roger hollander

Health-Care Reform Could Kill the GOP December 6, 2008

Posted by rogerhollander in Barack Obama, Health, Political Commentary.
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“…for most of my lifetime, prominent Democratic leaders have been chucking liberalism itself for the sake of immediate tactical gain.”

This is a quote from the article posted below that appeared in the Huffington Post.  Although the article focuses on the issue of universal health care, it raises much wider issues.  After one reads the article, one cannot help but asking the question: Why is this the case?  (Why does the right tend to implement its agenda when elected to government, while the left has a marked tendency to waffle and back track?)

My comments continue after the article.

 

Huffington Post, December 3, 2008

 Thomas Frank

 Can policy be both wise and aggressively partisan? Ask any Republican worth his salt and the answer will be an unequivocal yes. Ask a Democrat of the respectable Beltway variety and he will twist himself into a pretzel denying it.

For decades Republicans have made policy with a higher purpose in mind: to solidify the GOP base or to damage the institutions and movements aligned with the other side. One of their fondest slogans is “Defund the Left,” and under that banner they have attacked labor unions and trial lawyers and tried to sever the links between the lobbying industry and the Democratic Party. Consider as well their long-cherished dreams of privatizing Social Security, which would make Wall Street, instead of Washington, the protector of our beloved seniors. Or their larger effort to demonstrate, by means of egregious misrule, that government is incapable of delivering the most basic services.

That these were all disastrous policies made no difference: The goal was to use state power to achieve lasting victory for the ideas of the right.

On the other side of the political fence, strategic moves of this kind are fairly rare. Instead, for most of my lifetime, prominent Democratic leaders have been chucking liberalism itself for the sake of immediate tactical gain.

Former President Bill Clinton, who is widely regarded as a political mastermind, may have sounded like a traditional liberal at the beginning of his term in office. But what ultimately defined his presidency was his amazing pliability on matters of principle. His most memorable innovation was “triangulating” between his own party and the right, his most famous speech declared and end to “the era of big government,” his most consequential policy move was to cement the consensus on deregulation and free trade, and many of his boldest stands were taken against his own party.

The results were not pretty, either for the Democrats or for the nation.

Still, conservatives have always dreaded the day that Democrats discover (or rediscover) that there is a happy political synergy between delivering liberal economic reforms and building the liberal movement. The classic statement of this fear is a famous memo that Bill Kristol wrote in 1993, when he had just started out as a political strategist and the Clinton administration was preparing to propose some version of national health care.

“The plan should not be amended; it should be erased,” Mr. Kristol advised the GOP. And not merely because Mr. Clinton’s scheme was (in Mr. Kristol’s view) bad policy, but because “it will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests.”

Historian Rick Perlstein suggests that this memo is “the skeleton key to understanding modern American politics” because it opens up a fundamental conservative anxiety: “If the Democrats succeed in redistributing economic power, we’re screwed.”

In the Clinton years, of course, it was the Republicans who succeeded. And the Democrats’ failure — the failure to deliver national health care that is, not the act of proposing national health care — was a crucial element, in Mr. Perlstein’s view, in the Republican Revolution of 1994. Assessing the accomplishments of the “party of the people” after those first months of Clintonism, middle-class Americans were left with what? A big helping of Nafta. Mmm-mmm.

Fourteen years later, we find ourselves at the same point in the political debate, with a Democratic president-elect promising to deliver some variety of health-care reform. And, like a cuckoo emerging from a clock, Mr. Kristol’s old refrain is promptly taken up by a new chorus. “Blocking Obama’s Health Plan Is Key to the GOP’s Survival,” proclaims the headline of a November blog post by Michael F. Cannon, the libertarian Cato Institute’s director of Health Policy Studies. His argument, stitched together from other blog posts, is pretty much the same as Mr. Kristol’s in 1993. Any kind of national medical program would be so powerfully attractive to working-class voters that it would shift the tectonic plates of the nation’s politics. Therefore, such a program must be stopped.

