What a shame there are so many millions of people just like my neighbor throughout the country. I maintain hope that rational, well-meaning people can overpower the conservative defeatism that is attempting to drag down our efforts to create positive change and to instead mire us in the conservative muck.

Conservatives are opposed to change. That is what the word “conservative” means: people who espouse this philosophy wish to conserve the status quo. It does NOT have anything to do with fiscal responsibility, as was so aptly evidenced by the egregious economic mismanagement of the Bush administration. The result of Republican economic policies: double-digit unemployment.

So Bush was in the White House for eight years, and the Republicans controlled Congress for four years prior to that. Twelve years of Republican philosophy had their inevitable consequence: the worst economic disaster our country has suffered since the Great Depression. The American people got mad enough about the economy that they voted President Obama into the White House. Now he’s been in office for all of a year, and people are already angry at him, because he hasn’t somehow magically fixed twelve years of Republican mismanagement in twelve months of Democratic presidency. Come on people, we all heard the jokes, but did you REALLY think he was some sort of magical messiah? He’s a person like any other, and a person elected to the Presidency is only as strong as his support in Congress.  Commentators like to go on and on about how the Democrats have been unable to pass a health care bill even with a majority in the Senate; but they didn’t really have a filibuster-proof majority, did they? They didn’t even have 60 Senators who campaigned on the Democratic ticket.  Senator Joe Leiberman (Independent) stumped for John McCain’s Presidential campaign, for crying out loud: he is NOT a Democrat!

Now that Republican Scott Brown has won the Senate race in Massachusetts, the health care bill is unquestionably dead. The bill may have been bloated, misguided, and loaded with ridiculous provisions, but meaningful health care reform is long overdue in this country, and without any bill we can all look forward to a continuation of the status quo: skyrocketing rates for insurance policies that only the healthy can buy; coverage that is dropped or refused for sick people; and an endlessly growing number of medical bankruptcies. Thank you, conservative America, for imposing this little corner of Hell on the working people of our country.

Yes, the conservatives love their status quo. The status quo is, the rich get richer, and the poor get poorer. The conservative agenda is neo-feudalism, as I discuss at some length in the book. Woe to anyone who attempts to interfere with the conservative march towards a feudalist oligarchy! The media will gleefully allow conservative pundits to talk for as long as they like about how the opponents of neo-feudalism are themselves somehow opposed to freedom or something. Their argument doesn’t make any sense, but it doesn’t HAVE to make sense, it just has to appeal to the gut reactions of their xenophobic base demographic.

But there are progressives out there: real progressives.  I’m not talking about self-serving Senators doing back-room deals with big corporations; they will say in public whatever they have to say to get more campaign contributions, but they are hardly progressive.  I’m talking about the ordinary citizens of this country, everyday people, me, you, our spouses and friends.  With poorly paying jobs in a bad economy, we are too busy trying to make ends meet to clog up the streets with anti-”TeaParty” demonstrations, but we know that we are in the majority because we elected President Obama, and we elected him because we believe in change.  It is difficult, when presented with the endless, insufferable cynicism of the other side, it is difficult to maintain hope; but that is precisely what we must do.  Keeping our hope alive is the only way forward.

In the book I have an entire chapter titled “Consciously Creating Positive Social Change.”  The main thrust of the chapter’s thesis is that everyday people can change the system, against the system’s will, by building consensus until it achieves critical mass.  The election of President Obama was not the attainment of that critical mass: it was just the beginning, and it was a call to arms for the opponents of change, the opponents of peace, the opponents of freedom and equality.  They have gone on the offensive and frankly they have done a better job with their PR for the past year. 

They can’t be allowed to shout us down forever. We have to get out there and be heard.  We have to let the world know that America is not just a country of the haters, by the haters, for the haters.  We have to let the world know that we believe in change, that we will fight for change, and that we’re not going to give up just because somebody with a hacked copy of Photoshop pasted a Hitler moustache on the face of the President of the United States.  We have to let the world know that we believe in reform, and that we are going to stand up for freedom and equality, in the face of conservative opposition, for as long as we have to, because it is the right thing to do.

We have to let the world know that we still have hope.

I do.

The first of these is affordable, portable insurance coverage for everyone, including those who are presently uninsured.

Then he mentions the broad goal of controlling costs and cutting systemic inefficiencies, and gives examples of ways in which such cost-cutting measures would impact other aspects of the system.

