Healthcare: Was it Screwed Up or Were We Screwed

In last month’s “American Prospect”, Paul Starr writes about his part in the Clinton healthcare plan and why he felt it failed. The timing was wrong.  It was Bill not Hill. It was too generous.  It was those commercials. http://www.prospect.org/cs/articles?article=the_hillarycare_mythology

In last Monday’s “Counterpunch” on line , Vincente Navarro who also was on the team presents a different view.  Navarro is Professor of Health and Public Policy at the Johns Hopkins University, U.S.A., and of Political Sciences in the Pompeu Fabra University, Spain. His tale is very interesting. The whole essay is a great read and I urge you to read it. http://www.counterpunch.org/navarro11122007.html

He was put on the Clinton health care task force when Jesse Jackson, Dennis Rivera (then president of Local 1199, the foremost health care workers union),and himself pressured Hillary Clinton to include a “single -payer” advocate.  She asked Jackson and the Rainbow Coalition to come up with somebody and  they picked Navarro.  But he found himself not terribly welcome.

I later found out that there was considerable opposition from senior health advisors, including Starr and Zelman, to my becoming part of the task force. According to a memo later made public and published in David Brock’s nasty book The Seduction of Hillary Clinton, Starr and Zelman disapproved of my appointment “because Navarro is a real left-winger and has extreme distaste for the approach we are pursuing”­ which was fairly accurate about my feelings, but I must stress that my disdain for managed competition and the intellectuals who supported it did not interfere with my primary objective: to make sure that the views of the single-payer community would be heard in the task force. They were heard, but not heeded. I was ostracized, and I had the feeling I was in the White House as a token–although whether as a token left-winger, token radical, token Hispanic, or token single-payer advocate, I cannot say. But I definitely had the feeling I was a token something.

Navarro had been Jesse Jackson’s health advisor and, like so many other things about the 1988 campaign, historical revisionists like to pooh pooh Jackson’s amazing run for the presidency.  It turns out that he ran on a commitment to universal health care and had 40% of the delegates to the Democratic Party Convention in Atlanta with him.

This shook the Democratic establishment and stimulated responses from Governor Clinton, Senator Al Gore, and Congressman Richard Gephardt to block this rise of the left in the Democratic Party, which they did by establishing the Democratic Leadership Council, among other interventions. (Gore and Gephardt have changed since then; Bill Clinton hasn’t.)

Jackson wanted a plan similar to Canada, but Clinton, when he ran, decided to take the less “radical ”  more establishment approach of “managed care competition”.  He even “borrowed” Jesse’s slogan “Putting People First”.  As Navarro points out “While borrowing the language and the symbols [of the Jackson Campaign], however, Clinton changed the content dramatically.”

Paul Starr said that the healthcare debacle was not Hillary’s fault, but Bill’s.  He gives the conventional explanation that it was partly bad timing and partly that the plan had too many benefits.  But Navarro believes that real healthcare reform was sold out to NAFTA.  Bill and Hillary needed the people behind them to fight the for-profit health insurance system.  But by selling and approving NAFTA, they lost the people, especially the working class and therefore, lost the Congress.

When NAFTA was approved, Clinton signed the death certificate for the health care plan, and for the Democratic majority in Congress. The number of people who voted Republican in 1994 was no larger than in 1990 (the previous non-presidential congressional election year). The big difference was in the Democratic vote. Abstention by working-class voters increased dramatically in 1994 and was the primary reason why Democrats lost their majority in Congress. This is a point that Starr ignores. The Gingrich Revolution of 1994 was an outcome of voter abstention, particularly among the working class, who were fed up with President Clinton. But NAFTA was also the death knell for health care reform. One could see this in the White House task force. NAFTA empowered the right, and weakened and demoralized the left.

I’m not sure what I was doing in 1994, but I sure wasn’t paying attention.  NAFTA didn’t seem like a good idea, but I decided to leave it up to Bill and Al and I would go about working on my new business.  Well, I should have paid attention because I didn’t know at the time how much health care would become more and more important to me as would the consolidation of the media and the increasing irrelevance of the Democratic Party. I was in the simmering pot with some other frogs and thought it was a jacuzzi.
Navarro states:

A continuing shift to the right (erroneously called the center) has been the Democratic Party’s strategy for the past 30 years, abandoning any commitment to the New Deal and the establishment of universal entitlements that make social rights a part of citizenship…I told Mrs. Clinton that the only way of winning, and of neutralizing the enormous power of the insurance industry and large employers, was for the President and the Democratic Party leadership to make the issue one of the people against the establishment. It was a class war strategy that the Republicans most feared. My good friend David Himmelstein, a founder of Physicians for a National Health Program, told Mrs. Clinton the same thing. And as I judged by her response, she seemed to think we did not understand how politics works in the U.S. The problem is, we understood only too well how power operates.

