The Three Artificially Manufactured Assumptions Driving the Insurance/Drug Industry's Health Bill

by: David Sirota

Sat Dec 19, 2009 at 14:00

Without getting into the policy debate about whether this health care bill should be passed or rejected (my personal opinion is here for those interested), I think it's important to step back and just look at the false assumptions that are being made. Not about the bill's substance, mind you, but about the process. And it's important to consider those assumptions, if only to understand how the parameters and rules of the game are inherently - and dishonestly - rigged:
David Sirota :: The Three Artificially Manufactured Assumptions Driving the Insurance/Drug Industry's Health Bill
ASSUMPTION - This Is the "Last Chance" to Pass Health Care for a Generation: This is one of the key rationales being cited by the those who want to immediately pass the Lieberman-gutted legislation. It actually makes zero empirical sense. Last I checked, Democrats will still control Congress and the White House for all of 2010. These are the Democrats making this "last chance" argument - and they are the same Democrats who would get to decide if that's actually true. You can't cite your own future discretionary decisions (say, not allowing Congress to revisit the health care issue) as reason that this is automatically the "last chance" to pass health care. If it is the "last chance" then it's the Democrats who control Congress and the White House who are deciding it's the last chance (by the way, a decision that Democrats in the past made differently - it took multiple tries to pass Medicare before it finally passed). Put another way, this assumption isn't ironclad reality. It's a choice whereby the Democrats saying this are actually issuing a threat - a threat to not allow health care to come up again unless this particular Lieberman-gutted bill is passed. I certainly agree that with thousands dying every year for lack of health insurance, there's an urgency to passing a health care bill - but especially when you consider that many of the bill's benefits don't start becoming a reality until 2013 or 2014, there's no reason why this bill must be passed ASAP, or why this is the "last chance" to pass health care legislation.

ASSUMPTION - Dems Couldn't/Wouldn't Come Back to Health Care Again Soon If This Bill Fails: This is related to the first assumption. Maybe they would, maybe they wouldn't - but there's the assumption that they would be strongly inclined not to because of the politics of it. I don't get this at all. Seems to me Democrats and the White House are so completely vested in getting something - anything! - done that they'd have to come back to it, and quickly. I think progressives have really missed an opportunity to call the buff of this assumption, because if you believe it's not true (and there's strong reason to believe it isn't), then it means progressives hold potentially far more power than they think. It means that if they take the bill down, the Democratic leadership and White House will be even more desperate to pass something - anything! - and will be forced back to the negotiating table on key progressive priorities. This is why the White House freaked out on Howard Dean - because his clarion call to vote this bill down undermines this particular assumption.

ASSUMPTION - We Need 60 Votes to Pass Anything: Again, just not true, even though it's been said over and over and over again. Sure, there are problems with reconciliation - but it's a fact that Democrats could at least attempt to pass a public option or Medicare buy-in via reconciliation. Somehow, that's not talked about anymore. Somehow, even after Lieberman sliced out the public option from the overall package, there's been no talk of giving progressives the concession of even allowing for a reconciliation vote on a public option. We are to assume reconciliation just doesn't exist - when, in fact, it does.

Now, you can disagree with me on some of the speculative opinions in what I've just written. But you cannot disagree that these assumptions being made are artificially manufactured - they are not scientific Laws of the Universe. In many ways, they are contrary to ironclad fact (see the reconciliation assumption, as an example). Yet, they are being treated as Laws of the Universe. And what that proves is that the very terms of the debate we're having is tilted - just like it tends to be tilted on so many fundamental economic issues.

It's not surprising that Democratic politicians and the media are trying to hem in the discussion of health care with these artificial assumptions. As Sen. Russ Feingold (D-WI) has suggested, the president and the Democratic leadership has wanted to pass an insurance/drug industry giveaway from the beginning, and then happily declare some great victory on behalf of the little guy - and these assumptions help make that more possible.

It's also not surprising that much of the Professional "Left" - DC organizations, pundits, etc. - is backing this bill. They have insider access to protect and White House Christmas Card lists to try to stay on - and the last thing they've shown any willingness to do on any issue is stand up and fight with Democrats.

But it is somewhat stunning to me that so many activists would so quickly accept these assumptions without question. I say "somewhat" because it's become fairly obvious over the last year that in this age of Obamania and worship of politicians as celebrity deities, we haven't seen a rise in consciousness. We've seen an exponential increase in the willingness to swallow Establishment bullshit without any questions - a rise of a Nation of Sycophants, a Country of Zombies, an Idiocracy, or whatever else you want to call it.

The truth will, of course, persist, as it always has in our history - you can't hero-worship away reality. And the reality is this: Only when we start asking some fundamental questions about such assumptions will we be able to marshal more power and leverage over these kinds of negotiations. But rest assured - until that happens, we'll be - at best - fighting over legislative scraps as we are right now.

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Or (0.00 / 0)
they are making the assumption that this bill will save many lives, and that it will make a bad situation somewhat better, so it is worth passing. And that it would be morally cavalier to do otherwise.

