Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Wednesday, February 15, 2012

My Journey w/ the Contraception Debate

Part 1. Left Out

When the debate over full insurance rights for employees of religious institutions began to bubble up to the surface of media waters, my immediate and impassioned reaction was quickly checked by the realization that said reaction was too far Left to matter to the debate. At Organizing Grievances we've been fond of locating ourselves on "the socialist wing of the Democratic Party," and in this instance my participation or even belonging within mainstream debates felt exactly as impossible and necessary (c.f. Laclau) as that political identity. To me, the debate was one between public health and religious autonomy: between the socialized administration of equal access for the public good and the privatized, identitarian claims for religious exceptionalism and gender-based exclusion. Can you guess which side was on? Can you see how quickly I realized that just my framing of the debate, if enunciated into a microphone of consequence, could quickly undermine the ends I championed and their Democrat proxies? It is very possible to wager that "the public good," if not "public health," signifies nothing less than statism and death panels for a swath of Americans I'd be too frightened to count. And if anything, I think Left pundits' fascination with the totally ballyhooed, mostly failed and nonetheless ongoing fits of privatization in American life obscure the extent to which the public sector, such as it's been, has never been accompanied by an ethic or an infrastructure of a public sphere as imagined by Habermas or enjoyed by other democracies. This is a consequence, I suppose, of the USA being a capitalist democracy that at all points has been more capitalist than democratic, and thus valued private property, privatization and simple privacy over the Enlightenment ethics of rationalism and secularism that shakily birthed modern ideas of pluralism, if not multiculturalism.

Generalizations aside, I imagine the US historians working in and around this blog would rightly assure me that the relative currency of each of these values have risen and fallen, zero-sum style, over the years. As an example, I suppose we could compare consequential speeches on religion by two candidates for president, JFK and Willard "Mitt" Romney. For his part, JFK is eager to assure US voters that his papal overlord will enjoy no authority over the White House; indeed, JFK asserts that religion will be sidelined in the political sphere, if not to say subjugated by it. This implies an understanding that secularism in public life actually enables religious pluralism in private life, or that a secular government is necessary, even, to protect such private practices from intolerant majorities, etc.

Contrarily, Mitt Romney, whose religion has faced and continues to face popular suspicion and government repression, delivers a speech predicated on Mormonism's shared strains with Christianity. More importantly, he posits that religious Americans of all stripes should look past their differences and recognize their common enemy, encroaching secularism. The devolution apparent in these two speeches - from religious freedom guaranteed by a secular government to religious solidarity enabled by common opposition to secularism - speaks to my suggestion that pluralism and multiculturalism emerge uneasily out of the Enlightenment values underpinning political modernity. The former is a social compact that self-governing peoples can manage through elected representation and the society of laws, whereas the latter, in its Left and Right forms, raises the stakes of identity practices and cultural recognition such that these matters may no longer be confined to the extra-political inner lives of voluntary associations and failures.

In short, the war on secularism jeopardizes the social, not at all unlike how a certain kind of postmodernism threatens the Enlightenment, among other things. The common postmodernism of George W. Bush and Osama bin Laden resides in their fundamentalism of rich men's sons: a neo-traditionalism that need be underwritten by commercial capital, Yankee guns, 20th-century theology and a constructivist's avid attention to the naming and outlining of the nonexistent past to which his neo-traditionalism is willingly addressed. The Left postmodernism of French Theory, or of Baader-Meinhoff, takes socialist, social democratic and welfare capitalist variants in the industrial West as failed experiments, belied by racism/sexism at home and imperialism abroad, as well as by the very repressive and bureaucratic drabness of even a redistributive politics that takes the social as its proper object of governance. Postmodernisms Left and Right gesture away from a social and secular political imaginary. As if they were coordinating, religious fundamentalisms demand political recognition for religious agents just as philosophers and frustrated revolutionaries declare enlightenment a failed ideal and slippery slope to genocide, and denounce society as unrepresentable.

Hardly a hater of the postmodern contribution to my line of work, my mature academic provenance is nonetheless staunchly socialist-feminist, particularly in its assertion that the neoliberal assault on welfare and the religious assault on women and reason reveal deep problems with the uncritical adaptation of this side of pomo. What's more, I believe very strongly that the aforementioned unrepresentability of the social, rather than making for a dead end, is actually the starting point of political identity (c.f. Laclau). It is in this way that the allocation of contraception in religious spaces can stand in for a far greater battle over where "politics" belongs, whether public health comprises a goal worth defending, and of course if it is possible to elevate the socialized defense of women's bodies over the sacral authority of Christ on the cross and that other ritual text, the US Constitution.