Liberal that I am, I support health-care reform on its merits alone. My liberal blood boils, for example, when I read that half of the personal bankruptcies in this country are brought on, in part, by medical expenses. And my liberal soul is soothed to find that an enormous majority of my fellow citizens agree, in general terms, with my views on this subject.

But it pleases me even more to think that the conservatives’ nightmare of permanent defeat might come true simply if Democrats do the right thing. No, health-care reform isn’t as strategically diabolical as, say, the K Street Project. It involves only the most straightforward politics: good government stepping in to heal an ancient, festering wound. But if by doing this Barack Obama also happens to nullify decades of conservative propaganda, so much the better for all of us.

Thomas Frank’s column, The Tilting Yard, appears every Wednesday at OpinionJournal.com

Continuation of remarks by Roger Hollander:

 The answer to this question (Can policy be both wise and aggressively partisan?) I believe, is both simple and complex.  Complex in its detail with respect to the myriads of forms in which decisions are made in a capitalist democracy; but not that hard to understand in its broadest terms.

Follow the money.

The Republican agenda, again broadly speaking, is very much in tune with the objectives of corporate America, the military-industrial complex, the financial industry, etc; in other words, with capital.  If it goes to extremes, as with the current Cheney/Bush administration, some Republicans may take a longer perspective and believe that it needs to be reined in.  Nevertheless, no one could seriously argue that the Republican Party is much more than a front for organized capital.

Is the Democratic Party then, the opposite, its foil?  Dream on.  Because even in a capitalist democracy the power structure must at times respond to popular demands, the Democrats have taken the advantage of this by being the repository for such phenomena.  But within strictly defined limits.

Bob Dylan wrote, “Money doesn’t talk, it swears.”  Now I have nothing against money per se, I use it all the time.  It’s one of my best friends.  But what we are talking about here is enormous concentrations of money that exert an influence through campaign contributions and lobbying that cannot possibly be matched by any one or ones who represent the general interest. 

To go back to the original question, “can policy be both wise and aggressively partisan,” if we assume by “wise” that we mean the general interest, than from that perspective the answer in no.  Lobbyists have been referred to as the fourth branch of government.  The metaphor is useful to the extent that it demonstrates the colossal power of corporate and military lobbyists; but in effect the influence of lobbyist permeates all branches of government.  My favourite example of the effective lobbying is the Helms-Burton Act of 1996, which tightened the restrictions regarding doing business with Cuba, and was apparently actually written by staff at Bacardi and passed on the legislators who introduced it.

Of course the most obvious example of the Democratic Party’s winning representation in support of popular sentiment only to renege on its promise is the Iraq War (or, rather, the invasion and occupation of Iraq).  In the 2006 mid-term elections, the Democrats were able to gain control of both Houses of Congress based upon their support of enormous public sentiment for an immediate or prompt withdrawal.  With that power and authority under its Beltway belt, the Democratic Congress proceeded to approve every budget request for the war and went so far as to allow for its escalation, which was thinly disguised by the Orwellian use of the word “surge.”

Thomas Frank, the author of the posted article on which I am commenting, identifies himself as a Liberal.  We all know that the past two decades have been dominated for the most part by Conservative ideas and policies: anti-labor, anti-welfare, anti-environmental protection; pro-war, pro-corporate, pro-rich, etc.  But you wouldn’t know that by looking at the results of polling American voters, which consistently support universal health care, environmental protection, more equitable taxation, etc.; that is, the Liberal agenda!  But the Democratic Party (Clinton 1992-2000; Congress 2006-2008; Obama 2008?????) for a variety of reasons is neither willing nor able to give Americans what we want.

Two factors, not entirely unrelated to “money,” should be mentioned as means by which the general will and interest are thwarted in our capitalist democracy: manipulation through massive spending on public relations and influence bordering on control of the mass media; and manufactured crises or the appropriation of actual crises (this well documented in Naomi Klein’s blockbuster, “The Shock Doctrine”) to scare us into accepting unpleasant medicine.  The current economic crisis is being used, for example, to give Wall Street and its supporters in BOTH parties the opportunity to maintain its advantages while millions of Americans lose their homes and/or their jobs).

