FROM: YOUR BENEFACTORS IN THE INSURANCE INDUSTRY AND YOUR VERY SMART DC DEMOCRATIC CONSULTANTS
TO: CONGRESSIONAL DEMOCRATS AND OBAMA ADMINISTRATION OPERATIVES
You are, of course, generally familiar with how the game works but this memo should serve as a refresher in how the whole health care reform hocus pocus should go down in DC this year. After all, it has been a while. We haven't had to seriously deal with this problem since the Clinton years. Think of this as an Executive Summary of how to play the game. We'll handle most of the logistics, details and other staging in concert with your staffers so the blame is spread around and everyone looks good after we kill this thing. It won't be all that different than the dives you took on the $750 Billion giveaway to Wall Street last fall, FISA Telecom Immunity last summer, renewing The Patriot Act, your acquiescing on torture, or even your support for illegally invading Iraq on false pretenses. It's like riding a bike. Remembering how to do it comes back to you right away even if it's been a while since you've sold out your constituents and your country's best interest. You really never forget once you know how to do it.
Given how concerned the public has become over the sky high premiums they pay and the outrageous out-of-pocket expenses they must incur on top of those premiums, it is especially important this year to have strict "message discipline" and to follow the scenario and instructions closely so we don't have any mishaps, okay? Right! So let's get to it then shall we?
Here's how our little game works (generally speaking) in case you haven't noticed or don't recall:
1. First and foremost tell the people that single payer would be great but just isn't "practical" or "realistic" in today's political environment. Do not explain why this is so even though you have the majority in both houses of Congress and the President this time around which means you control the political environment. Do remember to make vague references to Republican opposition and the power of various industries. Also, remind anyone who will listen that this issue is so important that "we must be reasonable and pragmatic." That means first and foremost we have to be sensitive to industry and Republican concerns and we have to understand how expensive solving the problem will be. IMPORTANT: Try to deflect any questions that point out that nothing could be more expensive than the system we have now since we pay more and get less than any western nation. Getting bogged down in this sort of thing will get us off message and could cause problems.
Now, having dispensed with the obvious, clear and best solution (and incidentally the approach of every civilized western nation except the United States) we have guaranteed that option won't even be discussed and so we are free to move on to talk about ways to keep the insurance company parasites bleeding the life out of the workers and businesses of the country forever and ever Amen! And this must all be done despite the obviously life threatening malignancy it represents for the American economy overall, for businesses being vastly overburdened by obscene health insurance costs, and for families who are desperately trying to hang on to coverage (if they have it) or who are foregoing insurance if possible because it simply is too expensive.
2. Call all the interested parties (except anyone interested in single payer) to the proverbial "table" to work on a common approach. Make a big show of this at a major photo op. This will give the gullible a reassuring, but false, sense of hope that "this time it will be different". Make sure most of the seats are taken up by the very lobbyists who have thwarted every common sense reform for the past 40 years and allow them to set the parameters for discussion and control the agenda from start to finish. They'll know how to handle this and keep things from getting out of control. Otherwise, they might be unhappy and their mean friends in Congress (the omnipotent Republicans and centrist/conservative Democrats) will get mad and make a scene. Again, make sure you don't even discuss looking at single payer except for the "not practical" disclaimer, otherwise we can't service the needs of the insurance companies as they have grown accustomed and who, in return, will support our campaigns financially. If we even discuss the actual solution they will turn off the money spigot and that's a problem, I think we can all agree, the nation simply cannot allow to occur. The one exception would be if someone would want to take some time out to equate single payer to Soviet totalitarianism and death. It's always good to remind people that nothing could be worse or more dangerous for America or for their families than adequate, affordable health care for every citizen regardless of income.
3. Drag the process out as long as humanly possible, and then some, as though the alternatives and possibilities have never before been considered. During the process, create all sorts of complicated alternatives the public and the stenographers (a.k.a. the corporate media) find too confusing, time consuming and intricate so they'll lose interest. Make it so bad that watching paint dry would be like watching an action movie like "Live Free or Die Hard" in comparison. Oh, and never settle on one option to use as we transition away from the old system. Make absolutely sure legislative deadlock is achieved so nothing passes and it remains cloudy as to who exactly killed the various pieces of legislation. In the worst case scenario, if passage of legislation is impossible to avoid, then make sure it is so onerous and unworkable that the President can not, in good conscience, sign it into law. Your Republican friends will be happy to vigorously support any such effort. But there's only a very, very far outside chance we will ever have to worry about that eventuality.
4. Once the effort fails, tell the public "we did our best under the circumstances", but the insurance companies, the pharmaceutical manufacturers, and of course the always handy omnipotent, mean old Republicans prevented passage once again. But fear not citizens! We hope to try again in the next session of Congress. (wink, wink to the lobbyists and whisper "They fall for this one every time. It's really something. It's like they never learn a thing and by the next time they'll have forgotten everything so we can start all over.") Don't forget to leak word to the stenographic pool that we plan, in the all important interest of bipartisan cooperation and civility, on going back to the drawing board and offering up a new version next time that will be designed to be even more attractive to Republicans and the business interests they love. We hope that will ensure passage of a bill that, perhaps is not perfect, but will cover at least a few hundred more families over the next 10 years. After all, we'd rather take it slow and get it right than to be too hasty wouldn't we?
Remember, as a Democratic member of Congress or an operative in the new administration complicit in this genuinely immoral sell out of the health of the American people: there could be side effects. If you have trouble sleeping at night or think you can't live with yourself knowing what you've done, salve your conscience by rationalizing to yourself that the only real solution "isn't practical in this environment" so in the end, that bogus set of half-measures you supported really was the best you could do. Remember, single payer isn't a realistic option in our country! Ever! Repeat this as many times as it takes to calm you down and not worry about how many people you could have helped are now doomed to inadequate or no health care as a result of your pusillanimous actions.
Sure, single payer is workable, affordable and realistic everywhere else on earth, but not in the richest country the planet has ever seen. No Sireebob! Here in the good ol US of A we are better off letting people get sick, stay sick, live in poor health, die prematurely and pay twice or three times as much as people elsewhere pay in return for much more. It makes perfect sense! It's the American way! The important thing is that the insurance interests are satisfied that their profits are not threatened by anything we do. Don't think about the fact that your own party has the votes (but not the political will or guts) to institute single payer and a new President who says it's best but falls back on the "it's not practical" dodge too. If you start to think about those things too much, the side effect might recur. So say to yourself... "See? There was really no point in even attempting to do the right thing since it wouldn't work anyway." Then, close your eyes and try and get some rest. You have fundraising calls to make in the morning.
5. Rinse and repeat every two years. Just make sure you are thorough and effective in step #1 so "you know what" doesn't get discussed and also that things remain as complicated and confusing as possible for the public. If you do that, they'll never wise up.
