Wait a minute, Jon! Are you saying that 18,000 Americans dying each year for lack of health care matter more than my right not to have the FBI listen in on my phone conversations? Let me explain to you the difference:

1. When the FBI wiretaps me, that's "police state," "dictatorship," "Brown Shirts," the end of civilization as we know it.

2. When 18,000 poor people die because they can't afford medical care, you know what I say: "Damn, we can do better."

(God, I hate it when the FBI messes with the elites.)

...health care should get BY FAR the most effort and attention from progressives, online and elsewhere.

You're saying between health care and FISA, or overall? If it's the former I'd agree, but if it's the latter I'm very surprised to hear that that's how you feel.

"But health care should get BY FAR the most effort and attention from progressives, online and elsewhere."

I disagree. I think stopping the US military-media-industrial-financial complex from doing more wars and occupations of foreign countries is far, far more important. As Chomsky said "hegemony or survival". I think stopping our lawless police state and gutting of the US constitution (ie: FISA bill)is far more important.

I moved from Canada to the USA in 1993, and gave up working for universal health care for Americans when Hillary Clinton did, which I think was 1995. If Americans want to be unhealthy, why stop them? We all make choices in life, and as long as Americans are only choosing to hurt themselves, I will not do a thing.

or complain about it.

I'm about IMPEACHMENT FIRST.

Susan: I agree with you about the MIC, the wars, and all of that. I disagree about FISA.

I go by body-count.

Wars= hundreds of thousands.
Health Care= tens of thousands.
FISA= 0? (You say "lawless police state": hyperbole or am I missing something?)

Perhaps taking care of FISA first is the most effective way of stopping wars. Perhaps FISA is the nexus of all evils in this country, and it should be our top priority. I'd love to hear the argument. Is it available anywhere in the liberal blogosphere?

>> If Americans want to be unhealthy, why stop them?

Over 40 millions Americans have no health insurance: 18,000 of them will die as a direct result this year alone.
They did not "choose to be unhealthy."

Sorry to hear that you "won't do a thing." That certainly is your choice.

Finally, you realize I assume that imperial conquests are perfectly constitutional.
As long as Congress declares war, the US can kill as many natives as it wants and our glorious Constitution is fine with it.

FISA by itself might mean little, but the erosion of liberties ought to have some consequences. Free societies do fall apart and can descend into truly awful messes. We are not immune. Personally I would think the US becoming a fascist state would be far, far worse than continuing this current health care debacle, and FISA is a brick on that road.

A president Obama isn't going to do a damn thing about healthcare. He'll propose some clever-sounding initiatives and a pilot program or two, offered in much the same spirit as a magician shows kids at a birthday party something shiny to distract them while he sets up his next trick.

I don't know if creeping fascism is worse or not, the way some of the other commenters seem to feel some kind of certainty-- I am still wrestling with this question, as in whether voting for the democrats is still remotely relevant.

Obama has said he'd appoint justices "like Souter or Stevens", but hey, he's said a lot of things.

To me the fact that he's criticized the putative "excesses" of the 60s and slammed Clark shows me that he's actually eager to make the rhetorical work that liberals have to do that much harder...

or, he's just a dumbshit who's memorized some uplifting phrases from the wall hangings at his dentist's office.

I'm curious what you and Bernard think.

John Caruso:

You're saying between health care and FISA, or overall? If it's the former I'd agree, but if it's the latter I'm very surprised to hear that that's how you feel.

Susan:

I disagree. I think stopping the US military-media-industrial-financial complex from doing more wars and occupations of foreign countries is far, far more important

saurabh:

Personally I would think the US becoming a fascist state would be far, far worse than continuing this current health care debacle.

I do think health care should get more attention from progressives than anything else, including global warming, wars, and encroaching fascism. That's because we'll never get anywhere with the other issues unless we fight and are seen to be fighting for health care.

