This is Senator Ben Nelson's Fault

(I started writing this post before Nelson announced he is planning on retiring. As you can guess, I'm not sad to see him go.)

In terms of electoral politics, Barak Obama's 2008 platform was among one of the most popular in recent memory. Not only did he secure 54% of the vote, but the Democrats gained seats in both the House and the Senate, and, until the special election of Scott Brown, had a near super majority in the Senate. And yet almost none of that platform was enacted, and, somehow, so many Americans were convinced they didn't actually want what they voted for the first time around, that the Democrats lost the House entirely and many seats in the Senate. I've talked about the madness of this whole process before (I mean, Republicans held health care benefits for 9/11 first responders or “heroes” as they are occasionally called, hostage to extending the Bush tax cuts on the top 1% of Americans) but I think it is important to place blame where it really belongs. On Nebraska Senator Ben Nelson.

By the time the debate over health care reform started, the Obama administration had already stabilized the economy (not in the way I would have, but we didn't have a second Great Depression so I guess that's something) and saved the American auto industry. Rightly concluding that any recovery and subsequent economic growth would be hampered by the cost of health care on Americans and small businesses, they decided to pursue health care reform. Not wanting to repeat the mistake of Bill Clinton's attempt to reform health care, for better or for worse, Obama left the work of crafting the policy in the hands of the legislature. (It being their job and all.) Really, who could blame him given the make up of Congress at the time. And, honestly, the results weren't that bad, even after all of the compromises. If the rolling reforms are allowed to happen, we'll have taken a few steps towards a humane health care system. They weren't what I wanted, but they were reasonable given the state of American mainstream politics, and, when asked about specific aspects of the legislation, most Americans support most of the reforms.

Enter Ben Nelson, Democrat Senator from Nebraska. I think of Nelson as a Regional Democrat, meaning his party affiliation has a lot more to do with where he lives than what he believes. He's only a Democrat because Nebraska Republicans are so conservative. It's the same with Scott Brown and old Mitt Romney. The only reason they run on the Republican ticket is because Massachusetts Democrats are more liberal. Brown in Nebraska is a Blue Dog Democrat. Nelson in Massachusetts is a moderate Republican.

However, this isn't Nelson's fault because he disagreed with the content of the health care reform bill. It is legislators' responsibility to vote with their conscience, no matter what the party whip says. This wouldn't be his fault if he had argued against the bill on the floor of the Senate, if he had sought to change the legislation in committee or through other influence, and it wouldn't be his fault if, even after changes made to deal with his concerns, he still voted against the legislation. It's his fault because he joined the Republican filibuster.

By joining the filibuster, Nelson single-handedly turned what should have been a three month process into a ten month process, one in which all sorts of absolute insanity was spewed by opponents. At one point, in an effort to do anything to get the bill through, Reid tried to tack on what became known as the Cornhusker-Kickback, but that vote-purchasing was too overt even for Washington.

Of course, there were Blue Dog Democrats in the House who railed against the bill, some of whom even going so far as to essentially campaign on their opposition to it. (Just a side note; many of these “Blue Dogs” were elected on Obama's coattails and to thank him for creating a political climate in which they get jobs in Congress, they shat all over his most ambitious legislative goal. Thanks guys.) However, there was really nothing they could do about it, because there isn't a filibuster procedure in the House that allows for the minority party to dictate legislation.

The perpetual filibuster over health care reform sucked all of the policy momentum out of the Obama administration, making it almost impossible to take any additional steps in fixing the economy. Furthermore, by joining the filibuster, Ben Nelson changed the narrative of governance from “The Obama Administration Doing  Stuff” to “Congressional Republicans Making Sure Stuff Doesn't Get Done.” Our national political discussion was as much about what the Republicans were preventing as it was about what the Obama administration was doing. (For example, how many people are talking about the Obama administration's foreign policy successes in the last four years; ending the war in Iraq, assassinating Osama bin Laden, leading from behind in Libya, while navigating two inherited wars, radical changes in an already unstable Middle East...) And, along with all the stuff in the committees and the anonymous holds on legislation and nominations, the filibuster became the primary technique of Congressional Republicans until they took back the house.

And that brings us to now. Obviously, a lot of other factors went into that mysterious process in which “then” inexorably becomes “now,” but I believe a lot of those wouldn't have been possible without Ben Nelson's filibuster. The radical optimist in me assumes he truly believed that the policy was so bad for this country that he stood in the way of a vast majority of legislators to prevent it from being adopted, but I'm pretty sure he just assumed his constituents wouldn't vote for him if someone accused him of supporting something somewhat somehow connected to socialism.

