Democrats: the strategy of "now or never" is failing.

Our health care problems are being treated much like forest fires are.

I understand the concern. Experts, pundits, politicians and others tell me that our health care system is broken, and that it has to be fixed. I agree. They say that it simply won't work. Eventually, it simply goes bankrupt. Sure. Then they say that if Democrats/Obama can't get it done soon, it won't get done. What? They point to how many have failed. Although the right wing would simply like to kill reform, some continually engage the opposition as if they were for a different solution. This gives the illusion of a battle between two ideas, but in reality Democrats propose reforms that Republicans oppose.

We constantly set it up as an imperative, which I believe is doing more damage than it is good. In my opinion, it's a flawed strategy I call the "Now or Never" approach.

The current strategy seems to be to send out the message that we must do something now to fix the health care system or that it won't happen because democrats won't have the power to get it done. This says to everyone that if the opposition succeeds in stopping health care reform now, that it becomes a closed issue. It also seeks to motivate people to act now -- out of fear -- by highlighting the negative effects of a health care meltdown. I understand the moral imperative, but it is a two sided message, one that says "Change Will Happen" yet simultaneously tries to convince people that "Change Must Happen Now".

**Just for fun, transpose this strategy to another issue: Energy and Mass-Transit. Our current message is akin to saying: "Oil prices will rise to 40 dollars a gallon eventually!" "We must build trains now! It's now or never!" Then, Republicans react: "Keep your government hands off my Chevy!" and "Just say NO to Obamatrains!" Since it's been framed a "Now or Never" issue for so long, we even begin to believe that losing isn't an option. We mistakenly believe that we have no choice. We compromise on the core reform--for a few votes. In return, the right wing then agrees that we should mandate a transition to hybrids and other low fossil fuel cars, etc. We scrap the big public trains. The price of fossil fuel then skyrockets, and cars become impractical. We have to build trains anyway, but it costs a fortune.**

I believe the correct strategy is to send out a more accurate message which happens to be more positive. Health care reform will happen regardless. If the system goes bankrupt and discontinues it is true that in order to survive, we the people will have to build a new system. We're just saying that if we do it right now we will save a lot, I mean a LOT, of money by utilizing our current infrastructure. Whether or not this or that bill happens, this system breaks. This message says "Change Happens Either Way". The argument becomes whether to pay a "little" now or a "lot" later.

**Transpose this back to mass transit. We argue that mass transit is an inevitability. We point out that the previous transit solution is just a band-aid, and that opponents are just arguing that we spend a HUGE amount building rail, and out of necessity. If we provide an alternative to automobiles right now, gas demand and prices will drop, and cars will still be driven. Right now, we can afford the gas to get the building materials to construction sites in trucks, so it's a bargain--a builder's market. It's not "Trains or else", it's a positive message: "Trains happen, so let's get them cheap".**

Back to health care. The ideal message would say that Republicans can stop a bill now, but that it would be be a victory only for those who want a radically different system. A complete collapse of health care, as happened to post-war Great Britain, will demand a radical solution. In a complete collapse, we would have only simple choices. We could embrace the idea that health care can only be provided to some, or we could decide that business competition and profiteering have no place in basic health care.

If we don't do anything, the problems (like a forest's debris) collect. 120 foot flames ensue as a matter of inevitability. This is a collapse. After a collapse we would agree that health care is in fact a right of everyone, because everyone would miss it. A publicly owned, single-payer system would be only the affordable option left. We'd simply have to cut out private interests.

If we decide to make small steps now? We start "controlled burns" that eliminate the debris. A publicly owned, single-payer system will probably occur anyway, but without the 120 foot flames.