Pt. 2. Left Out Again
Then I realized something plainer, simpler and truer. So much for my socialist-feminist provenance! [To my credit, I was never one for wearing "This is What a Feminist Looks Like" t-shirts, which is the White Guy with Dreadlocks equivalent of male participation in women's movements.] We've subsequently come to know that "religious freedom" argument of conservatives could be cast aside as remote and contrived as my own abstruse socialism were it not being deployed, effectively, on women's bodies. I had made a corporeal issue into an intellectual one (again.) How does a dude proceed from there? Not by pushing to the front of the people's assembly to speak for anybody. No, there's too much of the anti-choice movement's choice of angry white male avatars in that decision. And so I shut up and watched.

Pt. 3 Auto-erotic Race-Punditry trumps Women's Rights
Meanwhile all kinds of (male) liberal pundits broke ranks, couching ethnic affiliation and a contrived discourse of white authenticity in their gentle and ironic denunciations of "government intrusion" and its gloomy consequences for their President of choice. The flabby and fervent suggestions of these analysts swallowed whole the "hands off Catholicism" argument demolished by Garry Wills , just as they so often succumb to the "deficit hysteria" Dean Baker works himself silly debunking. Fucking liberals!!! Similarly, countless constitutional scholars begged to differ with the formal first amendment defense, but in the face of that criticism said pundits pivoted to the worrisome political ramifications. Should President Obama pursue his invasive defense of women's and employee rights, he might alienate Catholics, whom he desperately needs to win the Presidency. While I'd be remiss not to mention the polling data that showed that a majority of Catholics, let alone women, supported the measure, that misses the essential point of the pundits' essentialism. Silent majority, Reagan Democrats and swing voters past and present have long enjoyed a sought-after status with both parties, and analysts have featured them and their voices as steadily as academics have profiled the race-baiting characteristic of their right-left-right shifting. The demographic composition of the independent voter has long since shifted, as has the demographic nature of the nation, but would you believe that even after their vote has proven decisive, "white ethnics" dominate liberal commentary? It's no different from the "real American" construction of the tea parties, although this population appears conspicuously within an arcane formulation, "white working-class," that is as conspicuous in its use of the expression "working-class" as it is foolhardy for literally whitewashing the designation with racialized strokes of identification and exclusion.

Alas, the "white-working class" has never been a large part of Barack Obama's coalition, and will not be in 2012. Sad but true. Women, however, are quite important to the President for electoral reasons and, I'll suggest momentarily, for more substantial reasons. Much attention was paid to how Irish-Catholic Joe Biden and Catholic Bill Daley had forewarned the President of the dangers of his contraception decision, yet how a visit from leading women in government, Kathleen Sebelius and Valerie Jarret, had compelled him to move ahead with it. Now, I love Joe Biden. He was right about Iraq, right about Afghanistan, and wrong about this. Still, top liberal talkers much more sanguine about the VPOTUS' more dovish moments were assured that his admonishment about appeasing the Catholics was unadulterated truth. This kickstarted a return to an old theme: Obama doesn't connect with people (that is, with white working-class people, real people) as well as Bill Clinton did. Had old Bill been around, he'd've triangulated the shit out of this situation, including chastity belts with school uniforms and cutting welfare for good measure. That's what it means to "get over" on people, right? Well....here's another version of building support with a key constituency.

There goes that out-of-step, academic, and, uh, black President, opposing the discrimination of women which is also discrimination against workers. He dared to ignore his important dude-advisors in favor of those of women, and seems to believe in contraception. Ha! Consider the deal he struck: not only did he rob opponents of their "defense of faith" argument and leave them baldly defending the right of men to savage women's health, he also shifted from government intervening on religious agencies from government intervening upon insurance companies to lower costs, which is way closer to what Americans with and without a uterus want to see. It's sad to me that the white, liberal commentariat is too submerged in an arcane fascination with the vestiges of Richard Nixon's coalition to see how this excellent policy play was also strong politics. Worse, it's the umpteenth example of Obama's "long game" hitting political marks and backing off radical conservative advances at the same time. As I remarked to Gabba recently, I increasingly suspect a racial undertone to a narrative that paints Obama as too brilliant and removed, however occasionally inspirational. (This faint praise is the liberal analog of the conservatives' fascistic wish-dream that denounces Obama as "leading from behind" except for communist moments when he tries to deface religious traditions of white Americans.) In this narrative Obama is juxtaposed with Bill Clinton, the man of action who got things done and could talk to "real people." I wish neither to bury nor praise Mr. Clinton, but this assertion that his were "real politics" - welfare reform, Don't Ask, Don't Tell, overturning Glass-Steagall - says something about cleavage between his and Obama's coalitions. I'm not happy to see so many whites outside the D tent, but I will not confuse their section of the working-class with some kind of universal race-proletariat, especially when they haven't shown themselves to be opposed to contraception or in favor of an all-male referendum on women's organs. That's a different group, and they, of course, can go fuck themselves.

