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THE OTHER WHITE MEAT! Next time around, progressives should push the other moral argument: // link // print // previous // next //
THURSDAY, JANUARY 7, 2010

Dorgan’s departure: Ha ha ha ha ha ha ha ha ha ha ha! We’re always amazed by the insouciance pervading the halls of Versailles:

LADY COLLINS (1/7/10): Until recently, all I knew about Byron Dorgan was that he was a populist from North Dakota who had once been named Person of the Year by the durum wheat growers. Now he is the center of the universe.

Ha ha ha ha ha ha ha! That sally came after the lady mused about the race to replace Chris Dodd:

COLLINS: [Richard] Blumenthal’s opponent might turn out to be Linda McMahon, who formerly ran World Wrestling Entertainment with her husband, Vince. There are other, perhaps better, Republican candidates in the race, but I am rooting for McMahon for entertainment value.

Wonderful good solid time-killing fun! Splendid sound strong entertainment!

Might we add a point about Dorgan? Many people know that he warned against the repeal of Glass-Steagall, back in 1999. (For Wikipedia’s account, click this.) Ed Schultz briefly discussed this matter with Dorgan on last evening’s Ed Show:

SCHULTZ (1/6/10): Senator, you have also had a record, well-documented, of having great political foresight. And I want to take you back to November 4, 1999. This is what you said on the Senate floor about deregulation:

DORGAN (videotape): We are almost certainly moving towards substantial new concentration and mergers in the financial services industry. I think we will in ten years time look back and say, “We should not have done that because we forgot the lessons of the past.”

SCHULTZ: You voted against deregulation. How do you feel about it today? You were correct.

DORGAN: Yes, that was one of the biggest mistakes in the history of this country, Ed. I mean, it steered the country into the ditch. It’s cost us trillions and trillions of dollars. And, you know, once again, this was some of the biggest financial interests in this country trying to get the laws changed, repeal the laws that were put in place to protect us after the Great Depression.

They succeeded. I was one of eight people, and I led the fight on the floor of the Senate against it—one of only eight people to vote no. But you know, the spoils of that system at this point have been so costly to this country. And now we need to put it back together.

Like you, we don’t really understand this critical history. Our lords and ladies, smirking and smiling, are much too grand to go there.

The durum wheat growers once honored this man! Beyond that, matters get hazy.

Special report: After reform!

Read each thrilling installment: After health care reform, we’ll need health care reform! Why not read each installment:

PART 1: After reform, we’ll need health care reform! How can we win the next time? See THE DAILY HOWLER, 1/5/10.

PART 2: If we want stronger reform the next time, we have to start telling the people. See THE DAILY HOWLER, 1/6/10.

In today’s installment, T. R Reid praises one “moral argument.” Next time, we should go with another:

PART 3—THE OTHER WHITE MEAT: Let’s say it again: Despite its shortcomings, T. R. Reid’s The Healing of America is very much worth reading. Reid tours the world, describing the ways developed nations deliver health care—and Reid is a very good raconteur.

We reread Reid’s book over the Christmas break. As health care starts to move off center stage, his book provides a good debriefing about the subject our nation pretended to discuss all through the last year.

That said, the book has several weaknesses. We think Reid does a very poor job explaining America’s vast over-spending (see THE DAILY HOWLER, 1/6/10). In our view, he fails to explain where all the money goes, as we spend two to three times as much on health care, per person, as the rest of the developed world. Most Americans simply don’t understand the size of this apparent looting. The mainstream press did little to address or explain this problem this year. Reid fails to do the job too.

Reid fails to explain where the money goes—a groaning problem in American health care. This brings us to a second problem we found on rereading his valuable book:

Throughout The Healing of America, Reid moralizes mightily about what he calls “the central ethical/moral argument” concerning national health care. But we think he has a limited view of the moral problems which characterize our own American health care “system.” In our view, he focuses so hard on one moral problem that he fails to see the rest.

Health care reform will be debated again, some number of years in the future. If progressives want to win wider reform at that time, we ought to get clear, starting now, about where our vision is limited.

In chapter 10, Reid starts discussing “the basic moral question that should drive [health care] reform.” He visits two countries—Switzerland and Taiwan—which achieved health reform in 1994, successfully negotiating this “central moral question.” Reid focuses on this “basic moral question” in chapters 10 and 12, as he ends his book. And alas! As is so often the case in our political journalism, he leans on a familiar old crutch—he complains a bit about Bill Clinton and his “driven” wife.

Alas! As president, Bill Clinton didn’t emphasize the “basic moral question” enough, Reid says:

REID (page 182): President Clinton emphasized economics. Health care reform, he said, was a key element of “our efforts to strengthen the economy.” “Over the long run, reforming health care is essential to reducing the deficit and expanding investment,” Clinton argued in his first State of the Union Address. He named the smartest and most driven member of his White House team, First Lady Hillary Rodham Clinton, to head the Task Force on National Health Care Reform—and she, too, emphasized the economic impacts of change. But the economics of change in a $2 trillion business were hardly attractive to those whose interests were tied to the status quo. The health insurance industry committed tens of millions of dollars to the famously effective “Harry and Louise” TV ads, which began denouncing the “Hillarycare” plan months before it was completed.

