Watching the Supreme Court undo 100 years of established judicial precedent on a 5-4 vote, it made me wonder why we suddenly think it takes 60 senators to change the menu in the Senate cafeteria. If democracy is based on majority rule, the majority in one branch of government--especially the LEGISLATIVE branch--should not be rendered impotent by a set of rules that were never written or intended by the framers.
I don't know the precise moment when this 60-vote, veto-proof majority became the requirement for passing laws. I seem to remember when we were excited about winning the majority. Weren't those chairmanships supposed to mean something?
I still remember the Reagan years and how Ronnie beat up and alternately wooed Tip to get his agenda passed. I know we're in the Gingrich-DeLay era of take-no-prisoners republicanism now, but I can't believe that independent-minded Americans don't want the Congress to do anything.
In the words of one anonymous talk-show caller, "this shit has got to stop!" We, as Democrats, have got to stop being patsies for the right. And we have to get our campaigns and OUR government more disciplined and organized to get the results the American people voted FOR in 2006 and 2008.
Yes, there has been an economic calamity that has taken all the anger that was aimed at Bush and Cheney and turned it into fear and helplessness over personal economic security. It would have been nice if the health care debate had been more focused on the middle-class rather than the uninsured. But getting 30 million people health insurance is not exactly a bad thing.
Why the Speaker, after all her success, had to declare she couldn't or wouldn't pass the Senate health care bill I don't know. The shortest distance between two political points is still a straight line to the bucket.
But the President's declaration of being ready for a fight on financial reform seems like a good place to start the New Year. I can already see Scott Brown's truck in the rearview mirror.
Congress has some work to do reversing the Supreme Court's crazy decision on campaign finance. Changing the rules of the senate would be a good place to start--for that and a lot of other things. It's time for the Democrats to bring back majority rule.
THE PATIENT COMES FIRST
The health care debate, a critical national security issue, has been a humuliating embarrassment with the facts and the national interest both major casualties, on life support with the The Republican Party, the Tea Party, Rupert Murdoch's Fox News, Rush Limbaugh and assorted other rabid ideologues for whom ideology is a substitute for thought, trying to pull the plug.
Delaware Insurance Commissioner, Karen Weldin Stewart has long founded her approach to state health care regulation on the mantra "The Patient Comes First." If the national government were to build a health care reform founded on "The Patient Comes First", making that clarion call more important than options, public or private, more important than profits and bottom lines, and, for the moment, putting cost controls aside, the United States could produce a health care system that delivers infinitely better care that is truly universal at significanly less cost.
Virtually every indice that determines the quality of health care and its delivery throughout the world reveals that our nation has, despite its wealth, advanced technology, splendid hospitals and doctors, medical schools that are the envy of the world, a shockingly inferior health care system that is approximately twice as costly as those of the other advanced nations throughout the world.
From Canada's single payer universal system to Switzerland's universal system that does not have a "public" option but where health insurance is mandatory for every citizen and where no insurer can deny anyone coverage for any reason, the delivery and quality of health care far exceeds that of the US and does so at much less the cost.
The "Patient Comes First" is both a slogan and an approach. Its focus is changing the emphasis in medical ideology from treatment to wellness, preventive care and preventive medicine. It mandates healthy lunches and an emphasis on the importance of physical education in elementary and high school. It steers the nation away from the forces that drive the too often problem of over testing, over treatment and over medication and toward what is appropriate and necessary. It implements systems to reduce the serious problem of errors and infections indigenous to hospitals. It is a force for tilting the provider's emphasis back to being physicians focused on the well being of his or her patients as opposed to being a CEO onbsessed with unit costs and the bottom line. In addition Commissioner Stewart's approach in Delaware examines the health care needs of each demographic separately (the uninsured, the working poor, the impoverished elderly, the young etc.) while championing uniform coding, electronic access to medical records and electronic, real time billing as well as the general modernization of the administration of health care and its delivery to reduce provider and caarrier administrative head counts.
Finally, the President is opposed by powerful corporate interests, a Republican Party hijacked by rabid ideologues, dangerous Tea Party true believers, a TV broadcast network owned by a foreign profiteer and assorted radio and TV personalities for whom ideology is a substitute for thought and the national interest an inconvenience. Instead of worrying about the loss of the 60th vote in the Senate and fighting a battle over majority rule, the President has to draw a line in the sand, send out a rallying cry and convincingly, simply and directly tell the American people what his vision of health care reform is while declaring war against the opposition in the arena of public opinion.
As FDR said:
"They had begun to consider the Government of the United States as a mere appendage to their own affairs. We know now that Government by organized money is just as dangerous as Government organized by mob.
"Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me and I welcome their hatred.
"I should like to have it said of my first Administration that in it the forces of selfishness and of lust for power met their match and now these forces will meet their master."
Elliott Jacobson
Chief of Staff
Delaware Department of Insurance
Karen Weldin Stewart, CIR-ML
Commissioner
Note: For those interested in understanding this, I refer you to Dr. Atul Awande's article in the June issue of the New Yorker, his new book, "The Checklist Manifesto" and T. R. reid's book "The Healing of America".