What Should Be Done (Broken Record Edition)

More and more questions are being raised about the efficacy of the various economic stimulus efforts attempted since last year. From my perspective, nearly everything that's been done so far follows the Hooverite model of propping up the top of the economic pyramid while leaving the masses to fend for themselves. "Tough luck, suckers!" and all that.

Unemployment continues to rise, and nothing at all is being done about it. In fact, the high unemployment rates we're seeing today are expected to get worse, and are expected to stay high indefinitely. Those who still have jobs are seeing their wages and benefits cut while their workload in many cases is increasing. Ah! Productivity gains! But all the economic benefit from those gains is going to the top 1%; working people get higher debt, bankruptcy, foreclosure, homelessness and despair. Just like under Hoover. (Who, by the way, tried lots of programs to stave off the worst of the Depression, but who could not bring himself to actually institute programs to help people in desperate need.)

The Health Care Mess is looking grimmer every day. The Republicans are doing their usual Swift Boat routine and getting away with it; the Dems are -- as always -- gobsmacked and lost in Wonkery, unable to explain just what is being proposed and how it will affect ordinary people. From appearances, all that will be accomplished, if there is a bill, is to give a huge bonus to the Insurance Cartel. More Hooverism in other words.

The Cash for Clunkers program seems to have been a big hit -- except of course with the dealers who have to whine and complain about all the bureaucracy it entails (it is their duty to complain after all!) -- but I question the notion of so many people taking on so much more debt in the middle of a recession/depression. Things are still predicted to get worse before they get better.

Some predictions suggest they aren't going to get better. Ever. At least not for most people. We are in a permanent economic decline.

So what should be done about it? I argued last year that the recovery and stimulus effort was exactly backwards. It was providing huge amounts of money to the banking industry and Wall Street, and it would eventually provide a far more modest amount of money to various heavy industry contractors, but it was providing almost nothing to households (well, there was lower withholding, by about $15 a week). There was no debt relief for households (but there was essentially complete debt relief for bankers and Wall Street); there were no significant foreclosure prevention mechanisms to keep people in their homes; the extensions of unemployment insurance and food stamps didn't account for the millions of unemployed and now destitute Americans who don't qualify for the programs, nor were there any job creation or job maintenance programs.

Turn each of these factors around, in other words debt relief for households, not bankers and Wall Street. Income support, jobs programs, foreclosure moritoria for the duration, etc, etc. All of this and more should have been done from the outset. It hasn't been done yet.

Because the economy is being restructured, with a vastly reduced workforce in mind, it makes sense to let people retire early and collect Social Security -- at 50 or 55 if they want -- in order to relieve the downward pressure on wages and benefits from the astronomical unemployment rates (in some parts of California, unemployment is 30% and more) and to provide more employment opportunities for younger people. If retirement comes early, SS payments will have to increase significantly -- double or triple at the lower end. Medicare should be available retirees regardless of age. And the Medicare for All proposal suggests that anyone who wants to should be able to buy in to Medicare at any time.

These are all very straightforward and relatively simple economic programs to move the stagnation we're facing now out of the doldrums and to really give people dignity and hope again.

Of course Libertarians and Propertarians will howl -- it is their way. And a lot of those types like to masquerade as "Progressives" so that when proposals like these are made, the progressive end of the discussion tends to devolve into libertarian and propertarian cant. And "can't". See Crooks and Liars regarding Thom Hartmann's SS proposal.

Hooverism is winning the day, but Hooverism doesn't work in the context of economic catastrophe. Something bolder and simpler is required, starting at the bottom of the economic ladder and working up. Economic recovery can't happen from the top down.

We learned this many years ago, but everything we learned was forgotten when Ronald Reagan went on his crusade against progressive governance.

Now we have to relearn it. But at the rate things are going, it'll take either several more generations to break free of the Reaganite/Cheneyite hangover or it'll take a revolution.

