As the summer wears on, and autumn nears all too soon, it seems that we have wasted a lot of time to arrive at the nexus on healthcare reform at which we now find ourselves. The push began so long ago and was going to be wrapped up before August. Now it looks like late fall, and any meaningful bill at all seems less than certain.

Those in opposition to healthcare reform seem loud and insistent, as I’ve written my feeling about before. While there are legitimate questions that should be debated and settled upon before any bill is passed, the shouters in the marketplace of ideas are not even discussing them. They are shouting about death panels and abortions and contraceptives and the fact that the Founding Fathers didn’t put the right to affordable healthcare into the Constitution.

You know, I really don’t care what the anti-reform riff raff think. I don’t care how loud they shout, or how off topic, or how far from any semblance of truth they get. I mean, just look at the polls and Republicans are still nearly as popular as HIV infections. So does it really matter what the trailing quarter of the bell curve thinks? 
Perhaps if we just ignored them when they acted out, gave them some milk and cookies and pulled up a John Wayne movie on the Tivo, they’d act like normal retarded children instead of the attention deficit disordered cast of “Night of the Living Dead”.

In actuality, there’s still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House’s is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.

But that’s the problem. It’s always easier to stir up fear and anger against something that’s amorphous than to stir up enthusiasm for it.

The White House has just announced a web page designed to rebut some of the insane charges that the right is instigating. That won’t be enough. The President has to be more specific about what he’s for and what he’s against. Without these specifics, the right can conjure up every demon in its arsenal while the middle and left can only shrug their shoulders. That’s pretty much what’s happening right now, and the healthcare industry is spending a million and half dollars a day to oppose any reform of any kind. They don’t care how crazy the lunatics look and sound. It all plays into their gameplan, which is to kill healthcare reform in any way possible.

The President needs to forge ahead without holding on to the pipedream of bipartisanship. The Republicans aren’t interested in a bipartisan bill. They’re interest only in doing the bidding of the health insurance industry, big pharma, and corporate hospital groups, while destroying the President’s popularity and agenda. It’s time for the Democrats to circle the wagons and get a unilateral bill through both houses of congress, even by the narrowest of margins. That’s how Johnson passed the Medicare bill, and that seems to have worked out fairly well for over forty years now.

In order to get a bill of any kind, the President needs to be very specific about two things in particular: (1) Who will pay? and (2) Why the public option is so important — and why it’s not a Trojan Horse to a government takeover.

As to the first question, he needs to admit that taxes will have to be raised and that cost-savings won’t be sufficient to achieve nearly universal care. But he needs to be absolutely clear that taxes will be raised only on the very top wage earners. He needs to decide whether he favors a surcharge on the top 2 percent of earners, or a cap on tax-free employee benefits, which would affect only those at the very top, or some combination, and then announce which he prefers and why.

He needs to answer the second question by saying unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care. This plan will still be market based, and will be a matter of choice for those seeking health insurance.

Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies, doctors, hospitals, and other participants in the healthcare industry. But he needs to reiterate that this won’t lead to a government takeover of health care. The whole point of cost containment is to provide the public with health care on more favorable terms. If the public plan negotiate better terms — thereby demonstrating that drug companies and other providers can meet them — private plans can seek similar deals.

He needs to convince people that the reform plan will have low administrative costs — Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs. One goal of health-care reform is to lower administrative costs. Competition with a public option is the only way to push private plans to trim their bureaucracies and become more efficient.
While it’s true that the public plan won’t have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.

The public plan won’t be subsidized by government. Subsidies go to families who need them in order to afford health care. They’re free to choose the public plan, but that’s only one option. They could take their subsidy and buy a private plan just as easily. The public plan may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans will not favor the public plan.
Now’s the time for specifics. It’s impossible to fight fearmongering lies with nothing but positive principles. So come on Mr. President, speak up. Lay out the above information in clear, cogent, and consistent language, and keep speaking up on these issues. Nows the time to lead. For only by shining the light of truth into the darkness of the lies being shouted out at town hall meeting all over the country, can those telling the lies be silenced. And only by those truths will get healthcare reform in our lifetime.

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