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Trying to have an intelligent discussion about health care on KPFA (and not succeeding)

If you think the above title is long, here’s the one I suggested to Radio Survivor’s editors:

Dr. Michael LeNoir tries to have an intelligent discussion of Health Reform on the KPFA airwaves, and is mercilessly pummeled: A Case Study of the Left’s vilification of Obama and its dismissal of Partial Reforms

Last week, respected San Francisco Bay Area physician Dr. Michael LeNoir devoted his weekly “About Health” program to the just passed health care reform bill and the political debate around it. LeNoir is a pioneer in treating asthma in inner city children, and has a regular show on listener sponsored FM station KPFA in Berkeley. After saying that the bill is much less than he wanted, being an advocate of single payer, he said that it was important to understand what is in the bill, the good and bad of it, and to think about how we can use it as a foot in the door to widen and deepen the reform. He also said that he was disturbed that the Right seemed to dominate public debate about the bill, and he challenged his listeners to think about how we – those who want real reform – can have more of a voice in the debate.

LeNoir also expressed fear that unless we do that, the bill could be blocked, crippled and even repealed. The possibility that the Right could unseat those who had voted for the bill should be taken seriously, he warned.

This was clearly an attempt to engage in an intelligent and rational discussion of the bill and the political debate around it, but he got anything but that. Instead, a barrage of negative, polemical, incurious and dismissive attitudes were expressed by the eleven callers heard during the hour long program. Here is a summary of what LeNoir was told:

. A Single Payer plan is the only valuable option. Otherwise, all we’re doing is just making “them” richer. What we’ve got is just band aids “that will all fall down”.
. Only medicare for all will work. They tried twice (in California), only to have it vetoed. The reform bill is a debacle. Marches and things like that will not help, we’re going to have to sit-in at the congressional offices and demand single payer. Even that probably won’t help because they are all beholden to moneyed interests.
. Only when we ‘get the money out of politics’ will we be able to get health reform.
. The insurance companies will be able to raise rates as they like, so reform won’t work. Only the State Insurance Commissioners, like the right wing Republican we have in California, could stop them, and that’s a laughable prospect.
. Even if we had a million people marching, it wouldn’t help, because the media is so biased that they wouldn’t cover it.
. You’re wrong, there are lots of people out on the streets, for example the Peace and Freedom party, and if we elected a Peace and Freedom governor we would get single payer. That’s what people should be working for. By saying we’re not out there in the public dialog you are undermining us.
. We should take away everybody’s insurance so that they will see that they need it.
. People who voted for Obama are dupes, and this is an example of why.
. If Jerry Brown would run on single payer, he would win easily and that’s how we could get something worthwhile.
. The bill won’t work because the insurance companies will be allowed to charge 4 times as much as they do now. Whether or not the bill will be implemented or overturned will be determined in the courts and in the bureaucracies, and that’s not something that public advocacy can change.

Every one of the italicized claims above are either factually wrong (often egregiously), or are politically simple-minded. Over and over again, LeNoir politely challenged both the inaccuracies of these statements (for example, the bill provides for several mechanism for regulating rates, none of them being the whim of the State Insurance Commissioners), and kept asking people to see that the good of this bill could easily disappear if the Right’s superior position in the national debate is not challenged. No one would respond to these corrections honestly, no one would acknowledge that the Left has been missing in action (in fact, present only to express outright hostility to the bill). Everyone knew better than LeNoir that the bill was worthless (yet they had no interest in its contents), and everyone thought LeNoir was nave if not stupid in not recognizing that working with and within the bill was a waste of time.

Perhaps the most interesting case was the last caller, a member of a national reform group who probably had more practical political experience than the rest. His claim that public advocacy does not affect court rulings, the actions of attorneys general, or the decisions of government bureaucracies, could not be more false. It is the very sum and substance of real-world advocacy to do exactly these things. Yet here he was ignoring the implementation of the real bill just passed, in favor of the comparatively diffuse possibility of getting single payer legislation enacted and implemented in California (the most bankrupt state in the nation, as LeNoir reminded his audience).

This is a pathological political situation, I think. In all important respects, the reality is emphatically the opposite of the one posited by KPFA callers. LeNoir knows more about this bill, and about medicine, and about politics, than all these callers put together. Their condescension to him illustrates that the Left is no more civil or educated than the Right it mocks. The silliness of some of the statements – like the idea that there’s no hope until we elect a Far Left Governor from a fringe party largely populated by senior citizens from Berkeley, or until we eliminate the influence of wealth in politics – is only the most obvious piece of the problem. Worse is the lack of interest in the real world – in this case, the many interesting and complex provisions of the bill, and how they might or might not work. And of course the roots of all this is the need for a justification to do nothing. If the political system is rigged, if only single payer is acceptable and we’ll never get it because of (fill in the blank), then no action is required.