It is on his fourth point that President Obama’s editorial waxes the most eloquent with specific policy agendas for the legislation under discussion:

Our reform will prohibit insurance companies from denying coverage because of your medical history. Nor will they be allowed to drop your coverage if you get sick. They will not be able to water down your coverage when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. And we will place a limit on how much you can be charged for out-of-pocket expenses. No one in America should go broke because they get sick. Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies.

All of these are, as I say, admirable sentiments: goals which you would think our whole country could unite behind.

Yet as it turns out these goals are quite divisive.  Such a hoopla in the press and in the halls of Congress has rarely been heard; and the things some of the pundits are saying are just simply unbelievable, as in, “I can’t believe you actually said that!”  The wild accusations are beneath us here at the Principles blog, we have no time for them.  Heck I hardly have time to post at all, these days…

But I think it’s worth noting here that there is a certain taste of political vagueness to that first point mentioned in President Obama’s op-ed piece.  In presenting the tremendous goal of providing affordable health insurance to everyone (including all those who are presently uninsured, as well as the significant portion of the population whose head of household is presently unemployed) the President’s op-ed does not mention any specific mechanism for providing affordable health care to those who can’t afford it.

We’ve all heard some options tossed around lately.  Some say, make health insurance mandatory.  Some say, create a whole bunch of local health insurance co-ops that would somehow offer alternatives to the large national health insurance corporations.  But what the Senate so far has been unwilling to say, what the President is no longer saying as loudly because he wants to get some darn legislation passed already, is that the best way to control the cost of health insurance is to offer a government-backed alternative and truly give people a choice.

This is what I would like to hear from the President:

All those who want to pay more for less coverage, you go ahead and keep your current private insurance provider.  All those who want better coverage for less money, fill out this form to sign up for the government option, and then just keep going to your preferred physician or other care provider.

I discussed this issue explicitly in the book in section 5.2.2, Universal Health Care:

In current public debate, the opponents of public health care never fail to mention that there are sometimes waiting lists for certain health services in other countries with public health care systems. Never do they mention that trauma patients must already wait several hours for emergency care in many underserved American hospitals. Never do they mention that the economics of health care in America excludes millions from the system.

It is defeatist to say, “We should not try to improve our system because there are problems with someone else’s system.” That is not a positive, winning attitude. Instead we must acknowledge our own faults as well as those of our neighbors, learn from those mistakes, and move on to create a new system, perhaps the best one devised so far.

The insurance system is the problem: it costs too much, and it provides too little care to too few people. The single-payer system, where a portion of all tax revenues is paid into a health care fund which in turn covers the operating costs of the health care system as a whole, is part of the solution. Re-instating the ban on advertising prescription drugs, which was lifted in the 1990’s and which is strictly enforced in many other developed nations, would help to decrease pharmaceutical costs and unnecessary prescriptions.

…The idea of mandatory health insurance completely misses the point. Our health care system has been destroyed by the insurance industry. We cannot look to the insurance industry to fix the problems they have caused. Instead we must make a new system.

Health care, including preventative medicine, should be free of charge for all Americans.

As you see, the goal I outline in the book is a much broader, more aggressive goal than anything Congress is debating right now.  Since it is clear that my ideas will not be passed into law this year, I think offering a government-backed health insurance plan that competes with private insurers is the best alternative that I have heard.

If Congress does manage to pass a health insurance reform bill in 2009, the reforms they implement could possibly be a first step towards the creation of such a system as the one I describe: health care funded by tax revenues instead of user fees.  Or, if their new system works well enough for now, the reforms implemented this year might continue to work well enough for the next fifty years or more.  Alternatively, if the new legislation is widely seen as a total waste of money flop and a failure, then the Republicans will have a better shot at the White House in 2012.  The Republicans are doing their best to convince people of this already, before the legislation is even passed.  They would prefer no reform to any reform; and if reform is to be passed, they will pick at it and pick at it until only the most useless parts of it remain.  I fear that if a complete compromise bill is passed with two or three grudging Republican votes, it will end up simply providing a tax subsidy to the insurance and pharmaceutical industries without actually changing anything.

The Democrats must not let the party of George W. Bush follow up the twin disasters of Iraq and the economic depression with a third disaster by letting the health care system continue to ruin lives by forcing people into health care related bankruptcy even when they have insurance.  Reform is essential, and the broader and more lasting the reform, the better.

If the Democrats in the Senate cared what I said, I would tell them not to listen to all the lobbyists crawling all over the capital right now; because if the Democrats in the Senate can stand together long enough to get the public option through, the American people will certainly thank them by giving them a majority again in the next two or three election cycles at least.

I’m sure President Obama will continue to do his best to exhibit leadership on this issue.  I hope that he will recognize how essential a public option is to any real reform.