Healthcare reform is going to pass, for better or worse

I admit to having been – and remaining still – terribly torn over the issue of healthcare reform. For a while there I spent altogether too much time on the subject. Lately, I’ve been trying to stay away from the mayhem of domestic political battles. For one thing, I am a lousy partisan. For another, I find myself – in my personal life – taking on many of the worst attributes of the political: namely, that I become more argumentative, more unpleasant generally, and far less willing to act and speak with humility. This, even though I am a lousy partisan, and not subject to taking extreme positions let alone regurgitate the accepted talking points. I am a lousy moderate as well, as I find the positions of the middle-ground often lacking in any real conviction and seeking rather to find false consensus, a politics of compromise rather than conviction or independence.

But I digress. I remain divided on the issue of the impending passage of healthcare reform. On the one hand, I sincerely hope that it will mean a better and more secure existence for millions of Americans. On the other, I question whether the actual reforms will do enough to improve health outcomes while at the same time imposing an enormous new cost on the American public, both in terms of taxes, the mandate to purchase insurance, and on the federal and state coffers. Yes, the CBO has scored the bill as an overall savings, but that score is reliant upon numerous ‘what-if’s’ and budgeting gimmicks, and if you look close enough the view isn’t of savings but of vast new expenditures. On the silver-lining side, reform does – or at least should – create a better marketplace for health insurance; yet it does so without enacting enough competitive reforms, and instead seeking to cut costs by subsidizing those costs. The problem with that equation, naturally, is that when you subsidize something it is far more likely to become more expensive, not less.

And yet, I am once again drawn back to the fact that many Americans are really in dire straits, incapable of even purchasing insurance on the private market. (That the private market is expanded and enforced, and that the monopolies are not broken up at all by this bill is no comfort of course.) The problems with the status quo are manifold, and I do hope that this reform will get at some of the worst practices in the industry.

On this note, you should take a look at these ‘final thoughts’ on the passage of healthcare reform from Russell Arben Fox, who shares some of my concerns, and expands upon them (while also hoping for the best). He writes:

What about my deep, theoretical concerns with it all? That it is, in the end, another entitlement, however well-meant, and not true reform: not anything that moves us towards greater solidarity, greater community empowerment, greater appreciation of the common good?

Well, those concerns are still there–indeed, reading the text of PresidentObama’s final pep-talk to the House Democrats, just deepens those concerns, with the President insisting “this piece of historic legislation is built on the private insurance system that we have now and runs straight down the center of American political thought.” Great–making our “private insurance system” central to a program designed to create a common foundation amongst all the members of our polity, not being subject to the divisions and competition which that same private insurance industry contributes to! It’s frustrating, to be sure. It’s frustrating because I’m convinced those same corporate entities are primarily responsible (most indirectly, but sometimes directly) in so isolating us and individualizing us, as consumers and citizens, as to make it almost inconceivable that real democratic government, real populist action, real community sovereignty and sufficiencv, is ever to be recovered.

I don’t share Russell’s admiration for populism, but in many other ways we see eye-to-eye. Is it possible that a great increase in both the statism and corporatism in our society could possibly lead us closer to the ‘common good’ or to a society less atomized and less communitarian? I doubt it.

In the end, perhaps the greatest thing going for this bill is the possibility that it will open future avenues for better reforms down the road. That is not a very compelling argument, of course, but who knows? It may in fact be the most important argument of them all. The future will demand reform, and we may as well begin the process. As the House prepares to vote this thing through (or ‘jam it down our throats’ as the Tea Partiers and the Fox News crew are so quick to remind us) we may have little say in the matter soon enough. Healthcare reform will pass – and soon – and the changes will become law.

In ten or fifteen years we’ll know what that means for America.