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Why don’t most “progressives” talk about what is really going on in health care reform?

January 16, 2010

I heard a very nice discussion today on KPFA radio about the latest on health care reform. (You can listen to an archive of the show here for the next two weeks.) This show has been featuring regular programs about heath care reform  (HCR) and what activists can do to improve the legislation. The regular guest is very knowledgeable and is experienced in lobbying for health related causes. She and the other guests today went into a lot of detail and suggested many action steps for people who want to make the bill better.

The discussion was mostly about the behind the scene reconciliation negotiations going on in the congress and how different parts of different bills might make it or not depending on who among the Democrats would refuse to vote for the final bill. There was also a lot of discussion about the abortion restrictions in both bills, what they would mean for women and different efforts going on to prevent them from going forward in the final bill. But in the end the guests made it clear that, despite all their complaints about the bill and their previous statements about how bad the abortion restrictions will be for women, they would encourage their representatives to vote for it because it really is a step forward, or some such nonsense.

The main problem with the discussion, and much of the HCR discourse among so-called progressives, is that it is like getting a great description of the ripples on the surface of the water produced by a feeding frenzy of sharks in the depths. You can analyze and describe the ripples very accurately, but they aren’t what is really going on. Since you aren’t fully aware of what is actually going on, you can never calm or control the ripples in any  significant way. Even if you do influence the ripples, the sharks don’t care and will keep on feeding until they have finished the seals. In other words, the people on this show never talked about what is really going on. As I outlined in this post, HCR is happening this year and taking the form that it is because corporations need new regulations and government funding to maintain their future profitability. The left has had no victories in HCR this year because they don’t understand the sharks and they still believe the ripples respond to their constituents. One of the most pitiful statements made by a guest was that we should keep up those phone calls and emails because the congress people and staff tell them that they keep track of those calls and “they aren’t hearing from us”. What are they going to say? “Don’t bother, we would love to take your concerns into consideration, but we can’t because the representative is depending on contributions from Pharma/AHIP/AARP to win the next election. Or, if he loses, to get appointed to the board of  Novartis.” The suggestions to call your representatives to ask them to tweak one element or another of the legislation is completely pointless. You are not a shark. They will send you to the answering machine.

Today there is yet another example of the sharks calling the shots. Obama and the Dems are being forced to re-negotiate their deals with Pharma and other industries as described in this article on Politico. Demonstrating how important the 12 year data exclusivity term for biologic drugs is to them, Pharma will pull its support for HCR if the final bill cuts the time down even to 10 years. The form the final bill takes doesn’t have anything to do with what we need. It is about the different industries with sometimes aligned and sometimes competing interests each trying to get the most they can out of the bill, and the Dems trying to give them as much as they can without getting a worse score from the Congressional Budget Office.

So why don’t many otherwise well informed and well-intentioned people on the left pay any attention to this or talk about it even they do know about it? I’m not them, of course, but I have several ideas.

1. If you admit this then you have to admit that everything you’ve been doing in your life as an activist (communicating with your representative, marching in the street or standing in front of buildings with signs, sending letters to the editor, etc), and that you’ve been telling others to do, has been mostly ineffective and a waste of time.

2. If you recognize that corporations call the shots then you have to admit that the US is no longer a democracy.

3. If you admit these things then you will have to conclude that your strategies and tactics need to change.

4. If you think about what might lead to a positive change, you have to conclude that what you do must actually negatively impact the corporations, the dysfunctional government structures, and the people who most benefit form the current status quo. Then you realize that this kind of action involves much more personal risk than you are willing to take. So you try not to think about it anymore and be hopeful instead.

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