Evidently, you don't read very well (4.00 / 3)

I think it's important to step back and just look at the false assumptions that are being made. Not about the bill's substance, mind you, but about the process. And it's important to consider those assumptions, if only to understand how the parameters and rules of the game are inherently - and dishonestly - rigged:

A good tip that I repeat over and over and over again: It's important to read the posts you are commenting on before commenting.

[ Parent ]
Ah. (0.00 / 0)
Now I remember why I don't comment on your posts anymore.

My point - and sorry if this wasn't clear - was that you can't extricate the substance from the process. Maybe all of those are false assumptions, but to push the issue - to say that we can get a better bill next year, that the whole process won't collapse when we've barely, through heroic efforts, gotten just enough support for the bill as its is; and that a later effort would produce a better, rather than a worse, bill - is a huge gamble. I don't assume any of the 3 things you list, but I do think points 1 and 2 are likely. I also do make another assumption which you don't list: namely, that it would be better to try to build reform on top of this bill in later years, rather than try again from scratch.

That is why I would consider it morally cavalier to not try to pass the bill we've got before us at the moment.

[ Parent ]
This assumption is the one that confuses me. (4.00 / 2)
I also do make another assumption which you don't list: namely, that it would be better to try to build reform on top of this bill in later years, rather than try again from scratch.

Because it seems to rely on the mechanisms in Sirota's 2nd assumption evaporating. Why should it be any easier to "fix" the bill in future years than to re-visit the issue by starting over from scratch?

It seems that passing a bill that needs tweaking will take the wind out of the sails for reform, so it will be less likely that the congress will revisit HCR in the near term.

"It sounds wrong...
     ...but its right."

[ Parent ]
Terror, terror, 911, or have you got another talking point. (4.00 / 4)
People are fodder in Irag and Afghanistan and nobody cares.  If they cared whether or not the bill was actually worth a damn and helpful to people in medical and financial trouble, they'd take the time to do it right.  After all these years of leaving them to die in the streets, we now have to have a bill by christmas - even if it sucks?  talking points and scare tactics, they just don't work anymore.  

[ Parent ]
Fourth assumption (4.00 / 2)
There is a fourth assumption, here.  Democrats lost control of the House in 1994 because of the failure to pass a health bill, any health bill. In fact, many factors were involved.  One of them was the effect of passing a bad bill, NAFTA.  Another was the House banking scandal.  Another was the large number of retirements (to take advantage of unspent campaign funds.  Partisan redistricting for the 1990 census played a role.

Since passing a bad bill is also dangerous, Versailles needs to realign the meme.  It is important to pass a good bill, not just any bill.  The voters know the difference and vote (or stay home) accordingly.

On the last assumption (4.00 / 1)
It just seems obvious to me that Lieberman would filibuster the non-reconciliation portion of the bill if the reconciliation route were taken for the PO. So it would be crazy to announce that that was the plan.

However, what would be awesome is if, after the final bill passes, Reid was all of a sudden like, "Hey guess what? We're pushing for a PO through reconciliation. Lieberman, you got played, SUCKA!!!!!!!!"

Guy can dream, right?

I understand that the subsidies would be in the non-rec. part. (0.00 / 0)
And Joe "Aetna" Lieberman would vote against those juicy, low hanging fruit? Uh, not likely...

[ Parent ]
If you think Lieberman is fundamentally motivated by corruption. (0.00 / 0)
But I think he's just a crazy narcissist.

[ Parent ]
Well, our opinions differ on this. (0.00 / 0)
Evn though I won't exlcude that he's also a narciss.

[ Parent ]
They are certainly not laws of the universe (0.00 / 0)
But they all seem like pretty reasonable and smart assumptions to make.

Sure they aren't laws of the universe.  However what would have been gained by not following these assumptions?

Maybe 3-4% of the bill might have been slightly better but you will never get anything done if you focus on the 4% rather than the 96%.


You have joined the Church of the Savvy (1.33 / 3)
It must be nice in there.

[ Parent ]
Right on Taget -- AGAIN! (4.00 / 1)
All of your posts this past week or two have been exceptional.  I wonder what Bernie Sanders is thinking today. I heard him yesterday on Thom Hartmann's radio show saying that the bill was not good enough, and that he was still working to improve it. That was before Reid caved to Ben (my hair can whip Donald Trump's hair) Nelson.

I sent the lovely Senator Nelson an email last night, and found out that one cannot SHOUT (use all CAPS) at him. Maybe it is that way for all Senators, but he is what I have to deal with. I will not hold my nose and vote for him ever again.

Except... (0.00 / 0)
Yes Dave they have the ABILITY to try and pass it again.   But they WON'T do it.    

Three Artiifically... (0.00 / 0)
David, you are brilliant and a great writer, but the health care fight isn't just a matter of a few people deciding to do it or not.  It's the culmination of movement work, local/state/federal, going back decades.  Of fighting and losing in 1993-4, regrouping and rebuilding.  Of putting together a coalition, HCAN, that is historic and unusually unified on our side (full disclosure: I'm a founder and co-chair).  Of having a President and a strong Democratic (no, not progressive, Lord knows we've learned that well enough) Congressional majority who campaigned to win health care.