I like the controlled burn method: the private insurance. The alternative, eventually rebuilding from scratch is possible, but there are more realistic and economical ways to utilize and modify any assets in the system we already have. Do we need to see the suffering that takes place while we build a new and untested single payer system from scratch? We could allow the debris to collect--we could pass a bill without nonprofit health care--but we SHOULDN'T! We are compromising already, to find ways to not risk the current state of care to seniors and those that depend on at least SOME system functioning continually. Still, if that doesn't work, it's better to get it over with: let it burn! Don't create a situation where private companies get the chance to screw us even more. It would be better just to buy the entire insurance industry at its current value than to allow it to dictate if, how, and for what price a person accesses care.

Republican voters should pay attention, since they're so outspoken against single payer: Shouldn't they be aware that it is in fact Republican politicians that are doing the most for our prospective chances of going single-payer quickly? How? They're simply eliminating any other choice!

I know that the common Republican is used to fighting against self interests. Votes for politicians who cut taxes on the wealthy are tallied every election cycle. However, health care opposition takes the cake as far as self-mutilation goes.

The right should know: you can back down and have something that resembles what you've got, or you can block reform--leaving no choice but to radically alter the system itself.

Lose now or lose worse.

The New Message

Obama and other Democrats should stop this "Now or Never" nonsense. The message ought to be something more like this:

"We can do this this the easy way, or we can do this the hard way, America"

Why? It's a better strategy, Obama. We've learned that putting out every forest fire simply makes the inevitable burn worse. I can't help but wonder if these band-aid reforms from Democrats that help us now but don't address the issue aren't going to make the health care "fire" bigger anyway. Either way, change happens. It should be reflected in our strategy.

Republican voters should know that they can stop a radical change from happening. We can simply refer to them as "pro single-payer" from now on. Maybe they will demand that their candidates concede the point: profit-driven businesses have no place in human health care. Sure, the gravy train for insurance company executives breaks down, but that's really just a glorified "triangle scam" anyway.

During the "controlled burn" of the current system, we might find efficiencies. Maybe it's cheaper for taxpayers to simply buy these companies out now at their current value and transform them into nonprofits, for example.

If they concede the public insurance? It's to any human's self interests to have health care guaranteed, regardless of politics or current economic situation.

If they block health care? They do accept responsibility for both the negative consequences (the flame) and the forced solution--a system they claim to despise.

These "pro-single-payer-by-means-of-necessity-not-reformers", or 'PSP's for short, would scramble to distance themselves from THAT label.

On Fox News they'd move right on to such serious topics as "Canadian Border Fences: Can We Afford to Wait?"

If only we had the right strategy and laid down the brutal truth. Here it is, in a nutshell:

Now:
Impression a non-political bystander gets from TV:
"We've got to stop these spiraling costs!" "Gloomy Future!"

Our message: we will take anything we can get. It's a moral obligation to help people. If malpractice reform lowers costs, do it. If we can't get the public insurance, whatever. We've GOT TO PASS SOMETHING because we can't afford failure. It's now or never! OMFG! IT's...
Y 2 K!

Worst case outcome: We continue, and present a watered down bill. It ends up being a well-disguised bailout for the health care industry's recession. No one seems to grasp the necessity of health care until they are sick. Insurance executives get rich and report Quadzillion dollar earnings. Other things we need to address, such as
as clean energy, education, environmental protection, and economics, are neglected. Everyone eventually realizes that medical companies have duped them out of half the country's tax dollars. Democrats are blamed. A total loss of public confidence in Democrats ensues.


What our message should be:

A change in the system happens anyway no matter what we do. Fires happen. Although not putting out fires seemed like a good idea, we now know that if you don't allow the debris to burn off, the forest is eventually destroyed. A new, different forest will then have to grow if there is to be one at all. We're trying to avoid a destruction of the health care forest. We can save a lot of money and lives if we do this "the easy way". That means no one is left out, that we provide a nonprofit public alternative to private, for-profit care! A person's right to access to health care can't be debatable. At the point where the opponent refuses to crack, what do we do? Hold steady, not compromise!! Our message should say that if you want to kill health care reform, the blood is on your hands.

