Vouchercare, schmouchercare

President Obama arguably scored only one point in the first debate with Republican opponent, Mitt Romney. It was getting the former Massachusetts governor to admit that his team's proposed Medicare reform amounts to providing a $6000 annual voucher for the under-55 crowd to buy private insurance.

Given how high health insurance rates leap from year to year, the vouchercare scheme merits that band-aid-slapped-on-a-hemorrhaging-wound kind of metaphor.

What such policy debates always overlook is the assumption that health care should be dispensed primarily as a commodity rather than as a necessity.

Even President Obama affirmed that the conversation would steer clear of questioning healthcare's profit-driven structure. Marking a crucial difference between Medicare and the health insurance industry, the president acknowledged that "private insurers have to make a profit. Nothing wrong with that; that’s what they do."

Certainly, nothing wrong with that--unless one considers the industry's practice of denying coverage to patients with "pre-existing" conditions; or worse, refusing to pay for life-saving treatments.

"All the incentives are toward less medical care, because--the less care they give them, the more money they make." So said White House counsel John Erlichman to President Richard Nixon back on February 17, 1971, about the beauty of Kaiser Permanente's HMO model. Consider it as a pivotal moment in the history of health care in the U.S.

The Nixon administration had looked to the HMO as means of containing inflating cost of medical care, without ever questioning whether or not it should be embedded within a transaction for profit.

This is the starting point for any serious conversation about health care affordability that can produce action-worthy conclusions.

A sincere debate begins by posing the following question: If private industry's primary aim is profit making, how will it muster the self-restraint needed to deliver health care at an affordable cost?

Get by gridlock with a little help from voters

Former president Bill Clinton appeared on ABC's This Week With Christiane Amanpour on Sunday (Sept. 18) to talk government gridlock and the economy. He imparted two points that capture the crisis of our times.

Speaking to the question of what it will take for Washington decision making to break through the stalemate, he replied that it would require “a little help from the American people.” His answer followed with a reminder to voters of the crop of freshman Congressional nay-sayers elected in 2010--those who impeded such matters like raising the debt ceiling and opposed a balanced approach to the federal budget deficit. Clinton elaborated by saying, "It's very hard for the people in Washington who got there based on pure conflict, pure attack, pure ideology to take it seriously when their same constituents are saying please do something positive."

This is especially true of elected legislators who behave as if their sole mandate is to oppose President Obama. As far as anyone can measure, this agenda has yet to have any direct impact on creating jobs.

On that note about jobs and their 'creators' Rep. Paul Ryan (R-Wis.) on the same day joined the Fox News Hour discussion to cry 'class warfare' at President Obama's suggestion of raising taxes on millionaires (the White House calls it "The Buffet Rule"). Rep. Ryan also repeated the usual, fraudulent claims against raising federal levies on the wealthy and their impact on how jobs get created. Such arguments loop in the multi-million dollar S-corp. companies among that sacred class of small business owners that must be spared any increases.

His reasoning mashes down to "if you tax more... you get less. If you tax job creators more, you get less job creation." Rep. Ryan would be in the oddest position to explain with a straight face why Bank of America, a beneficiary of Bush-era tax cuts, is fixing to lay off 30,000 employees. All that may remain of Ryan's once-fervent audience is the low information voter.

Speaking of the low information voter, Bill Clinton's second important point emerges. In an attempt to account for the few bright spots of economic development around the country, he emphasizes how crucial "networks of cooperation" are to the success of a local market. As for the rest of the country's lagging economy, a significant disconnect prevails between "the way the economic system works and the way the political system works." In other words, we cannot expect economic success when the political system endures the legislative standstills of the magnitued we witnessed this past summer.

As for other disconnects that figure prominantly into our political dysfunction, the influence gap is one that rarely receives attention. Yes, there are those whining references to "campaign finance reform" that pepper some conversations about how to improve government, however, rarely, if ever, does anyone name the players or what is at stake. 

The influence gap occurs between two classes of citizens distiguished by their earning power. As troubling economic times have ginned up talk about class conflict, increasingly the two groups have been referred to as the elite 2 per cent and the everyone-else 98 per cent. Each election they enter into what has been  called here a zero-sum faceoff--the 2% being in a position to finance the media resources necessary to reach the remaining 98% through television, radio and internet ads.

Conventional wisdom drives Bill Clinton's caution that "until the American people make it clear that-- however they voted in past elections--they want these folks [Democrats and Republicans] to work together and to do something, there's going to be a little ambivalence in Washington."

For the millions of unemployed or foreclosed-upon Americans hanging to their wits by a tattered thread, relief will require something far bolder than conventional thought. 

What voters too often forget or fail to understand is the influence they wield when working in concert. If the 2008 economic meltdown has anything to teach us, it has to be how interlinked or mutually dependent our occupational and financial destinies are. Given that interdependency, won't survival require a serious reconfiguration of the influence gap? It would be up to the 'lower' 98 per cent to insist that candidates and elected officials alike, must honestly bear their concerns.