Is Health Care Reform Just Paper on the Bird Cage Floor?
By Pat Racimora on February 1, 2010 at 7:15 PM in Current Affairs

It depends on who you ask, but Press Secretary Robert Gibbs said Sunday that health reform legislation is “still on the one yard line.” Other prominent Democrats, such as Evan Bayh and Howard Dean, suggest that we dump that House turkey and start all over again.
Who’s right?
Last August I predicted that health care reform was unlikely to materialize in the near future because that little window of factors that had to line up was not open wide enough.
Let’s revisit and update (my comments in italics):
1. The political landscape needs to be dominated by one party (i.e. who controls decision-making, primarily Congress and the Executive Branch). Obama should have this one on his side, but some donkeys are restless, perhaps because the public does not seem to like what has been put out so far, and members of Congress want to keep their jobs after this election cycle.
2. The President has the ability to pull people together (“a uniter”). He still has lots of friends, but poll numbers continue to slip. The “magic” is wearing off for many previous supporters and those who did not think he was ready to be President are learning how right they were.
3. The people are willing to give government a chance to do something right and competently. Awful timing. People are now watching helplessly as our treasure depletes even further as two wars rage on abroad and the economy only limps along.
4. The medical establishment realizes that health reform is inevitable, so it is best to join the team to help shape it than to fight it. (This happened in Canada.) The American Medical Association has endorsed the plan, but the AMA is no longer representative of practicing doctors. There does not appear to be a sufficient medical force promoting what has been put forth so far.
5. A resurgence of working class organizations and unions. This seems to be on Obama’s side. Organizing new political groups continues on the heels of the stunning organizational capabilities of Obama’s campaign, but others may have learned new tricks and will launch their own advocacy groups. I see a good one on the horizon. Stay tuned.
6. Our foreign affairs concerns, if not solved, must be stabilized. This depends on who you ask, but a lot of turmoil remains in the Middle East and we remain in the thick of it. Still lots of killing and too little progress on the ground.
7. The economy must appear to be on the mend (more jobs, less reliance on foreign oil, etc.). I don’t see enough green sprouts yet, and people are still losing homes and jobs.
8. Demands for health reform from powerful social or political groups. Obama has powerful allies here. And powerful opponents.
9. A weakening of current health care markets, such as an increase in “high profile” criticisms of for-profit HMOs. Well, people are pretty fed up, and yet the majority of Americans like the devil’s insurance they have more than the devil’s plan they don’t know.
10. A rise (or resurgence) in national pride and a return to the exercising of fundamental values such as caring for others. Well, I don’t see it yet. Maybe people are too busy trying to survive.
11. A savvy social marketing campaign for health care reform. Given that Obama won the election despite a thin resume, satisfying this factor should have been a piece of cake. But it appears that people want a lot more than well-delivered words and promises once someone wins.
12. A mechanism for rapid communication of ideas/programs that the public views to be in its own best interests and that successfully counters the fear tactics by opponents. We have the Internet, blogs, Facebook, text messaging, and Twitter, but these innovations are so sprawling that it is difficult to coordinate efforts. Furthermore, people tend to hang out in cyberspace with those who believe as they already do—just as in the non-virtual world.
13. Ideally some substantial degree of healing between Democrats and Republicans or at least a strong bipartisan agreement that health care must be enacted. Bipartisanship? Don’t see that anywhere in sight.
14. Meaningful lobby reform, cutting off to some extent powerful interest-group access. A big Obama promise that has been badly broken is coming back to poke him in his privates. Deals seem to have been made with corporate entities that have a lot more to gain from the plans floating about than do our people.
15. Public financing of elections, again, reducing the influence of powerful interests. Maybe someday, but not even on the horizon. One gets the sense that incumbents care more about retaining their jobs than adjusting our system to make for a more level playing field.
16. Agreement on the shape/scope of a health plan from among various health care reformers. So far those who favor health care reform have been unable to coalesce around a single plan.
17. A significant external shock (e.g., skyrocketing health care costs threatening the collapse of our economy, a major health care scandal, a plague or natural disaster or terrorist attack that injures large numbers of young and healthy middle and upper-income Americans, or other unfortunate occurrences that force change). Well, health care costs are skyrocketing, but the problem with what is being put forth is that no one quite understands it (Lord knows I have tried reading these monster documents and come away with an Excedrin headache) or how it will be funded.
So things still do not look good to me. Unless Congress makes even more sweet deals to buy votes, as was done for Nebraska, I doubt we will see anything in the near future. I say, start from scratch after more people get jobs and back into homes .






















