Morgen on December 9, 2009 at 4:08 pm
Back in April 2007, congressman John Conyers hosted a forum on possible solutions for health care reform. Conyers is a big single payer supporter, and so of course this was a significant focus for this meeting. However, Conyers also invited some more moderate Democrats to give their perspective. Chief among these was none other than Rahm Emanuel, and his comments are actually very relevant to the compromise currently being considered in the Senate.
Here’s Rahm on the nature of the problem (emphasis added):
So what has happened over the last 40 years in the history of politics of health care is we have failed at universal care, but we have succeeded at universal, I think, care for segments of the population. That is what Medicare is, that is what Medicaid is, that is what S-CHIP is, and you can also argue it’s what veterans’ care is.
So although we have failed in universal care for the country, we have succeeded and exceeded at universal care for segments of the population.
Now, the problem is, as the system builds up, there’s so many inefficiencies in there, not only in the health care system, as well as in the tax code side, et cetera, we’re paying for a lot in basically the private area and overlapping inefficiencies to paperwork, et cetera. We pay more for administrative costs than any other major industrialized nation because we don’t have a single system that controls cost.
Got that? In Rahm’s world view, universal healthcare is defined by whether its a government-run program such as Medicare, Medicaid, S-CHIP, and the VHA. And so the central failure for Democrats, according to Emanuel, is that up until now they have only “succeeded” in providing universal care for segments of the population. In other words, Single Payer for Some.
Furthermore, Emanuel attributed the problem with run-away healthcare costs solely to administrative inefficiencies in the private sector. His solution of course is for Democrats to find a way to implement a “single system” enabling the government to control costs. (Call it “Command and Control Healthcare”.)
Emanuel went on to identify what he saw as another key problem with the current system – employers (emphasis added):
Now, I’m for changing course from an employer-based system into one that has the public policy, the public initiatives of care from the government is more involved in the delivery and health care, because that’s the only way you can control costs. And if you can control costs, you can deliver universal coverage and it is fundamental.
The second piece is businesses are going to want out. Now, here’s the dilemma. Business that wants out of this, they don’t care if it’s an individual mandate, they don’t care if individuals have to do it. Progressives want universal care and they want some universal delivery…
The difference in the next two years will be business wants out. We have to marshal that political will towards a health care plan.
Don’t worry – some of this gibberish doesn’t make much sense to me either. But what’s clear is that Rahm was all for a system which would transition away from employer-provided health insurance. A system where the government would be much more involved not only as a payer, but also with actual delivery of healthcare. Since this is an important element of controlling costs. (An early argument for Death Panels, perhaps?)
Rahm also saw an opportunity for a grand bargain with Corporate America which would look favorably on the prospect of shifting health insurance costs off their books in the long run. Democrats get the power and control they so badly want, and the business community reduces their long-term fixed costs. They just have to stay quiet, or better yet support the Democrats’ initiative. Such a pact could go a long way towards explaining the virtual elimination of the employer mandate in the Senate bill.
So exactly what sort of transitional plan did Emanuel envision to move in this direction? The very plan that is now being considered in the Senate, natch:
I think what we should use is the model, in my own view, of the Federal Employees Health Plan. It is the most efficient pool, marketplace, if you want to use that language, of insurers delivering health care with a way to control costs, but having basically a system that gives people, A, the word “choice,” but you can manage costs and get universal coverage.
Ah yes – the word “choice”. As long as choice can somehow, someway be spun into the equation, no matter that Democrats are feverishly trying to ram through a 2000 page monstrosity that will fundamentally alter every aspect of our current healthcare system. In exchange for a system where the government will dictate exactly what sort of products and services can be offered, who they can be sold to and how, and what can be charged for them. If this is expanding “choice” in the market-place, then the word has ceased to have any meaning.
The simple truth is that with half of our population already covered by Medicare and other government programs, the Democrats are already a long way towards achieving their ultimate goal. And there is more than one way for them to continue to advance this ball down the field. There was nothing magical about the Hacker-public option plan. If anything, it overly complicated matters for Democrats in a futile attempt to obscure the real agenda. In fact, if they are able to pass an expansion of Medicare in conjunction with the FEHB plan, they will be much farther along than they would have been with a neutered public option. It won’t take long for most liberals to realize this, so look for them to coalesce support around this “compromise” in short order.
Looking at the bright side, the continued unpopularity of the ObamaCare plan, combined with the liberal suicide pact to ram through as much of their radical agenda as they can get away with, virtually guarantees a good result for Republicans in the mid-term elections next year. It could very well end up being a backlash of epic proportions. So keep the faith.