Remember the
Overton Window, folks. We need to pull everywhere from both the moderate parts and the extreme parts of the spectrum in order to effectively move the window of what is possible and shift where people believe the moderate middle is (the location of the window.
Let's see what people are talking about in the health care debate. What's on the spectrum that people actually discuss?
Single Payer - Public Option - Mandatory Private Plans - Increased Regulation - Non-Mandatory Private Plans - Lowered Regulation - No Regulation At AllWell, it's a rough sketch - some people may argue about the details, but you get the idea. Where we are now is in the area of Non-Mandatory Private Plans and Lowered Regulation. Where Congress is discussing putting us (where the Overton Window of the politically possible is) is somewhere between Public Option and Increased Regulation.
The problem is that people are not talking about options further to the left of Single Payer. Because we're only talking about choosing between Single Payer, Public Option, and the insurance lobby's watered down proposals of increased regulation and Mandatory Private Options, Single Payer looks like radical communist left-wing insanity even though it isn't. The right-wingers have stacked their options on the other side and shifted where people think the middle is. They moved the Overton Window so far right that Baucus refuses to even allow Single Payer to be discussed.
I want to look further left. Doesn't mean I agree with all the ideas, but we should start talking about them and bringing them to the table. Maybe some of you will think the reforms I bring up are a good idea - GOOD. Bring more ideas on the table - something that makes Single Payer look moderate - that will make it more politically possible!
So what's to the left of Single Payer?
There's requiring providers of basic care to be non-profit. IIRC, Switzerland does this - they have private insurance, but by law, insurance for basic health care is non-profit. They can have for-profit insurance plans that include luxury services like private hospital rooms, plans that include things like plastic surgery, that sort of thing. You still get multiple choices, but at the same time, you take the profit out of the equation, which should make things cheaper. Hospitals too are non-profit IIRC, unless you splurge for the private room and the better food. In other words, I'm taking the non-profit idea and applying it to things other than just insurance. There are more restrictions on how doctors are paid, how pharmcos are allowed to operate, that sort of thing, so the profit motive doesn't send prices into the stratosphere.
Next, there's Partial Nationalization of medical care. What's funny is that for some people, this already exists - there's the VA, and people actually like it. They have government run hospitals and doctor's offices, and doctors and medical staff that are government employees. A lot of what I hear from veterans that use the VA system are quite positive - they get very good medical care, at low cost. The benefits are that you remove the profit motive completely. And a well-run government system is quite good. There's accountability. Just as places in the U.S. have school boards that have elected officials, there should also be hospital boards, or health service boards with officials we elect - that way, we can throw out assclowns if our government hospitals are being run badly. This system has promise.
Go further than that to total nationalization. The closest thing I can see to this is the British National Health Service, though you can see private doctors in the UK if you want and get private insurance. Of course, the problems are that if you don't have a private alternative, and assclowns are running the public system badly, you get things like waiting lists for heart operations, bad bureaucracy, and so on. Nevertheless, my impression is that the horror stories the right-wingers howl about the UK's NHS are for the most part, exaggerated, and most people in the UK get health care that's good enough that they'd riot if their government tried to privatize it.
There you have it: an expanded spectrum, and by our use of the principles of the Overton Window, we make Single Payer look moderate, and maybe if enough people talk about this, we can go further in terms of reforms.
The new spectrum:
Total Nationalization of Services - Partial Nationalization - Non-Profit-Hospitals - Single Payer - Public Option - Mandatory Private Plans - Increased Regulation - Non-Mandatory Private Plans - Lowered Regulation - No Regulation At AllSee how Single Payer is closer to the moderate middle if we frame this way, and the vaunted Public Option looks downright conservative?
It's all about the framing!
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