So, Obama wasted time talking to the Republicans about the stimulus, weakened the bill on their behalf, and in return they trashed the bill in the media and voted 100% against it.

I'm sure various Obamians will argue that he played this whole game with the Republicans just to control the narrative at some unspecified future time, or that it's always worth opening the door to your opponents even when they are scum who want to destroy you, or that it's more important to Change the Tone.

Well, the thing is, Obama is not Batman. He does not always have just the right gadget on his Obamabelt, or a secret plan that will befuddle his opponents. Sometimes he is, and will be, wrong. Sometimes he does, and will, make mistakes. He was wrong to to think that he could find common ground with a dishonorable opponent, and it was a mistake to deal with the Republicans.

As for the narrative, if the Dems don't get this bill back up to par in conference, and it works poorly as a result, the Republicans will say "OMG, we totally gave him everything he wanted and Reid and Pelosi were super mean and now look, we had a way better bill just ready to be pulled out of our ass." And all the media idiots will say "oh-ho ah-hah, does this statement from the Republicans make Obama look weak, stupid or like a big silly goose?" 

You control the narrative by taking control of the narrative. You don't take control of the narrative by letting your enemies dick around with you and then pretending you have some super poli-ninja backflip maneuver in store for them.

We know the following things about the health care system in the U.S.:


1) There are 30,000,000+ people without coverage.

2) Those without coverage pay too much.

3) Because private insurers make their profits by covering healthy people and denying care to those who need it, health care is an excellent example of a good that a market cannot provide efficiently or effecitvely.

4) People without health coverage do not get important preventive care, leading to more serious and expensive health problems.

5) People with health coverage get overtreated because much of the payout from insurers is based on how many services/tests/procedures the doctor or hospital performs.


We also know that in civilized countries, there are national universal coverage systems. If you think about the fact that today, someone could get fired or laid off, lose their health coverage, get hit by a car and end up owing thousands of dollars, or that someone could suffer a heart attack or stroke from hypertension that went undetected because that person did not have access to regular primary care, you realize that the situation is not only outrageous but literally deadly. When you look at the fact that dozens of other countries have fairer health care systems that cost less while providing better outcomes, then things start to look ridiculous.

Some wingos think that national health care systems are some sort of fascism, or something, but you probably know that old quote about capitalism giving the rich and poor alike the right to sleep under the bridge at night. Personally I don't think of "dying from a preventable condition" as a "freedom." I think of it as a cruelty. And everyone knows someone whose cousin's best friend's mom was in Canada and had to wait 39 weeks to get their inflamed appendix removed, or whatever.  The fact is, the system in the United States does not do a good job of controlling wait times. But more importantly, all (that's all) health care systems allocate care. The question is, do we want to allocate care based on wealth and employment status, or do we want to allocate it based on need?

But really, I think it's important for liberals/progressives/leftists to discuss health care systems in a productive way. People who like being sick or dead more than they like efficient, fair, high quality health care cannot be part of such a discussion. At some point we need to realize that we will have to move forward without 20% or so of the people in the country. Opposition to universal coverage is like climate change denial or neo-Hooverite "cut spending during a recession" talk; it's ignorant, it's often mean-spirited, and it's largely irrelevant to solving problems. Conservatives can believe what they want. When we fix the health care system without them, they'll benefit like everyone else.

One problem with our discussion of health care is that people seem over-focused on single-payer systems. There's an article in the latest Harper's magazine that refers to all universal coverage systems as "single-payer." This is just incorrect -- there are as many universal health care system types as there are countries with universal health care systems. Hybrid systems are common. The Canadian system is different from the English system, which is different from the French or the Swedish system.

As a socialist, I lean toward actual national systems like Great Britain has. In such a system, the doctors actually work for the government. Canada has a successful single-payer system, as you know, which is basically like our system except that there is one major insurer, which is the government, and it covers everybody. France and Germany have a "social insurance" model, with hundreds of insurers run by employers and the government. This sounds like it could never work but apparently it does. Actually I should just link to this much better explanation from PNHP:

Health Care Systems - Four Basic Models

Anyway, I am posting this as a discussion starter, or a polemic, or both, or whatever. The important question at this point is not, "Should we have a national universal coverage system?" The important questions are "What will our national universal coverage system look like?" and "When the hell can we get it???"

Global warming irreversible for next 1000 years

I'd just like to go on record with a prediction.

Starting with today and going forward, no Bush Administration official at the Assistant Secretary level or higher will ever be punished in any meaningful way for the various crimes committed during the Bush Administration. Some lower-level functionaries and stooges might get some trouble, but the main dirtbags are going to retire rich and happy, secure in the knowledge that they made the country great again.

For this purpose, "meaningful punishment" means actual imprisonment for at least one month, and/or a fine substantial enough to cause actual hardship. It does not mean a millionaire is fined $10k, or that someone is merely humiliated. Humiliation means very little to someone with no conscience. So hearings and truth commissions don't do the job. There has to be an actual trial and conviction.

I will further predict that once "the country" has "healed" and "we" have "moved forward," within 20 years we will see yet another Republican scandal which we will be expected to forgive in the interests of not making Washington Democrats feel awkward when they go to work. And finally, I predict that, if I am wrong and someone is actually convicted and punished, that conviction will not be a bar to employment in any future Republican administration, if there ever is one.

I think that if we want to see these people get theirs we will have to hope that they accidentally go to Spain or something. Personally, I'd like to see Powell go down first just to establish that your reputation won't save you.

He gets it.

Eschaton