Relentless

One thing that's very obvious about Republican and right-wing behavior in general since the election and inauguration of Barack Obama to the Imperial Presidency is their utter relentlessness in pursuit of their political objectives, objectives which were made very clear almost immediately: resisting everything the Administration tries to do, and preventing as much of it as they possibly can, with the goal of undermining and eventually destroying the Obama reign.

Not only are they relentless, they are ruthless as hell. Their lies come in barrages. Doesn't matter how often they are debunked and refuted, the old lies are repeated, new ones crop up. On and on, no matter what.

The right wing ruthlessness and relentlessness are redoubled when the ease of rolling Team Obama is revealed, as it has been with the Health Care "Debate."

The Administration has backed off nearly every promise they ever made to attract Progressive support and has generally backed the Senate Finance Committee's efforts to reduce and restructure Health Care "Reform" legislation so that it is essentially little more than a give away to the Insurance Cartel, paid for on the backs of the groaning middle class. Republicans continue to say NO!, loudly. Their propagandists in the media make the case endlessly that Health Care Reform will lead inevitably to Pulling the Plug on Granny, guaran-damn-teed, while they whip up as much fear as can be mustered among a generally ill-informed and typically apathetic audience. The propagandists love it, the Republicans love it. And, from what they can tell, it works.

We can go on at endless length describing what the Rs are doing, and part of the blogospheric process is to do just that -- describe and discuss the perfidy of the opposition -- but my point today is that what the Rs are doing is what the Dems and their progressive/liberal allies should have done in the early stages of the Bushevik takeover of the Government. But they didn't do it. In fact, those who were capable of doing it, and who wanted to do it, were deliberately and forcefully silenced and/or marginalized by both the establishment liberals and by much of the "serious" lefty blogosphere.

The Rightists are giving us all an object lesson in how to cripple a regime right out of the gate, and yet I don't think the idea is penetrating the shields put up by the Dems and their progressive/liberal allies. The idea that you can actually do this in a political context is alien to both the Democrats and the primarily blogospheric progressives. It's just too... rude, and nothing is worse than being rude when you're trying to make a Logical Argument to win the day.

Now they are calling for Eric Holder's head on a platter because he has opened an investigation into the "possible" abuse of prisoners by the CIA in 2003 and 2004 based on the CIA's Inspector General Report. They are calling for his firing and for the end of any and all "investigations" into what was or was not done during the early years of the GWOT, by civil or military authorities. And they are going full tilt in their insistence and outrage. Well, that's how you conduct a political campaign if you intend to win.

I expect the Cheneys -- père et fille -- to emerge from their bunkers any minute now to condemn and otherwise denounce the Obama administration for entering into areas they are not authorized to go and stirring shit they know not of. Muttering darkly all along about the New Horror that will be unleashed upon America because of it.

It's how it's done.

If you want to win. But because this lesson is never learned by Democrats and their allies, it is reasonable to suspect they don't want to "win" -- except to hold on to their position at Court.

Still in Summer

The Health Care Debate continues apace, fury and ignorance abounding.

It's been very easy to convince a horde of Americans, not all of them right wing reactionaries, that the changes in health care insurance in the works will result in bureaucratic interference, rationing, euthanasia, deteriorating quality of care, treatment of illegal aliens, higher costs, and so on.

In other words, things that are already happening thanks to the kindly ministrations of the for-profit health-care insurance industry, things that the "reform" is supposed to address.

Whether the "reform" will do it very well, I can't say. We still have only the outlines of a Reform Plan, and all we can take from the outline is that everyone will be required to have coverage, and some of the more egregious practices of the Insurance Cartel will be curbed. Apart from that, nothing is certain. Even those things are not all that certain, but they seem to be consistent through all the permutations of the bills working their way through congress

