Summary: Build Back Better is falling short even on modest health reforms. Let’s focus on building the popular movement needed for truly progressive transformation of our health care system.
Locked Out of the Sausage Factory: Will Medicare Expansion Survive the Budget Reconciliation Debates?
October 27, 2021
By Michael Lighty & Mark Dudzic
The Build Back Better Bill started out as a great, sprawling piece of legislation comprising the most ambitious set of social programs since the Johnson Administration.
But the fact that the Bill appears to be floundering is a reminder of the persistence of the forms of neoliberalism that exercised near hegemonic control over the policies and practices of the Democratic Party from the 1990s through the Obama administration (coupled, of course, with a generous amount of shameless corporate hucksterism.)
A big reason that we are in this fix is because we have not yet built the kind of popular movement strong enough to back up the resolve of our Progressive Caucus stalwarts in the House. All too often, advocates and organizers get infatuated with the inside game when their real job is to build the kind of mass movement that can hold politicians accountable to real principles and real people.
They say that legislation is like sausage-making. The healthcare profiteers and their army of lobbyists all have their hands in the process together with all of the other monied interests with a stake in the Bill. Meanwhile the people whose lives will be most affected by the legislation have been locked out. And, as any trade unionist will tell you, the only way to break a lockout is to maintain unity, bring in new allies and shine the light of day on those who would deprive people of their livelihoods in order to keep the profits flowing.
Comment by: Don McCanne
Our healthcare system is the most expensive in the world yet fails in achieving the performance goals we should expect. What are some of the goals that would create a system of which we could be proud?
Universal – Everyone should be included
Comprehensive – All reasonable health care should be provided
Affordable – For each individual, and collectively for society
Equitable – Distribution of healthcare resources should be fair regardless of factors such as age, sex, race or ethnicity
Patient-oriented – Designed to serve patients rather than private corporate interests
Publicly funded – Using economic tools such as modern monetary theory and progressive taxes only available to the people’s government
Publicly administered – to provide efficiencies in administration available only through our government and not through the fragmented private corporate sector
Deprivatizing healthcare financing will eliminate the high costs, inefficiencies, and inequities of private corporate greed.
With our current president and current Congress that are debating the Build Back Better Bill, how many of these goals can be attained? Absolutely none. Not even close.
According to Michael Lighty and Mark Dudzic, astute observers of the healthcare political scene, we have not yet built a strong enough popular movement that can hold politicians accountable to real principles and real people. We have been spinning our wheels in excitement over the prospects of passing the Build Back Better Bill, while we are sliding into disappointment over how inadequate the surviving elements of the legislation will be. We are forgetting that at the most optimistic peak of the process we would have gained none of the features of a healthcare system that we should be striving for.
Regardless of the outcome of the current negotiations, we should pull all stops in our efforts to achieve health care justice for all through a single payer, improved Medicare for All program. Anything less will sentence us to an expensive, mediocre system that is designed primarily to serve the interests of the privatizers rather than the interests of the public – the nation’s patients, all of them.