I have a confession: I am cynical about Washington\’s efforts to pass good healthcare reform.
Sorry for those of you who I just shocked; would those standing next to them please administer CPR? I know most of you trust our government to do what\’s best. Sorry to burst that bubble.
The reason I am cynical is that I think the real problem has nothing to do with healthcare; it has to do with the way our government runs. Here\’s why: let\’s wildly imagine that one party came up with a plan that would actually fix the problem. This plan would:
- Ensure that all Americans have coverage.
- Improve the quality of care, and set in place means to continue improving quality.
- Fairly reimburse medical professionals for what they do.
- Eliminate waste.
- Save money.
And let\’s say it did all this without pandering to special interests with deep pockets.
What would be the politically expedient thing to do for members of the other party? They should oppose this plan with every ounce of their strength. Politics is all about power, and if one party solved the healthcare problem they would be lauded as saviors. They would have enormous political capital and would gain much more control of the government. That wouldn\’t be good for the opposition.
So here\’s what the opposing party should do if they are thinking politically:
- Misrepresent this plan to the public as something that would result in disaster.
- Run commercials that would scare people.
- Get special interest groups to harass and threaten those who support this bill. Make it so supporting this good bill would be an end to their political career.
- Try to influence members of the other party to vote against their colleagues in exchange for more power.
Politically, this would be the best thing to do. It would also be the worst thing for our country. It happens with regularity.
The reason this happens because nearly all of the members of congress are constantly campaigning. They are constantly positioning themselves to get reelected, and this requires that they stay at or near the center of their own party. If they break ranks and side with the other party, they stand to lose in the next primary election. If the oppose the special interests with lots of money, they stand to have people spending that money to make sure they don\’t get reelected.
The system encourages partisans and punishes those who go by conscience or work for compromise. The system dooms us to legislation aimed at maintenance of power. The system guarantees that the better the legislation put forth by one party, the more the other will misrepresent and smear it.
Just like the headache isn\’t the main problem when a person ruptures an aneurism, the outward flaws of our government are caused by a much deeper problem: our legislators are far too vulnerable to abandon the greater good for the sake of political power. To seek good is to give up power. That dooms us to mediocre results at best.
There is one thing that would help undo this problem: term limits for members of congress. Limiting senators to 2 terms, and members of the house to 3 would rid us of career politicians who are totally out of touch with the country they govern.
What\’s the problem with term limits? It will take an act of congress to make it happen.
Unless the people force the issue.
I would love to see term limits.I see another problem with the current system. The politicians are campaigning from the day they are elected. Rather than term limits I would like to see a system where running for office while in office was prohibited. That way they would not be campaigning while they should be working. If they really loved giving their time for the good of the country they could run again later after they are out of office.
I would love to see term limits.I see another problem with the current system. The politicians are campaigning from the day they are elected. Rather than term limits I would like to see a system where running for office while in office was prohibited. That way they would not be campaigning while they should be working. If they really loved giving their time for the good of the country they could run again later after they are out of office.
Found you through little blurb in This American Life. . . .I love you
Aw shucks.
Yeah I found you from This American Life also and really enjoy your blog.
I totally agree with you about the term limits. And like you mentioned, I always say that it’s so hard to get people in American to sacrifice for the greater good. And its sad and frustrating that congressmen are the last people in our country who would ever do so!
Found you through little blurb in This American Life. . . .I love you
Aw shucks.
Yeah I found you from This American Life also and really enjoy your blog.
I totally agree with you about the term limits. And like you mentioned, I always say that it’s so hard to get people in American to sacrifice for the greater good. And its sad and frustrating that congressmen are the last people in our country who would ever do so!
You know, few years ago I co-owned a counseling center w/my ex-husband. And medicaid and medicare were the very worst of the insurance companies we dealt with. It is for that reason and that reason alone I am against gov run healthcare. Medicaid not only did not fairly reimburse but they had 100 hoops to jump thru to get their pitiful pay and required so much paperwork we had 1 hour of admin time for every hour of therapy – so 2 hours for their $50 some bucks reimbursement…Absolutely awful! Medicare decided to only cover their patients at 50% for therapy, requiring their mental unhealthy elderly to pay $45 coinsurance for 1 hr therapy. Which of course they could not afford! No way I want the government controlling healthcare!