Bureaucratic interference, of course, is a constant of the for-profit health insurance industry. Second only to the collection of premiums, this industry exists to scrutinize and too often deny payment for treatment for injuries and illnesses, to interfere with preventative treatment and to stand on the alert between doctors and their patients to ensure that nothing is ordered or treated that conflicts with ever-changing, arcane, and indecipherable insurance company rules. Everybody knows that is how the Insurance Cartel operates, and yet for some reason, the howlers insist that the only "bureaucratic interference" that matters is the interference of a government drone approving this or that payment for services rendered. Hunh? And when it is pointed out that in government programs under way, the government drones have a very light hand indeed, hardly even noticeable, whereas the insurance company bean counters are always on the tail of physicians and patients looking for ways and means to deny payment and treatment, the rejoinder is that one can always choose another insurance company, but you can't choose another government!!! That's not the point, you patiently offer. The point is that it is the insurance companies that throw up all these bureaucratic roadblocks you fear and deplore, not the government. Nazi/Socalist!!!! Stalin!!!

Huh.

As for rationing, goddamned right there's rationing by the insurance companies, and by the fact that so many millions of Americans go without health care insurance and so must -- how you say -- "self ration" health care until there is an emergency. And in the ER there's ongoing rationing starting with the triage of your case. You may be left to die in the ER if the triage nurse doesn't believe your condition is serious enough for immediate or urgent treatment, as we have seen happen over and over again. If the ER is the only place you can get treatment for whatever serious matter ails you -- the Bush Regime was famous for insisting that everyone in America had access to Health Care at the ER, it was the law!!! -- then you're in deep trouble. The ER is the least efficient and the most expensive form of medical treatment possible. Insurance companies put strict limits on the amount and kinds of treatment they will pay for, regardless of the patient's condition, and that's about as strict a rationing plan as you could ask for. Government programs in existence have their own rationing standards, but for the most part, they take into consideration the condition of the patient such that there is no cut off of treatment for individuals in need of care. Strange, that. But the foamers insist that the only rationing that matters is the rationing that government does. OK, sure. Whatever.

Euthanasia does go on. Insurance company denial of treatment, or insurance company cut off in mid-treatment, is often a death sentence, and surprisingly enough, that is a form of euthanasia. But you can always get a different company!!!! No, you can't. If you have a "previous condition" in most cases you can't get insurance. Ahem. And so... if you don't have insurance, you can't get insurance, or you're cut off from treatment, be prepared to get your affairs in order because you're on the Euthanasia Train. Between 18,000 and 22,000 die every year for just this reason. That doesn't even get into what medical "procedures" can be utilized when nobody's watching. The government programs that exist, however, seem to organize their approach to care and treatment so as to prevent any attempt at euthanizing patients -- or to prolong their suffering. It's really a remarkable difference. One that people would do well to appreciate. But no. The howlers and foamers have to go crazy over (sometimes justifiable) fears that someone wants to kill them or their granny, and that someone is in the government!@!!!!1. Well, no. No it's not. It's probably someone in the private sector, though.

Deteriorating care under "government" programs? Or under private sector programs? You decide. In fact, "government health care" has a solid reputation, though not perfect. The actual "government" programs that exist: Military and its offshoots, VA, Indian Health Service, etc. provide generally excellent care at reasonable costs for the government, and as a rule, inadequate or inefficient care issues are addressed with speed. IHS has had a lot of problems, to be sure, and those problems are being rectified. Meanwhile, access to private sector care is becoming less and less available to more and more people, as they lose -- or can't get -- private insurance, and so their care is self-evidently deteriorating. But the government!!!! It's just idiotic.

Treatment of illegal aliens is a bête noire for many of the howlers, regardless of the "debate" under way. The existence of "illegals" drives them nuts. They're all criminals!!!!! Yes, well. Like everyone else, illegals have to be seen (but not necessarily treated) in the ER, but beyond that, they have no special rights or privileges with regard to health care coverage, and almost all can get into dire straits if they become sick or injured. Their situation is very much like that of the typical uninsured American. Except for the fact that there are no programs at all to assist them -- no Medicaid, no Medicare, no "charity care." Nothing. Nothing that has been proposed so far will alleviate that situation in the slightest. But the howlers need something to howl about, so why not "illegals!!!!!?"

