Reforms Don't Always Magically Get Fixed Over Time

People in the "pass any bill, regardless how bad" camp often talk about “fixing it later.” They point to previous progressive change like social security, Medicare, and the civil rights legislation as proof that progressive reforms start small but grow into something better. This mantra is repeated as an article of faith, but it is not based on a true, dispassionate examination of history. For every progressive reform that slowly grew into something better, there is a counter example of reform efforts that, due to poor design, withered or died over the years.

Arianna Huffington uses the example of the badly designed “No Child Left Behind” program. It has turned into a disaster, but has remained unfixed for almost a decade. Rupert Russell, John Aravosis, and Atrios point to the example of welfare programs that were part of Johnson's Great Society. It is hard to argue welfare has become better and more progressive over the decades. The parallels between welfare and this health care reform bill (both only help a rather small group of typically lower income Americans) is something to be seriously concerned about.

There is also the example of the slow rollback of labor union rights, and, most importantly for me, banking regulations. The critical post-Great Depression banking regulations have been under assault for decades, and I think last year's financial meltdown made it clear that deregulation mania has been to the detriment of our society. With the Republican party hellbent on deregulation, I have little faith in the long-term viability of a health care system that relies solely on regulation to keep the health insurance industry honest.

Many are championing this bill as an imperfect step toward greater reform, and claim it is built on a strong foundation. Say what you will about the benefits of the bill, but I refuse to accept that funneling trillions of dollars, and forcing millions of new customers, into the private health insurance system that got us into this mess is a smart foundation.

A strong fear of mine is that this bill will only intertwine another powerful industry complex into our system of government. Like the military industrial complex, agricultural industrial complex, and now, possibly, the financial industrial complex, I fear the private health insurance industrial complex will begin feeding off the government tit and never let go. It will become another bloated industry that survives by extorting ever-greater amounts of money from the government in a vicious cycle of legalized corruption. I worry passing this bill will make it effectively impossible to ever rein in or eliminate this extremely wasteful industry. It will become another burden this country can't afford to support.

We should debate the health care bill before us with eyes wide open. We should not delude ourselves with wishful thinking or the mistaken belief that every small, imperfect attempt at progressive reform always grows into something great. Not every attempt at progressive reform in this country has kept moving forward in a linear direction. We must also fully acknowledge the terrible potential ramifications of what this bill could do. The private health insurance system is ruining our nation and making us uncompetitive in the global market place. This bill will help some Americans, but at the terrible price of greatly increasing the power of those who ruined the health care system to begin with.

This bill may be a small step forward toward better reform. It might end up a new welfare program that is slowly pared down to near uselessness over the years (and health reform is not starting from a robust place to begin with). Or by empowering the enemies of real reform, it could be the political equivalent of a starving farmer feeding his children the seed stock. It holds off the hunger for now, but, in the long term, it dooms the farmer because he has nothing left to plant. Temporary relief at the price of even greater long term trouble.