Tuesday, January 05, 2010

Hendrik Hertzberg on the health care bill

Hendrik Hertzberg (The New Yorker):
“All violent feelings have the same effect,” John Ruskin wrote, in one of his most famous essays. “They produce in us a falseness in all our impressions of external things, which I would generally characterize as the ‘Pathetic Fallacy.’ ” Ruskin published “Of the Pathetic Fallacy” in 1856, as a chapter of “Modern Painters.” His subject, in this chapter, was poetry, not painting, and it was certainly not politics. But his insight may help explain the American political atmosphere at the beginning of the year 2010, especially the subdued, sometimes even angry, mood among many of President Obama’s wavering, if not quite erstwhile, supporters.
When Congress reconvenes a few days from now, it will be on the cusp of enacting a sweeping reform of American health insurance and health care that could be, as the President put it on Christmas Eve, just after the Senate passed its version of the bill, “the most important piece of social legislation since the Social Security Act passed in the nineteen-thirties and the most important reform of our health-care system since Medicare passed in the nineteen-sixties.” Perhaps he was exaggerating, but not by much. Jonathan Cohn, the New Republic’s health-care correspondent, calls the bill “the most ambitious piece of domestic legislation in a generation—a bill that will extend insurance coverage to tens of millions of Americans, strengthen insurance for many more, and start refashioning American medicine so that it is more efficient.” Paul Krugman, the Times’ resident Nobel laureate (and a frequent Obama critic), calls the bill “a great achievement” that “establishes the principle—even if it falls somewhat short in practice—that all Americans are entitled to essential health care.” Princeton’s Paul Starr, the author of the Pulitzer Prize-winning history “The Social Transformation of American Medicine,” calls it “the single biggest measure on behalf of low-income Americans in more than forty years.” How big? The University of Chicago’s Harold Pollack has done the sums. By the time the reforms are fully implemented, “the Senate bill would provide about $196 billion per year down the income scale in subsidies to low-income and working Americans.” That’s more, Pollack notes, than the federal government spends on the earned-income tax credit, Head Start, assistance to single mothers and their children, nutrition programs like food stamps, and the National Institutes of Health combined.

None of these people, from Obama on down the wonk scale, deceive themselves that the Senate bill, which now must be merged with its (marginally stronger) House equivalent, comes within hailing distance of perfection. All of them recognize that the final bill, in the now overwhelmingly likely event that it surmounts the remaining hurdles, will be flawed and messy. All of them also understand that, compared with the status quo—and the status quo, not perfection or anything like it, is the alternative—it will constitute a moral and material advance of historic proportions.

Nevertheless, a nontrivial portion (though far from a majority) of the Democratic left, particularly its Internet cohort, feels alienated and disappointed, with the bill and with the President. As the Senate vote neared, Markos Moulitsas, the chief of Daily Kos, sent his followers a tweet: “Insurance companies win. Time to kill this monstrosity coming out of the Senate.” MoveOn.org called on “progressives” to “block this bill.” Arianna Huffington dismissed it as “reform in name only.” Keith Olbermann, MSNBC’s Savonarola, lectured the President that he was about to consign his countrymen to a “Chicago stockyards of insurance” that would be “immoral and a betrayal of the people who elected you.” Even Dr. Dean himself—Howard Dean, the former Vermont governor, Presidential candidate, and Democratic Party chairman—wrote that the Senate should defeat the bill, claiming that it “would do more harm than good to the future of America.” And in the nether reaches of the left blogosphere the epithets flew. Obama is a “sellout.” He’s a “liar.” He’s a “Judas,” a “fraud,” a “corrupt fool.” He’s a “Liebermanite.” (Ouch!) He’s “an Uncle Tom groveling before the demands of the corporations that are running our country.” (This last not from some anonymous blog commenter but from Ralph Nader, without whose efforts Joe Lieberman would be just another former Vice-President.)

The pathetic fallacy is a category mistake. It’s the false attribution of human feelings, thoughts, or intentions to inanimate objects, or to living entities that cannot possibly have such feelings, thoughts, or intentions—cruel seas, dancing leaves, hot air that “wants” to rise. The American government has its human aspects—it is staffed by human beings, mostly—but its atomized, at-odds-with-itself legislative structure (House and Senate, each with its arcane rules, its semi-feudal committee chairs, and its independently elected members, none of whom are accountable or fully responsible for outcomes) makes it more like an inanimate object. In our sclerotic lawmaking process, it is not enough that the President, a majority of both Houses of Congress, and a majority of the voters at the last election favor extending health care to all citizens.

The left-wing critics are right about the conspicuous flaws of the pending health-care reform—its lack of even a weak “public option,” its too meagre subsidies, its windfalls for Big Pharma, its capitulation on abortion coverage, its reliance on private insurance. And there are surely senators and representatives whose motives are base or, broadly speaking, corrupt. But it is nonsense to attribute the less than fully satisfactory result to the alleged perfidy of the President or “the Democrats.” The critics’ indignation would be better directed at what an earlier generation of malcontents called “the system”—starting, perhaps, with the Senate’s filibuster rule, an inanimate object if there ever was one.

On May 20, 1962, at Madison Square Garden, John F. Kennedy spoke to some twenty thousand people at a rally in support of a bill to provide hospital care for the aged, one of forty-five such rallies around the country. In his speech, President Kennedy acknowledged that his bill would fall short of meeting every need. “We’ve got great unfinished business in this country,” he said, “and while this bill does not solve our problems in this area, I do not believe it is a valid argument to say, ‘This bill isn’t going to do the job.’ It will not, but it will do part of it.”
Two months later, Kennedy’s bill was defeated in the Senate. It took his assassination, a huge Democratic victory in 1964, and the legislative talents of President Lyndon Johnson to get Medicare enacted. The health-care bill now being kicked and prodded and bribed toward passage will not “do the job,” either—only part of it. Are Barack Obama and the Democrats in Congress doing enough? No. But they are doing what’s possible. That may be pathetic, but it’s no fallacy.
Howie P.S.: I would have thought my old friend Mr. Hertzberg was able to keep up with things a little better: "Howard Dean Now Supports Passage of Health Reform Bill After Winning Improvements." I won't use any rhetorical flourishes to correct the record, but I hope Rick will, with or without.

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