A friend pointed out to me earlier today that the market capitalization—the value of all the outstanding stock—of the publicly traded health insurers is about $150 billion. Add a little premium to sweeten the pot and you could nationalize the lot of them for about $200 billion. The total administrative costs of the U.S. healthcare system, which are greatly inflated by all the paperwork and second-guessing of docs’ decisions generated by the insurance industry, are about $400 billion a year. Those administrative costs are about three times what a Canadian-style single payer system would cost. So that means we’d save about $250 billion a year by eliminating the waste caused by our private insurance system.In other words, the nationalization could pay for itself in well under a year.
Will Obama propose anything like that? Of course not. Instead, he’s going to propose that Americans be required to buy insurance, probably with some government subsidies. So instead of euthanizing the private insurance industry, Obama & the Dems are going to provide them with tens of millions of new customers—compelled to by their product by law, and with some degree of public subsidy. That’s lunacy.
Just a reminder, though: Suppose for the sake of fantasy that Obama and the Democrats were not corporate collaborators, and were willing to nationalize American health insurance in this way, just because it would be more efficient and affordable. There would still be a lot of opposition to such a move, the insurance companies and the corporate media would go berserk, and the Teabaggers would be foaming in the streets. Just as they are now. Much of the reason why most Democrats and Obama are worthless is that they don't want to confront opposition, or to be an opposition themselves. (To be fair, many Republicans are the same: stand up to them, call them a few choice names, and they run for the exits, screaming "Political correctness!" But the Democrats' refusal to be an opposition party is leagues beyond this.) If a measure can't be passed by consensus ("bipartisan" in Obama's terminology), it's just too scary, it's not viable, it can't be done. The Republicans generally know better. But since the Dems are so terrified of opposition and criticism, it is going to be necessary to put them under pressure from the other side: if Obama's unwilling to do the right thing because the Republicans will be mean to him, then liberal Democrats and independent progressives and liberals must be mean to him too. There must be no shelter for him or for any other Democratic politician who wants to collaborate with the corporatists and the Republicans.
The same would apply if, by a miracle, some sort of substantial health insurance and health care reform were passed. The Republicans, with lots of corporate funding, would promptly start trying to undermine the reform and ultimately to roll it back. (Look at the history of the Right's opposition to Social Security, for example: in principle, the Right wants to get rid of Social Security, and in practice they just try to chip away at it until it's not worth saving.) This should surprise no one, yet the Democrats and a good many independents are constantly surprised when they encounter opposition. There is never going to be an America, or a world, without conflict; we might as well recognize this, and decide how to deal with the conflicts we must face.
In his What's Liberal About the Liberal Arts?, Michael Berube quoted his fellow English professor, the conservative Mark Bauerlein (page 88): "Being the lone dissenter in a colloquy, one learns to acquire sure facts, crisp arguments, and a thick skin." I'd like to think that I've acquired sure facts and crisp arguments, but that's not for me to say. I have acquired a thick skin over the years, and if Democrats want to keep Congress and the White House, they should do the same. Some sure facts and crisp arguments would help too.
That being said, back to the real world. Obama and the Democrats are, as a party, corporate collaborators. It's fair to doubt that Obama wants meaningful health care reform, any more than he wants an end to the wars in Iraq and Afghanistan, or peace in the Middle East, or ... If he did, he'd do more than the posturing he's been doing since before he took the oath of office.