The Thinker

Not exactly Waterloo

What a curious analogy by South Carolina Senator Jim DeMint: if Republicans and others opposed to “socialism” can stop President Obama and Democrats in Congress from passing health care reform, it will be Obama’s Waterloo. He will be doomed to finish out an ineffectual term, kind of like Jimmy Carter.

Most of us Americans have a hazy idea at best about The Battle of Waterloo. A quick recap for those of you who might have been asleep during the lecture on European history: in the Battle of Waterloo, Napoleon had managed to return to power in France after being exiled to the island of Elba off Tuscany. (It would be like Obama losing a second term, and then later winning another term.) Napoleon had already held power for a decade. Having been bitten many times by Napoleon, allied powers quickly organized to defeat him again. English and Prussian powers were able to defeat his armies rather handily in June of 1815 at Waterloo in Belgium. After all, they knew what they were up against and brought forty thousand more soldiers than Napoleon to the battle. After the battle, Napoleon went to live on another island, this time St. Helena in the South Atlantic Ocean, where he died rather ingloriously of stomach cancer in 1821.

In short, Waterloo was the concluding battle of Napoleon’s resurgent short second reign. In contrast, President Obama has been in office a little over a year. The closest analogy one can make between Napoleon and health care reform legislation was Napoleon’s administrative reforms, which included a tax code, a public road and sewer system, establishing a central bank, and a set of civil laws known as the Napoleonic Code which were, at least in theory, quite progressive. Many of these laws and institutions survive today and may be Napoleon’s true legacy in France.

In this health care battle, if any side has superior forces, it is the establishment. It is true that Democrats have the political advantage in Congress. However, the watered down legislation making its way toward the reconciliation process represents significant concessions to the health care and health insurance industries. Single payer health care? Gone. A public option health care plan to compete with private health insurance plans? It has virtually no chance of being added during the reconciliation process, based on press reports. If brought up, it stands little likelihood of making it through reconciliation.

In many ways, if the current legislation were enacted, it would be a great victory for the health insurance industry. These companies understand that in the end they cannot sell health insurance if no one can afford to buy it. The legislation requires most uninsured Americans to buy health insurance from the private health care insurance industry. The government is basically requiring Americans to dole out more of their hard earned money to give to private corporations, not the government. That sounds like the government is assisting the corporatocracy, not socialism. If Americans cannot afford to buy the product, in many cases the government will offer subsidies and tax credits to make it possible.

To label these reforms as socialism is ridiculous. If regulating the health care industry is socialism, then one has to ask the obvious questions of what else the government is doing is socialism, because most of the federal government could be construed as socialist. Regulating drugs for safety and efficacy must be socialism because it interferes with the free market for drugs. Federal highway transportation standards and interstate commerce regulations must be socialism. Most significantly, Medicare and Medicaid must be socialism. Yet, few of those railing against socialized health care are talking (at least openly) about getting rid of Medicare and Medicaid. Many of them loathe Medicaid (health insurance for the poor) but to vote against Medicare would estrange them from virtually every senior citizen in the country. Republicans, of course, thrive on cognitive dissonance. So sure, of course they can be for socialized medicine for senior citizens yet bitterly oppose it for the rest of the working class whose taxes, by the way, are funding the Medicare system that seniors are using.

The only health care legislation that would truly be socialist would be a certain forms of a single payer health care system. This would have the government pay all Americans health care bills. In return, you would have to get health care from a government approved health care provider. Even so, as envisioned, the single payer health care approach is probably not socialistic, because the government would not directly provide the care. Most single payer health care systems follow this model. Great Britain’s Public Health Service is a major exception. Curiously, in Great Britain the Conservative Party is aligning itself as the savior of the PHS.

Is a public option socialistic? A public option provides a government administered (not owned) health care plan open to all legal U.S. residents. It would probably look a lot like Medicare; in fact, it might be Medicare extended. However, practices currently do not have to accept Medicare patients, and many do not (or do so only with grumbling) because they do not feel they are adequately reimbursed. A public option would probably not be wildly successful. A public option would probably be like buying a “good” or “better” model refrigerator. Most Americans would lust for the “best” models available from companies like Blue Cross. However, having a public option, even if it is not as great as Blue Cross, beats having no health care at all. Ask forty seven million uninsured Americans. What a public option does is help make health care more affordable because health insurers would have genuine competition. However, as I noted, the public option has little chance of passing with health care reform.

The argument really amounts to whether the federal government should mess further in the health insurance marketplace. It’s about making sure the government does not grow any further, except in ways that matter to Republicans, like having large defense contracts to privileged contractors like Halliburton. It is apparently okay for the government to ensure that securities are traded in a fair and open manner. However, it is not okay for the government to require a level playing field for health insurers. State corporation commissions ensure level playing fields all the time with electric, sewer and water rates and we don’t fret about it. Some states even regulate health insurance providers. We recognize that industries that are monopolies, or near monopolies like the health care industry in many states, need regulation to ensure that a vital service is available at all. It is hard to think of any service more vital than health care. Moreover, it’s hard to think of an area more in need of regulation, given astronomical premium increases and no constraints about whom a company can insure.

It is clear what the cost of inaction would be: eventually there will be no health insurance industry at all. Maybe that is what Republicans are secretly hoping for, although the way they take major contributions from the health care industry it is hard to believe. After all, if no one but the very wealthy can afford to pay out of pocket for health care, perhaps with all these surplus doctors costs would finally drop to an affordable level. I personally think it’s more likely I will get a visit from the tooth fairy than this ever happening.

So I would not hold my breath there. I can guarantee you one thing: if health care reform does not pass, eventually the health care industry will be petitioning Congress for regulation. The last thing they want is not be the broker between you and receiving health care. So take your health insurance reform now or later. The reality is the current legislation is a great gift to the health insurance industry, which will likely ensure its survival with, at best, only a light touch from government.

Waterloo? In this case, Napoleon is not President Obama, but the health insurance industry. Perhaps the rock group Abba got it right:

Waterloo – knowing my fate is to be with you.


One Response to “Not exactly Waterloo”

  1. 5:54 pm on March 15 2010, John Smtih said:

    Republican Senate 51-49 or 53-47 come 2012 and Dems hold the House only if Blue Dogs don’t defect and join with the Republicans to elect Steny Hoyer as Speaker.

    Mark, Obama is probably finished. He’s a flash in the pan, much like Carter was. The Republican nomination, which was worthless less than 16 months ago for 2012 is now, quite likely going to translate into that nominee defeating Obama by a wide Electoral College margin.

    If you really can’t see the similarities between Carter and Obama than, sadly, you are even more of the traditionally lost uber liberal than I thought you were.

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