So she didn’t take their advice and Navarro worries that she will not take it again. He calls our health care system “a cruel system” supported by large employers and the insurance companies.  Large employers use health care as a way of controlling the labor force.  Navarro calls this control “oppressive”. And to get rid of it will take a warrior.  That’s not Hillary.  Hillary believes in incremental approaches and not taking on the system. In a recent  Harper’s Kevin Baker wrote a devastating and spot on essay called “A Fate Worse Than Bush: Rudolph Giuliani and the Politics of Personality.”   But it wasn’t just about Guiliani.  It was about Bill and Hillary Clinton and Rudy all working for George Mc Govern and the lessons they learned from that campaign.  
http://www.harpers.org/archive/2007/…

What the Clintons learned from this, and would learn and learn again over the course of their many years in politics, was that progressivism could be advanced only in the most incremental installments, and only with the imprimatur of powerful corporate and financial elites. They would adopt a sort of “post-ideological” politics–a politics that abandoned the old ideologies and claimed none of its own.

The term “post-ideological politics” once primarily referred to the technocratic best-and-brightest approach of the Kennedy Administration, but in America today post-ideological politics generally progresses under the rubric of the Clintons’ preferred, misleading “third way,” or “triangulation”–which is really more the politics of the possible as Bill and Hill came to understand it.

But I agree with Navarro.  We must challenge the whole system.  It’s corrupt and rigged and dreadfully out of balance.  Thomas Jefferson said that the divide in our country would always be between “aristocrats and democrats”.  It’s an argument that has taken place since Hamilton argued with Madison and Adams argued with Jefferson.  When John Adams jailed newspaper editors that called him “fat”, Americans knew that we had tipped the balance too far in favor of the aristocrats.  This is another time like then.  We need to restore balance by kicking out the status quo with a swift kick and not some nudges.

Navarro ends with a plea:

Love of country is measured by the extent to which one promotes policies that support the well-being and quality of life of the population and, most particularly, the working and middle classes that make up the vast majority of the population…People in this nation die due to lack of health care…even based on the most conservative number of 18,000 (from the conservative Institute of Medicine), this is six times the number of people killed on September 11, 2001, by Al Qaeda. And these deaths continue year after year. The deaths on 9/11 are rightly seen as the result of enemy action. But why do the 18,000 deaths each year go unnoticed? Why aren’t they seen as the outcome of hostile forces, whose love for their country is clearly nil? Mark Twain said, “You cannot love people and then go to bed with those who oppressed them.” Why is it so difficult to understand such a basic truth?

Bobby Kennedy also reminded us that the progress of a nation should not be measured by its gross domestic product or Wall Street numbers, but of the quality of life it offers for ALL its citizens.  What a nation values also determines how great it is.  America must return to the notion of labor being virtuous and that money is one small by-product of work.  

Ben Franklin laid out what happiness is.  It’s to be healthy, wealthy and wise.  We are no longer healthy because we’ve forgotten what being truly wealthy is. We’ve settled for gruel instead of gumbo. We’ve abandoned wisdom, for pure calculation.  We have become quite small.

Time to jump out of this simmering witch’s brew of a failed phoney Utopia.
Jump out, my fellow frogs, before you get stewed.

Update [2007-11-20 14:7:27 by Montana Maven]:

I’ve updated the story to address one of the
concerns that RonK Seattle had on dkos as to some dates problems of Navarro’s and problems with Navarro contention that working people stayed home in 1994. As far as the 1994 election is concerned, I will look into that some more but I heard 2 labor leaders and 2 congressman this past week say that their working friends stayed home whether they were registered Republican, Democrat or Independent. They all felt betrayed by NAFTA. Many of those who did vote, voted for the party that reflected more of their personal values since they saw no difference, economically, between the two parties. This is a continuation of the “What’s the Matter With Kansas” voting against your own economic interests.
RonK Seattle objected to Navarro’s saying that Al Gore, Bill Clinton and Dick Gephardt formed the DLC to combat the rise of the left after the 1988 convention.
Navarro seems to get his dates confused about the connection between the formation of the DLC, stopping Jesse Jackson and Bill Clinton, Al Gore’s and Dick Gephardt’s involvement. The DLC was officially formed in 1985 after the Democratic defeat to Reagan.
————————-

Perhaps Navarro is switching the two Jackson presidential campaigns. Jackson formed the “Rainbow Coalition” in 1983. In 1984 Jackson received 21% of the primary vote and came in third behind Mondale and Hart. I once heard a black caller on Thom Hartmann radio show say that the big support by Jackson in 1984 freaked out the establishment and conservative Democrats. He said they started getting in bed with corporations and taking money to push back against Jackson.
——————————
In 1988 Jackson won 11 primaries. He won the Michigan primary at 55% and was then considered the front runner. But he narrowly lost to Dukakis with he and Al Gore splitting the southern vote. If Al Gore had not been in the race, Jackson might have gone on to be President. We will never know. The Progressive Policy Institute which is a wing of the DLC was formed in 1989. Maybe that’s what Navarro meant.
——————-
Anyway, there is enough weirdness here to keep digging under the surface of this story. I like to put conventional wisdom on its back and look at its belly.