Pt. 4. Good Gals Win
So here we are: access to cheap contraception's been guaranteed, it's enemies have been given a shovel with which to keep digging themselves into the past and out of contention for office, and mark my words, the Affordable Care Act came away with something of a positive advert on its behalf. None of this is to say my issues about secularism and political modernity have been treated with any kind of soothing coos or theory balm, but in the short and medium runs these issues will remain only obliquely evoked or modified. A government which outlaws ACORN or cuts unemployment during an unprecedented economic crisis is a government which abandons poverty as a problem and society as an object. The attack on Planned Parenthood will continue from male Rs who have abandoned the legitimacy of popular support for the inference of cloudy thumbs-up from God. The persistence of the faith-based institution might be perfectly fine if its advancement in a world of withering welfare didn't signal a prostrate state seeking alms and the subjection of social welfare to whims paternalistic, superstitious and charitable.

The attendant populisms and ur-populisms of the moment make things worse. Like the tea parties' vaunted Real Americans, many liberals broke ranks perhaps unconsciously to promote a worldview in which white catholics were politically definitive and a raced (if also classed) stand-in stand in for the nation. These tactics around championing the political identity of a privileged and race- and faith-based group can no doubt nationalize society out of existence. Perhaps that fate befell the USA around the writing of its Constitution, or perhaps it really was Nixonland and neoliberalism which brought low social justice, secular authority and civil tolerance.

But is it possible to socialize, or re-socialize a nation? Not with this much culture going on, I fear. We have traded the social imaginary, as well as socialism as a political project, for the smallpox blankets and glass beads of identity. And we've been had. What we thought was identity was merely lifestyle, what we thought was symbolic was simulacra, what we thought was transgression was consumption. The film and punk rock have been great, thanks, but there are fault lines ripping, and who looks to art in an earthquake? Culture's colonization of politics and society means that one imagines identity, national identity and nationalist discourse, when they imagine political action. So too even the economic recovery is couched in patriotic tones. After politics, culture. After society, culture. Bloated, culture backslides into nationalism. And nationalism kills, Billy.

Thursday, December 17, 2009

"Used in a Cynical Way" by the BHO admin

Inspired by a day spent stewing on EZ's previous query:
  1. From a trade unionist point of view, was it worth tabling EFCA for the Senate version of health care reform?
  2. Or, knowing what we know about the White House after this debacle, were we insane to thing we'd get any real "support" on EFCA in the first place?
  3. Would EFCA help more people, at this point, than the existing Senate health care bill?
Extra Credit: Is it disingenuous to talk about the "Senate bill" at this point, given that we've still got a lotta empirical questions about what, exactly, is in the Senate bill.

Monday, November 30, 2009

Senate HCR Debate Open Thread


Oh, 2008. What was it all for, anywho? Maybe it was so everybody could be forced/entitled to pay private insurance companies a buncha money. Either way, I'm rooting for this piece of shit/historic legislation to pass.

Discuss. I will keep throwing thoughts down here for the rest of the debate. Muuuuuuuurrrrrry Christmas.

Tuesday, November 10, 2009

Why We Probably Best Be Getting Psyched About The Partially Shitty Health Bill

It's 2010, stupid:
Sen. Ron Wyden (D-Ore.) said Clinton suggested Obama wants to move health care off the table so he can turn his entire focus to the economy by January — in time for 2010 elections.

“What he focused on was how important it is to move this year. And I think there is a general sense is the clock is ticking," Wyden said. "That certainly in terms of the president being able to focus on the economy next year at the State of the Union that getting it done this year will in effect clear the tables and allow the focus to be on jobs and education and infrastructure.”
I dunno how the President helps the jobs picture without an aggressive and politically suicidal govt jobs program, but, shucks, he's surprised me before.

