Paul Rosenberg:

Private insurance companies take roughly one third off the top for their bureaucracy, their advertising, their lobbying and their profits, and they don't contribute anything to providing health care. In fact, they are a clear impediment, as millions of people know from their personal experience on a daily basis. They are, at this point, purely parasitical on our diseased political culture. Yet, getting rid of them is politically unthinkable in Obama's mind, in the world he accepts as given.
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A true pragmatist would say, "Fine, private health insurance creates perverse incentives. We won't use it." It would just be as simple as that. That doesn't mean "socialized medicine." It doesn't mean government bureaucrats assigning you a doctor against your will, and then telling your doctor what they can and cannot do. And it's only free-market ideologues--and their neo-liberal enablers--who think that that binary choice is the only one we have.

In short, there is nothing the least bit pragmatic about the neo-liberal's "pragmatic" compromise with the conservatives. It is not just incredibly costly in the purely economic sense, it is systematically wrong-headed, ands its costliness ensures that many other things will have to be sacrificed to keep it in place.

There is nothing the least bit pragmatic about it at all.

Obama's Anti-Pragmatic Ideology vs. Universal Health Care

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Open Left