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Hey! Let’s talk about US healthcare reform!

Don’t worry, I’m not going to start blogging about politics. But I thought this (via Andrew Sullivan) was an interesting way of looking at things. David Frum writes:

There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

13 replies on “Hey! Let’s talk about US healthcare reform!”

Yeah, Frum’s one of those Conservatives-in-name-only who no longer understands the base so he just insults them. Very much indicative of the problem with the Republican Party these days, which is why so many Conservatives have stopped voting Republican lately.

Deal-making is exactly what the base were against on this issue. That leaders failed to deal because of pressure from the base is democracy at work: a feature, not a bug. And there are perfectly sound rational reasons not to do a deal, strike a compromise. If you disagree with them, that doesn’t mean they amount to nothing more than frothing-at-the-mouth murderous paranoia. And if you’re supposed to be one of the country’s leading Conservative commentators, and your job is to understand Conservatives, then just slagging them off whenever they fail to be as left-wing as you — which is all Frum’s done for going-on five years now — is pathetic and stupid.

So you’re not a fan of Frum, I take it? :)

> If you disagree with them, that doesn’t mean they amount to nothing more than frothing-at-the-mouth murderous paranoia.

Oh, of course. That said, much of the online debate I’ve seen about the bill *has* been frothing-at-the-mouth murderous paranoia. It’s been really weird to see, even on respectable, fairly chilled-out sites such as metafilter there’s a level of fury around this that you’d normally only expect to see around the abortion debate.

People should be furious about it. That travesty that got passed the other day was the effective end of the American Republic.

Rather than having an argument about that now, though, let’s just wait thirty years and then I’ll say “Told you so.”

“That travesty that got passed the other day was the effective end of the American Republic.”

I think Gary may have a point about “frothing-at-the-mouth murderous paranoia”.

It was both the largest federal power-grab in the US’s history and the point of no return. Once the state controls healthcare, you get nothing but more and more state, year after year. There is no counterexample to that. The American republic was founded on minimal centralisation of power. That’s taken some serious knocks over the years, but it was still more alive than in pretty much any other nation, certainly any remotely that size. But that’s it dead now.

Hey, don’t take my word for it; look at the Democrats: it’s hugely unpopular with the public, yet they forced it through anyway, many of them voting for it in the full knowledge that they’re going to lose their seats over it. Why would any politician do that? Because they know that, long term, it tips the entire game in their favour.

Which is why the Conservative base didn’t want the Republicans to do a deal. What’s the point of a deal? Once something like the NHS is in place, it gets bigger and more expensive every year. So you strike a compromise now by agreeing to introduce an NHS but on a slightly smaller scale, and all that happens is you end up back at your opponents’ position a few years down the line and the compromise becomes meaningless. What American Conservatives wanted was to oppose the thing’s creation in the first place.

As ever, I repeat that this is the one thing I agree with Tony Benn about: compromise and centrist politics are a Bad Thing, because, in a democracy, you have to give the electorate choice. When you agree with your opponents, you take choice away from the people. The Opposition are supposed to oppose, and the Republicans did — though not at all effectively and only because of such intense pressure from the grass roots — as Frum points out, most of them wanted to deal. If the Republicans themselves had managed to understand that opposition was actually a good and principled thing to do, they might have done it properly.

The electorate have only themselves to blame for this, but I still think it’s sad.

For some reason I can’t reply to S2’s comment. Weird.

Anyway,

>>Once something like the NHS is in place, it gets bigger and more expensive every year.

How is it like the NHS? The hospitals are still privately run and, like now, they are usually paid from medical insurance. Other than the funding of medical insurance for people who can’t afford it and possible changes in taxation, how will it effect the overall standard of care? The government, unlike here, won’t have anywhere close to the same level of involvement in the healthcare system. I can’t imagine it being much greater than they have now.

You’re being more literal than me about “something like the NHS”. Once the state is responsible for your healthcare, is what I meant. Once it’s there, it will get bigger.

> The government, unlike here, won’t have anywhere close to the same level of involvement in the healthcare system. I can’t imagine it being much greater than they have now.

A lot of firms are pointing out that they’re going to have to stop offering private insurance to their employees because this new legislation makes it far too expensive for them to do so. The legislation is designed to drive people away from private insurers and towards the state (or, if it’s not designed to do that, it has been badly fucked up).

Like I said, wait a while, then I’ll say “Told you so.”

I thought that one of the things removed from the bill was the provision of insurance by the state? They would fund it for people who could not afford it, but they wouldn’t provide it themselves – it would still be provided by private insurers. They did impose additional limits on why insurers were allowed to withdraw cover, which is perhaps why they are claiming costs will increase, but that’s because they will actually have to pay for treatment without weaseling out of it.

Sorry I’m late to this, been staying offline due to bad hands.

> Once the state controls healthcare, you get nothing but more and more state, year after year.

Surely, though, this is small beer indeed compared to Medicare and Medicaid? I’m no expert, but my understanding is that it’s essentially the same thing proposed by the republicans back in clinton’s day. Seems less like a power grab by the govt and more proof that the US has shifted dramatically to the right in a very short space of time.

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