Sunday, March 21, 2010

Obama's first year in office (pt. 1)

So, we're on the precipice of the vote that will surely come to define the Obama administration one way or the other, the potential enactment of a bill for something that might approach the general vicinity of being close to the edge of the realm where universal healthcare could be the gleam in the eye of some young and newly inspired individual who might then rise to the office of the president and enact such a thing. And, yes, there are a great number of reasons to feel like this bill is dog shit. Dennis Kucinich is not wrong. Nor do I think he is wrong for having changed his vote. To take the metaphor a little too far and too smaltzy, shit, whether dog or otherwise, can be the nutrients for the seeds of a brighter tomorrow. A tomorrow where the young boy suffering from non-hodgkins lymphoma might just get the treatment he needs even if his parents work at Wal-mart. Or a tomorrow where the idea of equality has substantive weight. Or a tomorrow where the tired, poor, and huddled masses can look to this country again and see a vast land of opportunity, a land where rainbows shine across the cloudless blue skies and puppies run free and ice cream is plentiful and flat screen televisions grace the living rooms of every home and, and, and...okay, maybe I'm getting a little carried away here. We'll probably be okay without the rainbows and puppies. I wouldn't suggest getting between an American and their ice cream or their flat screen though. Like getting between a hippopotamus and a river that is.

Anywho, let me just say this, and this is something that's been in my head for a while, this notion of political capital is a load of horse shit (we'll get to the bull excrement eventually). It's a completely fictional idea. The only reason it has any power is because we give it power. Could we have started over on healthcare as the Repubs claim they want to do and get it right? Only if we recognize that the idea that big B shot his wad with this one go round is only true because we have made it so. And the Republicans know this, and so they know that by calling to start over they are in actuality calling for the end of any attempt at health care reform. It's what I call the bullshit highroad (told you we'd get there). This does not have to be the way our political process works. I don't want to get hung up on that problem just now cause it's a doozy and really the center of much of the rest and would take more than a blog post to outline even if I had the answer. I'm gonna hew a little closer to the pragmatic though for just this moment.

Just one more quick point about political capital: much of the reason this idea exists in the first place, beyond the perceptions and internal states of the legislators and their staffs that create the energy necessary to push forward against opposition, is the way politics tends to get covered in the news, especially on television but also in newspapers and on-line. It tends to be the case that the focus centers on the so-called horse race elements of a political debate or election and not so much on the substantive issues. And as a result much of the substance gets lost. (If you want substantive debate on television there's only one place to go-Charlie Rose. I officially retract my negative statements about the irreplaceable Mr. Rose. He is still and forever will remain the greatest roundtable moderator of political issues that the invention of television has ever known. [Although Gwen Ifill {sic?} is no slouch herself] His health care roundtable this week was massively informative both on the questions of process and substance, and Petraeus for the hour was masterful as well.)

The polling bears this out. While the general numbers have been improving as the 'momentum has shifted', even at the nadir during the whole death panel tea party uprising, the polling numbers dealing with the substance of the bill have always been good. People want the underwriting process (the denial of care for pre-existing conditions) ended, among other of the provisions.

The problem with the bill is that it does not 'bend the cost curve'. Single payer was one of the best ways to do that, reducing your administrative overhead potentially 10% and also strengthening yr bargaining position by being a larger entity. Now let me say this as well, the notion that government is inherently inept or ineffective is also substantially nonsense. Government bureacracy is no more inherently inept than business is inherently corrupt. It's all about structure. Properly structured these institutional constructs can and are of great value to our society. Also, the best way to bend the cost curve. Get rid of ice cream and flat screens. (Seriously, poor diet and a lack of excercise are a serious component of the U.S. health care problem [Also stress and income inequality {which is a major stressor the research has shown}].)

Okay, so I've been rambling around here, and I've about reached the limits of what I know about the current bill, as I've only been casually following the details. I still want to know more about the exchanges. Why does Minnesota work? Why did so many others fail? What's the structure of the national exchange? I don't know. And I'm curious about medicare advantage. I've heard from a few places that it's actually works pretty well and costs one third of what it was supposed to cost. How does that work? When I get a few moments, maybe I'll poke around and see what I can find with regards to this.

So, I had wanted to talk about process and big B's first year in office and the general political situation and my general thoughts about how Obama's done. Maybe I'll try again later in the week, as I'm now in possession of computational ability once again and can work form the comforts of my own confines. I do have to give the man his propers. He's committed to the fight and is seeing it through to the end one way or the other, even as they fumbled badly out of the gate by letting congress take the lead. We'll just have to wait and see which way it goes today.

Also, I'm not really sure I can forgive Terry Gross for soft pedaling the Karl Rove interview. I know Fresh Air isn't meant to be a hardball news program, but she practically handed the ball off to him and let him sprint down the sidelines.

Also again, Karl Rove is still a dick.

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