Impression a non-political bystander could get from TV:

There's a choice:

1.Give all of our health care money to a very few people. Then there's only one option: public cooperation to provide enough health care for everyone.

2.Eliminate the private industry's monopoly on insurance, forcing lower prices. To compete for profit, private insurance will have to offer things that benefit the patient--rather than eliminate them from coverage. They would have to back up their higher price. They wouldn't be able to cancel care when someone is already sick. Insurance would be much more like it's supposed to be, like it is on a blackjack table: a gamble, not a guaranteed profit!!

Worst case outcome:

Republicans defeat public nonprofit solution in the senate. Democrats scowl and proclaim that they are just making it worse on everyone, but get to work on clean energy production. Republicans celebrate the hollow victory, but everyone pays for it--exponentially quick now. Soon it's common that people are evaluating whether to call an Ambulance for themselves during a heart attack, or to get a broken bone fixed, to absolve their children of a lifetime of debt. Eventually everyone realizes they were duped: Insurance company reports Quadzillion dollar earnings, prices skyrocket. The image of a the quickly-ascending price becomes most popular screen saver. It displays the amount of money going into private hands since the "Republican Victory" over health care reform.

The end is what I'm going for: If it doesn't pass, Democrats move on to other important issues and it will be up to the voters to provide the ACTUAL mandate to pass something which the GOP completely lines up against and which all Democrats don't support due to conservative excuses (they were elected by southern Republicans.

If we stand strong on what matters, they can still shut down our plans. We don't have a Progressive super majority, just one that is Democrat. If we get shut down fighting, at least we'll have a case--to elect more Progressive senators.

Contrast that to passing a bill that simply ensures more money for private companies. We could end up providing security to profit-motivated health care, and that's great for them. It's only a temporary fix, however. We will, in effect, put out more and more brush fires... and that's a strategical mistake.

That is silly. Insurance companies aren't blind or stupid. They will raise rates up to but below the point of causing such a collapse. They are not going to engineer a suicide pact. The same "collapse" arguments have been made since Truman proposed national healthcare. Somehow, year after year, the system... doesn't collapse. Somehow, Congress after Congress doesn't enact single payer (or even come close). People continue to vote (decade after decade) for Congresspersons that don't even consider it. Since Truman!

This logic is the same logic that people used to vote for Nader in Florida. We should just keep electing Republicans, because eventually this or that would collapse and there would be a huge mandate to elect Greens. It's not just that this logic is morally disgusting (screw people in the short term in pursuit of some speculative long term goal). It is empirically baseless. Close to 30 Congresses have been elected since Truman, and the same number have refused to enact Single Payer. Each and every time. 8 years after the Naderites achieved their goal, at what is probably the peak of the Democratic Party's power for the next 5-10 years, we can't even enact a public option, let alone Single Payer.

Your post is steeped in denial of reality. The problem is that the "collapse" theorists (whether in healthcare or politics in general) can't resolve the following two statements:

1. I really, really, really, really want something.
2. I am not going to get what I want, despite 1.

Reasonable people don't see a huge tension in 1 and 2; they learn (usually by the age of 5 or so) that there is a difference between wanting something and getting said something. But for some people, this idea never clicks, and statements 1 and 2 will forever be in tension with each other. People assume that the more they want something (or think something is a good idea), the more likely it is to happen. The better a policy becomes, the more the probability of enacting it increases. When this is proven false time after time and year after year, in a desperate attempt to resolve cognitive dissonance, they come up with some silly "collapse" theory that magically erases the contradiction.

Make no mistake: I would be totally against your proposal of massive short term suffering for long, long term gain EVEN IF a collapse were guaranteed at some later point. I find it hard to believe that people who agree with such a policy actually call themselves Democrats. But not only is a collapse not guaranteed to happen: it is guaranteed not to happen. The end result of your proposal is to prolong suffering and bankruptcies and death indefinitely when there are proposals that would significantly reduce it that could actually pass.