Cost control is a real issue. I don't know why medical costs are so prone to gross inflation, though I suspect the current rattle-trap "system" is a big part of it. But many costs seem to be wildly out of proporation to the services provided (the famous $12 Tylenol comes to mind as an example), so bringing some rationality to the fee and payment structure of the medical industry would be a relief for everyone. Of course, that's socialism!!!!!! Hitler!!!!!! Stalin!!!!!!!!!!!!! which makes no sense, but there you are.

The lies keep coming. "Mandatory Death Panels" is one that was spread with lightning speed. There are so many more. But then, there are so few real details about what will be in the health care reform legislation, so much political posturing, so little effort toward a comprehensive system overhaul.

There isn't even any clarity about what the supposed "public option" we're expected to be enthusiastic about is supposed to be. Are we talking "Medicare-like" as Gov. Dean keeps saying, in that a public entity of some sort would be responsible for paying medical bills submitted by private sector providers (a la Medicare), or are we talking about a new-model health care provider system (a la VA, etc?) At times, it is impossible to tell. It's also very difficult to suss out what the "vision" for the future of health care in America is. Maybe there isn't one.

At any rate, this endless summer drags on...

Terminal

The Health Care "Debate" seems to have devolved into a question of euthanasia thanks to the media's obsession with anything that comes out of Sarah Palin's prolific tongue/pen/keyboard.

OK. Let's talk.

Digby has a good post up about the origin and development of Advance Directives, DNRs and Durable Powers of Attorney in California, and I've had considerable recent experience with the whole panoply of those things (as have many others, it appears, on the blogosphere.) I'm not at all sure where we'd be without them.

Well, no. I can figure how Betty's care and passing might have been different without her advanced directives and my power of attorney over health care issues.

Her last episode began last October when I took her to the clinic where her primary care physician was medical director. She'd been complaining of shortness of breath, chest pains, and she had developed wounds on her lower legs that were not healing. Her doctor was off that day, but Betty was seen by a nurse practitioner and one of the other staff doctors who diagnosed a heart attack in progress, ordered up an ambulance, and took her to the hospital.

She already had an advance directive stating that that no extraordinary efforts should be made to keep her alive if her condition was terminal. She was not considered to be in that state, although her heart was giving out, it was still functioning in afibrillation, and she was able to consent to treatment at the hospital. They determined that the primary cause of difficulty was edema, fluid build up, and they drained her of the excess fluid promptly. She felt much better almost immediately. A heart specialist was consulted, and she was taken for angioplasty and stent insertion. Her decline in the hospital commenced thereupon, not so much because of the angioplasty and stents themselves but due to some botched after-treatment including misplaced injection shunts (that missed the vein causing immense pain and suffering whenever fluids were administered through those shunts) and a very strange (and still inexplicable) determination that Betty could not eat or drink and so was being fed and hydrated through an NG tube.

Then her wounds became infected.

She became depressed and despondent. Her physical condition was not improving, and her psychological condition was deteriorating alarmingly. She wanted to go home, that was really all she thought about or cared about. She wanted out of the hospital, the sooner the better.

Her attending physician, however, wanted her to stay another week, and then go to a skilled nursing facility for three to five more weeks. Then she wanted to put a PEG in her stomach to feed her. Then, maybe, she would be allowed to go home.

Betty verbally agreed to this regimen but she was disconsolate with us about it, and we determined she was going home no matter what, and it practically took an act of congress to get her out of there, but out she came, and home she went.

Ten months later, she died, but she died at home.

She outlived every prediction of her impending doom, and her passing was as close to what she wanted as it was possible for us to provide.

Had she stayed in the hospital and/or gone to skilled nursing for "recovery" I sincerely believe it would have been a death sentence. She would have been dead within a week or even less.

I would call her continued treatment in the hospital or nursing facility a form of euthanasia, in that it was not what she wanted, and her will to live was being sapped there every day.

And if she had not had advance directives, DNRs and durable powers of attorney, quite likely she would have stayed in the hospital and would have died there. I will not, for the moment, go into the ways and means that medical professionals can and do prolong and/or retard patients' survival.

