Washington, D.C. is an echo chamber in which anyone who sounds authoritative repeats the conventional authoritative wisdom about the “consensus” of inside opinion, which they’ve heard from someone else who sounds equally authoritative, who of course has heard it from another authoritative source. Follow the trail to its start and you often find an obscure congressional or White House staffer who has seen some half-assed poll number or briefing memo, but seeking to feel important hypes it a media personality or lobbyist who, desperate to sound authoritative, pronounces it as truth. In any other place on the planet it would be called rumor, gossip, or drivel. In our nation’s capital it’s called “inside information.” The process would be harmless except that it creates self-fulfilling prophesies. Since most of our elected representatives would rather not stick their necks out lest they lose their heads, they tend to rush toward whatever consensus seems to be emerging — which, of course, is based on authoritative reports about the emerging consensus.
In the last few days authoritative sources have repeatedly told me that the public option is dead, that the President won’t be able to get a comprehensive health care bill, and that the White House and congressional leadership already know the best they’ll be able to do now is move incrementally — starting with insurance reforms such as barring insurers from using someone’s preexisting health conditions to deny coverage — with the hope of more reforms in the years ahead. The rightwing media fearmongers and demagogues have won.
Don’t believe it. The other thing about Washington is how quickly conventional authoritative wisdom changes, especially when the public is still in flux over some large matter. Rightwing fearmongers and demagogues thrive only to the extent the mainstream media believes they’re thriving. Although polls continue to show that while most Americans like the health care they’re getting, they also dislike their insurance companies, worry that they or their families will be denied coverage, and are anxious about the increasing co-payments, deductibles, and premiums they’re facing. Most are still eager for reform.
In addition, we’ve come to the point where health-care incrementalism won’t work. To be sure, the health-insurance industry is powerful and will fight reforms that threaten their profits. But they won’t fight if they know their profits will be restored when everyone is required to have health insurance. (This isn’t just conventional authoritative wisdom; it’s political fact.) Obviously, in order to require everyone to have health insurance, tens of millions of Americans will need help affording it. The only way the government can possibly pay that tab is to raise taxes on the rich while also getting long-term health-insurance costs under control. And one of the surest ways to get long-term costs under control is to force private insurers — which in most states and under most employer-provided plans face very little competition — to compete with a public insurance option that can use its bargaining clout with drug companies and medical providers to negotiate lower prices.
When you go through the logic, it starts to look a lot like comprehensive reform.
Years ago, as the story goes, Britain’s Parliament faced a difficult choice. On the European continent drivers use the right lanes, while the English remained on the left. But tunnels and fast ferries were bringing cars and drivers back and forth ever more frequently. Liberals in Parliament thought it time to change lanes. Conservatives resisted; after all, Brits had been driving on the left since William the Conquerer’s charriot. Parliament’s compromise was to move from the left to right lanes — but incrementally, on a voluntary basis. Truckers first.
Lest anyone in Washington repeat this story authoritatively, it’s a joke — but with a kernel of truth. Sometimes reform has to occur in a big way, everything or nothing, if it’s to happen at all. That’s the way it is with health care reform at this stage. Every moving piece is related to every other one. That’s also why a public option is necessary.
So forget the authoritative sources. Mobilize and organize. We can get comprehensive, meaningful health care reform if we push hard enough. And we must.