At The New Republic blog Jonathan Cohn goes out of his way to attack Marcia Angell’s clear and courageous article at the Huffington Post.
Mr. Cohn begins with a disclaimer:
I’m a longtime single-payer supporter myself. If Angell could get her way, I’d be thrilled. But Angell can’t get her way.
This old saw is by now condescending, tiresome, gratuitous. Mr. Cohn merely tells us what leading politicians have been telling single payer advocates for decades: real health reform is not politically feasible (so go away!) This is not the stance of a single-payer supporter. It also falls well short of a license for the lame straw man argument that follows.
To Angell–and to others on the left, as my colleague John Judis notes today–this is reason for ditching the whole effort. But what, really, would that accomplish? The immediate impact would be to undermine Obama and his allies in Congress, creating the (accurate) impression they are incapable of passing major legislation. The Democratic Party would lose seats at the midterms and then, quite possibly, suffer even bigger setbacks two years hence. That’s not exactly a recipe for progressive revival.
Perhaps Angell and those who agree with her that this would be a constructive failure–that eventually growing frustration with our health care system will help us elect even more progressives and pass more ambitious reforms. Well, maybe. But that’s an awfully big chance to take…
Dr. Angell is not writing about electing Democrats! She is writing about health reform.
The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we’ve tried health reform and it didn’t work. But the real problem will be that we didn’t really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
The nation asked the Democratic White House and the Democratic Congress for health care and so far we have gotten “health insurance reform” with a bonus – restricted access to abortion.
It is this fact that makes the Democratic Party “insurance reform,” – how does Mr. Cohn put it? – “not exactly a recipe for progressive revival.” Yet he blames Dr. Angell instead.
Our nation can do without “insurance reform” that will criminalize the uninsured, subsidize unaffordable insurance premiums with rivers of tax money, protect pharmaceutical company superprofits at patient expense, hugely expand Medicaid in the face of nationwide state budget crises and thus quickly prove fiscally unsustainable. (Incidentally the insurance industry projects its price increases will reach between 79% to 111% by 2019, under the proposed “insurance reform.”)
Dr. Angell keeps her eye on the prize – comprehensive health care for all. A single payer system is the minimum increment of change that can bring that about.
Mr. Cohn wants to change the subject to electing Democrats. Yet ironically, the amazing development of a nationwide grassroots effort for single payer has been the real “progressive revival” of 2009.
If those inside the bubble still feel they can dismiss us by holding up a straw man, it simply means we must try harder, and grow our effort for a single-payer national health program larger and louder. It is not only our duty to our patients, but to a nation that expects genuine health reform.
Andrew Coates is secretary of the Capital District (NY) chapter of PNHP. He practices medicine in Albany, NY.