We can wish that most Americans cared deeply about the whole panoply of progressive issues. But they don't. And they're not going to listen to us if we don't concentrate on the most important, immediate issue in their lives, which is health care. Moreover, people will never have the freedom to get politically involved on a large scale without universal health care. And they'll never be able to understand *why* all the other progressive issues matter without getting politically involved, and by far the most likely way to get people politically involved is...health care.

Jonathan's argument is over political tactics, and I find it somewhat persuasive.

But I'm surprised at Bernard's total dismissal of the importance of FISA. Clearly a major reason why our elites want to gut the 4th amendment is because it will enable them to more efficiently dis-organize the public.

It's also hard to see how this can stop at the 4th amendment. Now that everyone's agreed that the president can order companies to commit felonies for national security, the president's power is pretty much unlimited as long as he does it through Blackwater.

Carl: For the record I am NOT dismissing the importance of FISA. I want that bill to be filibustered. I want firm judicial control over wiretaps, etc.

I am just saying Let's not panic! A FISA setback would not mean we're on our way to North Korea.

So yes let's be vigilant, but why is it a top priority?

I have my suspicions.

No one seriously thinks all the bricks will unravel one by one and it'll be hello Kim Jong Il!

Rather, bloggers and intellectuals (the elite) worry that they will be the victims, and they are scared shitless. Intellectuals are usually wimps.

Personally the FBI doesn't scare me much. A bunch of incompetent buffoons who probably wouldn't even know how to upload my wiretaps on their main servers.

I do worry about vulnerable Muslims, however. But to think that FISA will protect them from unlawful arrest... Yeah, right.

Jonathan V. I think there's a fighting chance health care can happen with enough public pressure. Why? Because a large majority wants it to happen.

But like you I bet Obama will resist it (too much to lose for insurance/pharma/medical interests.

The empire is different. Most Americans approve. It'll take an economic downturn to make them change their viewpoint.

I am not aware of any empire that folded voluntarily.

True, true, true... but

the resistance to health care will be much greater than to FISA. (For the paranoids out there, no the government is not trying to download your life. It does not need to. You already do as the government wants, completely uncoerced.)

But health care will crash into mega corporate interests. The pharma/med/insurance complex is the biggest extortion scheme ever invented in America. They deliver a shitty product at exorbitant prices. They won't go down without a fight.

Already single-payer is out. Which right there might well kill the whole thing.

I agree with Jon that it's the next battle to fight because it is fightable (and sadly, losable).

Moreover, people will never have the freedom to get politically involved on a large scale without universal health care.

Ah, that's why I like reading this blog so much - the unbridled optimism that masquerades as calculated disdain and sometimes even pragmatism.

Your comment there Jon made me think of progressives in the early part of the 20th century, sitting around a table, deep in discussion of how if they could just get a 40 hour work week and a reasonable minimum wage enacted into law it would solve so many problems and free people up to do more activism in other areas.

Keep with the optimism - I'd like to think you're right. Unfortunately, my personal belief is that once the health care "crisis" is taken care of it will just free people up to work their two jobs, watch some American Idol, and possibly cheer on the next war - but in much better health than their parents had.

Bernard,
the Brits folded their empire voluntarily, as far as I can see, but they were influenced by the shock of WW2, and without trying to disrespect or diminish anybody's loss, it seems to me that 9-11 just is not of the same scale.

I think that's why Obama bugs me so much-- the combination of economic unease, recent scandals and the debacle of Iraq make Americans more ready for someone who would lead them down the path of questioning and discarding empire than they've been in a long time.

And even though I see him as a phoney, I recognize that tons of people groove on his shtick, which makes him particularly well-suited to be that guide, but he's clearly averse to high-risk strategies that would offend his powerful new friends.

I think of that scene at the end of House of Games when Joe Mantegna insists Lindsay Crouse is bluffing, because she doesn't want to give up her "book and the doctor thing, and all that good shit" that she's accumulated. I paraphrase.

