Dennis Kucinich: Enemy of the good, pursuer of the perfect

I never thought health care reform would be a slam-dunk. My private ideas about what I consider to be a health care reform victory look nothing like what passed the House of Representatives Saturday. In some ways, my expectations were exceeded. In others, I was deeply disappointed. One belief was strongly affirmed: the reform process is down and dirty, messy, often ugly, and has absolutely no room for perfection.

Dennis Kucinich has some ideas about what health care reform should look like, too. His ideas closely mirror the ideal: a single payer Medicare-for -all health care  system. Kucinich rightly argues that it’s the most cost-effective, efficient system to provide affordable access to health care for all. Because the bill that passed the House on Saturday night did not in any way, shape or form resemble his ideal, he not only voted against it, he also condemned it as a money grab for insurance companies.

I love idealists and dreamers most of the time, but there are some times where they don’t really help me all that much: in line at the grocery store, when I’m scrubbing my toilets, and when I’m facing the potential to lose my home if anyone in this house becomes seriously ill. I’m already juggling around bills for the diagnosis and treatment for my son’s ulcerative colitis and type I diabetes which is not covered by insurance and which renders him uninsurable. I need for Congress to stop posturing — dithering, too — and get this done.

Kucinich has run for President three times and never made much of a showing in the primaries, mostly because people recognize that while his ideals are wonderful, there isn’t even a small snowball’s chance in hell of getting any it done. There’s no pragmatic streak in him at all. He speaks to the purists on the left, those who believe that there is some sort of magic fairy dust that will convince every elected representative and Senator to vote based upon logic and facts. In his quest for the perfect, he slaps each and every one of us out there who would settle for even a tiny incremental change to what we have now.

HR3200 contained an amendment sponsored by Kucinich which would have allowed states to have a single-payer health plan in place of the public option plan or plans on the national exchange. The final version, as voted on Saturday, had that provision stripped out, partly because it requires that ERISA be waived in those states. ERISA is the law which applies to employee benefit plans, including health insurance plans. Because ERISA trumps state law, the only way for states to initiate their own single-payer plan would be to receive a waiver from ERISA.

Unfortunately, that waiver could open the door for many other challenges to ERISA that have nothing to do with health insurance, weakening retirement security in the name of health insurance reform. But you will not hear that analyis from Rep. Kucinich. Instead, we’re hearing this:

But instead of working toward the elimination of for-profit insurance, H.R. 3962 would put the government in the role of accelerating the privatization of health care.  In H.R. 3962, the government is requiring at least 21 million Americans to buy private health insurance from the very industry that causes costs to be so high, which will result in at least $70 billion in new annual revenue, much of which is coming from taxpayers.  This inevitably will lead to even more costs, more subsidies, and higher profits for insurance companies — a bailout under a blue cross.

Here’s the problem I have with Kucinich: He represents a part of Ohio that is in severe distress right now. Today. And STILL, he condemns the House bill as a bailout — a term that is used on a near-hourly basis by Republicans to deride the President — while failing to acknowledge that real people are suffering in real time.

Does anyone understand that? Republicans certainly don’t. Progressives like Kucinich don’t seem to, either. My problem with it is they can unite or divide right now. We have an imperfect bill that needs to wend its way through a tiny, miniscule needle eye to get to the President’s desk. Imperfect or not, it represents some immediate, desperately-needed reform to our current health care insurance/delivery system. It is not the best we can do in the long term, but it represents a very large victory and gives momentum toward crafting a better, more efficient system.

Incremental change is how it works. It’s why Medicare was adopted only for seniors and only with very limited benefits at first. Even Richard Nixon understood the need to expand it, and he did. Insurers understood the stakes at once, and undertook to build a large, expansive ecosystem around private, employer-based insurance. Thirty years ago, employer-provided health insurance wasn’t a given. Insurers created a market and sold it. That market will not be dismantled overnight, no matter how much we might wish otherwise.

My advice to progressives is to be careful about how much criticism you level and how much opposition you stir toward this bill. If it dies in the Senate at the hand of progressives, you will have accomplished much, but none of it good. Undermining what we have is a long step toward electing Republicans in 2010 and a Republican president in 2012. They know that, and love the sound bites and quotes Kucinich and others like him are providing for the ad campaigns.

Division will kill us and break the thread before it reaches the needle. What Kucinich and his fans should be doing is preparing the next round of reform, rather than trying to kill this one.

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• Single Payer vs. Piecemeal Reform (drumsnwhistles.com)
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• Kucinich: “There Weren’t 14 Votes to Force Single Payer Vote, and Nobody Tried to Get Them” (fdlaction.firedoglake.com)

Tagged as: health care reform, kucinich, medicare for all, perfectionism, progressive, single-payer