So OK re the whole Obama thing, remember when I admonished people for not enjoying the spectacle of Republicans with their pants round their ankles, running six ways from crazy a coupla months ago, because it was rare to get a win, and it wouldn’t last, and soon it wouldn’t be fun anymore?

Well, OK, I can officially declare I am not having fun anymore. I noticed this a couple of days when I went to click on the bookmark for nationalreview.com, the centre of US right-wing sane craziness — and decided not to. For a while — since about November 5 last year I think – it’s been great to read their rolling blog The Corner an extended version of the sick room dialogue in Cuckoo’s Nest, try to convince themselves that everything Obama got done, from overtures to the Arab world to getting two journos back from North Korea, was some sort of catastrophic disaster for the US.

Now, not so much. With Obama’s health care plans running into the ground, and his team carving off and giving away so much of it in order to get a bill they can pass, I don’t need to read the enemy — the friends are idiotic enough to take care of all my anger needs.

Team Obama has already given away Medicare parity — the idea that fees for the public provider would be set by using the government’s aged-care (Medicare) free health service fees for providers (i.e. doctors hospitals etc), which are mandated lower than most health insurances fees. This means that the proposed public health care provider has less scope to leverage fees down, a big part of the exercise.

Then there was the “death panels” madness, in which a specific line item whereby providers could bill for the specific tasks of treating end-stage patients — counselling, etc — was constructed as some Nazi health selection, and the ruling Republican on the Senate health committee sucked up to his lunatic constituency, even though he knew the charge to be false.

This had these line items “removed” — i.e. hidden in other more general parts of the proposed service — and was a pointless distraction, though enough of one for conservatives, including one Australian who, had he been subject to US health care for an illness he publicly discussed a couple of years back, would be bankrupt or dead or both, to declare a win.

But the real biggie is what it was always going to be — the simple refusal of “Blue Dog” Democrats to vote up a public option, because they receive over the odds funding from big Health, and are elected by Republican states. The whole Obama health care strategy was designed on making the public option as small a target as possible, in contrast to Hillary Clinton’s approach in 93, and to avoid the kamikaze charge that finished off the Clinton presidency as any sort of left-liberal adventure.

The White House has tried to appeal to Blue Dogs to adopt a one-two strategy — don’t filibuster the bill, allow it to get through to an up-down vote, and then vote against it. The White House only needs to get 51 votes then, which they’ve got — though not by much — but half a dozen Blue Dogs could peel off and boldly announce back in the mid-west that they’d voted against ObaHitla’s communist Nazi health plan etc etc.

The strategy relied on presuming that Midwest American republicans and independents had the memory of goldfish and the intelligence of a lawn sprinkler, in other words it was sound, strategically. But the Blue Dogs are running so scared that if pushed, they would vote Obama down, to ensure their risk-free political survival. As Obama ruefully noted, what LBJ was trying to do with the Civil Rights Act in 1965 was harder — but he had a more disciplined party, who ultimately had the courage to make a vote that would “lose us the South for a generation” as the man put it.

LBJ was pointing the cattle to the slaughterhouse, Obama is herding cats. But that doesn’t make up for the terrible terrible game the White House has played on this. With the word “swiftboating” now in official dictionaries, how on earth was it possible to be surprised by the way in which a batsh-t Right would use the tactics of hysteria and the big lie to turn a debate about health care provision into a war for civilisation?

As they did in the campaign before the financial meltdown hit, they retreated to an austere, wonkish position that let the feistier GOP kick the sh-t out of them. This was retrospectively canonised as ‘tactical restraint’. It’s unlikely that this weak campaign will be — it will be seen as the worst trait of American liberalism, the failure to step up for a fight, unless it’s one with your onside, in order to conspire to lose again.

The Democrats express amazement at the lies the Right use – but the whole debate has been so topsy-turvy from the start, that what was required was to combat their myths with ours. Good sense went out the window long ago. Take this issue of ‘rationing’ that the Right twitters on about. This is the idea that a public health care provider will bar access to drugs and treatments that are too expensive, given the chance that they will make a difference.

Yes, public insurers do it. But so of course do private ones – firstly by refusing to insure people with pre-existing conditions, and then by simply hiding the limits of treatment in their contracts, so that policy holders then have to beg and plead on the phone to their HMO, to get another set of tests, another round of treatment etc.

This rationing has been normalised in the American mind, as business practice. But the other aspect of rationing is weirder — it’s the unsustainably generous provisions of Medicare, a piece of open-ended socialist provision by Big Government that half of the crazies in the town hall meetings appear to be on. It’s pure cognitive dissonance — get the government out of our lives, but pay for any and all care for the last 20 years of our lives.

Obviously it can’t go on. The US is heading towards a health care bill of 20% of GDP, at which point the country has, economically, become one huge hospital. If Obama is not allowed to fix it, it will crash and burn. But politically the important thing is to get through any sort of bill that will extend care — because there is then a constituency who will resist it being taken away.

And then it becomes everyone’s problem.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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