I understand why you would feel that way. Mental health is absolutely the worst insurance coverage. The problem is that if things continue as they are now, we will bankrupt our country. Something needs to be fixed. I don’t care who runs it, as long as it is a fix and it is fair. It’s hard to trust the government, but private insurance and “competition” have done nothing to fix the problem either.
Don’t forget that having a public option still makes it optional for the small number of people who qualify. If there is a better insurance option for them they can choose it. Of course mental health should be covered at the same rate as the rest of our health problems.
You know, few years ago I co-owned a counseling center w/my ex-husband. And medicaid and medicare were the very worst of the insurance companies we dealt with. It is for that reason and that reason alone I am against gov run healthcare. Medicaid not only did not fairly reimburse but they had 100 hoops to jump thru to get their pitiful pay and required so much paperwork we had 1 hour of admin time for every hour of therapy – so 2 hours for their $50 some bucks reimbursement…Absolutely awful! Medicare decided to only cover their patients at 50% for therapy, requiring their mental unhealthy elderly to pay $45 coinsurance for 1 hr therapy. Which of course they could not afford! No way I want the government controlling healthcare!
I understand why you would feel that way. Mental health is absolutely the worst insurance coverage. The problem is that if things continue as they are now, we will bankrupt our country. Something needs to be fixed. I don’t care who runs it, as long as it is a fix and it is fair. It’s hard to trust the government, but private insurance and “competition” have done nothing to fix the problem either.
Don’t forget that having a public option still makes it optional for the small number of people who qualify. If there is a better insurance option for them they can choose it. Of course mental health should be covered at the same rate as the rest of our health problems.
I like the idea of limitting how many terms any elected representative can run for. In fact, I’d suggest that this should apply to all elected posts from “second assistant dog-catcher” on up.
Of course, given some of the elected posts the USA has, you might need to change some of the “political posts” that aren’t part of the legislature (eg County Sheriff, 2ADC (qv)) to civil service type posts like the equivalents would be in the UK but I’m not sure that’s actually a problem.
I agree. Are there term limits in the UK?
There aren’t, which has led to the phenomonon of the “career politician”, who really does do “being an elected official of the legislature” as a full-time job (complete with superannuation). The most obvious US parallel I can think of would be the County Sheriff who was elected to lead the County Police Dept in his 30s, and is now in his 60s and nearing a normalish retirement age.
I like the idea of limitting how many terms any elected representative can run for. In fact, I’d suggest that this should apply to all elected posts from “second assistant dog-catcher” on up.
Of course, given some of the elected posts the USA has, you might need to change some of the “political posts” that aren’t part of the legislature (eg County Sheriff, 2ADC (qv)) to civil service type posts like the equivalents would be in the UK but I’m not sure that’s actually a problem.
I agree. Are there term limits in the UK?
There aren’t, which has led to the phenomonon of the “career politician”, who really does do “being an elected official of the legislature” as a full-time job (complete with superannuation). The most obvious US parallel I can think of would be the County Sheriff who was elected to lead the County Police Dept in his 30s, and is now in his 60s and nearing a normalish retirement age.
The problem with term limits is that it treats governance as an amateur pastime. How many fields with that kind of influence on people’s live are there with no training program and where no one can possibly have more than a maximum of 4, or 6, or what have you years of experience?
The problem isn’t that the opposition has an incentive to kick up a disingenuous fuss in opposition to ideas that are good for the country, it’s that in the past they’ve never been called on it. You can make any crazy claim you want and never be fact checked, your conflicts of interest are never brought up, and pundits or party officials who repeatedly make wildly wrong predictions or claims are never punished for it with less exposure or respect.
The answer is a more informed populace and a better media, which we’re getting slowly but surely, not a further marginalization of governance as a career worth pursuing.
