From DAVID ATKINS
Here we go again.
We now know that the Obama Administration traded away the public option in order to gain support from the hospital industry for the Affordable Care Act. And we know that it traded away, among other things, the importation of cheaper drugs to PhRMA in order to secure their support for the bill.
Some of these details were known long ago, of course. Good policy was scuttled in order to secure industry support. The question is why it was done, and whether it could have been done any other way.
In 2009 I wrote my most recommended diary ever on DailyKos called No One Is Going to Save You Fools. To reprise what I said then:
Barack Obama has indeed sold you out. He and many of his Democratic colleagues have sold you out on healthcare, and they’ve sold you out on financial reform. You were looking for a savior, and you’ve been had–not an altogether atypical result for those looking for a strong leader to “save” them.
He hasn’t done this because he’s a bad guy. In fact, he’s a great guy. I think he’s doing pretty much the best job he can. He’s sold you out because he’s not afraid of you. And really, if I may be so bold, he shouldn’t be afraid of you. You don’t know who really runs the show, and you’re far too fickle and manipulable to count on.
The first thing you need to understand about healthcare reform is what Jane Hamsher identified long ago: nothing–absolutely nothing–is going to trump the White House’s deal with PhRMA and the insurance industry. The question you need to ask yourselves is: why? If you’re intellectually mature enough to get past “personal betrayal” as your best answer, you’ll be on the right track.
While you ponder that one, you might want to also consider why nothing has been done–nor will anything serious actually be done–about financial industry reform. Standing up to the financial industry in the current political environment should be a no-brainer. So what in the heck is going on here? If you can think past shadowy conspiracy theories and possible personal enrichment for the Obama family, you’ll be doing the kind of thinking that will help actually solve the problem.
I noted that money to purchase persuasion is extremely powerful. Sophisticated marketing research and framing techniques mean that hundreds of millions or even billions of dollars spent on advertising can be completely devastating to political careers. It’smuch harder to “welcome their anger” when that kind of money is being thrown around that effectively.
So here’s what you have to understand. If the health insurance and financial industries really felt scared by any particular politician or political party, or their lobbying efforts were inadequate, they could throw them out of power in a heartbeat. With a wave of their hand and a few billion dollars or so in our direction, the pharma companies and Goldman Sachs could absolutely destroy the Democratic Party in 2010 and beyond. The only reason they don’t do so is that it’s cheaper and easier to buy a few key Democrats off instead, and intimidate the rest. Plus, they don’t have to run the risk of a right-wing populist backlash, either.
That’s why Barack Obama can’t renege on his deal with PhRMA: PhRMA almost singlehandedly destroyed Hillarycare in 1993, and spent the money to tip the balance of the elections in 1994. They can easily do it again. So could Goldman Sachs and the rest of the financial vampires. Rahm Emmanuel knows this, too: the deals are in place in return for their holding their fire.
And each and every one of you is being taken for fools. You work for an election or two to put chosen leaders in place, and expect those leaders to work their “leadership” magic to ram reforms down the throats of the corporate sector, failing to understand just how fully the corporate sector holds the cards. It’s not the campaign contributions: it’s the persuasion money…
If you want to win, you will ORGANIZE. You will organize in the same way the Right has done for the last 40 years, and you will spend money on persuasion, where it really matters. You will, in short, make the politicians as afraid of you as they are of them. The Right has built vast networks of think tanks, newspapers, periodicals, cable news channels, and political advocacy organizations to spread their finely tuned, well-honed messages. Their politicians may fail them, and their actual policies may be deeply unpopular, but their message machine nearly always works its magic to get them what they want, even when Democrats are in power.
That’s partly because the American political Right never quits and never gives up. They know that organization is the key to their success, and they don’t trust politicians to do their work for them. Democrats, on the other hand, get disappointed and quit when our politicians don’t pan out the way we wanted. That’s why we lose.
As the healthcare debacle went on month after month, I didn’t ask myself why the Democratic politicians weren’t pushing single-payer or Medicare for all. I wanted to know where the Left-leaning organizations were. Where were the think tanks, the message machine, the newspapers, the whole infrastructure? Where were the national, well-tested ad campaigns pushing Medicare for All? Where were the free screenings of Sicko at major movie theaters across the nation, complete with sponsored food & drink for those who attended and signed up to take action? Where were the mid-cycle ads done by Madison Avenue professionals targeting specific Senators and making them deeply uncomfortable? Where, in effect, was the message campaign?
It didn’t exist. What we had were labor unions and the AARP delivering generic hopeful messages without an ounce of the power or creativity that one might find in a random Budweiser ad.
If you want to win, ORGANIZE. Develop parallel organizations willing to persuade with the power and intensity of a corporation.
It was the case back then. It remains the case now.
The Affordable Care Act barely squeaked through with a minimum number of votes as it was. Had either PhRMA or the hospital industry come out against the bill to the tune of hundreds of millions of dollars in ads against those who considered voting for it, it would never have had a prayer of passing. The blessing of PhRMA and the hospitals was a necessary condition for the passage of any bill, which is part of why single-payer was never on the table in the first place.
Replacing Barack Obama with a “stronger progressive” won’t solve this problem, because the problem lies with the system, not with the person in the Oval Office.
The power to defeat PhRMA and the hospitals won’t come from the top down. It will come in two ways: 1) from the bottom up via progressives rolling them over state by state; and more importantly 2) through campaign finance reform that prevents them from threatening the careers of every politician in Washington if they don’t get their way.
But the days of an FDR jamming legislation down the throats of corrupt industries with 70 likeminded Senators isn’t coming back, particularly if we’re interested in holding onto the civil rights movement. FDR may not have compromised with the corporations, but he certainly compromised with the racist Dixiecrats. That is no longer negotiable, morally or logistically. And the corporations aren’t going to stand down, either: they’ve been on the march ever since the Powell Memo, and they’re not going to stop now.
What we do about that is up to us. It’s not entirely clear what the strategies for success will be, but the strategies for failure are obvious: waiting for a progressive savior who will never come because the structures of politics no longer allow it, and assuming that decentralized and disorganized angry people power will magically bring about change.
It’s going to be a long, hard slog. And it’s going to take organizing on a variety of fronts, chief among them campaign finance reform, that don’t seem to immediately impact the problem. But if one wants to cure a disease, it’s important to treat the underlying problems, not just the symptoms. But no one is going to save us from this morass but ourselves.