A word on single payer: The Left seems to believe that we must destroy the private insurance companies to have real reform. They seem not to understand that this is somewhere between impossible and fantastical within our particular capitalist system. So, in effect, there are saying that only fully socialized medical care – ‘socialized’, as in socialism – is acceptable.

Strikingly, this is the mirror image of the Right’s fantasies: that ‘Obama-care’ is socialism, and therefore the beginning of dictatorship. The idea that the reform bill just passed is socialism, or that only socialism can bring meaningful reform, are mutually reinforcing political fantasies. The armies of the Left that have recently written endless screeds denouncing Obama and House Speaker Nancy Pelosi (D-CA) often express themselves more intelligently than these KPFA callers. But their message is, overall, similarly useless and self serving. If the Left had thought like this in the thirties, we’d have never have gotten the New Deal. If it had acted this way in the sixties, Medicare would have never been implemented. And if it continues this know-nothing-ism in the next few years, it may well doom the only chance we will have for useful reform for the foreseeable future.

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3 Responses to Trying to have an intelligent discussion about health care on KPFA (and not succeeding)

  1. Doorworker April 21, 2010 at 5:55 am #

    “…Every one of the italicized claims above are either factually wrong (often egregiously), or are politically simple-minded….”

    Maybe so, but is it any less ‘politically simple minded’ to expect general publics of any political or apolitical tilt to have a grasp of the weedy minutiae of the Rube Golberg machines of either a broken Senate or a rather absurdly structured HCR?

    Another thing–seems to me there’s quite a solid case to be made for seeking simple, maximally comprehensible (to the lay observer) policy in this country as a rule. If this is a seriously-taken democracy, the reasons are self evident why this is a solid goal.

    And even aside from this ‘incrementalist’ health care reform (time will tell for it) other real world examples speak to this point as well.

    Hedge fund finance capitalism, and EU cap and trade carbon trading are two examples, both with the highest of stakes riding on their very dubious backs, that spring to mind.

    The sorry history of climate change in particular, and the utter failure of this sort of technocrat centrism you seem to champion as the prudent, pragmatic response to such an existential mess…that’s a particularly inconvenient 800 pound gorilla in yr living room. One that seems to suggest to the likes of me that an incrementalism that refuses to see when it’s simply not getting the job done, really isn’t ‘pragmatic’ in the least.

  2. ChrisFS April 21, 2010 at 1:28 pm #

    I wasn’t able to listen to Dr Lenoir’s show, I am disappointed that people rejected a good starting point for a theoretical solution that would have taken another 5-10 years to arrive.

    KPFA’s Letters From Washington was able to have a more balanced discussion of health care reform on his show while the bill was being passed. I heartily recommend people interested in the subject to go to the KPFA website and look up Letter’s To Washington in the archives to listen to shows about healthcare reform.

  3. bob mason April 23, 2010 at 9:53 pm #

    A couple of responses:

    It would be nice to have simpler public policies, and the health may be the most overly complex of all. Various provisions in the new bill should simplify some things — for example, if pre-existent conditions no longer disqualify you, then there’s less need for rules about what is such and condition and what isn’t.

    But health care is complicated, in part, because medicine is complicated, and medical technology makes it more and more complicated all the time. Controlling this dynamic, including dubious uses of expensive technology, is one major task of health care reform. This involves bringing a lot of expertise to bear, and make difficult judgments about life and death and quality of life and how to spend public and private money.

    It seems to be me that when to be pragmatic – willing to make compromises with people who oppose you – and when to be more more principled, and insist that certain lines not be crossed, has to be handled one issue at a time. Abortion rights, health care, pollution of the environment, the war in Afghanistan, financial reform, help with mortgage defaults, jobs programs, internet issues — I don’t think that one size doesn’t fit all.

    My highly negative characterization of the KPFA audience was selective, intentionally, to make a point about how certain arguments on the left are carried out. I perceive a combination of intransigence and irrelevance that dismays me. It certainly is true that other programs have had good discussions of the issues — Letters to Washington, as mentioned, and also Kris Welch’s series with Ellen Shaffer has been excellent.

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