I see your point, but I think the negatives of career politicians outweigh those of “amateurs.” Governance happens on all levels, but these people are being sent to Washington to represent us, and many represent their own interests far more than ours.
An informed populace and responsible press are great ideas. You could also get rid of wars if people you get people to stop fighting and get rid of crime if you teach them to be good. Reality is different than the ideal. I don’t disagree that we need to push in those areas, but what sounds simple is not at all easy.
Fair enough. This really is one of those issues where we can all agree there’s a problem, and while I’m optimistic that the system can be fixed I certainly can’t deny the appeal of just getting so disgusted the only rational response left seems like just tearing the whole thing down.
Just one quick clarification though. When I say we need a better press and more informed population, I’m not really looking for a Kumbaya moment. Of course we’re never going have a dedicated corps of brilliant muckrakers or a citizenry who’s completely above fearmongering and lies, but we can and really are improving along those lines. The blogs legitimately have provided a viable fact checking avenue for the traditional media, and there’s a larger chunk of the population that actively follows current events and is politically active than in decades. To tie it back to the thing that really sticks in my mind recently and gives me a bit more hope for healthcare is the recent report/hatchet job AIHIP commissioned from WellPoint is a perfect exampel of what I’m talking about. It’s the kind of thing that might have killed the entire bill earlier, but this time around it was instantly slapped down and pretty much every blog post I read about it mentioned at least in passing that WellPoint has a history of this kind of stuff given all the time they spent trying the same thing for the tobacco industry.
And even the worst offenders on the fear mongering and distortions aren’t as bad as they used to be even a decade ago. Sure the death panels were beyond insane, and they did come from the same Betsy McCaughey who was lying about healthcare when Clinton tried to do it, but it took longer for any craziness to stick, she was dogged with her role from the last healthcare reform the whole time, and we beat it back faster than before. McCaughey had been doing the rounds for months trying to come up with some distortion the opposition could use as a cudgel and getting pushed back before anything finally took, and despite people not being ready for it the idea is discredited everywhere except the extreme fringes only a few months later.
You speak lots of sense. That’s very well-articulated. I do think you are more optimistic than I am. I have a basic assumption that if you give people enough power, you shouldn’t trust them. Absolute power corrupts absolutely. But I don’t think that means you sit around doing nothing (that’s part of why I blog in the first place – I can actually make my voice heard, which is amazing to me). The bottom line we do agree on: folks in DC need to answer to all Americans, not just those who give them political advantage.
The problem with term limits is that it treats governance as an amateur pastime. How many fields with that kind of influence on people’s live are there with no training program and where no one can possibly have more than a maximum of 4, or 6, or what have you years of experience?
The problem isn’t that the opposition has an incentive to kick up a disingenuous fuss in opposition to ideas that are good for the country, it’s that in the past they’ve never been called on it. You can make any crazy claim you want and never be fact checked, your conflicts of interest are never brought up, and pundits or party officials who repeatedly make wildly wrong predictions or claims are never punished for it with less exposure or respect.
The answer is a more informed populace and a better media, which we’re getting slowly but surely, not a further marginalization of governance as a career worth pursuing.
I see your point, but I think the negatives of career politicians outweigh those of “amateurs.” Governance happens on all levels, but these people are being sent to Washington to represent us, and many represent their own interests far more than ours.
An informed populace and responsible press are great ideas. You could also get rid of wars if people you get people to stop fighting and get rid of crime if you teach them to be good. Reality is different than the ideal. I don’t disagree that we need to push in those areas, but what sounds simple is not at all easy.
Fair enough. This really is one of those issues where we can all agree there’s a problem, and while I’m optimistic that the system can be fixed I certainly can’t deny the appeal of just getting so disgusted the only rational response left seems like just tearing the whole thing down.