So there's your goddamned Death Panels, and I don't want to hear another stupid word about it.

Eleventy Dimensional Chess

Do they... want Something to happen?

The freaks and weirdos are out in force showing up at the various district events and townhalls that the congressmembers are throwing, and they're headed out to the various presidential appearances as well.

Shouting, howling mobs, not a lot different from the shouting, howling mobs who tried so very hard to thwart school and housing desegregation back in the day. Of couse they lost... eventually... but getting to that point didn't happen without a good bit of bloodshed and much social and political upheaval.

Some thinkers posit the necessity of sacrifice, blood sacrifice, to obtain desired goals, and I'm wondering...

When Gun-boy showed up at the New Hampshire presidential town-hall and was instantly lionized by the media, it was clear Something Big was -- potentially -- in the offing.



Imagine, just imagine what would have happened to Gun-boy if he'd shown up at a Bushevik event last summer. The gurney would have hauled his smoking corpse away, especially if he'd shown any sort of Leftist tendencies. But just being there with his gun and his sign would have been enough for the snipers to take him out, or maybe they'd have sent a Predator drone armed with a Hellfire missile. And the media would have done everything in their power to justify his summary execution. Everything.

So I'm pondering this. I'm pondering the contrast between what would have occurred under the Busheviks and what is occurring under the Obamanauts. The White House and the congressional Dems are seemingly encouraging this summer's townhall anarchy. Certainly the media is playing along. Entertainment, not danger as far as they're concerned, and it is the August Recess, after all.

Guns seem to be proliferating at these events, being shown or dropped or threatened. The howling and shrieking becomes louder... pushing, shoving. Police stand by, ordinary police, not Robocops, and the Secret Service and all the apparati of the National Security State are all but invisible.

The anti-desegregation mobs ultimately had to be fended off with the National Guard as there was no reasoning together with them. They had to be stopped. But even the presence of the Guard only partially defused their fury, and many people would die trying to defend civil rights for all even after the Guard made clear whose side the Government was on.

The current mobs are ostensibly assembling to oppose ObamaCare, whatever that may mean, but "issues" proliferate endlessly, swirling around the tradional antipathy to "socialism" and "communism" and "Government Control of Our Lives," and all of that -- right out of the Segregation Forever playbook, chapter and verse. It's the same thing based on the same fear of Teh Negroes, and the loss of what tattered remnants of White Privilege remain.

So let's consider what is really going on. Segregation was... eventually... ended, at least as a matter of law. Defacto segregation, of course, is still typical of much of America, but there is no legal support for it any more, and many Americans have become comfortable among members of other races and ethnic groups. Progress. Yay.

But a way of life was ended along with segregation, and it was a way of life that centered around notions of racial superiority and inferiority that were comfortable and comforting for some -- regardless of race -- and intolerable for others.

Is a way of life in jeopardy now? I would say certainly, it is the middle class as we have known it, and the assault on that way of life is reaching its climax. I've written before about the forced impoverishment that is underway what with the continuing unemployment, bankruptcy and foreclosure statistics that have not improved a bit -- and in fact have worsened -- under the current administration. There is immense downward pressure on wages, and the government is doing nothing at all to counter or ameliorate that situation. The number of foreclosures is skyrocketing, and the government is still unable to -- or is it unwilling to? -- intervene in any significant way. Households' debt burdens continues to extinguish any sign of consumer spending, and thus retard any sign of economic recovery among the masses, and the government will not do anything whatsoever to ameliorate the household debt problem. Only the Universal Masters get bailed out. Households? No way. In fact, actions taken so far have mostly served to increase the burden on households.

And now comes Health Care Reform which will place another burden on households and individuals. That burden is the Mandate.

Everyone has to be covered. What that means is that everyone has to be in a Program -- like Medicare and Medicaid or Veterans Health Care or Indian Health Care or what have you -- or they have to have health insurance coverage through private insurance that they have to purchase on their own or through their employer -- if they have one.