Having worked in a public hospital for twenty six years, I can say, the health care system is completely broken. "Practice of medicine" is not a profession anymore. It has become a business and corporate driven, for profit industry. Community hospitals have closed due to inadequate reimbursement by the state and federal government which has increased the demand for services on public hospitals which have never received adequate funding. It is also well known that the health care recived by the minorities is of inferior quality which results in incresed morbidity and mortality.
Because health insurance is connected to employment, when a person changes employment, there is no continuity of care ( nothing could be worse for the patient ). According to many reports, a large number of workers will stay with a job they dislike, only for the sake of health insurance.
But things will have to change. Due to exhorbitant increases in the cost of providing insurance to their employees, major corporations are now demanding reforms. Even physician groups are in favour of universal health care and single payer system. Recent research has shown that.
http//:www.prospect.org/cs/articles?article=the_doctors_revolt
Thousands probably have lost all they have paying their hospital bills ( many may have died )inspite of having insurance because there is a maximum limit on the amount the insurance company will pay. Hence health care reform is of utmost urgency.
Of corse, that does not mean, one can not fight the government's draconian onslaught on our privacy and liberties at the same time.

THIS same conversation is archived over at Maxspeak. Coberly came up with the best plan, I thought, selling it as blocks of insurance policies. In reality NO-ONE came with an agreeable workable plan. So what plan are WE talking? THESE WARS are sucking up ALL the money for ANY plan. 18,000 people? WE're liable to do that in an afternoon in IRAQ.

The FISA thing pisses me off more because it closes off yet another avenue for potential investigation into the crimes of both the Republican and Democratic leaderships than because of the creeping fascism angle, though that is disturbing as well.

The health-care-enables-us-to-be-more-involved line of argument is a good one, and I hadn't actually thought of it exactly that way before, though I should have. But I do think that arguing over what our priorities should be is at least slightly silly, because progressive causes (or whatever less wussy word you want to use for it) reinforce one another--working for peace reinforces working against empire reinforces working against racism reinforces working for health care reinforces blah blah blah blah blah. If people can just be made to see that all these things are part of the same thing, then we'll be a lot better situated to get things done. Maybe.

JV: Churchill did all he could to hold on to the empire. But the UK was a wreck and they were smart enough to pack their bags before the natives went native on them. (Though the Brits held out in Kenya far longer than they should have... Churchill again.)

RS: Very interesting why corporate America didn't go for single-payer early on. A clear case of blind greed.

ethan:

But I do think that arguing over what our priorities should be is at least slightly silly, because progressive causes (or whatever less wussy word you want to use for it) reinforce one another--working for peace reinforces working against empire reinforces working against racism reinforces working for health care reinforces blah blah blah blah blah. If people can just be made to see that all these things are part of the same thing, then we'll be a lot better situated to get things done.

I completely agree, except for the silly part. People will inevitably see it's all connected if we can get them involved in any part of it. And the most obvious entry point for non-weird people is health care. That -- in addition to the fact it's a fight we can win that will also make people's live significantly better -- is why we should give health care as much attention as we can manage.

Bernard:

Very interesting why corporate America didn't go for single-payer early on. A clear case of blind greed.

I think to some degree it's not -- for some, at least, it's a case of long-term thinking. Much of US business benefits directly from Social Security, but is still willing to try to destroy it, because destroying people's sense they can work together and make things better helps business more indirectly in the long term. Chomsky has pointed out somewhere that business has opposed a Tobin tax, for the same reason.

Jon: What I was thinking was how Detroit and others thought they'd make a killing by running their own health insurance system (with tax breaks to go along with it).

@bernard

Already single-payer is out.

of course. could tell that from the listed members. ordinarily i'd say something like, "regulating the insurance industry is about as reliable a way of permanently securing a public benefit as is regulating margin buying on wall street." little by little the safety disappears. whittle whittle, chip chip chip.

we need to clean house and the democrats' big cheerleaders aren't interested. hand-in-hand with that should be fixing consumer bankruptcy law, since that's bound up with medical costs, but that's not part of "health care for america now!" either. i'm so tired of this electioneering junk!

meanwhile everybody i know who writes about peak-whatever planning thinks medicare is the way to go. it takes so much less work than the other systems. to be able to act and plan effectively people need to know they won't get reamed by fine print.