Reviewing the failure of the Clinton health plan, Reid notes the added opposition of “the hospital industry, the drug industry, and many physicians’ groups”—groups whose contributions to our massive over-spending tend to get underplayed in his book. He notes the opposition of major Republicans—and the unhelpful antics of major Democrats, people like Pat Moynihan. And alas! Apparently because President Clinton and his “driven” wife chose to “emphasize economics,” their health plan failed in 1994, with “the central ethical argument...nowhere to be heard:”

REID (page 183): By early 1994, when the Clintons abandoned their plan, the central ethical argument for universal health care coverage—the notion that a wealthy country ought to prove medical treatment for all who need it—was nowhere to be heard. The moral issue that drove major change in Taiwan and Switzerland never really got moving in the USA.

According to Reid’s (fascinating) account in chapter 10, “the notion that a wealthy country ought to prove medical treatment for all” was “the moral issue that drove major change in Taiwan and Switzerland.” But this “central ethical argument” has always gotten short shrift in this country, he says. In his chapter 12 (“The First Question”), Reid complains that “Americans have never really carried on an ethical debate about health care as a right”—and he states this complaint all through this penultimate chapter. “The ethical question—what Professor [William] Hsiao calls “the first question” in the design of any national health care system—has generally not been part of the conversation in the United States,” Reid says.

We’re not sure that we agree with Reid’s overall assessment. In our view, several talking-points have emerged from progressive discussions of health care over the past few decades. One of the most familiar points reflects what Reid calls “the basic moral question:” 47 million Americans lack health insurance, progressives (and Democrats) have always asserted. (The number jumps around, of course.) We’re also not sure that Reid’s account of the Clintons’ approach is fair; as President Obama would later do, the Clintons spoke about economics, but they spoke about the moral need to expand health coverage too. Has this country ever “really carried on an ethical debate about health care as a right?” We’re not sure how to answer that question. But there may be reasons why major pols diversify their discussion of health care, and progressives would do well to keep that in mind if we start to prepare, right now, for future health care reform.

Why might major pols move beyond the “central moral argument?” Why might they discuss “economics” too? We can think of several reasons:

First, the United States isn’t Taiwan, and it isn’t Switzerland. More specifically, it isn’t “an island nation of 23 million Chinese people with a deep commitment to Confucian traditions” (Taiwan, page 164), and it isn’t a nation of 8 million people who “constantly talk about solidarity” (Switzerland, page 176). Alas! The United States has a brutal, tragic racial history—and a recent political history in which a major politician got quite fat on talk about “welfare queens.” Talk of national solidarity may play better in some other lands than it plays around here. That said, this country has agreed to offer health coverage to many of the poor (through Medicaid), to children (through CHIPs) and to the elderly and the disabled (through Medicare). But high-minded talk about solidarity may not play as well in this country as elsewhere. High-minded ethical discussion may appeal to a type of liberal intellectual. But when major pols avoid or downplay such approaches, they may have sensible reasons.

Second, big pols may discuss “economics” for a second, very sensible reason—because it’s a major problem! No other country has ever had to confront so much over-spending on health care; this would include both Switzerland and Taiwan, according to Reid’s fascinating accounts. And here’s where Reid’s big error occurs, as least if you’re going to listen to us: That massive over-spending—that matter of “economics”—is a “central ethical issue” too! Sorry: When the average shlub spends two to three times what everybody else is spending, we’d have to say that he’s getting looted! Until somebody shows us different, we’d say he’s getting looted by the big, upper-end interests Reid tends to pass by in his book.

And that’s an ethical issue too! It’s an ethical issue progressives should stress in future reform debates.

Have Americans ever “really carried on an ethical debate about health care as a right?” We’re not sure how to judge that. But if the current health reform passes, Americans will have extended coverage to 94 percent of the population—including much of the poor—even in the absence of such a sweeping debate. Our “system” will be a crazy-quilt hodge-podge—but tens of millions will be subsidized in their health care coverage, whether in whole or in part. Unfortunately, average citizens and their employers will still be paying massive amounts for health care—amounts which will likely remain comically high when judged by international norms. Example: The Swiss are the biggest spenders in Europe—and they spend only about 60 percent what we spend, per person! Where’s all that extra money going? That’s an “ethical question” too! In our view, Reid, like so much of the mainstream press, gives it short shrift in his book.

Health reform will come round again. Will our side be ready next time? In many ways, our effort was pathetic this year—unless you want to live in a world where industry and corporate groups are allowed to loot average people, to an extent which is comically awful.

In many ways, the progressive effort was weak this year. Tomorrow, a glorious future.

Tomorrow: A glorious future