We just aren't going to get this opportunity again in a long time.  How long?  You don't know and I don't know, but I don't want to find out.  I don't want to fight this fight when health care is over 20% of the GDP, when 60 million people are uninsured, when even fewer doctors practice primary care, when private corporations have even further dismantled one of the best public goods our government offers.  

We are going to win big things.  And in the next 4-6 weeks, we can win more of them, if we'll all fight like hell for them.  We can and should post-mortem afterwards. Now, we should demand that our champions lead (don't you have a pretty strong relationship with some of them?), that the President uses his bully pulpit and his arm-twisting to get the best bill.  

Because I'm not too excited to tell my next acquaintance with cancer that hey, we could have gotten you insurance, but we decided it wasn't really worth it yet.


That sounds all well and good (4.00 / 5)
I respect your work very much, Jeff, but at least here, you address none of the assumptions outlined in this post. In fact, you fully embrace them. You simply state - as fact - "we just aren't going to get this opportunity again in a long time." With no factual evidence that's true. None. Nothing.

I've made a substantive case about why I believe those assumptions are self-serving, self-fulfilling, ridiculous and rigged. You've responded by saying you don't want to tell your friend who has cancer we could have gotten him/her insurance...even though the major "benefits" of this bill don't kick in until 2014. In other words, you are making a timetable "do or die right now" argument, without actually explaining why we're in a rush for this particular bill right now. Even your friend who has cancer right now - many of this bill's benefits won't help him for 5 years...and yet, somehow, we're all supposed to accept that this bill must pass immediately in order to help your friend.

Maybe there is that argument out there - but you've done nothing to explain why you've swallowed hook line and sinker the artificial, subjective and rigged assumptions about this being a "do or die" moment. You've not substantiated it - you've simply regurgitated it as a matter of blind faith. That's sad - but sadly typical in a political system that has convinced so many to simply accept such assumptions from the politicians we are taught to worship.

[ Parent ]
Perfect! (4.00 / 1)
Excellent response and an even better article, David. It is important to pull the covers off of the manipulation game that is being played by the Democratic leadership and their enablers in the media and punditocracy. Sick and tired of the games.

[ Parent ]
Assumptions (0.00 / 0)
Hi David - I think there are legitimate reasons to pass the bill aside from these assumptions, and I agree that these assumptions are largely bogus.  But I also think your counterpoints miss some dynamics.

First, one assumption often stated that is a good reason to pass it now - that you don't really cover in your list - is that if we don't pass a good bill before election day, we will experience more losses than if we pass it.  And the more losses we experience, the harder it will be to pass a bill in the future, whether it's reconciliation or non-reconciliation.

Second, there are several aspects of health care reform that we need that are not eligible for a reconciliation bill.  People often respond by saying that we can solve that by following a two-bill strategy.  One bill for reconciliation that contains public option and/or medicare expansion, and a second bill that contains the non-reconciliation reforms.  But that second bill is basically what we have now, so it's another reason to pass the bill.  And I'd argue (see the other comments here) that going for the non-reconciliation bill first is the only politically possible way to get both.

Third, I'm disappointed in the rhetoric you are using about Russ Feingold.  It's a gross mistating of what he said.  In the article you cite, Feingold doesn't characterize it as an insurance/drug industry giveaway, you do.  It would be more satisfying to debate you if you were fair in your characterizations.

Overall though, I find your article a little rootless, as you aren't really ascribing these assumptions to anyone in particular, other than them being "out there".  For what it's worth, I never felt that those with the power to kill/pass the bill were using those assumptions as the chief reasons to pass the bill.  I more heard them from other bloggers, and let's be honest, most of them are grossly misinformed.

Respectfully yours,

More Scare Tactics (0.00 / 0)
Has the thought occurred to you that the argument "we will lose more seats if we don't pass HRC" in the next election is as bogus and manipulative as the 3 that David listed in his article? And it is not just bloggers using those scare tactics, it is Democratic spokesmen, White House spokesmen, and many in the corporate media.

Now, I would propose that Democrats will lose more seats by passing HRC as it exists now than if they passed nothing. That's how bad a bill I believe it is.

But the bottom line here is that your argument's basis is rooted in political expediency and fear. You want progressives to STFU and accept whatever the Democrats claim is the best they can do rather than fight for more because your primary concern is losing seats in the next election. Either that or you want to scare us into dropping our demands by posing that as a threat.

In either case, I'm as sick and tired of Democratic apologists and manipulators as I was of Republican ones during the last administration.  

[ Parent ]
interesting (0.00 / 0)
You follow my opinion that we'll lose more seats if we don't pass it, with your opinion that we'll lose more seats if we do... and then launch into unfair characterizations and ad hominems.  So much for trying to raise the level of discourse.  I guess this isn't the site to come to to find rational discussion.

[ Parent ]

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