With his retirement, most pundits believe the seat will be filled by a Republican, and frankly that's fine with me. The Democrats might be begging Nelson to say, but from my perspective, it should be the other way around. It's the Republicans who should be begging him to stay, because he was one of the most successful Republican legislators of the last four years.

America's System of Wealth Redistribution

Most of the time when you hear someone use the term “the redistribution of wealth” that person is a conservative arguing against a social spending policy or tax increase on the wealthy. It has become a less than subtle euphemism for “this is kinda socialist;” another way to argue against a policy without actually arguing against the policy. Let's forget for a second that an economy is inherently based on the redistribution of wealth, on the movement of money from one entity to another in a process of exchange, and let's also forget for a second that any change in government spending and taxation is a redistribution of wealth; taking wealth from those whose programs were cut or who had their taxes raised and redistributing it to those whose programs were added or taxes were cut. In fact, any changes in government regulations that effect the making and spending of money are redistributions of wealth. It could be argued that no administration redistributed wealth more than the Reagan administration, but, even if you forget all that there is still a major aspect of the American economy that operates as a redistribution of wealth.

Some people have a level of wealth based on their health. Because of good lifestyle choices, a lucky draw in the genetic lottery, and a benevolent array of circumstance in the wider world, some people rarely have to pay health care bills. I'm one of them. I don't have any congenital diseases, or allergies, I eat alright, I exercise a bit, and I've never been injured enough to require serious medical care. I get check ups, I wear reading glasses, and I have to get some small fillings in my teeth, but on the spectrum of health I'm doing alright. Thus, I have a health based wealth. But I still pay healthcare premiums. 

My health insurance company redistributes my wealth to those who have a health based poverty; people who because of poor health decisions, an unlucky drawn in the genetic lottery, and an malicious array of circumstance in the wider world have to pay a lot of health care bills. Being a radical lefty, I don't have any problems with the idea of mechanisms that redistribute wealth from the wealthy to the poor...if they work.

The thing about the redistribution of wealth as done by the mechanism of health insurance (and all other insurance really) is how inefficient it is. How inefficient is it? Well, it's fairly easy to get at least a sense of this. First look at the profits taken in. One study stated that the five largest for-profit insurers “closed 2009 with a combined profit of $12.2 billion.” This means that, at an absolute minimum, health insurance companies redistributed to those with health based poverty, $12.2 billion less than what they took in from those with health based wealth. And this doesn't count the overhead; printing those extremely complex descriptions of benefits books, paying customer service representatives to answer questions about those extremely complex benefits, billing, mechanisms for denying benefits, lawyers if they are sued for denying benefits, janitors to keep their offices clean, executive and management salaries, office supplies, utilities... 

Despite what some might say, our health care system is already a system of wealth redistribution. Through the mechanism of private health insurance, the health based wealth of some is distributed to the health based poverty of others. Some might argue, with an eye towards critiquing the recent health care reform, that an individual could opt out of this redistribution by not carrying health insurance, and though there is some truth to this, those individuals (assuming they are able to pay out of pocket the costs they incur if they get hit by a car or diagnosed with cancer) wouldn't avoid redistribution all together. Since doctors and hospitals, by law, are required to treat people in need of care, whether they can pay for the care or not, doctors and hospitals must roll the cost of treating those who cannot pay into the fees charged to those who can. In the exact same way that the cost of all retail goods are slightly higher than they need to be to make up for lost inventory, the cost of treatment is slightly higher to compensate for treatment that is not paid for. In this case, the wealth is redistributed from those who have money to those who don't through a pricing mechanism.

There is nothing inherently wrong with a system of wealth redistribution. All economic activity, at it's core, is wealth redistribution. The problem with health care insurance as a system of wealth redistribution is its inefficiency; not nearly enough of the wealth actually gets to those who need it. Too often, people who carry insurance still can't pay their health care bills, even with the benefits from their insurance policy. Even if those massive profits (all those companies had enough to pay lobbyists, don't forget) were cut to nothing, the private insurance system would still be fairly inefficient as someone would have to administer it.

Soon, House Republicans are going to waste our time and tax payer money by bringing a bill to repeal the recent health care reform to the floor even though there is no chance such a bill could pass the Senate, and even if by some miracle it did, it would certainly be vetoed and Republicans do not have a big enough majority to overturn a Presidential veto. To me, this is more proof that they have no concrete policy solutions to the problems of the American health care system, and, frankly, only seem interested in the issue as a way to discredit, in general, the efforts of the administration. Regardless, as anyone with a lot of prescriptions or an impending surgery knows, the recent health care bill has not solved the problem of inefficient wealth redistribution.