Weekly Commentary — A Legislative Travesty

Whether it was Otto von Bismarck or some unheard-of American lawyer who actually originated the famous aphorism about the making of laws and sausages, he was very unfair to sausage-makers. After all, they don’t really try to hide the fact that their final product, the sausage, is a revolting mixture of ground-up bits of waste gristle and fat encased in cleaned-out intestines, or even the fact that they will send you to an early grave. And they’re very clear that they make them in order to make money.

Laws, on the other hand, like the so-called “health care reform” that may eventually pass through Congress, are frequently dressed up to hide the innumerable rat parts that somehow got included in them or at least to distract the average citizen from thinking of them.

The “public option,” in whatever emaciated form might conceivably have emerged, is dead. The passage of an individual mandate requiring that everyone buy health insurance will mean a gigantic boondoggle for private insurance companies, who will at one stroke get 40-odd million new subscribers. In return for making this gigantic sacrifice, insurance companies may be allowed to lower the already low rate of premium repayment; i.e., not only will the numbers of subscribers increase, the profit per subscriber may well increase as well.

On the other hand, the poor and young, who are often just scraping by, will be required by law to give money to insurance companies while in general receiving considerably less health care than they are paying for. If not, they will have to pay a penalty.

Yet another bright idea: an excise tax on so-called “Cadillac plans.” What this may well mean in practice is that those of us with half-decent health insurance through unions or because we are public sector employees will be hit with extra costs to help finance the extra profits of insurance companies. These groups, of course, vote Democratic, so the geniuses on the Hill will be hurting themselves.

Perhaps the most obvious reform was eliminating “rescissions,” the charming practice of many insurance companies by which they retroactively drop coverage when somebody gets sick — without repaying their premiums — if they can find the slightest misrepresentation, accidental or otherwise, on a form. Instead, there will probably be a loophole allowing rescissions in cases of “fraud,” i.e. business as usual.
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About the only real reform will likely be the requirement that insurance companies cease discriminating against people with pre-existing conditions. This is a small price to pay when you are delivered a gigantic new captive market.

There is no doubt a tremendous rogues’ gallery here. One can certainly include every Republican. And then there are various wonderful blue-dog Democrats like Max Baucus, Ben Nelson, Blanche Lincoln, and a sea of political mediocrities. And, as always, the ever-noxious Joe Lieberman, who never met a super-exploitative oligopolistic cartel he didn’t love (except those run by Arabs, of course), and who somehow manages to maintain his air of preening sanctimony whether he is arguing against accountability for torture and sexual abuse or in favor of increasing corporate profits by denying decent health coverage to millions of people.

But, honestly, it takes remarkable contortions to avoid criticizing President Obama for this, as well as every other debacle he is so calmly plunging into. He was exactly right during the primaries when he emphasized that major legislative changes could not be made by worrying about Washington, inside-the-Beltway culture, and picayune partisan politics; in order to get real change, he said, what was needed was broad principled appeals meant to mobilize the masses and force legislators to consider their concerns rather than those of entrenched interests. If you weren’t convinced of that before, watching all those Congressmen in the pockets of insurance companies should have done the job.

The problem was that he resolutely disavowed, then and afterward, every kind of broad principled argument on every conceivable issue. He tried to create a national crusade on health-care “costs,” as if costs were a problem in themselves. Why shouldn’t we spend more money on health care, instead of on plasma-screen TVs and SUVs? The problem is not how much we spend on health care but how little we get for it. And talking about that requires the unmentionable word “profits.” That is divisive and not Niebuhrian and Obama would not do it.

The truth is that we are not more alike than our politics would suggest. We are in large part what our politics make us. The Republicans, crazy as they are, understand this.