Jacobinning
I’ve got a new post up at Jacobin that y’all should check out. It’s a breezy piece on conflict-averse liberalism and its manifest shortcomings.
A taste:
I’ve never been in a real-deal, legit fight. I’ve seen a few, but I’ve never been in one myself. The ones I was witness to didn’t look particularly enjoyable, though, so it’s not like I look back regretfully on all those times I could’ve punched someone in the head. I long ago learned that I would have to make peace with my pacific nature.
All of this is to say, I empathize with the urge to duck a fight. They’re ugly things, fights. But despite what you’ve heard, there’s the personal and then there’s the political, and they’re not always one in the same. A conflict-averse person is OK; a conflict-averse politics is not.
I’m not sure you make your case all that strongly. You are nudging up against the Green Lantern type theory where just exerting will or having a fight will obtain an objective. I’d argue that if O had pissed off the insurance companies to much we would have not had any HCR, not even the middling at best reform we got. How do you go into a legislative battle trying to eviscerate an entire industry, especially one that has lots of money and power, then expect to succeed. I think at times more fight might work and it might look good, but it isn’t always a winning strategy.Report
Looking at the cigarette companies might prove instructive there.Report
I’m not seeing it. It took decades of fighting and an Everest high pile of science to get some restrictions on tobacco companies. And they are still in business, its not like they are gone or anything.Report
Public outrage on insurance companies (plus GM, Big auto, and tons of other corps wanting a level playing field) was enough to get ’em to bend.
I’d say, it’s a start.
A different start than Edwards — who would have used the poison pill approach.Report
This. There is no evidence that a more statist version of HCR could pass through Congress. More likely, it would have died in committee and HCR kicked down the road for another fifteen years at least.Report
I’d argue that if O had pissed off the insurance companies to much we would have not had any HCR, not even the middling at best reform we got.
My suspicions here run even deeper.
One of (IMHO) most crucial parts of ACA is efficacy research. And insurance companies have the data on medical outcomes, which is a crucial part of that research in some sort of cost-effective way. Even Medicare is (from the state’s I’m familiar with; may not be all states) contracted out to private insurance companies for billing/payment work; the states just oversee the program under federal guidelines. So insurance companies have the information needed for statistical analysis of health treatments, and that information is proprietary; they own it. It’s at the root of all those details of what they will/will-not pay for in your insurance policy.
This is just one of the reasons electronic medical records matter; because right not, the only place this information exists in in insurance data bases and paper files in doctors offices. Which is cheaper to access?
I’d guess that the potential of electronic medical records will eventually bring to efficacy research vs. the immediate value of information the insurance companies already own was a big part of the ACA negotiation process.Report
Good point. The Wife actually does some of this kind of case management for our state on Medicare/caid contracts.Report
Even Medicare is (from the state’s I’m familiar with; may not be all states) contracted out to private insurance companies for billing/payment work; the states just oversee the program under federal guidelines.
I think you mean Medicaid here. I don’t think there’s a state role in Medicare provision. (If there is, let me know!)Report
Interesting point, zic.Report
On anti-liberalism and its many shortcomings:
One that’s beginning to piss me off is the liberal media’s reporting on anti-liberal bias. Like, we cannot talk about any up-and-coming Republican without saying shiz like this:
That’s a quote from John Dickerson, just lifted it off Sully’s blog.
I heard the same on NPR this afternoon; Christie and his bromance (they actually used that word, too) with Obama and how the blowback if he runs for president.
Like all that matters is if they’ll run and how they might be pissing off the base. Building the narrative for 2016 already.Report
Correction: that’s John Sides in the blockquote.Report