Bernard: Detroit has their money invested on methane wells. One is out here in the yard owned by several Detroit pension funds. They are paying for their programs with oil and gas investments.

Bernard,

How would Detroit make a killing running their own insurance operations? In the end, they have to make the payouts, so it seems to me they can't come out ahead. Passing those expenses off to the government seems like a definite win for them, which is why I don't understand why it doesn't have more support from them and other large business interests.

Actually, I almost don't think the way things are financed is the main issue (e.g. hapa's expanding Medicare suggestion). Eliminating insurance companies removes a big part of the problem, but a bigger one is the providers and pharmaceuticals, who have been raising costs year after year and hiding behind the ghost of evil HMOs. I'm not sure what's a harder fight, destroying the health insurance industry or leashing the providers.

Bernard: why is [FISA] a top priority??

It's been a top priority for the last few weeks because a vote was imminent. Your dismissal of bloggers and people who've gotten active on the issue is insulting and unfair.

There can be no clearer example of the difference between you and Jonathan than your respective comments on this post.

People, people: let us try a little tenderness here. On all sides.

Jon, I think you may have convinced me. I have to think about it some more, but you seem pretty damn right to me. I'm sure you're filled with fuzzies about it, so congratulations.

you seem pretty damn right to me

I hereby ban every commentator except you.

Also, to fill up the space, you are now required to leave 28 comments saying this on every post.

Nell: It's been a top priority for the last few weeks because a vote was imminent.

Yes, exactly. The same goes for the Pledge of Allegiance brouhaha a few years ago, during which a lot of progressives were asking why we should pay attention to a relatively minor issue. And the answer was just that it had been raised to national prominence at that time, and so that was the time to discuss it. Of course domestic spying is far more important than the Pledge, but really, I don't think the amount of time and effort people have put into FISA has detracted from anything else.

Jon: I agree with you that better health care for Americans should be a high priority, but saying that it should be BY FAR the highest priority for progressives right now for the reasons you've given is in my opinion flawed in many ways and on many levels (practical, strategic, and ethical). Too much to go through point by point. But this is one of the few times I've been truly gobsmacked by something you've written here.

So I'll just say that I'm in total agreement with you that there's no reason we can't work on multiple issues at the same time.

But this is one of the few times I've been truly gobsmacked by something you've written here.

I thought I'd made it clear that everyone who doesn't pronounce me "pretty damn right" is banned forever.

I apologize for my harsh tone and direct personal attack on Bernard.

There's a lesson about comment dynamics in my lapse: Avoid personal attacks. (Corollary: Apologize when you've done something wrong.)

There's a lesson or two about comment dynamics in Bernard's comments, as well, which I'd have done better to specify than lash out at him:

Imputing unpleasant motivations to large groups of people encourages angry, defensive responses.

Pitting people who're broadly on the same side against each other on a question can be stimulating. Whether it stimulates flame wars or better mutual understanding depends on whether discussion stresses what's wrong with the other side or actual arguments for one's own position.

Oscar Wilde's "It is not enough to win. Others must lose." is amusing, but poison when applied to blog posting.

Oh sure, Nell, you're being all decent, thoughtful and humane, but when are you going to put your money where your mouth is and address the issue of whether I'm pretty damn right?

Hint: yes

Mike Meyer: This same conversation is archived over at Maxspeak.

Mike, or anyone -- Where are Max's archives?(other than on the Wayback Machine, which is very incomplete). When he closed the blog, Max invited readers to email him for information on the disposition of the archives, but I never did that. Did anyone here?