For many of the currently uninsured, this will be a significant new financial burden; for most of those currently insured it will be a burden over time. It will accelerate the forced impoverishment under way. But look. A Benefit goes along with it. You won't be forced into bankruptcy to pay for your appendectomy. At least not immediately.

If the chess player's goal is the remaking of society with the masses much poorer than before -- but let's say, "cared for" -- and the well off fabulously better off than ever before, it may take some interesting ploys and feints to get where the player is going. And it may take some sacrifice as well. Based on what we've seen so far, it's pretty clear where things are headed, and it is not toward a Progressive Paradise.

So are we seeing more eleventy dimensional chess? Maybe. By and large, Americans were not sympathetic to the howling mobs opposing desegregation, in fact, many were horrified. The bloodshed that accompanied desegregation efforts brought constant shame to the perpetrators and their supporters. Eventually, the disgust with those who insisted on preserving the status quo overwhelmed their ability to hold on, and even George Wallace admitted the error of his ways.

We're seeing similar mobs now. They're trying to hold on to their sense of privilege and right, something they believe is under assault through the advent of universal health care. The chess player who wants to win is going to want these mobs out front, in the hope that they will inspire the same sort of revulsion the segregationist mobs did fifty years ago.

It may work.

So... Where are the Robocops?

The other day, I posted about the Teabaggers going all loop-de-loo at various congressional townhalls, and I said I had some admiration for them getting off their duffs and actually making their voices heard. As misguided as they were and are.

But it occurred to me that there was and is something distinctly odd about the fact that these Teabaggers are going around shitting on these Congressmembers and shutting down their townhalls, and it's not the fact that they are being incited by the likes of Beck and Limbaugh and Hannity or that they are being used as tools by the same insurance cartel that's screwing them and everyone else.

It is odd that there is only a minimal police presence at these events, and there have been almost no arrests (for the all purpose "disorderly conduct," let alone the direct threats and incitement and violence), nobody's been tasered, gassed or bludgeoned, and there are no Robocops whatsoever.

Compare and contrast with last year's overwhelming police presence at the Democratic and Republican National Conventions in Denver and St. Paul last summer.

The video above is of one incident in St. Paul, in which peaceful street dancers were confronted with a phalanx of police who gassed and clubbed and arrested them.

Dozens of people were preventatively detained, people who had done nothing illegal, and some of them were charged with "terrorism."

Homeland Security, the FBI, and god only knows what other agencies of the National security state were deployed en masse to shut down legitimate, protected protest, through interaction with local and regional police forces acting in concert.

Nothing like that is happening now.

I admired the protesters in Denver and St. Paul because they were getting off their own duffs and putting themselves at substantial physical and other risk. Hundreds were arrested, thousands gassed, and all of them had their civil liberties massively impaired by an overweaning and frequently brutal police presence. So far as I know, nothing more radical than breaking a window and overturning a newsrack or garbage can (all of which could well have been done by provocateurs) was attempted by the crowds protesting at the conventions.

Yet here we have dozens of congressional townhalls throughout the country being beset by howling mobs, mobs whipped to a frenzy by right wing talk radio and television hotheads (who call themselves "entertainers"), who threaten and intimidate, and otherwise disturb the peace, proudly. What they were intending, and who their organizers were were all known well in advance, and what they have done has followed the plan laid out long ago. Yet so far as we know, there is no National Security State investigation and surveillance, there is no preventive detention, no mass arrests, no Robocop presence, hardly any police presence at all.

Clearly an order has gone out for the authorities to stand down. The Teabaggers apparently know they are at no risk whatsoever. They can do as they will. And they are doing it. While the police just watch.

If they are there at all.

What a wonderful example of Authoritarian America's disparate enforcement of "rules", "law" as it is known.

And even stranger than the absence of police and authority at these townhalls is that Americans just accept that DFHs will be subject to the full power of the authorities whenever they gather to protest, whereas the salt of the earth, good American right wing wackos can do what they want whenever they want and nothing at all will happen to them -- except cheers from their sponsors.

Interesting.

