I've just come back from Europe, where citizens in most countries (on the left, right and center) would revolt if their leaders dared to privatize their health-care systems. That's because they've grown accustomed to getting shoddy care rationed out by bureaucrats, opponents of health-care reform in the United States insist. In fact, it's because citizens in countries such as France, Germany, Finland and the United Kingdom – all of which boast lower infant-mortality and higher life-expectancy rates than the United States – don't think of health-care as a commodity. They think of it as a public good and a basic right.
A little bit of linguistic insight could have made a big dent in Press' travel budget. Is there any country other than the United States that classifies health care as an industry? Indeed, while just about every other American industry is on the rocks, the health care sector is one of the few keeping its head above water, thus becoming the darling of the Wall Street set.
If we want to understand why, as Press put it this morning, the White House if "caving" on health care reform (along with most of the Democrats in the Congress), we have to think like industrialists and investors rather than like reformers. Put another way, we have to remember Deep Throat's advice to Bob Woodward and Carl Bernstein and "follow the money," because there is one hell of a lot of money in play right now. The bottom line is that there are too many well-heeled stakeholders committed to maintaining the industrial status of health care. If they cannot get their way through the usual channels of logic and rhetoric, they will play the fear card through "the demonization of the concept of socialized medicine;" and, if that does not work, they will fall back on the Mein Kampf strategy of disrupting any effort to make sense of the situation (and then giving extensive media coverage to the disruption).
In a peculiar way this all reminds me of the days when I was building up my chops for writing about the avant-garde. It was that summer of 1968, when I had my first serious exposure to the music of John Cage and the choreography of Merce Cunningham. "Officially," I was working as teaching assistant for my thesis advisor, who had a visiting appointment at the University of Colorado in Boulder. However, when I realized who else was in Boulder that summer, I went over to the offices of the campus newspaper and basically barnstormed my way into covering the dance and music events. I wrote like a demon, using everything I had learned from one of my mentors back in Cambridge to bring both clarity and enjoyment to performances that were so different from the run of the mill; and, to my surprise, students were reading what I wrote and talking to me about it! Towards the end of the summer term, one of the graduate students in the class for which I was doing my teaching assistant work took me aside and said of my writing, "You came here like Attila the Hun, waving your sword to win supporters for your cause; but, now that the summer has ended, you should get out of here before your arm gets tired."
This is how I understand the "money war" over health care reform. It does not matter how many polls side with the Progressives in support for a public option, nor does it matter how heavy that support is. Those who wish to keep health care as an industry have the resources to wage a war of attrition. They know that they just have to keep at it until the Progressives tire out from waving their swords. When that happens, the powers that be will put some lipstick on this industrialized pig and declare it to be reform. The rest of us will be too tired (not to mention sick) to do anything about it.