Just one quick clarification though. When I say we need a better press and more informed population, I’m not really looking for a Kumbaya moment. Of course we’re never going have a dedicated corps of brilliant muckrakers or a citizenry who’s completely above fearmongering and lies, but we can and really are improving along those lines. The blogs legitimately have provided a viable fact checking avenue for the traditional media, and there’s a larger chunk of the population that actively follows current events and is politically active than in decades. To tie it back to the thing that really sticks in my mind recently and gives me a bit more hope for healthcare is the recent report/hatchet job AIHIP commissioned from WellPoint is a perfect exampel of what I’m talking about. It’s the kind of thing that might have killed the entire bill earlier, but this time around it was instantly slapped down and pretty much every blog post I read about it mentioned at least in passing that WellPoint has a history of this kind of stuff given all the time they spent trying the same thing for the tobacco industry.
And even the worst offenders on the fear mongering and distortions aren’t as bad as they used to be even a decade ago. Sure the death panels were beyond insane, and they did come from the same Betsy McCaughey who was lying about healthcare when Clinton tried to do it, but it took longer for any craziness to stick, she was dogged with her role from the last healthcare reform the whole time, and we beat it back faster than before. McCaughey had been doing the rounds for months trying to come up with some distortion the opposition could use as a cudgel and getting pushed back before anything finally took, and despite people not being ready for it the idea is discredited everywhere except the extreme fringes only a few months later.
You speak lots of sense. That’s very well-articulated. I do think you are more optimistic than I am. I have a basic assumption that if you give people enough power, you shouldn’t trust them. Absolute power corrupts absolutely. But I don’t think that means you sit around doing nothing (that’s part of why I blog in the first place – I can actually make my voice heard, which is amazing to me). The bottom line we do agree on: folks in DC need to answer to all Americans, not just those who give them political advantage.
In the end, the citizens of every nation get the government they deserve. WE ARE the system.
In the end, the citizens of every nation get the government they deserve. WE ARE the system.
I’m with you here.I personally want a single-payer system but we don’t have the right people in Congress to get that accomplished.
This plan they’re churning out now is going to be a disaster. It’s good for the insurance companies because they’ll gain a host of new customers to rip off.
I can’t wait to see the fireworks over the years.
In the mean time, I’ll keep spreading the word about single-payer. Most people my age are for it. (I’m 19 BTW)
I’m with you here.I personally want a single-payer system but we don’t have the right people in Congress to get that accomplished.
This plan they’re churning out now is going to be a disaster. It’s good for the insurance companies because they’ll gain a host of new customers to rip off.
I can’t wait to see the fireworks over the years.
In the mean time, I’ll keep spreading the word about single-payer. Most people my age are for it. (I’m 19 BTW)
Just to play devil’s advocate, I’ll point out that election to lifetime legislative positions would also eliminate the perpetual campaigning. I shudder to think what hell we would then endure, however.
Given that we already have term limits called elections, I think a more direct attack on how elections and campaigns are run might be more to the point. Open primaries would mean less kowtowing to the party line because candidates from each party would have to compete with the other party’s candidates as well as their own. Limiting campaigning (much as I would love that) would be a nonstarter in a country where freedom of speech is recognized as vital to democracy, but our constitution doesn’t enshrine any such right to ceaselessly raise campaign funds or to spend unlimited amounts on political campaigns. When you get right down to it, people generally want term limits to get rid of the congresscritters whose districts they don’t live in, because the ones whose districts they do live in, they can vote against.
Just to play devil’s advocate, I’ll point out that election to lifetime legislative positions would also eliminate the perpetual campaigning. I shudder to think what hell we would then endure, however.
Given that we already have term limits called elections, I think a more direct attack on how elections and campaigns are run might be more to the point. Open primaries would mean less kowtowing to the party line because candidates from each party would have to compete with the other party’s candidates as well as their own. Limiting campaigning (much as I would love that) would be a nonstarter in a country where freedom of speech is recognized as vital to democracy, but our constitution doesn’t enshrine any such right to ceaselessly raise campaign funds or to spend unlimited amounts on political campaigns. When you get right down to it, people generally want term limits to get rid of the congresscritters whose districts they don’t live in, because the ones whose districts they do live in, they can vote against.