Wednesday, November 4, 2009

A Rare Thing

It's rare that a little, teeny, petite blogpost about a blogpost (Klein, "Krugman on Krugman") can be so accurate a summation of (what Doug Henwood calls) what the people at The New Left Review call "the current conjuncture."
We began with an economic crisis that looked a lot like the Great Depression. But due in large part to the massive efforts of the Federal Reserve and the government, we pulled out of it, or seem to have pulled out of it.
Of course, I think people do understate the political work done by this administration simply to keep a Depression-ish financial collapse from sucking our entire society into a squalid crater. But the question for the people who govern us is: now that we have (maybe) "hit bottom," how, then, will we re-emerge? How long will it take to begin gaining ground again? And will we be a fairer society when we emerge, better-hedged against the asset bubbles and demand-side shortfalls that occasion these recurrent crises?

If the answer to that last question is "yes," I want to know how demand can be stimulated without rising wages, increased government investment in human welfare (i.e., government entitlements and government jobs) and, by extension, increased taxation of the wealthy? Will Democrats come to see that it is in their political self-interest to open themselves up further to charges of socialism, big-government, blah-blah-blah, if said charges arise while they are delivering actual benefits to voters?

Chris Matthews and Foucualt are both always right when they say that the burden of governing is heaviest on the 20th/21st century Left. If Ds win on the discourses of "health care" and "jobs," they can afford to lose on "socialism," because at that point, socialism'll be* just another (bleeping) tree falling in the (bleeping) woods.

*Actually, socialism already is a (bleeping) tree falling in the (bleeping) woods: at least in the northwest hemisphere. Go ahead and blame it on the whole previous century, or Stalin, or Mitterand, if that makes you feel better.

Tuesday, October 27, 2009

Ezra Klein re: Public Option, as such, not meaning so much



Voila. See also Ezra's earlier, very good point about what's good and what's not-so-good about the "public option" not being quite the same frame as "Medicare:"
A Medicare option would also probably have been a nonstarter in Congress, much as the public option attached to Medicare rates stands little chance of passage. But the advantage would have been that the ensuing debate would have been explicitly tied to the thing that makes a government option so effective: the power to negotiate on behalf of a huge customer base, as other countries do and as Medicare does. Instead, the debate has centered around the principle of an insurer run by the public, which is, at this point, going to have a lot less impact on premiums than most of its supporters expect. As a political move, that probably made sense, and allowed politicians to get to a place where they might just have a compromise that supporters like and skeptics don't hate. But the cost is that the compromise won't do what supporters wanted, and skeptics feared.

Wednesday, September 23, 2009

Jesus, Chuck Grassley [R-IA], etc.

As always, this bit of straight dope re: healthcare is pilfered from E. Klein, this time from a piece entitled "Why We Can't Have Bipartisanship in Two Easy Quotes..."

Quote one:

As recently as a month ago, Chuck Grassley ... announced that the way to get universal coverage is "through an individual mandate." He told Nightly Business report, "That's individual responsibility, and even Republicans believe in individual responsibility." Earlier this year, Grassley told Fox News that there wasn't "anything wrong" with mandates, even if some may view them "as an infringement upon individual freedom."

Quote two:

Iowa Sen. Charles Grassley, the Finance Committee's senior Republican, said the mandate is among the reasons that he couldn't support the bill despite months of negotiations with Mr. Baucus. "Individuals should maintain their freedom to chose health-care coverage, or not," he said.

Jeebus effing cripes, cats. We enabled this Iowan-ese craphouse!

Monday, September 21, 2009

Dean Baker Should Pay Rent in my Skull

These thoughts are as intimately built into my daily to-and-fro-ing as the records, medicine ball and vertical blinds pictured above:
The size and energy at the anti-health care reform protests last weekend were impressive. While some of the leaders are clearly racist nutballs who can’t accept that an African American is in the White House, many of the tens of thousands who showed up in Washington and elsewhere came out in response to their perception of a government that does not respond to ordinary people.

They have a basis for this complaint. It is hardly a secret that President Obama cut deals with the health insurance industry, the pharmaceutical industry, and other powerful interest groups. This may have been necessary for him to get a health package through Congress, but it’s hard to blame people for being suspicious.

Many of the protestors were not against the government playing a role in health care. In fact, one of the mostly widely expressed concerns was that the President Obama’s health care plan would worsen the quality of Medicare.

Supporters of reform believe that this reform will be a step forward in providing quality health care for everyone, but how confident can anyone be in this view? If there is no public insurance option, as is likely to be the case, how confident can we be that regulators will prevent the sort of abuses that are currently widespread in the insurance industry?

...

What do we get if the federal government requires people to buy insurance, which quite possibly would be bad insurance, and provides subsidies to do so? By definition this would mean more people have insurance, but it doesn’t mean that people will have good health care. And, in the process, we will have made the insurance industry, the pharmaceutical industry, and the hospital industry considerably more profitable.