In effect the United States is a one party democracy with two branches: the Democrats and the Republicans.  Wikipedia lists 210,000 entries for the word “Republicrat.”  The notion is not original with me.  Look at the political spectrum.  The Republican Party pretty much represents every interest almost to the extreme end on the right side.  On the left side, the distance between the left wing of the Democratic Party (with the exception of a tiny handful such as Dennis Kucinich and Barbara Boxer) and say Ralph Nader (whose policies on the environment, the war, corporate taxation, regulation of the financial industry are virtually congruent with public opinion) and Noam Chomsky – both of whom are no where near to being criminally mendacious or as irresponsibly and ludicrously extremist as the Bill O’Reillys and Rush Limbaughs – is gaping.

Going back to the money, Barack Obama has tried to create the illusion that his massive campaign contributions came largely from ordinary Americans making relatively small donations.  While it is true that much of the Obama movement has been fuelled by the enthusiasm of American youth and liberals, and small contributions have been considerable; nevertheless, the bulk of the nearly trillion dollars in his war chest came from similar sources as were traditional for both parties.  Once the band wagon gets rolling, the big boys know when to jump on.

And going back to health care, Canada provides an excellent example of the thesis stated by Thomas Frank.  In 1942, Tommy Douglas was elected Premier of the Province of Saskatchewan, and introduced the first democratic socialist government in North America.  In 1962 Saskatchewan, after a “fight to the death” with the North American medical establishment and the provinces’ physicians, introduced universal health care, another first for the western hemisphere.

In that same year, a Conservative (!) Prime Minister of Canada, John Diefenbaker, established a Royal Commission to study health care in the country, and that Commission, headed by a former Supreme Court Judge, Emmett Hall, recommended nationwide adoption of Saskatchewan’s model of public health insurance, which led to the introduction and passage of the Canada Health Act in 1966 under a minority Liberal government, headed by Lester B. Pearson.  Thus Canada became the only country in the Americas, apart from Cuba, to offer its citizens universal health care.  And it did so under the political pressures that were a consequence of Saskatchewan’s successful and enormously popular and socially beneficial initiative.

It is also interesting to compare the results of leftist governments coming to power via democratic election versus those coming to power via revolution.  I have not made a comprehensive study of this, but will just name some examples.  In Europe, in the second half of the last century, two avowedly socialist governments came to power in France (under François Mitterrand) and Greece (under Andreas Papandreou).  Neither of the two governments were able (or willing) to deliver on their promises from the standpoint of either domestic or foreign policy.

On the other side of the ledger, during roughly the same time period two socialist governments came to power in the Americas though armed revolution: the July 26 Movement (under Fidel Castro) in Cuba, and the Sandinistas (under Daniel Ortega) in Nicaragua.  In the early years of both revolutions, their governments made huge inroads in eliminating illiteracy and in introducing free education (in Cuba up to and including university level studies) and universal health care, along with other progressive social programs.  Although the Cuban government has ossified into a Stalinist style dictatorship (though not nearly as brutal) and had to withstand the hardships imposed by the US blockade, it has been able to maintain these social programs.  In Nicaragua, the Sandinista government was seriously disabled by the US supported Contras.  The major targets of their terrorist attacks incidentally, were schools and clinics.  It lost power in a democratic election and recently has regained it.

I’m not saying that these examples necessarily prove anything, they are anecdotal , but I think it is worth pondering.

The example with which I am personally most familiar has to do with the Province of Ontario in Canada, where I resided for many years and where I served on the Municipal Council of Metropolitan Toronto as a elected Councillor for seven years.  In 1990 the New Democratic Party (NDP), which originally considered it socialist, but over the years evolved into a non-socialist leftist social democratic opposition, won a large majority in the provincial parliament and its leader, Bob Rae, became Premier of Ontario.  

