How do I feel about health-care reform? Better than if it had not passed, but not very enthusiastic, in the end. I found this interview by Doug Henwood (March 25, 2010) of a single-payer advocate, Steffie Woolhandler, rather convincing on the question of cost-containment, and for months I had been hearing Robert Scheer say that costs have been skyrocketing in Massachusetts. (Henwood’s interview of Tom Athanasiou concerning global warming, in the same broadcast, is also excellent.)
On the other hand, my sense is that Americans generally do not want to confront the cost problem, or the explicit rationing that will result if and when the cost problem is addressed more explicitly.
I will have to read the John Cassidy articles in “The New Yorker,” to which we subscribe, referred to by Ross Douthat. These articles apparently argue that the legislation will likely cause health-care costs to escalate.
My overall sense is that the legislation will do some good for the class of additional Medicaid recipients it creates. Mainly, I am pleased about the legislative victory for Obama and the reversal of the sense that his would be a failed, and one-term presidency. It is important that the first black president not be perceived as a failure, or as extremely weak.
I came to believe that financial reform was more important than health-care reform, both on its merits and politically. Obama ceded too much ground to the Republicans and the new populism represented in part by the Tea Party movement by the way in which the bank bailouts were handled. I agree completely with Robert Scheer on this point.
I am fundamentally ambivalent. Part of me wants Obama to be more resolutely progressive/liberal than he has been, and perhaps more so than he actually is, and part of me thinks that this would be politically impossible, regardless of what Obama’s core beliefs are. One part of the country, the Democratic part, seems to be much more rational than the other part.
I just don’t see how the economic calculations of individual actors can possibly combine, by themselves, to do much to solve the problems of health-care, education, or global warming. It’s not that I love government bureaucracy. No one could possibly love government bureaucracy. But I don’t love corporate bureaucracy either. If the proponents of markets would spend some time talking about the problems of bureaucracy per se, rather than about the problems of government, they would be far more credible. And it is difficult to see how the profit motive, which is what distinguishes private from public bureaucracy, can really be consistent with providing good and affordable health care for nearly everyone. The debate that occurred tended not to address this question, but, regrettably, the debate is far from over.