Summer Obsession

The Teabaggers are having a grand old time venting their collective spleen at every congressional townhall they can hie themselves to before the end of summer. The spectacle has captured the attention and the imaginations of newscasters everywhere -- including throughout the lefty blogosphere -- to the point where even President Clinton going to Pyongyang to rescue those journalists was drowned out.

The Teabaggers are the New Summer of the Shark. Or maybe it's Chandra Redux.

I actually harbor a bit of admiration for the Teabaggers, because they have at least got themselves off their ample duffs, got away from the computer and the teevee and got out of the house and got themselves down to the local food bank or community center or parish hall or wherever their rep (or somebody's rep) is holding forth and they are discommoding the powerful, disrupting business as usual, and OUTRAGING!!!™ calm and rational wonk types who delight in navigating the intricacies of Health Care Reform Legislation. It's all good.

Participatory Democracy, eh?

Now, of course the Teabaggers have been sold a bill of goods, and they are obviously and sadly being manipulated for the benefit of the Insurance Cartel, but despite that, they have shown themselves quite capable of making a stink and shutting down the kind of crap that Our Congress is trying to peddle regarding the so-called "reform" of health care coverage now wending its way through the hallowed halls.

And despite the fact that the Teabaggers are essentially deep in error about the details of what they are railing over, at least they have the moxie to rail.

Because light entertainment is a staple of the summer rerun season on the teevee, these loudmouths are dominating everything -- much as the Sharks did, much as Chandra did (not to speak ill of either, you understand.)



What fun, eh?

The fact that millions of people could peacefully assemble all over the world, could march and carry signs opposing the invasion of Iraq and be ignored by the major mass media, or that tens of thousands of people who turned out in a rainy-freezing Washington DC in January, 2001, to protest the inauguration of W were made to disappear, or that the continuing struggle of single payer advocates to even be heard in the "Health Care Debate" is consistently overlooked is beside the point.

The point, this summer, is the Teabagger rage, its astroturf character, and how deeply passionate all these ill-informed but very dedicated lunatics are. Entertainment!

The mind would reel if these... characters... will really have any effect on what emerges from the Congressional sausage maker. And I don't think they really will. Assuming that Congress is actually able to agree sufficiently to pass something -- and it looks like they will be -- my sense is that it will be basically a "universal" health care coverage mandate, requiring individuals to purchase private health care coverage with the premiums taken as a payroll deduction from every worker's salary. There will be no "public option" -- whatever that means -- in any rational sense, everything will be handled through the Insurance Cartel.

This will be very expensive and very inefficient, but it will accomplish two primary goals of the makers of this reform: "universal" coverage and restrictions on denial of coverage and payment for treatment.

The deal was essentially agreed to between the major stakeholders months ago. The outlines were set then. The Cartel will receive a huge revenue injection (almost all of which will be paid by policy-holders, not "taxpayers") through the individual mandate to have coverage, and in exchange, the Cartel will agree to stop their more egregious practices of denial of coverage and rescission. There. Done. That's it. Have a nice day.

Like Medicare Part D, this will actually be "something better than nothing." It will help many who now fret that they will go bankrupt if they get sick, or who can't get health insurance at all. Premiums will still be outrageous, but some sort of arrangements will be made for a "subsidy" based on income. In other words, no one will be expected to pay more than a set percentage of their income for health care coverage, and the lower your income the lower the percentage, until at some point your coverage is essentially free (as in Medicaid now).

This is not the dreaded "socialism" or "government takeover" of healthcare the Teabaggers are frothing over, it's not even a step in that direction, but it does modify the current balky and over-administrated system to -- finally -- cover almost everyone, for the first time in our history.

So what if it costs 30% more than it needs to and will still bankrupt the already bankrupted nation? That's a feature, not a bug.

On the other hand, all of it may fall apart after Labor Day, it's just all too difficult, or the Summer Shark may be followed by something too awful to contemplate (like the summer of 2001 was, we may recall.) You never know.

But for now...

Rage on, Teabaggers! Rage on!