MJS passed along to me this TPMCafe contribution
one Jonathan Cohn, a senior editor at the New Republic,
to the donk wonk wrangle
over the single payer
universal health care solution.
What wrangle, you're thinking? Surely the solution is as obvious
as the nose on an elephant's face.
Well, not for Cohn:
"it's so big... its a trunk... and that's different."
He tells us that while others may
"suggest that the debate within the Democratic Party
is not over whether to insure everybody, but how.... I disagree."
Quite the bold fellow. Why does he disagree?
"it's one thing to say it
and another to commit the resources,
political and financial, to do it."
If he'd gone off stage right there to roll his pants
and wade down to the water line
this post would never have happened.
he's staying on the pot awhile,
just to make us wait,
he reviews the weedy, wind-rolling fields of his mind
and fidgets at maddening length before finally, proudly producing his little gift.
Of course in this throne-room one-man show,
the senior editor at New Repulsive
also must play Mommy too.
the obvious --
pushing for the plunge is "our" present task. Push, little America! Push!
But then... on the other hand:
"First, there's a transition issue."
Yup, we got millions doing next to nothing necessary --
shuffling IOU's and such
inside lots of office buildings
because of the Byzantine partitioning the present system
engenders, enhances, and ultimately worships.
Single payer would... well,
I can hear the deafening deadly job-killing silence
as 3 million superfluous
keyboards stop clicking. A magisterial note
is struck: "All things being equal, disruption is bad."
So... can we slow-mo here? Can we
"naturally evolve into a single-payer system?"
Citizen Paine's stentorian answer: Yup.
In fact, bring it on.
We can solve this one with uncle's credit line.
Run in the red for a stretch.
Deputize 'em all and do a slow winnow.
But our guy' wondrous idiocy peaks here.
"As a wise, widely respected health care scholar
recently reminded me,
it would have been one thing
to set up a single-payer system back in the 1930s ....."
But now...? Ah, fans, you just can't make this stuff up.
He moves on -- sort of.
"...Most single-payer systems ..
sacrifice some level of choice,"
but but but
"I think choice is frequently overrated in health care,"
but but but again
"there is a philosohpical appeal to letting people
choose what level of coverage they want
and how much they want to pay for it."
Ahthe endless joys of dither do -- always teetering on the brink, never quite there -- Tantric
Finally -- surprise, surprise -- it comes down to his own case.
Do I want a one size fits all,
"I'm willing to spend a larger chunk of my paycheck
on it in order to have easier access to more doctors."
But but but then there's the preferences "of somebody else who might want ...."
Talk about scared of your own shadow --
this is a non-issue.
Choice can build on top of basics. Easy. Next victim!
Now we get a lyrical little "small is beautiful" intermezzo:
recall the wonders of...
Group Health of Puget Sound,
"true to the original idealistic spirit of managed care."
Wouldn't an Uncle Sam
unitary timber giant crush out this type
of "ideaistic" littlehood?
Well, let's fucking hope so,
for the sake of all humanity
outside the local hand-thrown
clay pot shop.
Moving along --
is single payer really
"the easiest to explain?"
sounds easy --
"Medicare for all."
But but but but!
"There's another way to look at it."
What if they think that -- you know --
they get fearful --
they get spun --
some sort of profit boys stand to lose here,
their long and lingering howls
could scare folks.
"Maybe we need to tell them... you get to keep the insurance you have."
But but but!
That's not single payer anymore, is it?
What to do, what to do.
"Incremental solutions have so many more problems,"
but but but!
"single-payer has its inadequacies too,
and they're worth thinking through."
No one, I'm sure, will be surprised to hear that
this geep is
"now at work on a book
about the U.S. health care system."
He gets one point right, though,
about single payer:
"I think a substantial number of elected Democrats aren't there..."
But but but!
"Maybe deep, deep within the recesses of their hearts they are,
in any event, I'm not sure it really matters if they can't admit it."