was to be truthful with those who made phone calls, sent letters and organized rallies in support of the public option. Indeed, Kirsch is still being dishonest with this book, because, according to Talking Points Memo, it attributes the refusal of Obama to fight for a public option to a failure of political nerve and a misguided political strategy, when, instead, it is entirely consistent with the neoliberal, financial sector orientation of his policies.

Put bluntly, Kirsch and HCAN believe that people like you and me need to understand that we have to accept such manipulation as part of the effort to implement the progressive agenda. If this sounds familiar, it should. It is exactly what many of the Strauss influenced neoconservatives say about foreign policy. From this loss of credibility in the legislative process and the institutionalized progressive organizations that considered it pragmatic to manipulate their supporters for the benefit of the White House, we now have Occupy. The failure of the progressive mobilization for health care reform and a Keynesian stimulus plan for the economy induced many to draw the inescapable conclusion that the electoral process merely serves the purpose of legitimizing corporate control of the US political system. They embraced the direct action ethos of Occupy as a form of resistance.

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