This is an example of what was known in last fall’s presidential campaign as “spreading the wealth around,” but as is generally the case in this country, the direction of redistribution is upward. The government would be taxing ordinary people and/or requiring them to make direct payments to insurers, in order to enrich major corporations and their top executives. Certainly the townhallers have every right to be upset about being forced to give their money to the multi-millionaires running United Health, Cigna, and the rest.

...

It is clear that most of the health care reform protestors don’t have a clear conception of the policy issues. But they do have a real basis for concern that they are about to be ripped off for the benefit of the rich and powerful. It would be nice if those of us who support reform could honestly assure them that this is not the case.
Maybe this call for Dems to "honestly assure" us about upward redistribution is my version of wanting the movement for reform to "keep it simple"? I dunno, but this is the article of the week, so far.

"Is [Obama] On the Wrong Channel?"


Consider this a video supplement to my question from yesterday. I actually find the "sweat equity" argument about the "full Ginsberg" strategy to be pretty compelling in a parlor-room sense. Also, I appreciate Chris Matthews' particularly crabby attitude, here.

At Long Last: Le Trigger D'Olympia Snowe [R-ME]

Ezra reporteth - and it smells like "we're fucked!"
What this says, basically, is that the public option triggers into existence in a particular state if there aren't two or more health insurance plans that cost less than 13 percent of a family's income (or a bit less below 300 percent of the poverty line).

Color me unimpressed. I could imagine a stringent trigger that becomes more aggressive with each passing year: Start at 13 percent of income, say, but by 2019, it needs to be 11 percent of income, as the idea is that insurers need to be competing to bring down costs. But this isn't that trigger. It's also hard to see a public plan in a couple of states wielding much power. It would be better if, say, five states failing to meet the affordability threshold triggered a national public option. But, again, this isn't that trigger.

The "bright" side -- if you want to call it that -- is that health-care costs are going to continue to rise faster than incomes. Within a decade or so, it'll be likely that very few states will have comprehensive policies costing less than 13 percent of income. In that scenario, the trigger does produce a bunch of public plans, at least over the long run.

But in that scenario, the plan is in all sorts of trouble, as the individual mandate is too stringent, and the subsidies are ineffective, so it's a bit hard to say what changes get made. My sense is that Olympia Snowe does not, in fact, want 50 public plans, but that does look like the long-term outcome of the trigger. The question, I guess, is how ingenious insurers will be at creating crappy plans that don't cover much but provide two "affordable choices" to delay the trigger. That doesn't seem like a good incentive for the system, but it's definitely there.

Sunday, September 20, 2009

A Question?


Is "health insurance reform" failing because the plan "is too complex" or "doesn't make sense"?!

According to Robert Reich, FDR once summed up his unwilligness to pursue national healthcare as part of the New Deal by saying, "I just cannot explain it." Reich believes that (some of) the problems Dems have faced arise as the consequence of the existing plan lacking simple, self-evident entitlements and reforms as well as effective moral/psychological frames for these entitlements and reforms.

My question is, what does this insight actually illuminate? Aren't the institutional (but also individual, emotional) responses against health insurance reform - let alone the tinkering with the foundational architecture of the public/private division of labor in our political economy - pretty much inevitable in our liberal (-capitalist) democracy?

Isn't it a truism of US democracy that the politics of public/private are rife in all of our great debates, but that these politics always end up weirdly refracted through, translated by and spoken in caricature-ish, moralistic terms of nation, race, identity and catastrophe? Wouldn't that happen regardless of whether or not the President's health insurance plan was less than 140 characters?

Wednesday, September 9, 2009

Pre-Speech Waiting Area AND Open Thread

One thing we've learned since 2007 is that the President doesn't feel just-completely-satisfied with any plot points that don't involve him giving some kinda ur-transcendental speech that "resets," "pivots," "reconnects the American people with their core values," etc.

So what do we expect from him tonight? A "pragmatic" appeal to the independent, moderate co-pragmatists of America? A "grown-up" refutation of disappointed liberals' disappointment? A "bipartisan" concession to deficit-hawk lies, insurance company lies, and other hatefuck fantasies? A "good speech" that brings us closer to a vote, gives Blue Dogs and Olympia Snowe cover for said votes, and gets the country moving away from the direction of capital-administered, neglect-based health care?

I'm hoping for the latter, if only because, shucks, like my Tea Party friends, I'm ready to transfer all this animus and mawkishness into the emergent bloodbath over that other disappointing disappointment, cap and trade.