Reading the announcement about HCAN at TPMCafe yesterday, particularly the part about EPI's role in pushing the plan that's the start of the discussion among incoming Dems, made me realize to what extent and how long ago the fix was in -- something I picked up three years ago at Max's when he wasn't willing to advocate for single payer. His argument was that the transition was politically impossible given the power of the insurance and pharma giants.

My sense is that the HCAN plan accepts them as part of the landscape, and tries to be the outer edge of what would be acceptable to the corporate overlords. I have to say that as a bargaining position that makes me uneasy, because there's nowhere to move but toward the powers that be.

Or is the HCAN plan to the left of the Obama plan, in an effort to make sure we wind up with something at least resembling it?

The situation is so desperate for most of us (I've had no health insurance since I left my first job thirty years ago), that I'm freer than usual from the impulse to fight the okay on behalf of the much much better. But still I have a sinking feeling.

@Jon: Oh, you're pretty. Damn right!

I can't even get my Oscar Wilde right. The line is "It is not enough to succeed. Others must fail."

Nice commercial. But very flawed policy ideas -- basically rewarmed MassCare and ArnieCare. Here's the relevant post from the Physician's for a National Health Care blog:

http://www.pnhp.org/blog/2008/07/09/a-policy-response-to-health-care-for-america-now/

Nell: Just Email Max. He promised to save everything, its the stuff of history.

For context on my health-insurance-less career: I worked for a series of starving non-profits and underfunded political campaigns that offered no benefits at all (well, for a couple of years in the early eighties, I did have a week's paid vacation; woohoo!). So I chose my situation, and I was doing work that I wanted to do.

But right now in my county, many employers offer no medical benefits. It's gotten so that people expect not to have them. Half the workforce has only part-time jobs (often two or three), without benefits. They've got to drive between those jobs, and often a long way home (it's a rural county; cheap housing isn't concentrated anywhere).

There's been a quiet crisis for years, as about a third of the county residents scrape by on half the national median income. Now gas, fuel, and food prices have doubled, just as both the state and county are raising taxes, especially regressive taxes (on food and gas). The existence and growth of a free clinic has allowed businesses to get away without providing medical benefits -- but now both the clinic and the food bank are overwhelmed.

This county has two colleges and a lot of prosperous retirees moving in from elsewhere to support the private institutions that were buffering the misery (and keeping government off the hook). Things are even worse in some nearby counties without those resources.

Truthfully, I was so angry and disappointed at the health care debacle of the early Clinton years that I'd been assuming that absolutely nothing worthwhile in that department will come out of the next administration. But your and eRobin's enthusiasm about HCAN makes me determined to learn more, in hopes of finding that a conceivably winnable program will do something for the people hurting the most here.

Gore Vidal! Um, America's Oscar Wilde. Or something.

You're (damn!) right.

I came by here for a dose of sanity, for my no-shilling-for-Democrats zone. And then I find this! So here's the HCAN plan. Maybe if Andy Stern gets cozy with Wal-Mart, and maybe if we cut the insurance companies and big pharma in on the deal, then everyone will see that we're being nice and they'll be nice, too, and, you know, they'll sort of support our plan and everyone* will have health care** and we'll be, you know, like almost as good as the rest of the fucking world that has already more or less solved this problem.

Or we could remember 1993-94 and decide that the only way to win this is to beat the fuckers down. And then realize that the Democrats aren't going to do that, any more than they're going to end US imperial adventures in the Middle East, and that HCAN isn't going to lead us into this promised land, any more than other liberal "antiwar" groups whose main agenda is shilling for Democrats is going to get us out of Iraq. There's a good plan out there. It's HR 676. Anyone who's serious will get behind it. Anyone who doesn't is the enemy, no matter how nice their $40 million package looks.

Fuck, Jon, you're smarter than this. What the fuck happened here?

* - On a definition of "everybody" that includes an error term of 50 million.

** - On a definition of "health care" that includes routine denial of coverage and frequent bankruptcy.