How the Democrats Should Have Handled the Health Care Debate

A question for the Democrats: How long can you keep getting outplayed by the Republicans, not deliver on your promises and continue to ask for our votes?
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It is an axiom of American politics that the Democratic Party will negotiate from a position of weakness and the Republican Party will proceed from strength. The number of seats they hold in Congress is irrelevant to this paradigm. The Republicans could be down to five senators and they would still charge into battle. And the Democrats would, from the outset, assume that the Republicans are right (and mainstream) and that since their own position is too extreme they must concede as soon as possible to remain politically viable. There is no Republican talking point that won't scare the bejesus out of the Democratic Party.

Now, let us imagine for a moment a world where this axiom was not true, a world where the Democrats proceeded from strength. Here is how the health care debate would have unfolded instead.

1. Before introducing any legislation, the Democrats hold hearings on the state of health care in this country. They bring in the top health care industry executives and ask them to answer for these grave injustices and inefficiencies:

a. The practices of denying people care through rescission and denying people coverage because of pre-existing conditions. Rescission is where insurance companies will let people die because of a technicality. As soon as you have a serious, life-threatening condition (in other words, an expensive one, the kind you bought insurance for), they will go back over your original forms and see if there is any way they can deny you coverage. They have been known to deny treatment for cancer because someone didn't report that they had acne -- literally.

Then the Democratic congressmen and senators would get on all of the cable shows and pronounce that they are shocked to find out that private health care insurance companies kill people for a profit in this country. Of course, the reality is that they do. In fact, it is their fiduciary responsibility to do so. They must maximize profits, and in health care, one way to do so is to deny coverage for the most expensive treatments and conditions.

b. Then the Democrats would ask the CEOs of these companies how much money they make. The CEO of UnitedHealth Group would have to concede that he has three quarters of a billion dollars in stock options. Then a Democratic congressman would lean in toward his microphone with great gravity and ask, "You mean to tell me that you deny people the life-saving procedures they need because it costs too much money while you personally are set to make over $750 million?"

c. Then you bring out family members of people who have died because they were denied insurance coverage either for pre-existing conditions or because an insurance company executive had found some technicality in their forms. Ask them how it feels to go on without their loved ones and how they felt about the practice of rescission. Finally, ask them how they feel about the millions of dollars the CEO of the company that denied the coverage makes.

d. Bring out the private insurance bureaucrats who deny people coverage on a regular basis. Not just the people who practice rescission or find pre-existing conditions, but also the people who decide what procedures you can and cannot get based on your coverage. Have them explain what bureaucratic standards they use to get between you and your doctor.

e. Bring out the accountants of these private health care companies and have them explain how much money they spend on overhead, advertising and executive salaries. Ask them how much they have increased premiums over the last ten years -- the answer is a stunning 119%. Ask them to repeat how much money they spent on advertising and executive compensation.

f. Bring back the CEOs and show them pictures of the people who died because their companies wouldn't cover their medical expenses, as they had promised. Then show them pictures of their own houses/mansions and yachts and jets. And ask them, one simple question: "Was it worth it?"

After the hearings announce with serious concern and appropriate gravity that something must be done about this! The problem is undeniable and there has to be something that Congress can do to help protect the American people.

2. Introduce single-payer legislation. Say that anything less would continue the rapacious system of private insurance for profit in this country. You wouldn't leave fire protection in the hands of private bureaucrats who get to decide who lives or who dies based on how much money their CEO is going to make. So, why would you do the same in health care coverage? No, it is an essential duty of the government to protect the well-being of their citizens.

3. Announce that you must do the will of the people by voting as a Democratic bloc. The American people voted for 60 Democratic senators, and 60 Democratic senators they should have. Anything else would be a slap in the face of democracy.

If they wanted the Republicans to be in charge, they could have easily voted that way. If they wanted the Republicans to be able to block legislation with filibusters, they could have given them 41 senators. But the American people in their infinite wisdom chose not to. They chose to give the Democrats an unstoppable coalition so that they could bring the real change they were promised.

Treat the Republicans as the irrelevancy they are. Let them cry in the corner, but under no circumstances should you allow the press to consider them a pertinent part of this debate. Remind the press at every turn what they said and what they wrote when the Democrats were in the minority -- that the Republicans represented mainstream America and that the Democrats should not be covered because media coverage is about what will actually get done. Now that the Democrats have much larger majorities than the Republicans ever had, the opposite must also be true -- Republicans are an irrelevant minority party and the Democrats are the mainstream.

4. If absolutely necessary, compromise with some of the more conservative (read corporate controlled) Democrats and settle for a public option. Then make an enormous deal out of how reasonable and magnanimous you are for coming up with this middle ground approach. Then brag about how you delivered on your promises, got the American people the change they voted for, and you still did it in a moderate and centrist way.

Now, back in the real world, we know that the Democrats would never have the fortitude to do things this way, but you have to wonder why. What is missing in the politicians of this party that makes them incapable of putting together a strong argument for their own side? A spine or other body parts might be mentioned. But how long can people go on voting for a party that they know is constitutionally weak and almost never does what they promise? Especially when we know it's because they're too timid to?

But it's not just a matter of having the courage of your convictions, you also have to question how savvy Democrats are. Why have they not realized in all of these years how the media game is played? Can they not see that everything in politics is framing? That it's not the answer, but the question that's most important. If you ask the question "can government run health care in this country?" you're having a different debate then if you ask the question "should we allow private health insurance companies to make decisions on who lives or dies based on how much profit they're going to make?".

It's all in the question. So, I have one last one for the Democrats: How long can you keep getting outplayed by the Republicans, not deliver on your promises and continue to ask for our votes?

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