American liberals have a habit of withdrawing into cynicism and ennui at the most inopportune moments. The 2000 presidential election, and subsequent recount, was one such moment. The most die-hard reaches of the left, deeming the Democratic Party hopelessly corrupt, rallied to Ralph Nader’s fulsome populist denunciation of Al Gore’s subservience to the corporate agenda. Among more moderate quarters, an attitude of wry detachment prevailed. (“G.O.P.-lite, Democrat-lite,” sighed Frank Rich, “For the 95 percent of the country unwilling to go for Ralph Nader or Pat Buchanan, that is the choice, it always has been the choice, and it will still be the choice on Nov. 7.”) Those liberals who did see something large at stake took on an almost apologetic tone, conceding the lack of any inspired positive choice and focusing instead on the dangers of Bush.
The right, meanwhile, was engulfed in passion that occasionally flared into rage. Mobs of chanting conservatives harassed Gore at his residence day after day. Another such mob intimidated Miami canvassers into abandoning a recount then seen as potentially decisive. The left met all this with a shrug.)
The denouement of the health care debate has brought about a similar moment in the political culture. The opponents of the bill are full of passionate intensity. The right, of course, is subsumed in rage and paranoia. Conservatives have been joined by fiery liberals like Howard Dean and a slew of left-wing blogs, denouncing the bill as a corporate giveaway and urging its defeat. The attitude closer to the center is more resignation and disappointment. (Frank Rich again: “Though the American left and right don’t agree on much, they are both now coalescing around the suspicion that Obama’s brilliant presidential campaign was as hollow as Tiger [Woods]’s public image.”) The endorsements invariably have a defensive tone—the bill “has some imperfections but is worthy of support,” concludes a New York Times editorial.
At some level, it is possible to understand the roots of liberal frustration. The machinery of Congress has ground away at the health care bill, as it does to almost any bill. But at a broader level, the liberal mood is insane. What has emerged from that machinery is not merely “better than nothing” or “a good start.” It is the most significant American legislative triumph in at least four decades. Why can so few people see that?
Can't we be both pleased with the positive changes of the reform bill and be dismayed that we'll still be spending twice the average of OECD countries? Nothing will be controlling copays, deductibles, annual and lifetime caps. More of us will be insured; more of us will be underinsured. With mandates to policies that have 60% actuarial values, many of us will still be vulnerable to bankruptcies driven by medical expenses. The biggest cause of excess expense and gaps in coverage is our crazy quilt of government programs and private for-profit insurance. A single, not-for-profit system to pay for our health care is the way to bring efficiency and rationality to our health care financing. Inste ... view full comment
Can't we be both pleased with the positive changes of the reform bill and be dismayed that we'll still be spending twice the average of OECD countries? Nothing will be controlling copays, deductibles, annual and lifetime caps. More of us will be insured; more of us will be underinsured. With mandates to policies that have 60% actuarial values, many of us will still be vulnerable to bankruptcies driven by medical expenses. The biggest cause of excess expense and gaps in coverage is our crazy quilt of government programs and private for-profit insurance. A single, not-for-profit system to pay for our health care is the way to bring efficiency and rationality to our health care financing. Instead this reform strengthens the role of for-profit insurance, which will expand their political heft. At its core, this is not incremental change, but enshrining the basis of the status quo. States will even be forbidden to pursue waivers to create alternative funding systems, such as single payer, till 2017. I'm delighted that 30 million more of our fellow citizens will have some insurance, but this is not change I can believe in.
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