The very first thing that Rae did upon being inaugurated was to travel to New York and speak on Wall Street to assure that they had no fears from his government.  Although his government was mildly progressive in some areas (a large percentage of women in the cabinet, some environmental protection), on the whole it could not be distinguished from traditional Liberal or Conservative governments when it came to protecting corporate interests and other instruments of capitalist control (policing, for example, where the Rae government failed to implement effective civilian oversight). It’s most notorious legislation was blatantly anti-labor.  It introduced what it called the “social contract” for government workers, a measure whereby they could accept voluntary roll backs or the government would do it for them.

Ironically, the Rae government was attacked viciously by the right and the corporate media as if it had in fact introduced a democratic socialist progressive policy agenda.  It was soundly defeated after a single term in office despite its efforts to appease capital.  It may as well have implemented its “radical” platform and left the province with a progressive legacy.  Instead,the Rae government was replaced by the government of Conservative Mike Harris, who did not hesitate to keep his promises to deregulate, privatize, and drastically reduce social and environmental programs.  He left office in disgrace, but his legacy remains.  Not only that, his major advisors and cabinet members are now effectively in charge of the Conservative government of Canada under Stephen Harper, another rightist who more or less “keeps his word” when it comes to his regressive policies on labor, social programs, taxes, environmental protection, etc.

A final and unpleasant irony.  One of the major arguments coming from the right when progressive measures are on the table is that such things as taxing business or increasing government spending on social programs (which involves more taxation) have the effect of driving business out of the jurisdiction.  If we increase corporate taxes or increase costly benefits and wages in X state or Y province, business will abandon them and move elsewhere.

When the Woodrow Lloyd (successor to Tommy Douglas) government introduced universal health care before the Saskatchewan parliament in 1962, the right and the medical establishment went ballistic.  Saskatchewan doctors went on strike and threatened to leave the province.  The opposition used this to play on latent racism by raising the specter of having to be attended to by “foreign” doctors, who would be brought to the province to replace the good White Saskatchewan docs.

Of course, as we have seen, exactly the opposite occurred.  When the general public in one jurisdiction can see that progressive social programs can actually work in another, it puts enormous pressure on their governments to act in a similar way.  No political party, no matter how far to the right, would dare suggest that the Canada Health Act be repealed (although they do their best to hack away at it whenever they get the chance).

Those of us from the Vietnam era remember the phrase “domino effect.”  It was used to frighten Americans into believing that if Vietnam remained a Communist state, all of Asia (if not the entire world) would follow.  In this case it was a bogus argument, but as the Republicans seem to be well aware, the Democrats actually being able to achieve a workable universal health care plan for the country could cause other dominos to fall (Kyoto, disarmament, affordable higher education, etc.) and undermine what the Republicans have so laboriously built up in the way of firewalls against progressive domestic and foreign policy. This “Chicken Little” strategy along with the enormous lobbying influence on both parties of the AMA and the private health insurance industry (of whom Hillary Clinton had become the major beneficiary in the Senate) is what Barack Obama and his Democratic Congress has to face if they are serious about universal single payer health care.  Place you bets.

A final word about universal health care.  Plans that involve the Byzantine network of private health insurance are probably doomed to failure once in operation for a variety of reasons not the least of which is cost and unworkable bureaucracy.  The weakness of existing single payer health plans such as that of Canada is that, while the coverage is “socialized,” the costs remain private.  In Canada the government negotiates with the Medical Association on a schedule of fees, but cost containment remains a serious problem.  In Canada drugs and dental care are not covered.  In the US, when the drug benefit was introduced to Medicare, it specifically prohibited the government from negotiation with the pharmaceutical industry for lower prices.  In Great Britain, where the National Health Service represents genuine ”socialized” medicine in that it is government “owned and operated,” pressures to limit services in order to contain costs persist, of course, because costs are directly related to taxation. 

This takes us to the question of the role of the state in a capitalist society and what might things be like if and when capitalism were replaced with genuine democratic socialism, a minor issue but one which I will leave for future discussion.